Onyx Health

What Onyx Health does

Onyx Health (legal entity: Onyx Technology LLC) is a US-based healthcare technology company that builds OnyxOS, a modular FHIR-native operating system for healthcare payers. The platform ingests clinical, claims, pharmacy, and HIE data through Onyx DataBridge, structures it into a longitudinal patient record within the Onyx Integrated Data Repository (IDR), and powers payer-facing intelligence applications covering CMS compliance (CMS-0057, CMS-0053, CMS-0062-P), digital HEDIS and Stars quality measurement, HCC risk adjustment and RAF scoring, care gap closure, and payment integrity. The architecture is built natively on FHIR R4 with HL7v2, X12, C-CDA, and USCDI support and is jointly developed with Microsoft on Azure, with AWS available as an alternative deployment target and Snowflake-native variants certified.

The company was founded in 2019 by the team that built CMS Blue Button 2.0 and authored the HL7 Da Vinci PDex standard. OnyxOS is deployed across 50+ payer organizations covering 55M+ lives, including 25+ state Medicaid programs, and is sold on a multi-year enterprise subscription basis with implementation bundled through Expert Services. Customers are predominantly US health plans (commercial, Medicare Advantage, and Medicaid), with adjacent deployments into provider organizations and EMR vendors. The go-to-market is direct enterprise field sales augmented by a large partner ecosystem including Microsoft, Availity, Optum, Mastek, EY, Wipro, Citius Tech, Huron, Emids, Veritas Data Research, Abacus Insights, Midato Health, and Itiliti Health. Distribution leverages Azure Marketplace and the partner network for deployment, while thought leadership flows through an active blog, FHIR Academy, industry events, and analyst recognition including Best in KLAS 2025 and #1 Black Book Customer Satisfaction.

Onyx's differentiation rests on standards authorship (20+ FHIR and C-CDA standards authored by leadership), regulatory positioning around CMS interoperability mandates, layered architecture that eliminates duplicate integration work across applications, and named industry credentials including Best in KLAS 2025 and Black Book #1. The company's January 2026 acquisition of InteropX expanded its prior authorization and clinical data exchange capabilities. India delivery centers in Bangalore and Mysore provide cost-optimized engineering scale to support multi-payer enterprise rollouts.

Name

Onyx Health

Legal name

Onyx Technology LLC

Website

https://onyxhealth.io

Company type

Private

Founded year

2019

Operating status

Operating

Headcount range

11–50 employees

Short description

Onyx Health (Onyx Technology LLC) builds OnyxOS, a modular FHIR-native operating system for US healthcare payers that ingests clinical and claims data and powers CMS compliance, HEDIS/Stars, HCC risk adjustment, care gap closure, and payment intelligence across 50+ payers covering 55M+ lives.

Ownership category

akta.pro rank

Product category

Healthcare Payer Interoperability Software

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Custom Computer Programming Services (541511)

SIC

Services-Prepackaged Software (7372), Services-Computer Programming Services (7371)

akta.pro primary industry

Data Access, Sharing & Marketplace Platforms (incl. TEFCA/QHIN enablement) (HLACAIAL)

akta.pro secondary industries

Data Sharing, Data Exchange & Data Marketplace Platforms (HDAEABAH), Security Audits & Compliance (ISO 27001, SOC 2, PCI DSS, HIPAA, SOX) (BPAKADAC)

Keywords

• Healthcare interoperability
• FHIR data platform
• Payer intelligence software
• CMS compliance solutions
• Risk adjustment analytics

Headquarters

HQ city

Elkridge

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations

Revenue model

1. OnyxOS Platform Subscription: OnyxOS is offered as a subscription-based platform with implementation and expert services. The platform is deployed across 50+ health plans covering 55M+ lives. Customer engagements include regulatory compliance, data infrastructure, and clinical intelligence implementations backed by expert services.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

Onyx Health provides OnyxOS, a modular FHIR-native operating system for healthcare payers. The platform acquires clinical, claims, and HIE data through Onyx DataBridge, structures it via the Onyx Integrated Data Repository, and powers payer intelligence applications for CMS compliance (CMS-0057, CMS-0053, CMS-0062-P), risk adjustment (HCC/RAF), digital quality (HEDIS/Stars), care gap closure, and payment integrity. The platform is jointly built with Microsoft on Azure and supported by Expert Services and FHIR Academy training.

