Tenet Healthcare’s $4.3 billion acquisition of Vanguard Health Systems is likely to bring more business athenahealth’s way, Piper Jaffray analyst Sean Wieland concluded in a note he issued June 24, even as he offered up other possible scenarios, such as a MED3000 business win, or a boon for Cerner.

Tenet's acquisition of Vanguard is significant to athenahealth because Vanguard is an important athenahealth customer, Wieland wrote in the note. However, Vanguard uses MED3000 as its physician billing and EHR platform. If Tenet were to choose athenahealth as its standard ambulatory platform, the revenue upside would be $10 million, Wieland estimates. However if Tenet chose to standardize on the MED3000 platform at Vanguard sites, Wieland says athenahealth stands to lose up to $5 million in business per year.

“We like those odds, especially considering that we believe ATHN has the better solution,” Wieland wrote.

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Tenet Healthcare announced June 24 the acquisition of Nashville-based Vanguard. In the all-cash transaction, Tenet will pay $21 per share, the companies said June 24 in a joint news release. The acquisition is valued at $4.3 billion and includes the assumption of $2.5 billion in Vanguard debt.

Tenet expects to attain $100-$200 million in operational savings. Both boards have approved the deal, and financing is in place.

Vanguard went live with athenahealth in 2005 with athenaCollector and expanded with the implementation of clinicals in 2011, according to Wieland.

“Vanguard generates $178 million per year in professional fee collections, and assuming a 3 percent fee for ATHN, we estimate Vanguard represents approximately $5 million per year in revenue,” Wieland wrote.

Vanguard uses MED3000 as its physician billing and EHR platform. MED3000, acquired by McKesson in 2012, has more than 15,000 providers on its system, and so is “not an insignificant player,” says Wieland.

“Because the EHR and collections platforms are not integrated to the same extent as ATHN, we view ATHN as the better product,” he wrote. “We do not know what Tenet's plans are regarding physician billing and EHR, but we like the risk/reward for ATHN.”

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Wieland also raised another potential scenario, noting that “Cerner is Tenet's inpatient provider and will likely position Powerchart as the natural choice to provide better integration between the acute and ambulatory settings.”