Payers
Streamline interoperability, meet regulatory requirements, and unlock new value streams
For Medicare, Medicaid, and Commercial Payers
Featured Webinar
Improving Your Star Rating With CMS Access APIs
Join us to discover how the intersection of interoperability and Star Ratings can transform your MA plan.
Payers operate in a complex ecosystem.
As the backbone of the healthcare economy, payers interact with a range of partners, from Accountable Care Organizations (ACOs), third-party administrators (TPAs), and Pharmacy Benefit Managers (PBMs) to a wide variety of digital health companies. Each of these partnerships relies on data. But a lack of standards and connectivity makes accessing, processing, and exchanging data with these organizations hard.
1upHealth is the market leader helping Medicare, Medicaid, and commercial payers acquire, manage, share, and analyze health data, supporting not only their regulatory requirements but also helping them drive ROI from their interoperability investments. Stop chart chasing and start driving clinical and financial improvements with combined EHR and claims data standardized on FHIR. Make the move to 1upHealth.
Drive results with 1upHealth
Bi-directional value-based care enablement
Deliver timely post-adjudicated claims data to value-based partners and receive timely USCDI clinical data from provider EHRs on shared patient populations via FHIR® APIs.
Future-proof FHIR API compliance strategy
Meet all current FHIR API mandates and future-proof your compliance strategy ahead of upcoming regulations. Join the 75+ regulated health plans that are achieving CMS compliance with 1upHealth.
Leverage computable clinical data to drive improvements
Convert CCDA, HL7v2, and other flat files from Health Information Exchanges (HIEs) and other sources to FHIR to support analysis across your organization.
Unlock new value streams
Unlock population health insights and data exchange use cases that improve your top line.
The power of 1upHealth FHIR® data solutions
1upHealth takes a standards-based, modern cloud, and API approach to data portability and governance. In partnership with 1upHealth, health plans can easily access, process, and exchange data to improve member experience and outcomes, comply with CMS FHIR regulations, operate efficiently, share risk, carve out services, and improve profitability.
We’re built on FHIR – the open and truly portable data standard – from the ground up.
Our market-leading compliance solution enables you to meet CMS regulations without the hassle of building in-house or working with inexperienced vendors.
Our end-to-end platform supports all of your data needs – from ingestion to analytics and everything in between.
Ingestion of clinical and claims data from multiple sources results in a complete, standardized source of member health information.
Our implementation process is battle-tested, having brought 80+ health organizations live on our platform.
Dedicated customer success support ensures a strong long-term partnership.
1upHealth’s network effect
7,000+
provider endpoints for clinical data
150+
payer endpoints for claims data
1upHealth for payers
1up FHIR Platform
Acquire, manage, share & analyze health data with an industry-leading, end-to-end managed platform.
1up Patient Connect
Empower patients to access & share their health records with providers, payers, and digital health applications.
1up Population Connect
Drive better health outcomes & make better business decisions with patient population data imported from top EHRs.
1up Comply
Meet current & future health data exchange regulations.
1up Exchange
Streamline patient- and population-level data exchange with your key clinical & business partners.
1up Analyze
Unlock new insights & better outcomes by accessing healthcare data stored in FHIR® and integrating it into existing analytics systems.
Leading payers using 1upHealth
A regional health plan with three risk-based provider contracts uses 1upHealth to access EHR data in order to properly assess quality goals. This is the first time in its history that this payer has access to clinical data at scale.
One of the country’s largest health insurers together with a national health services organization uses 1upHealth to merge EHR data with other external and internal data, creating the backbone for prior authorization, analytics, and all care management and network interactions.