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1UpHealth

API-based health data interoperability platform

Overview

1upHealth provides API-based data interoperability for healthcare providers, payers, and patients, enabling secure access to and exchange of health data to meet CMS interoperability rules. Its platform connects disparate health data into clients’ analytics systems, supporting individual and population health insights and regulatory compliance. The core product is a suite of API services that securely exchange health information, with revenue from subscriptions for API usage used by large healthcare organizations. Compared with competitors, 1upHealth emphasizes scalable, compliant data integration and active industry collaboration, hosting events to share best practices and shape the future of healthcare data exchange. The company’s goal is to advance healthcare digital transformation by making data exchange easier, reducing costs, and improving patient care outcomes through better data analytics and interoperability.

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About 1UpHealth

Simplify's Rating
Why 1UpHealth is rated
B-
Rated B on Competitive Edge
Rated B on Growth Potential
Rated C on Differentiation

Industries

Data & AnalyticsEnterprise SoftwareHealthcare

Company Size

51-200

Company Stage

Series C

Total Funding

$76M

Headquarters

Boston, Massachusetts

Founded

2017

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Simplify's Take

What believers are saying

  • The January 1, 2027 CMS deadline forces health plans to buy now.
  • Capital Health Plan adopted 1up Clinical Connect on September 1, 2026.
  • Continuous clinical data improves HEDIS, Star Ratings, and risk adjustment economics.

What critics are saying

  • CMS-0057-F compliance work becomes commoditized as Epic and large vendors replicate APIs.
  • Capital Health Plan is a single inaugural customer; weak adoption kills 1up Clinical Connect.
  • If payer budgets tighten, point-solution interoperability vendors face brutal churn before 2027.

What makes 1UpHealth unique

  • 1upHealth first deployed all CMS-0057-F APIs by March 2026.
  • Its FHIR-first lakehouse supports tens of millions of covered lives.
  • 1up Clinical Connect pulls EHR data continuously from Epic and athenahealth.

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Funding

Total Funding

$76M

Below

Industry Average

Funded Over

6 Rounds

Series C funding is usually for startups that are doing well and are looking for more money to fuel major growth, such as acquiring other companies, expanding into global markets, or launching new product lines. Investors typically include larger venture capital firms and private equity.
Series C Funding Comparison
Below Average

Industry standards

$50M
$40M
$50M
$62M
$100M

Benefits

  • Unlimited PTO & Sick Time
  • Comprehensive Medical and Dental Insurance
  • 401(k)
  • Paid Parental Leave
  • Flexible Work Location
  • Quarterly wellness reimbursements or monthly commuter stipend
  • Home office stipend
  • Weekly catered lunches (Boston office only)
  • Team lunches – Grubhub stipends every other week
  • Identity theft protection

Growth & Insights and Company News

6 month growth

0%

1 year growth

0%

2 year growth

-1%
Associated Press
Sep 1st, 2026
1upHealth launches Clinical Connect to help payers improve HEDIS scores and Star Ratings with continuous clinical data

1upHealth has launched 1up Clinical Connect, a solution enabling health plans to automatically acquire clinical data from provider electronic health records and integrate it with claims data. Capital Health Plan, a not-for-profit HMO serving over 135,000 members in Florida's Panhandle, is the inaugural user. The platform continuously pulls clinical data from EHRs through secure FHIR APIs, including Epic and athenahealth. It addresses challenges health plans face accessing reliable clinical data for HEDIS, Star Ratings, and risk adjustment programmes. 1up Clinical Connect delivers USCDI-standard clinical data for targeted member populations, unifying it into longitudinal records. The solution is built on 1upHealth's FHIR-first data lakehouse, which supports tens of millions of covered lives and meets HITRUST r2, HIPAA, SOC 2, and NIST CSF 2.0 standards. The platform enables plans to surface completed care that claims data alone might miss, potentially improving quality scores and care coordination.

WBOC
Sep 1st, 2026
1upHealth launches 1up Clinical Connect to help payers strengthen HEDIS Scores, Star Ratings, and financial performance with Continuous Clinical Data.

