CMS Rule Interoperability Mandate for Payers
1upHealth’s FHIR API Platform is the first true implementation of the ONC’s intent for healthcare interoperability.
Cool Vendor Report 2020CMS Interoperability Final Rule
CMS recently introduced new interoperability mandates for health plans that must be implemented by July 1, 2021. These include:
Patient Access Rule - FHIR for members to share data with apps
Provider Directory API - FHIR API for a provider directory
Payer to Payer Data Exchange - Send and receive member data with other plans (Jan 2022)
Read more CMS patient access and interoperability requirements.
1upHealth Solution
1upHealth provides a fully managed solution to cover all new mandates. Our customers, including plans with millions of members, are already in production with 1up’s HHS award-winning API platform. Today, 100s of apps use 1up FHIR APIs to manage user directed connectivity across 1000s of health systems that we helped attest to similar patient access mandates. Plans can use the same infrastructure to meet all patient access and interop requirements.
Integrated FHIR Platform as a Service
Data Transformation
- Claims, encounters, etc. > FHIR R4
- Provider directory integration
- Support for X12, CCDA, and other interfaces
 | 1st place in ONC Health Data Provenance |
FHIR API Server
- Cloud-based, auto updates, serverless
- HIPAA compliant, SOC-II Audited
- Supports FHIR R4
- Automated testing built-in
| | 1st place in HHS Secure FHIR Server Showdown |
3rd-Party Access Mgmt
- Developer API token management
- Developer console
- Audit-log and API metrics
- Member consent management app
| | Award for HSS Consumer Health Data Aggregator |
Dev + Member Support
- Developer & member support (email & phone)
- 3rd-party app policy & security reviews
- FAQs / API Documentation
| | Winner in HHS Privacy Policy Snapshot |
Platform Capabilities
- Clinical Data Network - access patient data across 10K+ facilities
- FHIR Subscription alert notifications
- FHIR SQL analytics & bulk export
| | Winner in HHS $1M FHIR Bulk Data LEAP Grant |
Compliant, Secure, Easy
Meet all CMS Mandates
| ✔ | Patient Access APIs | ||
| ✔ | Public Provider Directory API | ||
| ✔ | Payer to Payer Data Exchange |
Demonstrated Security
| ✔ | 1st place in ONC’s Secure FHIR Server Challenge | ||
| ✔ | HIPAA Compliant | ||
| ✔ | SOC 2 Audited |
Go live on time with ease
| ✔ | Solution is already built, in production | ||
| ✔ | No additional integrations needed | ||
| ✔ | Quick 9 week implementation | ||
| ✔ | Fully, managed cloud deployment | ||
| ✔ | Simple pricing (per member per year) without license fees |
1up leads FHIR interop
| ✔ | 1up is literally setting the standard with HL7 | ||
| ✔ | Built the CARIN FHIR App Gallery | ||
| ✔ | Built the Bulk Data Analytics Reference | ||
| ✔ | Founding members of FHIR Business Alliance |
You'd be crazy to work with other vendors
| Only 1up is in production for all CMS requirements | |||
| Only 1up has a patient app network | |||
| Only 1up has 1000s of direct FHIR connections to health systems | |||
| Only 1up received numerous FHIR awards from the US Government |
1upHealth is in production at scale with hundreds of institutions
10,000
FHIR Connected health centers
600
Healthcare companies on 1upHealth APIs
7,000
Transactions processed per second
10
Government awards in healthcare IT
10M +
Lives under contract
All the features above are required to ensure success and security when meeting the new rules. Health plans must consider a broad list of interoperability, deployment, and support aspects to meet these mandates. 1up has everything health plans need to meet the regulations. You have flexibility and options with our platform and services and can utilize one module, a-la-carte, or the full solution for end-to-end use cases.
Why 1upHealth
1upHealth is well positioned to support health plans in meeting the CMS requirements for the July 2021 deadline.
Direct Payer Experience
We have direct experience through our work with as one of the first approved Blue Button 2.0 apps, with health plans supporting millions of health plan members and the Da Vinci Project through workgroups and connectathons.
Extensive Clinical Data Network
We've worked with 100s of health systems across the US in meeting Meaningful Use 3 (MU3) requirements. We’ve now connected to 10,000+ hospital and health centers, allowing patients to authorize access to their EHR medical records with 3rd party applications.
We are FHIR Experts
Our team is comprised of leading FHIR experts who have presented alongside CMS and ONC leaders like Don Rucker, had led HL7 standard balloting, and participate in numerous FHIR connectathons
Proven Platform for Regulation
Because our award-winning FHIR solution is already in production, we can ensure timely deployment and meeting the requirements of the new rules.