Product overview

Onyx Health offers OnyxOS, a modular FHIR-native operating system for healthcare payers that turns connected health data into operational intelligence. The platform is built as three layered tiers: Layer 01 (GET DATA) is Onyx DataBridge for data acquisition; Layer 02 (MAKE DATA USABLE) includes Onyx Integrated Data Repository for clinical data structuring; Layer 03 (USE DATA) comprises payer intelligence applications including Onyx Compliance (CMS-0057), Onyx DQ (HEDIS/Stars), Onyx RA (HCC/Risk Adjustment), Onyx CareGaps (chart abstraction), and Onyx PI (payment integrity). All layers are powered by Onyx Intelligence for AI-driven clinical document processing, semantic search, and HCC suspect detection. Expert Services provides implementation support, and FHIR Academy offers training. The platform is jointly built with Microsoft Azure, serves 50+ payer organizations covering 55M+ lives, and is deployed across 25+ state Medicaid programs.

Differentiator

Problem solved

Functional benefit

Brands

• OnyxOS: A modular operating system built for healthcare with FHIR-native foundation that turns connected data into operational intelligence. Includes payer intelligence applications (CMS Compliance, Digital HEDIS, Risk Adjustment, Care Gap Closure, Payment Integrity), payer data infrastructure, and model-driven data fabric.
• Onyx DataBridge
• Onyx Compliance
• Onyx Integrated Data Repository (IDR)
• Onyx Intelligence
• Onyx Expert Services

Products and services

• OnyxOS Modular FHIR-native operating system for healthcare payers that turns connected health data into operational intelligence across CMS compliance, risk adjustment, digital quality (HEDIS/Stars), care gap closure, and payment integrity.
• Onyx DataBridge Model-driven data fabric that ingests clinical, claims, and HIE data from any source and normalizes it into a FHIR-native model, building a unified longitudinal health record.
• Onyx Integrated Data Repository (IDR) Clinical interoperability and longitudinal patient record that ingests clinical data from EHRs, HIEs, and FHIR sources, normalizing it for analytics and downstream payer applications.
• Onyx Intelligence AI layer of OnyxOS that surfaces care gaps, missed codes, and audit-ready evidence using clinical NLP, semantic search, HCC suspect detection, and HEDIS gap analysis with pre-attached clinical evidence.
• Onyx Compliance FHIR-native compliance infrastructure for CMS-0057, CMS-0053, CMS-0062-P, Provider Directory, and Plan Finder modernization, covering Patient Access, Provider Access, Payer-to-Payer Exchange, and electronic Prior Authorization APIs.
• Onyx DQ (Digital Quality) Automated HEDIS measurement and digital quality reporting module that replaces manual chart reviews with AI-enabled, standards-based eCQM computation for Stars and HEDIS performance.
• Onyx RA (Risk Adjustment) AI-powered risk adjustment module for HCC opportunity identification, RAF score optimization, and risk gap surfacing across the full member population using configurable confidence thresholds.
• Onyx CareGaps Automated chart abstraction and care gap closure workflow module that coordinates outreach across care teams with longitudinal member data and provider outreach prioritization.
• Onyx PI (Payment Integrity) AI-driven payment integrity module applying clinical and claims intelligence across pre-pay validation, post-pay recovery, and fraud/waste/abuse detection with provider billing anomaly scoring.
• Expert Services Professional services delivered by FHIR, CMS mandates, and payer operations specialists providing consulting, design, implementation, testing, and support for OnyxOS deployments.
• FHIR Academy Training program developed with Learners Digital that has prepared over 500 engineers, integrators, and architects for FHIR-native healthcare implementation across payer interoperability, healthcare APIs, and clinical data exchange.

