1up.Health

Healthcare leaders offer their projections on the opportunities and challenges in the year ahead.

Explore how CMS is advancing AI in quality improvement and measurement, and what these changes mean for payers and the future of healthcare.

Every health plan navigating CMS-0057 must choose its own path to compliance: build it entirely in-house, buy a turnkey vendor solution, or land on a hybrid of the two. Plans already made that choice once for CMS-9115. Some of them chose to build their ow

Second in a quarterly blog series on partnership, ecosystems, and the future of healthcare interoperability A few months ago, I wrote a blog focused on why 1upHealth doesn't want to grow alone. The big takeaway was that the biggest problems in healthcare,

If you've spent any time in utilization management (UM), you know the drill: a request comes in, someone has to figure out which system it belongs to, route it there manually, wait, follow up, and hope nothing falls through the cracks. Multiply that acros

The CMS-0057 Payer-to-Payer Data Exchange API deadline is January 1, 2027. Technically speaking, most health plans affected by the rule are on track to comply with it. But here's what nobody is saying loudly enough: having a compliant Payer-to-Payer Data

Every 1upHealth customer hit the CMS-0057 March 31, 2026 deadline. They stood up Patient Access API reporting, submitted utilization data, and moved on. That CMS deadline measured one thing: could you build the infrastructure. It was a fair question, and

I recently joined 1upHealth's Chief Product and Technology Officer Mohammad Jouni for a webinar on what digital quality measurement actually means for health plans - and why most organizations are thinking about it the wrong way. Quality measurement is go

Readying your health plan for CMS-0057 compliance is a real technical and operational lift. Whether your team built the required FHIR infrastructure in-house or partnered with a vendor to get there, achieving compliance has been framed as the goal. The th

First in a quarterly blog series on partnership, ecosystems, and the future of healthcare interoperability There's a version of the health tech story that goes like this: build a great product, win customers, scale, and repeat. It's clean. It's simple. An