1up Platform

Simplify how you acquire, manage, and use healthcare data with a scalable, FHIR®-first platform.

Benefits

Interoperability That Works for Your Health Plan

Data complexity is slowing your health plan down. Clinical and claims data live in different systems – or outside your four walls – identities don’t align, and sharing information takes manual effort.

Built for healthcare and powered by a data lakehouse architecture, the 1up Platform brings it all together. We ingest your raw data, duplicate it, standardize it within a unified model, and deliver it in the formats your ecosystem requires. The result is lower operational friction today and a foundation that evolves with your business needs.

Data Activation and Value

Turns unified clinical and claims data into insights your team can use across quality, risk, care management, and operations.

Better Member Experiences

Supports faster onboarding, more complete member records, and timely access to data that enables personalized, responsive engagement.

Reduced Operational Costs

Reduces integration effort and ongoing IT lift by replacing one-off builds and manual processes with a single, scalable platform.

Stronger Provider Relationships

Makes it easier to share data, coordinate care, and support better outcomes across provider workflows.

We actually fired another vendor to hire 1upHealth because almost anything that 1upHealth did was better. We definitely see 1upHealth as a foundational partner. The implementation of the 1up Platform was very smooth. The amount of uptime and system availability is high.
Director, December 2024, collected by KLAS Research

Our Differentiators

What Sets the 1up Platform Apart

Seamless Integrations

Integrates with your operational and clinical systems to support embedded, frictionless workflows.

Network Effects

Connect once to a growing ecosystem of payers, providers, and third-party applications.

Flexible By Design

Modular, easy to adopt, and built to work within your existing environment.

Data Activation

Turns unified data into measurable impact across risk, quality, operations, and care management.

Data Transparency

Provides clear visibility into data flows, usage, and performance across your ecosystem.

Capabilities

Core 1up Platform Capabilities

The 1up Platform brings together the core capabilities payers need to support interoperability from ingestion to activation.

Faster Implementation

Flexible Data Ingestion & Storage

Ingests raw clinical, claims, and financial data into a unified, reusable data foundation.

Longitudinal Member Record

Unified Data Model

Organizes and links data across domains, resolving identities before mapping to FHIR or other external formats.

Trusted Data

Built-In Data Quality Controls

Applies automated data validation, matching, and completeness checks to ensure accurate, reliable data.

Reduced Risk

Comprehensive Data Governance

Manages access, consent, lineage, and auditing through centralized, consistent controls.

Secure Data

Enterprise-Grade Security

Protects sensitive health data using encryption, least-privileged access, and zero-trust security principles, aligned with HITRUST requirements.

Lower IT Burden

Network Connectivity

Provides secure, standardized API connections that support scalable data exchange across your ecosystem.

Faster Insights

Advanced Analytics & AI Enablement

Enables analytics initiatives with AI-ready, longitudinal data that unifies clinical and claims information across domains.

Format Flexibility

Flexible Data Export

Delivers normalized data in formats your downstream systems require - you can run existing use cases with minimal effort.

Proven at Payer Scale

Built to support national and multi-line-of-business payers operating at real-world scale.

Member Records Managed

34.8 Million

MCO Members Supported

14 Million

EOB Records Processed

4 Billion

Platform User Interfaces

1up Console

The command center for payer teams. The 1up Console gives you visibility and control over how data moves across your ecosystem. You can:

• Monitor ingestion and data flows.
• Manage connections with providers, apps, and other payers.
• Oversee integrations with utilization management, care management, and other downstream systems.
• Control cost and sensitive data sharing.
• View and manage member consent.
• Monitor regulatory and operational workflows.
• Track API usage and performance.

→ Better control and faster decision-making.

1up Dev Portal

The front door for external access. The 1up Dev Portal allows external payers, providers, and digital health developers to access authorized payer data. They can:

• Explore APIs in a sandbox.
• Request production access.
• Exchange data securely.

→ Faster onboarding and secure data exchange, without adding burden to your team.

How It Works

A purpose-built interoperability platform designed around payer systems and workflows.

Acquire Data

Ingests clinical, claims, and member data from internal systems and external partners.

Normalize & Resolve

Standardizes data, resolves identities across systems, and applies quality and governance controls.

Store & Manage

Maintains a centralized, scalable foundation built for healthcare workloads.

Data Exchange

Securely exposes data via APIs to providers, members, other payers, and applications.

Analyze & Activate

Enables analytics, reporting, and real-time event streams that power downstream workflows and use cases.

Strategic Interoperability Guide for 2026-2027

Learn what CMS-0057 requires, where your organization should be today, and how to avoid vendor risks that could delay compliance in 2026 and 2027.

Download now

Platform-Powered Products

Each 1upHealth product runs on the same underlying 1up Platform and can be adopted independently or together.

1up Electronic Prior Authorization

Automate prior authorization to deliver faster decisions and better experiences.

1up Payer-to-Payer Data Exchange

Unlock historical member data to improve onboarding and close care gaps.

1up Provider Access

Enable providers with timely patient data for better care decisions.

1up Patient Access

Give members easy, secure access to their health information.

1up Provider Directory

Publish accurate provider directories that make in-network care easy to find.

1up Formulary

Deliver transparent drug coverage details to members and providers.

1up Clinical Connect

Automate clinical data acquisition to improve quality, risk, and care management.

FAQs

How does the 1up Platform fit with our existing systems? The 1up Platform is designed to sit alongside your current infrastructure, integrating with existing data sources, UM systems, analytics tools, and identity providers without requiring a rip-and-replace.

Does the 1up Platform store everything in FHIR? No. FHIR is optimized for interoperability and exchange, not as an internal common data model. For greater flexibility and improved interoperability, the 1up Platform stores data in a unified internal model designed for identity resolution, cross-domain linking, and analytics, before exporting to FHIR and other downstream formats.

What formats can the 1up Platform ingest? The platform supports X12 (including 837 and 278), FHIR bundles, and custom flat files or CSV formats. Data is transformed and standardized using reusable mapping logic, reducing implementation effort for payer teams.

What visibility do we have into data usage? The 1up Console provides real-time insight into data ingestion, API usage, and data flows, along with usage and compliance reporting that helps you understand how data is accessed and shared across systems and partners.

How does 1upHealth reduce implementation time? By ingesting raw data and handling normalization, mapping, and identity resolution internally, 1upHealth removes the need for customers to pre-process or standardize data before onboarding.

How does the 1up Platform handle security and compliance? The 1up Platform aligns with HITRUST r2 and HIPAA requirements, using encryption, role-based access controls, continuous monitoring, and U.S.-based hosting to protect sensitive healthcare data.

Ready to Build a Stronger Interoperability Foundation?

Meet regulatory requirements. Reduce operational burden and complexity. Get more value from your data with the 1up Platform.