Quantifiable outcome

• 2x improvement in HEDIS gap closure rate compared to manual chart chase workflows
• +6 more outcomes

Named customers9 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

AI capability10 records

Feature10 records

Partnerships

22 partnerships are on record, tiered core, flagship and minor.

• Midato HealthcoreTechnology or Integration · 12 August 2025Integration of Midato's ShareApprove Consent Preference Management Platform with OnyxOS - enabling payers, Medicaid agencies, and MCOs to activate FHIR APIs with embedded, patient-directed consent flows supporting CMS-Aligned Network goals.
• AvailityflagshipStrategic or Co-development Partner · 6 August 2025Onyx and Availity have partnered to deliver a comprehensive CMS-0057 compliance platform combining OnyxOS's FHIR platform with Availity's connections to over 95% of payers, 3M+ providers, and 2,000+ trading partners. The joint platform covers patient access, provider access, payer-to-payer exchange, and prior authorization APIs.
• Itiliti HealthminorStrategic or Co-development Partner · 23 July 2025Launch of OnyxOS Connector enabling health plans to comply with CMS Prior Authorization API compliance requirements through integrated electronic prior authorization solution.
• EmidscoreImplementation/ SI/ Consulting Partner · 27 January 2025Partnership to help healthcare organizations comply with complex CMS Interoperability Rules for Patient and Provider Access and Prior Authorization through combined OnyxOS platform and Emids implementation expertise.
• MicrosoftflagshipTechnology or IntegrationOnyxOS is jointly built with Microsoft on Azure - the same cloud infrastructure behind CMS Blue Button 2.0. Every OnyxOS deployment benefits from Microsoft's enterprise-grade security, HIPAA-compliant infrastructure, and Azure Health Data Services. Available natively in the Azure Marketplace.
• Veritas Data ResearchcoreTechnology or IntegrationPartnership to deliver real-time mortality data directly into OnyxOS via FHIR - the first integration of its kind. Veritas's Fact of Death index, sourced from 45,000+ public and private records, flows into OnyxOS as a standardized, automated feed.
• Abacus InsightscoreTechnology or IntegrationAbacus Insights, the leader in data usability for payers, built their interoperability solution on OnyxOS - combining Abacus's longitudinal patient record and data enrichment capabilities with OnyxOS's FHIR APIs.
• MastekcoreImplementation/ SI/ Consulting PartnerPartnership for accelerated CMS-0057 compliance combining Mastek's healthcare consulting and implementation expertise with OnyxOS platform for faster FHIR adoption, mandate readiness, and improved Stars and HEDIS performance.
• EYcoreChannel Partner/ Reseller/ DistributorGlobal consulting and healthcare transformation services bringing OnyxOS to market through EY's advisory practices.
• WiprocoreChannel Partner/ Reseller/ DistributorTechnology services and payer digital transformation bringing OnyxOS to market through Wipro's healthcare IT practice.
• Citius TechcoreChannel Partner/ Reseller/ DistributorHealthcare IT services and digital health solutions bringing OnyxOS to market through Citius Tech's payer solutions practice.
• HuroncoreChannel Partner/ Reseller/ DistributorHealthcare consulting and performance improvement bringing OnyxOS to market through Huron's healthcare transformation practice.
• Tech MahindraminorChannel Partner/ Reseller/ DistributorIT services and healthcare payer solutions bringing OnyxOS to market through Tech Mahindra's healthcare practice.
• Gainwell TechnologiescoreChannel Partner/ Reseller/ DistributorMedicaid and government health program technology bringing OnyxOS to Medicaid and government health plan customers through Gainwell's implementation expertise.
• OptumcoreImplementation/ SI/ Consulting PartnerHealthcare services and technology at national scale providing implementation and integration services for OnyxOS deployments.
• ApexonminorImplementation/ SI/ Consulting PartnerDigital engineering and healthcare IT services providing implementation support for OnyxOS in enterprise payer environments.
• Kyruus + HealthSparqminorImplementation/ SI/ Consulting PartnerProvider data management and directory solutions providing integration support for OnyxOS provider access and directory implementations.
• LTIMindtreeminorImplementation/ SI/ Consulting PartnerIT services and healthcare digital transformation providing implementation and integration support for OnyxOS in payer environments.
• USTminorImplementation/ SI/ Consulting PartnerDigital transformation and healthcare technology services providing implementation support for OnyxOS deployments.
• Wisconsin Health Information OrganizationminorImplementation/ SI/ Consulting PartnerRegional health information exchange and data services providing implementation support for OnyxOS in Wisconsin and regional payer environments.
• ImpelsysminorImplementation/ SI/ Consulting PartnerHealthcare content and technology services providing implementation support for OnyxOS deployments.
• Learners DigitalcoreStrategic or Co-development PartnerAcademic partner for FHIR Academy - developing curriculum combining structured FHIR education with applied implementation training grounded in the standards and environments where professionals work.

