Akute vs Elation for Direct Primary Care
Akute is the better choice for a new or small DPC practice that wants to build its own automations and pay less while the panel is small, and Elation is the better choice for a doctor who wants an established primary care chart with a flat per-provider price that doesn't grow with the panel. The price lines cross at around 200 patients per doctor, so where you expect to be in two years matters as much as where you are today.
Every price here is a published price, checked on each vendor's site in November 2026. Treat them as a starting point and confirm them in writing before you sign.
The verdict
| Choose Akute if... | Choose Elation if... |
|---|---|
| You're opening with a small panel | You expect more than about 200 patients per doctor |
| You like building your own tasks and workflows | You want a long-established primary care chart |
| You want telemedicine without an add-on | You want controlled-substance eRx in the base price |
| You want Hint's billing inside your EMR | You want memberships built in, billed through Stripe |
| Two clinicians will share one plan | You'll have several office staff (they're included) |
Do the math at the panel you're aiming for, not the panel you open with. A per-patient price feels small at 80 members and very different at 500.
Published prices and features side by side
| Akute | Elation | |
|---|---|---|
| Starting plan | $300/mo Essentials, 1 clinician, 100 patients | $375/mo per DPC provider |
| Larger plan | $550/mo Premium, 2 clinicians, 300 patients | $425/mo Standard, $500/mo Premium |
| Extra patients | $0.75 each (Essentials), $0.85 each (Premium) | Priced per provider |
| Non-prescribing clinician | Ask on the demo | $215/mo |
| Office staff | Ask on the demo | Included |
| ePrescribing | On the plans | Controlled and non-controlled included |
| EPCS | $15/mo extra | Included |
| Telehealth | On the plans | $25/mo per provider |
| Labs | Ordering and results | Ask on the demo |
| Patient portal | Secure portal messaging | Messages, reports and health info |
| Memberships | Hint Core, $50/mo (Essentials) or $110/mo (Premium) | Built in, 2.99% per card payment |
| Phone line | $15/mo virtual line on Essentials | Ask on the demo |
| API | Ask on the demo | Developer Platform Core, $150/mo per provider |
What each costs as your panel grows
Because Akute charges by patient and Elation charges by provider, the right answer changes with size. Here's one doctor on each, using only published prices, with Akute's $15 EPCS fee included so the comparison is like for like, and before membership billing and card fees.
| One doctor, monthly | Akute Essentials | Elation Standard DPC |
|---|---|---|
| 100 patients | $315 | $375 |
| 200 patients | $390 | $375 |
| 300 patients | $465 | $375 |
| 600 patients | $690 | $375 |
If you'll add telehealth, add $25 to Elation's column, which pushes the crossover a little later. For two clinicians sharing 600 patients, Akute Premium works out to $550 plus 300 extra patients at $0.85, or $805 a month, against $750 for two Elation DPC providers. Elation also includes office staff, while staff seats aren't described on Akute's pricing page, so ask.
This is the part that's easy to miss at launch. Many new DPC doctors open with fewer than 100 members, and at that size Akute is the less expensive system. But a doctor who reaches a full panel of 500 or 600 will pay noticeably more on Akute than on Elation each month. Our DPC EMR pricing guide models more panel sizes, and ePrescribing costs breaks out the prescribing fees.
Automation and everyday charting
Akute calls itself an automation-first EHR, and that's the heart of its appeal. The idea is that routine follow-up (tasks after a visit, reminders, recurring steps in a workflow) gets set up inside the EMR so it happens without someone remembering it. Its plans include ePrescribing, telemedicine, lab ordering with results and secure portal messaging, so a small clinic can run on one system.
Elation's strength is the chart itself. Its published product guide covers ePrescribing for controlled and non-controlled substances, a patient portal, and ambient scribing and note automation inside the encounter. Its included documentation tools read scanned intake forms into chart fields and summarize a patient's history, and a deeper documentation package is a paid add-on at $199 a month per provider. Elation also has a Developer Platform with read-only and read/write APIs and webhooks, at $150 a month per provider, for clinics that want to connect other tools.
