Payers
Streamline interoperability, meet regulatory requirements, and unlock new value streams
For Medicare, Medicaid, and Commercial Payers

Payers operate in a complex ecosystem.
As the backbone of the healthcare economy, payers work with a range of groups, 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.
Drive results with 1upHealth
Payer-driven ACO enablement
Access EHR data to assess quality goals of the ACOs within your network.
FHIR data aggregation at scale
Meet all current FHIR® API mandates and future-proof your compliance strategy.
Unlock new value streams
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, share risk, carve out services, operate efficiently, and improve profitability.

We’re built on FHIR – the open and truly portable data standard – from the ground up.

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 75+ payers 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 members to access & share their health data with payers and digital health applications.
1up Population Connect
Drive better health outcomes and make better business decisions with patient population data imported from top EHRs.
1up Comply
Meet regulatory requirements for health data exchange.
1up Exchange
Evaluate – and make better decisions – at the population level with efficient data exchange.
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.