NAICS 621390Canadian industry · 6-digitlocal market

Offices of all other health practitioners

This Canadian industry comprises establishments of health practitioners other than physicians, dentists, mental health practitioners, optometrists, chiropractors, audiologists, and physical occupational and speech therapists, primarily engaged in providing health services. — Statistics Canada, NAICS 2022A

Establishments · CanadaA
8,409
with employees
Under 10 employeesA
91%
most common size: 1–4
01

Size and shape

How many businesses there are and how small they are. Fragmentation is the first thing an entrant — or anyone selling software into this industry — needs to know, and it is one of the few things that is actually measured.

Canadian establishments by number of employeesA

1–46,25374%
5–91,37116%
10–195176%
20–491962%
50–99541%
100–199140%
200–49930%
500+10%

Of 8,409 Canadian establishments with employees, 91% have fewer than ten — an industry of very small operators.

Where they areA

Ontario3,78745%
British Columbia1,47418%
Quebec1,37916%
Alberta1,01512%

Largest four provinces by establishment count. Establishments with employees only — sole operators with no payroll are not in this table, so in trades and personal services the true number of businesses is higher.

How many new establishments are still tradingA
Health Care and Social Assistance, US · opened 2020
84%
1 year
65.3%
3 years
52.6%
5 years
36.4%
10 years
opened 2015

Measured, not forecast: the share of US establishments opening in one year that were still active later. It counts good operators and bad ones together, which is exactly why it is the honest answer to “what are the odds”. It is for the whole sector rather than this market, and the ten-year figure comes from an older cohort because no younger one has reached ten years.

No US figure is shown. County Business Patterns is coded to the 2017 US edition of NAICS; this code either does not exist there, names a different industry, or is outside the programme's coverage (most of agriculture, rail, postal and public administration are). A figure is attached only where both the code and the title agree.

02

How businesses here compete

The structural profile of subsector 621, which every industry beneath it inherits. This is analyst judgment from how the subsector is organised — not research into this industry, and not a measurement.

local competitionmedium capitalUNVERIFIEDinherited from 621 Ambulatory health care services

Licensed professions with private-pay segments — dentistry, optometry, physiotherapy — are being consolidated by groups buying from retiring owners. The licence-holder shortage is the binding constraint.

Who sets the price
Public insurers for physician services; the practice for dental, vision, therapy and veterinary-adjacent care.
The software it runs on
Electronic records and practice management, split by profession, with insurer billing as the lock-in.
03

Market screens and studies

Market-entry records filed along this branch of the hierarchy. A record at or beneath this code is about this industry; one above it is about something wider that contains it.

Screened one level up. Nothing is filed at this exact code; the screen for 6213 Offices of other health practitioners covers it.

Vertical softwareScreenedfiled at 621310
Chiropractic Practice SoftwareOne thing must be true
binding constraint: incumbent vulnerability
Incumbent ChiroTouch (PracticeTek)

