Per-Location vs Per-User: The IDD EHR Pricing Difference That Punishes Growth

Two providers of the same size can pay wildly different amounts for their EHR — not because one negotiated better, but because they're on different pricing models. And the model, not the sticker price, is what determines whether your software cost grows with your team.

Here's the difference, and why it matters more than the number on the quote.

The per-user model taxes your headcount

Most IDD EHRs charge per user, per month. On paper it sounds fair. In practice, direct support is one of the highest-turnover roles in any industry, and a per-user model charges you for all of it:

• Every DSP you hire adds a line to the bill.
• Every DSP who leaves and gets replaced means onboarding a new paid seat.
• Seasonal and PRN staff either cost you year-round or create access gaps.

So the model penalizes exactly the thing you can't avoid — staffing a 24/7 operation. A 40-person program pays 40 times. A growing program pays more every month it grows.

The per-location model prices the thing that's stable

Your service locations change slowly. Your staff roster changes constantly. Per-location pricing charges for the stable thing — the number of homes or programs you run — and lets you add unlimited staff without touching the bill.

The practical effect: hiring five DSPs to fix a coverage gap doesn't raise your software cost. Onboarding a new class of staff before a survey doesn't raise it. Your software stops being a tax on the size of your team.

The questions to ask any vendor

1. Is pricing per user, per location, or per individual served?
2. If per user — what counts as a user? Do PRN and terminated staff count?
3. Are core modules (documentation, MAR, incidents, plans) included, or sold separately?
4. Is there a setup fee or a minimum contract?
5. What does it cost to add ten staff members mid-year?

The answers to 1 and 5 usually tell you everything.

Where CareHub fits

CareHub prices per service location, with unlimited staff on every plan — you're never charged per seat, so growing or backfilling your team never grows your bill. Core documentation, MAR, incidents, plans, and AI come on every plan rather than as à-la-carte modules. Pricing is tailored to your locations and service lines, so the right way to compare is to put your real numbers next to your current per-user quote.

Run the math on your own roster: current EHR cost times your staff count, versus a flat per-location price with unlimited seats. If the gap is uncomfortable, start a free 14-day trial and see the difference on your actual programs.