Nobody misses four stars by a lot. A plan can score 3.73, round down to 3.5 stars, and miss a bonus worth $40 to $60 million a year, over two hundredths of a percentage point. A few points across measures adds up fast – leading to significant lost revenue.
Some of those points go missing for a specific reason: a member gets screened, the result lands in an EHR, but it never reaches the plan. That member looks identical, on paper, to one who was never screened. Same score, different reality. It’s not a care gap. It’s an interoperability problem.
1up Clinical Connect closes that gap, connecting directly to provider EHRs through FHIR APIs to acquire clinical data and unify it with claims into one longitudinal member record, continuously, with no seasonal chart chasing. With that complete data foundation in place, HEDIS measure performance improves in real, measurable ways. According to NCQA, measures like Colorectal Cancer Screening improve by 14.0 points and Depression Screening and Follow-Up improve by 22.9 points once clinical data is added.Â
In this webinar, we’ll cover how that connectivity works and what it unlocks, including the ability to query claims and clinical data together for quality insights, like every member due for a colonoscopy with no screening record. We’ll also show how a leading Blues plan, our inaugural 1up Clinical Connect user, is putting it into practice, and close with a live demo.
What you’ll learn in this session:
As Chief Commercial Officer at 1upHealth, Nolan Kelly is responsible for driving business growth and overseeing customer relationships. He has extensive experience in healthcare technology, having previously led Enterprise Sales at PatientPing and having previously served as VP of Growth at Linkwell Health. With over 15 years in the industry, Nolan specializes in developing strategic partnerships and delivering innovative solutions for value-based care and population health management.
Alisa Haman is a Principal Product Manager at 1upHealth with over 10 years of experience building and scaling B2B SaaS products. She specializes in designing intuitive user experiences that simplify complex workflows and systems, and has launched numerous new products and features throughout her career. At 1upHealth, Alisa leads product execution while partnering closely with customers and the broader market to ensure solutions address real-world needs. She is passionate about advancing healthcare operations to improve experiences and outcomes for patients.
Ryan Ingram is an experienced healthcare technology leader with deep expertise in FHIR-based data interoperability and modern API-driven architectures. As Director of Sales Engineering at 1upHealth, he leads technical strategy for enabling scalable data exchange between payers, providers, and digital health partners. Ryan previously led customer implementations as one of 1upHealth's first solution architects. Prior to 1upHealth, he held product and strategy roles at athenahealth focused on national-scale interoperability and payer-provider integrations.