How chiropractic differs from rehab therapy (621340). Rehab software is built around insurance: WebPT and its rivals compete on documentation that survives payer and Medicare review, and the visit is billed to a third party. A chiropractic office sells many more short visits, usually as a care plan: a course of adjustments scheduled ahead and often paid up front or as a monthly membership. Part of the profession runs cash-only. That changes what the software has to do. It needs recurring card billing for memberships and prepaid plans, a ledger for plan balances, fast spinal-adjustment SOAP templates, and personal-injury and auto-accident case files alongside ordinary insurance claims. Discounting is also a compliance problem: charging cash patients less than insurers invites dual-fee-schedule trouble. A whole product, ChiroHealthUSA, exists to sell practices a 'compliant membership model' as a discount medical plan; it claims 7,700+ providers [C, vendor]. These are analyst framings of the workflow; the vendor pages confirm the features (ChiroSpring sells 'Memberships', ChiroTouch's CT Pay sets up recurring payments, ClinicMind sells a 'Cash-Only / Private Pay' plan) [C, vendor]. The incumbent is ChiroTouch, and it now sits inside a private-equity roll-up. It claims 12,500+ chiropractic practices [C, vendor]. K1 bought it in 2014, Waud Capital Partners took a stake in 2017 [B, socaltech], and in September 2023 Waud's platform (Integrated Practice Solutions, whose chiropractic line is ChiroTouch) merged into PracticeTek under Lightyear Capital majority ownership, with Greater Sum Ventures and Waud keeping stakes [B, Lightyear release]. PracticeTek also owns ChiroSpring, the cloud challenger that sells memberships; ChiroSpring's founder is quoted on PracticeTek's site, and the two share a San Diego address [C]. So the incumbent and one of the best-reviewed challengers have the same owner. Second consolidator: ClinicMind, which absorbed Genesis Chiropractic Software (its homepage now offers 'ClinicMind EHR 1.0 formerly Genesis') and sells EHR plus outsourced billing [A for the merger; date January 2024 from search summary, not opened]. The best-funded challengers. ChiroHD (Atlanta, founded 2017) raised $26M of growth capital from Mainsail Partners in April 2025 [B]. Jane (North Vancouver) is multi-discipline rather than chiropractic-only. It raised under $10M of primary capital, including $2M of CIBC debt in 2019 [B], and was valued at about $1.8B in a May 2025 secondary of $500M-plus led by TCV with JMI Equity and Tidemark [B]; reported revenue was about US$100M [B, The Logic via techcouver]. Practice Better (Toronto; US$27M led by Five Elms, April 2023, and US$13M of CIBC growth debt, November 2024) [B] named chiropractors as a target vertical when it raised. A new entrant would face a PE-owned incumbent that already bundles payments and recurring billing, a venture-funded cloud challenger aimed squarely at it, and a Canadian multi-discipline platform worth more than any of them. Incumbent vulnerability decides it. No vendor publishes revenue except Jane's reported figure.

NAICS 6213108 vendors named4 sourced figuresOpen →
Operating businessScreenedfiled at 621320
Optometry & Vision Care PracticeOne thing must be true
binding constraint: incumbent vulnerability

Two forces squeeze the independent optometrist from opposite ends. Below, the optical chains sell the glasses that carry the margin — National Vision alone runs 1,250 stores on $1.99B of revenue, with an exam priced as a loss leader for the frame sale. Above, the elective procedures that would lift the average ticket are performed in surgical centres the practice does not own, and online lens retail keeps taking the repeat purchase. The exam is the least profitable part of the visit, and it is the only part an independent reliably controls. Note what the chain's own filing now shows: the footprint is no longer expanding quickly. After exiting its Walmart and AC Lens businesses in fiscal 2024, National Vision opened 33 stores and closed 23 in fiscal 2025 for a net gain of ten — 0.8% — and guides to 30–35 openings in fiscal 2026 against 69 in fiscal 2024. Growth is coming from the existing base instead: comparable store sales rose 5.9%, and managed care is now 42% of revenue.

NAICS 6213203 vendors named8 sourced figuresOpen →
Vertical softwareScreenedfiled at 621320
Optometry Practice Management & EHR SoftwareOne thing must be true
binding constraint: incumbent vulnerability
Incumbent Eyefinity (VSP Vision) — Encompass, the successor to OfficeMate/ExamWRITER