1upHealth launches 1up Clinical Connect to help payers strengthen HEDIS Scores, Star Ratings, and financial performance with Continuous Clinical Data. * Sep 1, 2026 Interoperability Leader Announces Capital Health Plan as Inaugural User of New Solution BOSTON, MA / ACCESS Newswire / September 1, 2026 / 1upHealth, a leader in health data interoperability, today announced it has launched 1up Clinical Connect, a solution that allows health plans to automatically acquire clinical data from provider EHRs and unify it with claims data into a single longitudinal member record. Longstanding 1upHealth customer Capital Health Plan is the first to implement the new solution, using it to close care gaps, sharpen risk adjustment accuracy, and improve outcomes. Health plans need clinical data to run critical programs like HEDIS, Star Ratings, and risk adjustment, but reliable access remains a challenge: manual chart chasing, infrequent data pulls, and fragmented data sources drain resources and leave plans working with an incomplete picture. 1up Clinical Connect solves that by continuously pulling clinical data straight from EHRs, surfacing hundreds of additional clinical data points per member with no operational disruption or engineering lift, so plans can put that data to work where it counts. Capital Health Plan (CHP), a not-for-profit HMO and independent licensee of the Blue Cross and Blue Shield Association, serves over 135,000 members across the Florida Panhandle and is recognized as one of the highest-rated plans in the nation. CHP selected 1up Clinical Connect to automate access to clinical data from its provider network, addressing priorities that go beyond compliance to care quality and outcomes. "Through FHIR-enabled providers participating with Capital Health Plan, 1up Clinical Connect delivers direct access to clinical data beyond claims, helping us improve care coordination, support quality outcomes, and provide a more complete view of our members' healthcare needs," said Eric Smith, CIO of Capital Health Plan. Putting Clinical Data to Work In the hands of health plans, rich clinical data drives cost and quality improvements. 1up Clinical Connect combines clinical and claims data to surface completed care that claims alone miss, lifting HEDIS Scores and Star Ratings performance. 1up Clinical Connect enables health plans to: * Connect directly to provider EHRs through secure FHIR APIs, including Epic and athenahealth. * Automatically retrieve USCDI-standard clinical data for targeted member populations using claims-based or uploaded rosters. * Unify clinical and claims data into a longitudinal member record for a more complete view of each member. * Deliver data where it is needed in FHIR or non-FHIR formats to existing systems, analytics tools, and data warehouses. * Monitor data acquisition in real time with visibility into sources, retrieval status, and newly available records. * Query claims and clinical data together to surface quality, risk, and care management insights, such as every member due for a colonoscopy with no screening record. 1up Clinical Connect is built on 1upHealth's FHIR-first data lakehouse, the same foundation that helps health plans meet CMS interoperability requirements, now extended to power clinical data acquisition. Since 2017, that platform has grown to support tens of millions of covered lives and meets HITRUST r2, HIPAA, SOC 2, and NIST CSF 2.0 standards. "Healthcare data has long been fragmented, with payer and provider systems each containing separate parts of the bigger picture. But, as the industry and standards have evolved, seamless data interoperability has become non-negotiable," said Andrew Boyd, CEO of 1upHealth. "Offering 1up Clinical Connect to customers like Capital Health Plan represents our commitment to shifting the perspective from interoperability as a regulatory obligation to interoperability as an operating capability that creates sizable value and brings us closer to our purpose of better healthcare for all, through better data." To learn more about 1up Clinical Connect, visit our website. You can also view a demo and meet the team at Booth #316 at the NCQA Health Innovation Summit, October 4-7 in Atlanta, or register for the live webinar entitled "Connect Once, Improve Every HEDIS Quality Measure: The Benefits of Continuous Clinical Data Exchange," on September 29, 2026 at 1:00 PM ET. About 1upHealth Driven by a purpose of better healthcare for all through better data, 1upHealth is the national leader in health data interoperability and one of the fastest-growing health IT companies in the United States. Our modern data platform is built on a standards-based cloud architecture specifically designed for the healthcare industry, making it easy to acquire, manage, and use data. Payers large and small - commercial or government-sponsored - rely on 1upHealth to seamlessly exchange clinical and claims data across the healthcare ecosystem to reduce risk, lower costs, and improve patient outcomes. Visit our website. About Capital Health Plan Capital Health Plan (CHP) is committed to offering affordable, comprehensive health care to its members. Now in its 44th year, CHP has grown to serve more than 135,000 members in the Florida Panhandle and has an extensive physician network that includes three exclusive CHP Health Centers providing preventive, primary, and specialty care services. Based in Tallahassee, CHP is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit www.capitalhealth.com. Media Contacts: Elizabeth Grich Aria Marketing for 1upHealth View the original on ACCESS Newswire Media gallery

Health IT Answers
Jul 16th, 2026
Health IT business news - july 16, 2026.