The way to decide is to watch both handle the same day. Ask Akute to show you an automation you'd actually use (a new member's onboarding steps, for instance) and ask Elation to chart a full visit and send a refill. The demo checklist has more questions to bring.
Memberships and billing
Both can run your memberships, but they get there in different ways.
Akute brings in Hint's membership billing, called Hint Core. Akute's pricing page lists it at $50 a month on Essentials and $110 a month on Premium. Hint's own page for its Akute version lists Core + Akute at $200 a month with 266 members and $0.75 per additional member, with cards at 3% plus $0.30 and ACH at 1% plus $0.25. Those two published numbers don't match, so ask Akute for a written quote that shows exactly what you'll pay for billing and processing at your expected panel size.
Elation's Membership Management is built into the EMR. It needs a Stripe account and charges 2.99% of collected card payments, or 1% plus $0.25 per ACH payment with a $5 cap. That's simple and works well for straightforward tiers. If you need employer contracts or complex billing terms, Hint's fuller plans are worth a look, and Elation vs Hint covers how those fit with Elation.
Can you use Akute and Elation together?
Not in any sensible way. Both are full EMRs, so running both would mean two charts for every patient and two places to look for every lab and message, and we found no published integration between them. The real overlap is Hint. Akute embeds Hint Core for billing, and Elation syncs with Hint so that contact and demographic details, membership status and plan name stay current in both systems. If you start on one and move to the other, Hint can stay as the billing layer through the switch, which makes the move less disruptive. Our guide to switching DPC EMRs covers timing and data export.
Who each one is best for
Akute is best for new and small practices that want a lower bill while the panel grows, owners who enjoy setting up their own workflows, and two-clinician practices that fit inside Premium's 300 patients. Watch the per-patient cost as you grow, and budget $15 a month for EPCS if you prescribe controlled substances.
Elation is best for doctors who expect a full panel and want the cost per provider to stay flat, practices with several staff members, and anyone who wants a long-established primary care chart with built-in memberships. Telehealth and the deeper documentation package cost extra.
Our take
This comparison is mostly a question of timing. If you're opening this year with a modest panel and like the idea of building your own automations, Akute is the more affordable start. If you're already past 200 patients, or know you will be soon, Elation's flat price and mature chart are hard to beat. Either way, ask both vendors to quote your expected panel two years out, and see our best DPC EMR roundup for how they compare with the rest of the field.
The part most guides skip
Every tool in a DPC clinic is good at its own job, and none of them were built to talk to each other. A patient text turns into a refill in the chart, which needs a review, which needs a reply, and the follow-up lives in someone's head. That isn't anyone's fault. The tools just don't share a to-do list.
That's the job Tabflows does. Tabflows is a dedicated tech team for DPC clinics. We connect the tools you already chose and give your team one place for chat, tasks and patient context, with managed workflows for the repeat work like refills, lab follow-ups and onboarding. You keep every tool you picked.
Frequently asked questions
Is Akute or Elation cheaper for a DPC doctor?
Akute is cheaper for a small panel and Elation is cheaper for a large one. Akute's Essentials plan is $300 a month for one clinician and 100 patients plus $0.75 per extra patient, so it passes Elation's $375 per-provider price at about 200 patients.
Does Akute include ePrescribing for controlled substances?
ePrescribing is on Akute's plans, and controlled-substance prescribing (EPCS) is an extra $15 a month. Elation's published plan includes ePrescribing for both controlled and non-controlled substances.
How do memberships work in Akute and Elation?
Akute adds membership billing through Hint Core, listed on Akute's pricing page at $50 a month on Essentials and $110 a month on Premium. Elation has Membership Management built in, which needs a Stripe account and charges 2.99% of card payments.
Does Elation charge extra for telehealth?
Yes. Elation's integrated telehealth is $25 a month per provider. Akute lists ePrescribing and telemedicine together on its plans.