# 1upHealth vs ROOK

> ROOK scores 54.9 (C) to 1upHealth's 46.8 (D) for fhir servers. Prices, MCP, x402, uptime and agent notes side by side.

- Canonical: https://www.anchorterminal.com/compare/1uphealth-vs-rook
- Markdown: https://www.anchorterminal.com/compare/1uphealth-vs-rook.md (~2,200 tokens)
- Slim: https://www.anchorterminal.com/compare/1uphealth-vs-rook.min.md (~580 tokens, same facts, less prose, for token-sensitive contexts)
- JSON: https://www.anchorterminal.com/compare/1uphealth-vs-rook.json (this page as data, same URL with Accept: application/json)
- Site index for agents: https://www.anchorterminal.com/llms.txt (full text: https://www.anchorterminal.com/llms-full.txt)
- API: https://www.anchorterminal.com/api/v1/index.json
- Updated: 2026-10-14

ROOK scores 54.9 (C) on agent readiness against 1upHealth's 46.8 (D), and leads in 5 of 7 scored categories. 1upHealth leads on security & auth and transparency & trust. Both do fhir servers.

- 1upHealth: grade D, 46.8/100, rank #903 of 1076. Markdown https://www.anchorterminal.com/tools/1uphealth.md · JSON https://www.anchorterminal.com/api/v1/tools/1uphealth.json
- ROOK: grade C, 54.9/100, rank #718 of 1076. Markdown https://www.anchorterminal.com/tools/rook.md · JSON https://www.anchorterminal.com/api/v1/tools/rook.json
- Best health record and wellness data APIs for AI agents: https://www.anchorterminal.com/best/health-data/index.md
- All 63 health comparisons: https://www.anchorterminal.com/compare/health-data/index.md

## Which one, for what

### 1upHealth (D)

Good for: Consumer and care apps that read a member's health plan claims and clinical data under the CMS rules, and payers meeting those rules.

Ahead on:
- Security & auth, 63 against 32
- Transparency & trust, 72 against 55

Watch for: No rate limits, 429 handling or error formats documented

### ROOK (C)

Good for: A wellness, insurance, corporate wellness or remote monitoring product that wants normalised wearable data pushed to its backend, with plan prices it can see up front.

Ahead on:
- Reliability, 75 against 52
- Schema & documentation, 74 against 50
- Agent ergonomics, 49 against 32
- Payments & pricing, 25 against 20
- Maintenance & community, 73 against 37

Watch for: Credentials are one client UUID and secret per environment, sent by Basic auth, with no scopes or rotation documented


## Score by category

| Category | Weight | 1upHealth | ROOK | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 52 | 75 | ROOK +23 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 50 | 74 | ROOK +24 |
| Agent ergonomics | 13% (16.2 this run) | 32 | 49 | ROOK +17 |
| Security & auth | 14% (17.5 this run) | 63 | 32 | 1upHealth +31 |
| Payments & pricing | 10% (12.5 this run) | 20 | 25 | ROOK +5 |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 37 | 73 | ROOK +36 |
| Transparency & trust | 7% (8.8 this run) | 72 | 55 | 1upHealth +17 |
| Negative events | ≤15 | 0 | 0 | |
| **Total** | | **46.8 · D** | **54.9 · C** | |

## Facts side by side

| Fact | 1upHealth | ROOK |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | 1upHealth, Inc. | Rookeries Development Corp. |
| Hosted endpoint | no (local only) | no (local only) |
| Transports | HTTP | HTTP |
| Auth | OAuth | API key |
| Pricing | Paid | Paid |
| x402 | no | no |
| Licence | Proprietary service under 1upHealth's Terms of Service (effective 1 August 2024) | Proprietary service under ROOK's Terms and Conditions for ROOK services |
| Read-only variant documented | no | no |
| llms.txt | yes | yes |
| Last release | none | 2026-10-07 |
| Terms last updated | no date given | 2026-08-01 |
| Privacy policy last updated | 2026-06-25 | 2026-05-28 |
| Customer content may train models | not found in the text | not found in the text |
| Terms restrict automated access | not found in the text | not found in the text |
| Terms restrict benchmarking | yes | yes |
| Terms or service can change without notice | not found in the text | not found in the text |
| Arbitration or class-action waiver | not found in the text | yes |

## Verdicts

**1upHealth.** Self-serve Dev Portal sandbox clients and a demo health plan let an app test the CMS Patient Access, Provider Access and Payer-to-Payer FHIR APIs, backed by HITRUST and SOC 2 Type 2. No rate limits, error formats or dated releases are documented, and the Patient Access OAuth step needs the member in a browser.