Health IT business news - july 16, 2026. | / | Assessments Pop Health Minute Healthcare NOW Radio - for the Healthcare Industry - Streaming 24/7 | Caris Life Sciences Launches Caris Detect, the World's Most Sensitive and Comprehensive Multi-Cancer Early Detection Blood Test Caris Life Sciences(R), a patient-centric, next-generation AI TechBio company and precision medicine pioneer, announced the commercial launch of Caris Detect(TM), a groundbreaking multi-cancer early detection blood test designed to uncover cancer signals at earlier, more treatable stages. Product news. Carta Healthcare Brings Hybrid Intelligence to Oncology with Lighthouse for Cancer Registry Abstraction Carta Healthcare, a provider of enterprise clinical data management, announced Lighthouse for Oncology. Health systems can now apply Carta Healthcare's Hybrid Intelligence approach to cancer registries, one of the most complex and labor-intensive areas of clinical data abstraction. Cantata Health Solutions Announces New Capabilities for Child and Youth Services Organizations Cantata Health Solutions, a provider of technology solutions for behavioral health and human services, announced expanded child and youth services capabilities within Arize, its modern EHR platform for managing clinical, financial and operational workflows. The new features are designed to help organizations that provide foster care, adoption, family preservation, and related services to quickly identify available homes, manage placement requirements and reduce the manual work that slows operations. MedeAnalytics Announces Innovations to Improve Quality and Financial Performance of Medicare Advantage Plans MedeAnalytics, the healthcare performance improvement company, announced innovations to Medicare Advantage Insights, one of the core offerings of its enterprise healthcare analytics portfolio. These new capabilities help Medicare Advantage (MA) health plans unify fragmented data across quality, risk, finance, utilization, social determinants of health (SDOH), and member experience. By turning that data into predictive, prioritized insights and intelligent workflows, Medicare Advantage Insights helps plans improve financial performance, quality outcomes, and value-based care execution. CareHive Health Launches New Service to Help Members Choose High-Quality, Lower-Cost Care CareHive, a physician-led healthcare technology company, announced the launch of its healthcare decision guidance service in collaboration with a leading Texas health plan. The service proactively identifies plan members who can save money by receiving routine clinical services, such as laboratory tests, in lower-cost care settings without compromising quality. It then provides clear, personalized guidance and support to help members make a confident change. The service is available to members at no cost, regardless of how much they save. 1upHealth Announces 1up Gateway to Simplify CMS-0057-F Compliance for Health Plans 1upHealth, a leader in health data interoperability, announced the 1up Gateway, a new model to support compliance with the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) among health plans with existing FHIR infrastructure. With this new release, 1upHealth is ensuring the broader payer ecosystem is prepared for interoperability regulations ahead of the final January 1, 2027 deadline. Trice Workspace Reporting Launches to Evolve Obstetric & Maternal Fetal Medicine Workflows Despite declining birth rates worldwide, the complexity of pregnancy is increasing. Advanced maternal age, IVF assisted pregnancies, rising obesity rates and higher prevalence of hypertension and diabetes, means that more cases require specialist monitoring, advanced imaging, and multidisciplinary care. At the same time, clinical teams are stretched and facing increasing administrative demands. Designed to address the challenges, Trice Imaging, has launched 'Trice Workspace Reporting', an innovative reporting tool built specifically for Obstetrics and Maternal Fetal Medicine. MDaudit Advances Its Meaningful AI Strategy with the Addition of Auditor Assist to Its Continuous Risk Monitoring Solutions Suite Payers are denying claims at AI-driven speed, often autoflagging and subsequently denying valid claims for provided care that hospitals and health systems must fight to recover. Benchmark data from MDaudit tells the story: payer audit volume and dollars at risk climbed 30% year over year, with coding-related denials up as much as 