1Uphealth
Boston, US · Founded 2017 · Delaware corporation · 113 employees on LinkedIn · 8 known investors
1upHealth provides a FHIR-first health data platform that helps health plans and payers acquire, manage, and exchange healthcare data, including automating prior authorization, member data access, and provider directories. It supports interoperability and compliance with CMS regulations across Medicare, Medicaid, and commercial lines of business in the U.S.
Also known as 1up Health · 1upHealth
Founders & leadership
1Uphealth was founded in 2017 by Ritwik Sahu and Ricky Sahu.
Board
Investors · 8
Also in the syndicate · 2
Reported raises · per SEC filings
Form D private placements$79.6M disclosed across 4 of 7 rounds · 2018–2023
▶$45MraisedApr 2023 · 9 investors · Other TechnologyRule 506(b)
- Eden Avraham-KatzExecutive Officer
- Victor EchevarriaDirector
- Lee MooneyDirector
- David JegenDirector
- Joseph GagnonExecutive Officer, Director
- John LambrechtExecutive Officer
- T. Scott Law, Jr.Director
- Ritwik SahuDirector
- Offering amount
- $45M
- Amount sold
- $45M
- First sale
- Apr 2023
- Incorporated
- Corporation, Delaware
- Federal exemptions
- 06b
▶$25MraisedApr 2021 · 7 investors · Other TechnologyRule 506(b)
- Victor EchevarriaDirector
- David JeganDirector
- T. Scott Law, Jr.Director
- Joseph GagnonDirector
- Ritwik SahuExecutive Officer, Director
- Offering amount
- $25M
- Amount sold
- $25M
- First sale
- Apr 2021
- Incorporated
- Corporation, Delaware, 2017
- Federal exemptions
- 06b
▶$8MraisedFeb 2020 · 5 investors · Other TechnologyRule 506(b)
- Victor EchevarriaDirector
- Doug WilliamsDirector
- Ritwik SahuExecutive Officer, Director
- T. Scott Law, Jr.Director
- Offering amount
- $8M
- Amount sold
- $8M
- First sale
- Jan 2020
- Incorporated
- Corporation, Delaware, 2017
- Federal exemptions
- 06b
▶$1.6MraisedDec 2018 · 2 investors · Other TechnologyRule 506(b)
- T. Scott Law, Jr.Director
- Ritwik SahuExecutive Officer, Director
- Offering amount
- $2.4M
- Amount sold
- $1.6M
- First sale
- Dec 2018
- Incorporated
- Corporation, Delaware, 2017
- Federal exemptions
- 06b
Source: SEC EDGAR Form D. Amounts as filed; amended filings shown once at their latest values.
Company profile
researched Aug 20261upHealth provides a FHIR-first health data and interoperability platform aimed at health insurers. Built on a lakehouse architecture, the platform connects and standardizes clinical and financial data across payer ecosystems so plans can meet regulatory requirements and reuse the same data for operational purposes. Product modules can be used independently or end to end and include 1up Electronic Prior Authorization, 1up Payer-to-Payer Data Exchange, 1up Provider Access, 1up Patient Access, 1up Provider Directory and 1up Formulary, plus a 1up Gateway offering for CMS-0057-F compliance.
The company positions its work around US federal interoperability rules, specifically CMS-9115-F and CMS-0057-F, and around downstream data use cases such as closing care gaps, value-based care data sharing, HEDIS and Star Ratings performance, risk adjustment and digital quality measurement. It takes on API development, validation and system connectivity for payers and provides regulatory guidance and 24/7 support from a US-based team. Earlier in its history, the company built a FHIR API platform allowing patients to aggregate and share records from external health systems and wearable devices with providers, and developed the reference implementation for FHIR Bulk Data with Boston Children's Hospital, a specification it helped ballot through HL7.
Founding story
Ricky Sahu founded the company and served as CEO, describing its goal as helping people live longer, healthier lives through improved access to health data.
Business model
1upHealth sells platform and API-based interoperability software to health plans, offered as modular solutions that can operate standalone or as an integrated end-to-end suite, supported by services such as regulatory guidance, customer success and 24/7 support.
Sales of interoperability platform modules and APIs to health plans, positioned as turning compliance spending into ongoing data activation capabilities.
Traction
The company publishes scale metrics for member records managed, MCO members supported and explanation-of-benefit records processed, and references Aetna/CVS Health as a customer. At the time of its Series A announcement it reported tripling hospital system connectivity since 2019, connections to more than 10,000 US health facilities and reach to over 90% of the patient population, along with more than ten US government awards and grants.
