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Maintaining Clearinghouse Function with Redundancy

Maintaining Clearinghouse Function with Redundancy

Since the third week of 2024, the Change Healthcare clearinghouse has had a sustained outage.  This outage is worrisome, impacting thousands of physicians and payers, and provides important lessons on how to avoid similar situations in the future. 

Clearinghouses are platforms that support data transfer between providers and payers.  Healthcare providers get paid through clearinghouses.  For example, Change Healthcare clearinghouse processes medical claims for about 900,000 physicians in the United States, ensuring that the flow of payments is running smoothly.  

However, when an outage occurs do to a cyber attack this flow is interrupted.  The inability to submit medical claims causes millions of dollars in transactions to age because they cannot be paid and fulfilled.  This leads to a financial gap and additional financial challenges until stability is reached once more. 

Clearly, avoiding outages is important.  One way to do this is through payer gateway connection redundancy.  This redundancy establishes connections between multiple clearinghouses, decentralizing systems and allowing for backup plans.  If one clearinghouse faces an outage, others can step up and maintain the flow of payments. 

Clearinghouses are a key aspect of the healthcare system, supervising transactions and payments.  When they face outages, significant consequences can follow, making redundancy and decentralizing important areas to improve.  With a redundant system, outages will not have the same crippling effect, and medical claims can continue to be submitted, paid, and fulfilled.

Lessons Learned from the Change Healthcare Cyberattack
Source: Orbit Healthcare