26%. Regulatory scrutiny of AI-assisted coding and documentation is also intensifying, contributing to rapidly growing audit backlogs. To help healthcare organizations fight these headwinds, MDaudit, an award-winning continuous risk-monitoring platform, offers a suite of revenue integrity solutions grounded in its standard of Meaningful AI, in which technology is judged by its return on investment (ROI), the friction it removes, and whether a human remains firmly in control of every decision. Collaboration news. Doctronic and Simple HealthKit Partner to Create First End-to-End AI-Native Health Screening and Care Platform Doctronic, an AI native health platform, and Simple HealthKit, an end-to-end at-home healthcare platform, powered by AI, announced a first-of-its-kind partnership to create a fully integrated care experience from engagement, screening to follow-up care, built to meet people where they are. IMAT Solutions and Firely Partner to Accelerate Digital HEDIS(R) and Quality Measurement Transformation for Health Plans IMAT Solutions, a provider of healthcare data management, aggregation, and interoperability solutions, and Firely, a global leader in FHIR-native healthcare technology and digital quality measurement, announced a strategic partnership to help health plans accelerate their transition to digital quality measures (dQMs) and modernize HEDIS(R) quality reporting. PatientGenie and RevSpring Partner to Connect AI Scheduling Agents to Live Provider Directories PatientGenie, the orchestration layer for health plans and health systems to automate patient outreach and close care gaps, announced a partnership with RevSpring, the leading provider of healthcare engagement and payment solutions. The integration connects PatientGenie's AI agents directly to RevSpring's National Provider Directory MCP, giving agents accurate, real-time provider details, including phone numbers, locations, sub-specialties, clinical expertise, and availability they need to recommend and reach the right provider and schedule appointments on members' behalf. Making the cut, milestones, accolades, awards and more. Intermountain Health Doctors Perform 100th Surgical Procedure to Improve Lives of Epilepsy Patients Using High-Tech Brain Implants to Reduce Seizures Intermountain Health neurologists are celebrating a major milestone: the 100th surgery of a groundbreaking implantable device that is proving to be a major success in reducing seizures in patients with patients with focal epilepsy. Bassett Healthcare Network Nationally Recognized for System-Wide Excellence in Age-Friendly Care Bassett Healthcare Network has been recognized nationally among only 14 leading health organizations as an Age-Friendly Health System committed to care excellence for older adults. Adventist HealthCare Shady Grove Medical Center Named Among Newsweek's Best U.S. Maternity Hospitals for 2026 Each year, thousands of families choose Adventist HealthCare Shady Grove Medical Center to welcome their babies. Now, the hospital's Birth Center has earned national distinction for its care. Newsweek has named Shady Grove Medical Center to its list of America's Best Maternity Hospitals for 2026. Black Book Research Recognizes Inovalon for End-to-End Revenue Cycle Platform and Eligibility Intelligence Inovalon, a provider of data and solutions empowering data-driven healthcare, has been named a top-rated revenue cycle management (RCM) vendor by Black Book Research, earning recognition in two categories: (i) Full Provider Cloud RCM Suite: Intake-to-Final-Payment Platform Breadth and (ii) Eligibility, Benefits Verification, and Real-Time Payer Rule Interpretation. The rankings are based on verified evaluations from more than 1,300 hospital and health system finance and revenue cycle leaders. Product certification news. FDA Clears CliniComp PACS Viewer (MIMPS), Unifying Diagnostic Imaging, Enterprise EHR, and Native AI in a Single Platform CliniComp, a pioneer in high-performing, reliable, electronic health record (EHR) solutions, announced FDA 510(k) clearance of its PACS (Picture Archiving and Communication System) Viewer as a Medical Image Management and Processing System (MIMPS). The clearance enables diagnostic-quality image viewing and advanced image processing directly within CliniComp's New Era EHR with Native AI Solution Suite, expanding the unified enterprise platform by bringing diagnostic imaging, clinical workflows, and AI-driven decision support together in a single patient record.