Latest developments
Recent activity centers on CMS-0057-F compliance: the launch of 1up Gateway, utilization management vendors joining the 1up Network to scale electronic prior authorization ahead of the CMS-0057 final deadline, the addition of Inovalon, UST and AXIOM Systems to the partner program, and publication of a 2026-2027 Payer Interoperability Guide. The current executive team is led by CEO Andrew Boyd, with Mohammad Jouni as Chief Product and Technology Officer, Nolan Kelly as Chief Commercial Officer, Dr. Donald Rucker as Chief Strategy Officer and John Lambrecht as Chief Financial Officer.
▸Full profile — market position, technology, go-to-market, geography, history
Market position
1upHealth presents itself as a platform for payer interoperability and cites Aetna/CVS Health among the health plans using its FHIR data and interoperability capabilities. Its network model connects payers, providers and third-party applications in a one-to-many arrangement.
Stated differentiators include a FHIR-first, lakehouse-based architecture, modular products that fit existing payer workflows, managed compliance with evolving CMS rules, network effects from a one-to-many payer-provider-app network, and a fully US-based support and regulatory expertise team.
Technology
A FHIR-first data platform with a lakehouse architecture and a tech-agnostic, enterprise-security architecture, exposing FHIR APIs for patient access, provider access, payer-to-payer exchange, prior authorization, provider directory and formulary data. The company built the reference implementation for FHIR Bulk Data with Boston Children's Hospital and helped ballot the bulk data specification through HL7. Historically the platform aggregated records from EHRs across more than 10,000 US health facilities and from wearable devices.
Go-to-market
Direct enterprise sales to health plans supported by demo requests, a partner program (which includes Inovalon, UST and AXIOM Systems), and content marketing through webinars, blogs, ebooks such as the 2026-2027 Payer Interoperability Guide, and trade shows including the NCQA Annual Summit.
US health insurers and health plans of all sizes, including Medicare Advantage and Fee-for-Service Medicare plans, state Medicaid agencies and managed Medicaid plans, and local, regional and national commercial plans. Earlier positioning also addressed developers, providers, clinical trial companies and patients.
Geography
Operations and customers are in the United States, with support delivered by a 100% U.S.-based team; regulatory focus is on US federal CMS interoperability rules.
History
The company moved early on FHIR standards and built a FHIR API platform for aggregating and sharing patient records. It worked with Boston Children's Hospital on the FHIR Bulk Data reference implementation, supported by a $1M LEAP grant, and won MassChallenge HealthTech awards in 2019. It raised a $2.4M seed round, an $8M Series A led by Jackson Square Ventures announced in February 2020, a $25M Series B led by F-Prime and a $40M Series C led by Sixth Street Growth. Its focus has since concentrated on payer interoperability and CMS compliance products.
Compiled by commissioned research from 5 cited public sources — announcements, filings, and press listed under research sources below.
Key figures
latest reportedCompany-reported or press-reported figures, each dated to when it was claimed — not independently audited.
Competitors · 2
by search overlap
Companies competing with 1Uphealth for the same Google search keywords, organic and paid, via search-intersection analysis.
Timeline · 8
launches, deals, and filingsPress release announcing that Inovalon, UST and AXIOM Systems joined the 1upHealth Partner Program.
Company blog reports utilization management vendors joining the 1up Network to scale electronic prior authorization ahead of the CMS-0057 final deadline.
Press release introducing 1up Gateway, a product intended to simplify CMS-0057-F compliance for health plans.
1upHealth announced an $8 million Series A round led by Jackson Square Ventures, with existing seed investors Meridian Street Capital, Eniac Ventures and Social Leverage participating.
$8M source ↗
Referenced in company blog as a related funding announcement.
$25M source ↗
Referenced in company blog as a related funding announcement for the health data cloud company.
$40M source ↗
1upHealth received a $1 million LEAP grant, working with Boston Children's Hospital to build the reference implementation for FHIR Bulk Data, which was balloted through the HL7 community.
$1M source ↗
Won MassChallenge's 2019 HealthTech $100,000 Diamond award selected by judges and a $10,000 Startup award for 2019.
$100K source ↗
Dated company events from announcements, filings, and press; legal rows summarize public dockets and regulator releases.
Legal entities · 1
corporate structure▸Research sources · 5
primary sources listed
- 1Uphealth1up.health · web
5 public sources were cited for this profile; the first-party ones are listed here.
Frequently asked questions
- What does 1Uphealth do?
- 1upHealth operates a FHIR-first health data platform that helps health plans acquire, manage and exchange healthcare data.
- Who founded 1Uphealth?
- 1Uphealth was founded by Ritwik Sahu, Ricky Sahu in 2017.
- Who are 1Uphealth's investors?
- 1Uphealth's investors include Eniac Ventures, F-Prime Capital, Jackson Square Ventures, Meridian Street Capital, Sixth Street, Social Leverage.
- How much funding has 1Uphealth raised?
- 1Uphealth has disclosed $79.6M raised across 4 of its 7 known rounds.
- Where is 1Uphealth headquartered?
- 1Uphealth is headquartered in Boston, US.