**ROOK.** Graded on the REST API. A public OpenAPI file, a free Sandbox from the self-serve portal, published plan prices and a dated changelog. Credentials are one client UUID and secret per environment with no scopes, 429 handling isn't documented, the API is meant for occasional queries rather than bulk reads, and no SOC 2 report or security contact was found.

## Before you call either

### 1upHealth

1. Hand the Patient Access sign-in to the member, who must authorise in the health plan's auth app
2. Exchange the authorisation code within five minutes, and refresh before the 15-minute token expires
3. Email payer-patient-access@1up.health with the client ID to get the app synced to the demo environment
4. Expect only claims and coverage resources from some payers, and read /r4/metadata first

### ROOK

1. Send HTTP Basic auth with client_uuid as the username and the secret key as the password, plus a User-Agent header, or the WAF returns 403
2. Use https://api.rook-connect.review for Sandbox and https://api.rook-connect.com for production. Each has its own credentials
3. Read health data from the data webhook. Use the API only for occasional queries, and stay under 60 requests a minute
4. Deduplicate summaries on document_version and datetime. ROOK resends a summary with a higher document_version when it changes
5. Call POST /api/v1/user_id/{user_id}/data_sources/revoke_auth to end a connection. Some providers take hours to stop sending data

## Questions

### Which is better for AI agents, 1upHealth or ROOK?

ROOK scores 54.9 (C) on agent readiness against 1upHealth's 46.8 (D), and leads in 5 of 7 scored categories. 1upHealth leads on security & auth and transparency & trust.

### Do 1upHealth and ROOK need an API key?

1upHealth uses an OAuth sign-in. ROOK needs an API key.

### Can an agent call 1upHealth and ROOK without installing anything?

No hosted endpoint is listed for 1upHealth. No hosted endpoint is listed for ROOK.


## For agents

- This comparison as JSON: https://www.anchorterminal.com/compare/1uphealth-vs-rook.json, and with the fewest tokens: https://www.anchorterminal.com/compare/1uphealth-vs-rook.min.md
- Over MCP at https://www.anchorterminal.com/mcp (no key): `compare_tools {"a": "1uphealth", "b": "rook"}`. From a terminal: `anchor compare 1uphealth rook`
- Each listing in full: https://www.anchorterminal.com/api/v1/tools/1uphealth.json and https://www.anchorterminal.com/api/v1/tools/rook.json

## Other comparisons with 1upHealth or ROOK

- [1upHealth vs Terra API](https://www.anchorterminal.com/compare/1uphealth-vs-terra.md)
- [Aidbox vs ROOK](https://www.anchorterminal.com/compare/aidbox-vs-rook.md)
- [Health Gorilla vs ROOK](https://www.anchorterminal.com/compare/health-gorilla-vs-rook.md)
- [Medplum vs ROOK](https://www.anchorterminal.com/compare/medplum-vs-rook.md)
- [Metriport Medical API vs ROOK](https://www.anchorterminal.com/compare/metriport-vs-rook.md)
- [Particle Health vs ROOK](https://www.anchorterminal.com/compare/particle-health-vs-rook.md)
- [Redox vs ROOK](https://www.anchorterminal.com/compare/redox-vs-rook.md)
- [1upHealth vs Aidbox](https://www.anchorterminal.com/compare/1uphealth-vs-aidbox.md)
- [1upHealth vs Health Gorilla](https://www.anchorterminal.com/compare/1uphealth-vs-health-gorilla.md)
- [1upHealth vs Medblocks](https://www.anchorterminal.com/compare/1uphealth-vs-medblocks.md)
- [1upHealth vs Medplum](https://www.anchorterminal.com/compare/1uphealth-vs-medplum.md)
- [1upHealth vs Metriport Medical API](https://www.anchorterminal.com/compare/1uphealth-vs-metriport.md)
- [1upHealth vs Particle Health](https://www.anchorterminal.com/compare/1uphealth-vs-particle-health.md)
- [1upHealth vs Redox](https://www.anchorterminal.com/compare/1uphealth-vs-redox.md)
- [1upHealth vs Zus Health](https://www.anchorterminal.com/compare/1uphealth-vs-zus-health.md)
- [1upHealth vs Validic Inform](https://www.anchorterminal.com/compare/1uphealth-vs-validic.md)
- [Medblocks vs ROOK](https://www.anchorterminal.com/compare/medblocks-vs-rook.md)
- [ROOK vs Zus Health](https://www.anchorterminal.com/compare/rook-vs-zus-health.md)
- [ROOK vs Terra API](https://www.anchorterminal.com/compare/rook-vs-terra.md)
- [ROOK vs Validic Inform](https://www.anchorterminal.com/compare/rook-vs-validic.md)