Scale indicators14 records

Recent moves6 records

Expansion highlights6 records

Emerging players

• Diameter Health: Diameter Health provides clinical data optimization and FHIR-native interoperability for payers, providers, and HIEs, focused on cleaning and normalizing clinical records. Comparable to Onyx DataBridge's clinical data acquisition and normalization layer.
• Particle Health: Particle Health is a healthcare data exchange API platform that retrieves and normalizes clinical records from a national network of EHRs via FHIR. Comparable to Onyx DataBridge in clinical data acquisition and FHIR-native data fabric, though primarily provider-facing.

Direct peers

• Redox: Redox is a healthcare API integration platform that connects EHRs, payers, and digital health apps using FHIR/HL7 standards. Comparable to Onyx in FHIR-native interoperability and healthcare data exchange, though Redox is more developer-focused and less specialized in payer intelligence applications.
• Smile Digital Health: Smile Digital Health offers a FHIR-native health data platform ( Smile CDR) for building clinical repositories, integration engines, and interoperability solutions. Closely aligned with OnyxOS's FHIR-native data fabric and IDR for payer/provider interoperability.
• Datavant: Datavant is a health data connectivity and exchange platform that links clinical, claims, and other healthcare data across organizations. It is directly comparable to Onyx's payer-focused FHIR data fabric and longitudinal record capabilities, though Datavant has historically been broader across providers, payers, and life sciences.
• Innovaccer: Innovaccer is a healthcare data platform that unifies patient records across EHRs, claims, and labs and offers payer/provider applications for value-based care, risk, and quality. Directly comparable to OnyxOS's layered OS approach for payer intelligence and CMS compliance.
• Availity: Availity operates one of the largest payer-provider data networks in the US, connecting 95%+ of payers, 3M+ providers, and 2,000+ trading partners. A direct partner of Onyx, Availity is also a competitive adjacency given its own CMS-0057 platform for patient access, provider access, and prior authorization.
• Health Catalyst: Health Catalyst is a healthcare data and analytics platform serving providers and payers with data warehousing, quality, and population health applications. Comparable to Onyx in payer intelligence (HEDIS, risk adjustment) layered on a unified data foundation.
• Arcadia: Arcadia is a healthcare data platform for value-based care, risk adjustment, and HEDIS quality measurement, built on aggregated clinical and claims data. Overlaps with Onyx in risk adjustment, HEDIS gap closure, and population health analytics for payers and providers.
• Edifecs: Edifecs provides healthcare data interoperability, compliance, and value-based care solutions, with deep experience in CMS mandates, FHIR/HL7, and payer-provider data exchange. Overlaps directly with OnyxOS's compliance and interoperability capabilities.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UCOTcNXnOD0MfjvqqSll9XiA/featured

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles9 records

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Onyx Health