How this differs from general EHR and practice management (6211). The general record is about Epic and the hospital market, where certification and clinician training decide who wins. An optometry office is a clinic with a shop attached. The software has to run the eye exam (refraction, pre-test device data, retinal imaging) and also an optical store: frame and contact-lens inventory, a point-of-sale counter, and lens orders sent to labs. The money side runs on two tracks. Routine eye exams and eyewear are paid through vision plans (VSP, EyeMed and others), which have their own eligibility checks, authorizations and claims. Medical eye care is billed to ordinary health insurance. Generic EHRs do not do frames, lab orders or vision-plan claims, which is why the category exists. The incumbent is a payer. Eyefinity is part of VSP Vision, the largest vision plan, and sells the only optometry software with a direct connection to VSP for real-time eligibility, authorizations and claims [C, vendor]. That claims link is the moat. In October 2025 NextGen Healthcare licensed it too: its ophthalmology and optometry customers now get Eyefinity's VSP claims, frame inventory, point of sale and lab ordering [B, NextGen release]. The independents are old and private. RevolutionEHR (Madison, founded 2006, majority-owned by the RevOptix investor group since 2014 [B]) claims 13,000+ eye care professionals [C]. Crystal PM (Austin) claims 8,000+ independent optometry providers [C]. Compulink (since 1985) also sells to ophthalmology and other specialties. Sightview, formerly Eye Care Leaders, was sold to unnamed owners in July 2024 and carries My Vision Express alongside iMedicWare, Medflow and ManagementPlus [B]. Ocuco (Dublin; €60M minority investment from Accel-KKR in 2023 [B]; 6,750+ sites in 88 countries [C]) sells optical retail and lab software, and its Canadian arm grew out of the EMRlogic acquisition. The one funded newcomer is small. Barti raised a $12M Series A led by Five Elms Capital in August 2025, with AOAExcel (the American Optometric Association's for-profit arm) as an investor [B]. It sells an AI-first all-in-one system and has onboarded about 200 practices [C]. Patient messaging is a separate layer owned by Weave (NYSE: WEAV; $239.0M revenue in 2025, 39,625 customer locations across dental, optometry and other verticals [A]), and Eyefinity lists Weave as an integration partner. The buyer is consolidating. By the end of 2023, private-equity platforms ran hundreds of offices each: MyEyeDr 842, AEG Vision 400+, EyeCare Partners 385+, Keplr Vision 278 [B, Vision Monday]. Those groups standardise on one system and negotiate enterprise terms, which leaves a shrinking independent market split among 25-year-old vendors that each claim thousands of providers. A new entrant would need the vision-plan claims link the payer owns, the device and lab integrations the incumbents built over two decades, and a buyer that is not being acquired. Incumbent vulnerability decides it. No optometry software vendor publishes revenue.

NAICS 62132010 vendors named4 sourced figuresOpen →
Vertical softwareScreenedfiled at 621330
Behavioural Health Practice SoftwareOne thing must be true
binding constraint: incumbent vulnerability
Incumbent SimplePractice (EQT)

SimplePractice has the solo and small-group therapist market at scale and sits behind EQT's balance sheet, but the harder problem is the payer-network model: Headway and Alma give practice software away because they earn on the claim. Competing with free-plus-revenue against a buyer who is also being offered patient flow is not a wedge. Nothing is disclosed here. Every vendor named on this record is private, or sits inside a parent that does not break the line out, so no revenue floor can be built and the market size is genuinely unknown rather than estimated.

NAICS 6213304 vendors namedOpen →
04

Software serving this industry

The vertical software markets filed along the same branch — who sells to these businesses and who they would have to displace — and then the generic categories every business buys whatever it does.

Sold across the wider branch

Vertical softwareScreenedfiled at 621 Ambulatory health care services
Healthcare Revenue Cycle & Admin SoftwareOne thing must be true
binding constraint: incumbent vulnerability
Incumbent Optum (Change Healthcare)

