Onyx

Onyx Health provides OnyxOS, a FHIR-based interoperability platform designed to help healthcare payers and providers comply with CMS and ONC data sharing mandates. The company is built from NewWave, the team that developed the CMS Blue Button 2.0 API, which serves up to 60 million Americans and represents the largest FHIR implementation globally. This direct experience with federal healthcare standards positions Onyx as a reference implementation provider for regulatory compliance.

The OnyxOS platform is built natively on Microsoft Azure and addresses key regulatory requirements including the CMS Interoperability and Patient Access Final Rule, ONC Information Blocking rules, and the CMS 0057 Final Rule on prior authorization. The platform includes pre-built APIs for patient access, payer-to-payer data exchange, provider directory services, and prior authorization workflows. Onyx received Best in KLAS recognition for CMS Payer Interoperability in 2025.

The company's client base includes three large Blue Cross Blue Shield plans and multiple regional health plans and health information exchanges. With advisors including former CMS CIO Tony Trenkle and former U.S. CTO Aneesh Chopra, Onyx maintains close connections to federal healthcare policy development. The company holds memberships in CARIN Alliance, Da Vinci Project, Gravity Project, and HL7.

Choose Onyx if your organization is a healthcare payer or health information exchange facing imminent CMS interoperability deadlines and needs proven regulatory compliance. The company's role in building the Blue Button 2.0 reference implementation means OnyxOS is architected to meet federal standards by design rather than through retrofitting.

Expect a platform-as-a-service engagement with Microsoft Azure infrastructure, pre-registered application marketplace for member choice, and ongoing product updates as regulations evolve. Organizations selecting Onyx typically prioritize regulatory certainty and enterprise scalability over custom development flexibility.

Onyx operates exclusively in healthcare with 15+ years of experience building interoperability solutions for federal and commercial payers. The company specializes in health plan data exchange, addressing specific regulatory requirements from CMS and ONC including patient access APIs, payer-to-payer data exchange, provider directories, and prior authorization workflows. Their work on Blue Button 2.0 demonstrates deep expertise in Medicare and Medicaid data standards, claims data transformation, and FHIR implementation guidance profiles including CARIN Blue Button and Da Vinci specifications.

Ideal clients are healthcare payers with 500,000+ members, state Medicaid agencies, large regional health plans, and health information exchanges serving multiple payer organizations. These organizations face mandatory CMS compliance deadlines, have complex legacy data systems requiring FHIR translation, operate under strict HIPAA and security requirements, and need proven scalability for large member populations.