Health Data, On Demand

1upHealth makes it easy for health plans to acquire, manage, and use healthcare data.​

We Make Health Data Exchange Easy

You rely on accurate, timely, and secure data to run your business, but manual workflows, lagging information, poor data quality, and data silos are holding you back. It’s time to modernize your health data exchange strategy. That’s where 1upHealth comes in.

We simplify health data exchange so you can move faster, operate with confidence, and gain a competitive advantage. Whether you’re looking to simply meet government regulations or reimagine your interoperability strategy from end to end, we’ve got you covered.

Our FHIR data and interoperability strategy, powered by 1up, is key to delivering on our member-first promise.

Ron Wampler Executive Director of Interoperability, Aetna/CVS Health

The Platform Powering Payer Interoperability

1upHealth offers the most advanced, FHIR-first data platform built for the realities of healthcare. Powered by our lakehouse architecture, we connect and activate health data across your ecosystem – securely, reliably, and at scale – so interoperability works for your health plan, not against it.

The results: reduced operational costs, better member experiences, and stronger provider relationships.

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.

2026-2027 Payer Interoperability Guide

CMS-0057 deadlines are fast approaching. Download our new Interoperability Guide to learn what CMS requires, how to avoid costly vendor mistakes, and how to generate value beyond compliance.

Scale You Can Rely On

1upHealth is built to handle large-scale data exchange, supporting health plans as membership, data volume, and data exchange across the ecosystem increase.

Member Records Managed
34.8 Million
MCO Members Supported
14 Million
EOB Records Processed
4 Billion

Why Leading Health Plans Choose 1upHealth

Compliance Confidence

Simplifies interoperability by managing CMS-9115-F and CMS-0057-F compliance now and as regulations evolve.

Complexity, Covered

Takes on the complex work of API development, validation, and system connectivity – so payers can focus resources on building and differentiating on top of the platform.

Modular By Design

Offers solutions that operate independently or integrate end to end. Built to fit your existing workflows, systems, and infrastructure.

Network Effects

Provides you with a one-to-many network of payers, providers, and third-party apps that grows stronger with each connection.

Dedicated Partner

Lends regulatory expertise, strategic guidance, and 24/7 support through a dedicated, 100% U.S.-based team.

Data Activation

Turns compliance investments into business impact by standardizing and activating real-time clinical and financial data.

The 1upHealth Ecosystem

From integrated technologies to interoperability expertise, 1upHealth partners across the healthcare ecosystem to deliver scalable, trusted data exchange.

Built for Every Health Plan

Whether you’re a small regional plan or a national payer, 1upHealth supports interoperability across every line of business.

Medicare Plans

Supports Medicare Advantage and Fee-for-Service lines of business with interoperability that keeps pace with evolving CMS requirements.

Medicaid Plans

Helps state agencies and managed Medicaid plans meet compliance while supporting complex member populations.

Commercial Plans

Partners with local, regional, and national commercial plans to help them unlock value across all lines of business.

Enterprise-Grade Security, Trusted By Design

Enterprise-grade security and a tech-agnostic architecture ensure data protection and privacy while prioritizing accuracy and governance.

Unlock the Value of Strategic Interoperability

Meet CMS requirements. Reduce operational burden.

Turn health data into a strategic advantage for your health plan.