What this category is. The back office between a care provider and whoever pays: eligibility checks, claims and the clearinghouse that carries them, coding, denials and appeals, payer-to-provider payments, patient statements and collections, and the credentialing and enrolment that let a clinician bill a plan at all. The coded customer is ambulatory care (621): physician groups, clinics, labs and home health. But the largest buyers of several segments are hospitals and health systems (outsourced revenue cycle, inpatient coding) and health plans (payer payments, provider data, credentialing). How it differs from the neighbouring records. Electronic health records and practice management (6211) sells the chart and scheduling; athenahealth appears here only for its revenue-cycle business, and its funding is not re-researched. EHR+ patient engagement (6211) sells the portal and intake. Patient booking (6211) sells patient acquisition. HIPAA compliance (6211) sells security and audit. Medical imaging (621510) sells PACS. This record is the money and paperwork layer. Who owns the rails. Optum completed its combination with Change Healthcare on 3 October 2022 [A, Optum]. The February 2024 ransomware attack on Change touched about 192.7 million individuals, the largest US healthcare breach on record [B, CyberInsider citing the HHS OCR filing], and stopped claims for providers across the country. That shows how much of the network runs through one company. Availity says it connects over two million providers to every US health plan and handles over 13 billion transactions a year; its shareholders include Anthem (Elevance), Humana, HCSC and GuideWell, and Novo Holdings bought Francisco Partners' stake in July 2021 [A, Novo Holdings]. Waystar (Nasdaq: WAY) earned $1,099M of revenue in 2025, up 17%, from about 30,000 clients representing over 1 million providers [A, Waystar release]. Experian Health sells patient access, eligibility and identity inside Experian plc. Zelis runs the payer-to-provider payment side: 725 payer clients, 850K+ providers and $300B+ of payment volume by its own count [C]. Bain Capital and Parthenon sold a minority stake to a Mubadala-led group that closed on 26 November 2024 [A, Kirkland & Ellis]; the reported $17B valuation is Bloomberg's, not opened here. Who owns the outsourced work. R1 RCM was taken private by TowerBrook and CD&R at about $8.9B, closing 19 November 2024 [A, CD&R]. Ensemble Health Partners began as Bon Secours Mercy Health's revenue-cycle arm; Golden Gate Capital bought 51% in 2019 in a deal reported at about $1.2B [B, Becker's]. athenahealth, bought by Bain Capital and Hellman & Friedman for $17B [B, Healthcare Dive], bundles billing with its ambulatory record. The AI wave is already funded. AKASA (inpatient coding for 500 hospitals, by its own count) raised a $60M Series B led by BOND in 2021 [A]. Adonis raised a $40M Series C led by Quadrille Capital in March 2026, over $95M in total, and claims more than 4x revenue growth in 2025 [A, company release]. Candid Health raised a $52.5M Series C led by Oak HC/FT, $99.5M in total [B, HLTH]. Infinitus raised a $51.5M Series C led by Andreessen Horowitz, $102.9M in total, for AI agents that call payers [B, Pulse 2.0]. In credentialing, Medallion has raised $130M (latest $43M led by Acrew Capital, August 2025) and has acquired Andros [A]. CertifyOS raised a $40M Series B led by Transformation Capital in June 2025 [A]. Uno Health (Medicaid and benefits enrolment) was bought by Findhelp in October 2025 [B]. Canada. Provincial plans pay physicians, so the US claims-and-denials problem mostly does not exist. Billing is bundled with the record: more than 40,000 Canadian health professionals use a TELUS Health EMR [A, TELUS], and TELUS's CHR files OHIP claims through MDBilling [A, TELUS help centre]. mdbilling.ca now redirects to Dr.Bill, which claims 13,000+ physicians across OHIP, MSP and AHCIP [C]. TELUS eClaims covers direct billing to private insurers for allied health. Why a newcomer cannot get in. The clearinghouse and payment rails are owned by Optum, Availity (owned by payers), Waystar and Zelis. Each depends on connections to thousands of payers and on volume pricing. The outsourced hospital work is owned by private-equity platforms worth billions. Every point task an AI startup might attack (coding, denials, payer calls, credentialing, patient billing) already has a venture-backed player with $50M–$130M raised, and the incumbents are buying or building the same AI. Waystar's acquisition of Iodine is one example. In Canada the pain is small and the record vendors bundle it. Incumbent vulnerability decides it.

NAICS 62115 vendors named6 sourced figuresOpen →
05

Who works here

The occupations employed in Health care and social assistance, most concentrated in it first. The share is measured against the whole sector, not this industry — the published cross-tabulation stops there.

Concentrated in this sectorA

These jobs are mostly done here. An operator in this industry is competing for them against others in the same industry, not against the whole economy.

And the jobs every business has

Found across at least fourteen of the twenty sectors. But note the shape of this industry: 91% of establishments have fewer than ten employees, and at that size most of these roles are one person wearing several hats, or bought in from outside.

All 162 occupations →