Belleville News-Democrat
Jul 8th, 2026
1upHealth announces 1up Gateway to simplify CMS-0057-F compliance for health plans.

1upHealth announces 1up Gateway to simplify CMS-0057-F compliance for health plans. July 8, 2026 8:05 AM Gift Article New model enables organizations with existing data infrastructure to better meet interoperability requirements BOSTON, MA / ACCESS Newswire / July 8, 2026 / 1upHealth, a leader in health data interoperability, today announced the 1up Gateway, a new model to support compliance with the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) among health plans with existing FHIR infrastructure. With this new release, 1upHealth is ensuring the broader payer ecosystem is prepared for interoperability regulations ahead of the final January 1, 2027 deadline. As plans adapt to CMS-0057-F mandates spanning Patient Access, Provider Access, Payer-to-Payer Data Exchange, and Electronic Prior Authorization APIs, they must shift from just exposing their data to maintaining fully compliant, market-facing APIs. These organizations must also: manage external entity onboarding and vetting; maintain connectivity across a shifting ecosystem of payers, providers, vendors, and third-party applications; and fulfill ongoing reporting and auditing obligations. For plans that have already built sophisticated data infrastructure, meeting these requirements isn't the question. The real decision is whether to build and maintain that entire operational layer themselves. TOP VIDEOS The 1up Gateway addresses these emergent challenges by offering a single, managed API and compliance layer that sits in front of a plan's existing FHIR-capable endpoints. This allows organizations to build on the work they have already done, rather than migrating data or replacing existing systems, while tapping into 1upHealth's rich interoperability and compliance management expertise. "Many plans have spent years making meaningful investments and developing sophisticated data infrastructure and interoperability capabilities," said Mohammad Jouni, Chief Product & Technology Officer of 1upHealth. "What these organizations are looking for now is not a replacement but an add-on way to operationalize the requirements in CMS-0057-F without introducing administrative burdens or other disruptions. 1up Gateway allows our customers to keep their existing infrastructure while we handle everything at the front door." The 1up Gateway is purpose-built for organizations that have already solved the underlying data challenge and are looking for a more efficient way to manage compliance requirements while staying current with shifting regulations. The technology powers external connectivity, regulatory workflows, compliance oversight, and ecosystem management while allowing plans to maintain control of their existing data environments. The 1up Gateway complements the 1up Platform, 1upHealth's full data management solution for health plans that want to hand off the complete complexity of health data ingestion, standardization, and interoperability compliance. Together, the two deployment models ensure that health plans at every stage of their data infrastructure journey have a path to CMS-0057-F compliance and long-term interoperability value. The company also recently deployed its 1up Patient Access, Payer-to-Payer Data Exchange, Provider Access, and Electronic Prior Authorization APIs, becoming the first solution provider to deploy all four APIs required by CMS-0057-F to its customers. About 1upHealth Driven by a purpose of better healthcare for all through better data, 1upHealth is the national leader in health data interoperability and one of the fastest-growing health IT companies in the United States. Its modern data platform is built on a standards-based cloud architecture specifically designed for the healthcare industry, making it easy to acquire, manage, and use data. Payers large and small - commercial or government-sponsored - rely on 1upHealth to seamlessly exchange clinical and claims data across the healthcare ecosystem to reduce risk, lower costs, and improve patient outcomes. Visit its website. Media Contact

Associated Press
May 12th, 2026
1upHealth becomes first to deploy all CMS-0057 APIs, enabling health plans to meet federal interoperability requirements 8 months early

1upHealth has become the first interoperability solution provider to deploy all four APIs required by the CMS Interoperability and Prior Authorization Final Rule, enabling its health plan customers to meet federal requirements eight months ahead of the January 2027 deadline. The Boston-based company has launched Patient Access API reporting in its 1up Console, alongside its Payer-to-Payer Data Exchange, Provider Access and Electronic Prior Authorization APIs. Health plans using the platform can now establish data exchange connections with providers and other plans nationwide. Payers and providers can register through 1upHealth's centralised developer portal to exchange data. The company describes itself as a national leader in health data interoperability, helping healthcare organisations acquire, manage and use data to reduce risk, lower costs and improve patient outcomes.

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