Company profile

1upHealth

Generative AI & Healthcare Infrastructure

Company profile

About 1upHealth

AI-powered health data platform that integrates and normalizes patient data from multiple sources to enable interoperability and clinical decision support across healthcare systems.

Company description 1upHealth official website

Primary marketGenerative AI & Healthcare Infrastructure
Commercial modelCommercial information available on request
Company presenceOfficial website
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01 · Operating footprint

Where the Company operates

Company-profile context for clinical focus, customers, deployment, integration, milestones, and partnerships.

Clinical focus

No clinical focus areas are currently listed.

Who it serves

  • Commercial Health Plans
  • Fee-for-Service Plans
  • Managed Medicaid Plans
  • Medicaid Plans
  • Medicare Advantage Plans
  • State Agencies

Deployment & integration

Api Only · Cloud Saas deployment with recorded integration context.

Recorded integration context: Care Management systems, EHR systems, Medicare Plan Finder, Provider portals, Utilization Management systems.

Geographic context

MarketsUnited States
Company sourceOfficial website

Company milestones

Platform expansion

1upHealth Leads Industry in CMS-0057 Readiness with All Health Plan Customers Reporting Ahead of Deadline (2025)

Partnerships

Recorded partners

  • Aetna/CVS Health
  • Fallon Health

02 · Flagship portfolio

Products, workflows, and platform capabilities

Selected source-backed Company products and the available commercial context.

1up Console

Command center for payer teams to manage data flows and ecosystem connections

Software · Cloud SaaSCompany source

1up DevPortal

Developer portal for external payers, providers, and apps to access payer data

Platform · Cloud SaaSCompany source

1up Electronic Prior Authorization

FHIR-powered automation for faster prior authorization decisions

Software · Cloud SaaSCompany source

1up Formulary

Deliver transparent drug coverage details to members and providers

Api · Api OnlyCompany source

1up Patient Access

Give members easy, secure access to their health information

Api · Api OnlyCompany source

1up Payer-to-Payer Data Exchange

Unlock historical member data to improve onboarding and close care gaps

Software · Cloud SaaSCompany source

1up Platform

FHIR-first data platform for payer interoperability at scale

Platform · Cloud SaaSCompany source

1up Provider Access

Enable providers with timely patient data for better care decisions

Api · Api OnlyCompany source

1up Provider Directory

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

Api · Api OnlyCompany source

03 · Research intelligence

Research Intelligence evidence

Publications, preprints, clinical validation, and regulatory records in Evidence Position order.

04 · Company-reported outcomes

Outcomes and case studies

Company-reported outcomes and customer stories are distinct from linked Research Intelligence evidence.

100+ million member records managed

Platform scale

50+ million MCO members supported

Managed care organization coverage

1+ billion EOB records processed

Explanation of benefits processing volume

Unnamed Health Plan

Platform implementation and vendor replacement

Smooth implementation with high uptime and system availability; replaced previous vendor due to superior performance

Aetna/CVS Health

FHIR data and interoperability strategy implementation

Key to delivering on member-first promise

All 1upHealth Health Plan Customers

CMS-0057 compliance and reporting

100% of customers reported ahead of CMS-0057 deadline, leading industry in readiness

Fallon Health

Navigating interoperability regulations including prior authorization and patient data access

Successfully addressed CMS requirements with FHIR API expertise

05 · Leadership

Leadership team

Leadership profiles and professional links from the current Company record.

Ron Wampler

Executive Director of Interoperability, Aetna/CVS Health

John Budaj

Vice President of Information Technology, Fallon Health

06 · Company updates

Updates from 1upHealth

Recent articles published on 1upHealth's official website.

No Company updates are currently listed.

07 · HAIC coverage

Coverage and analysis

Health AI Central reporting that mentions this Company.

No HAIC coverage is currently linked to this Company.

08 · Official presence

Company sources and channels

Curated official destinations from the active Company record.

09 · Market pathway

Additional Companies in this Market

Other active Companies in the same market, selected alphabetically from the HAIC directory.

Market context

Generative AI & Healthcare Infrastructure

Companies providing generative AI platforms, large language models (LLMs), foundation models, or broad AI infrastructure specifically designed for healthcare applications. These companies serve multiple clinical use cases across the health system rather than focusing on a single clinical application or disease area.

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10 · Pro research

Coming soon

Expanded Company research is in development.

Health AI Central Pro · Coming Soon

Deeper Company research is coming soon.

Pro Research will introduce expanded technical context, linked evidence analysis, and comparative Company research.

ResearchEvidence analysis

Linked research, clinical, and regulatory source pathways.

CompanyTechnical context

Expanded product, deployment, integration, and partnership research.

MethodSource & review record

Record-level provenance and review context.

Coming Soon