The Dangers of Playing with FHIR: Why Health Plans Should Stop Building and Start Buying Interoperability
I sometimes have trouble explaining the risks of DIY to people who haven’t worked on cars. I became an inadvertent shadetree mechanic when I got my first car. I wanted to keep my maintenance costs as low as possible, and figured the best way to do that was to do repairs myself and learn as […]
Powering Electronic Prior Authorization with Integrated Data and AI
Prior authorization remains one of the most persistent sources of friction in U.S. healthcare. Manual workflows, fragmented systems, and unstructured medical policies slow care delivery, increase administrative burden, and create unnecessary costs for payers and providers alike. That challenge was front and center during a recent WEDI Virtual Spotlight, “How to Power Electronic Prior Authorizations […]
From ERs to APIs: The Infrastructure That Could Fix What The Pitt Portrays
The Pitt, the acclaimed 2025 television drama on HBO Max, feels chaotic because much of American healthcare is chaotic. The award-winning series follows a single day in a busy Pittsburgh emergency room and captures the pressure, uncertainty, and emotional weight of a fifteen-hour clinical shift. Guided by input from real emergency clinicians, the show has […]
2026 Healthcare Predictions: Policy, APIs, and the Next Phase of Interoperability
The US healthcare system is at a tipping point. Regulatory pressure is increasing. Patient expectations are rising. Payers and providers are being asked to deliver more value with fewer resources. At the center of this shift is data. How it’s accessed, how it’s shared, and how it’s used to drive better decisions. As we look […]
Beyond Compliance: Why Interoperability Should Be Your Strategic Advantage
Interoperability has reached a defining moment in healthcare. Federal and state data exchange requirements continue to accelerate, patient expectations are rising, and providers are demanding data that actually supports care delivery. In addition, payers are facing mounting pressure to improve efficiency and do more with fewer resources. At the same, many vendors are still approaching […]
FHIR Isn’t IT’s Problem: It’s a Strategic Imperative for Health Plan Leaders
Every transformation begins with a moment of clarity: realizing that what got you here won’t get you to your next stage of growth. For many health plan leaders, that moment arrives with four letters: FHIR. Fast Healthcare Interoperability Resources. On the surface, FHIR looks like a technical framework or another regulatory hurdle for IT teams […]
The Cybersecurity Hippocratic Oath in Healthcare Interoperability
Physicians recite the Hippocratic Oath during their commencement ceremony as they’re graduating from medical school. This oath represents their commitment to the core principle of medicine – to “first, do no harm.” Today, healthcare delivery is increasingly more holistic, data-driven, and inseparable from digital technology. As such, the security of healthcare data and systems requires […]
KLAS CMS Payer Interoperability Report 2025: 1upHealth Rated as a Top Performer
In the recently released KLAS report “CMS Payer Interoperability 2025: Which Vendors Are Payers Relying on to Meet Changing CMS Mandates? (October 2025)”, 1upHealth was recognized as a top performer, earning a score of 87.3. The report offers an independent view into how vendors are performing as the industry adapts to new interoperability requirements, such […]