Featured Webinar Series
Navigating The CMS Final Rule: Building Your Compliance Roadmap
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
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.
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.
Convert CCDA, HL7v2, and other flat files from Health Information Exchanges (HIEs) and other sources to FHIR to support analysis across your organization.
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.
1upHealth’s network effect
1upHealth for payers
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.
Meet current & future health data exchange regulations.
Streamline patient- and population-level data exchange with your key clinical & business partners.
Unlock new insights & better outcomes by accessing healthcare data stored in FHIR® and integrating it into existing analytics systems.
Leading payers using 1upHealth
Regional Health Plan
Accessing EHR data to properly assess quality goals
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.
Large Health Insurer
Improving processes using EHR data merged with other data
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.