Redundancy and Communication in Clearinghouses

Clearinghouses are a foundational aspect of the healthcare system.  They are platforms that allow data transfer between providers and payers, which is how healthcare providers get paid.  While clearinghouses have a vital role, they can also face challenges, such as the recent Change Healthcare clearinghouse outage. 

This outage began in February 2024 following a cyber attack and has had a big impact.  The Change Healthcare clearinghouse processes medical claims for about 900,000 physicians in the United States, so any problems with the clearinghouse has ripping effects for thousands of providers. 

Luckily, there are ways to minimize the chances of future outages.  A key tool in preventing outages is payer connection redundancy.  To establish redundancy, multiple clearinghouses need to be in communication with each other.  This decentralization lowers the risk of cyber attacks and develops backup systems. 

In order to establish decentralized communications, one should choose the right system.  It is important to use a system that is built on modern architecture, is highly scalable, communicates with multiple clearinghouses, and remains operational during outages.  These traits can go a long way in bolstering clearinghouse defenses in the face of cyber attacks. 

Clearinghouses hold vast amounts of information, and it is important to protect this information and support the continuous functioning of clearinghouses.  Emphasizing redundancy and decentralization is the key to successful clearinghouses.

Lessons Learned from the Change Healthcare Cyberattack
Source: Orbit Healthcare