Clearinghouses are an extremely important part of the healthcare process, as they are necessary to facilitate data transfers between payers and providers. These data transfers ensure providers are properly paid for their services, so the clearinghouse’s role in the healthcare system is extremely important. Change Healthcare is one of the most significant clearinghouses in the nation, as they process about half of all medical claims processed in the United States. They serve about 900,000 providers and deal with a staggering 15 billion healthcare transactions a year, which is a third of all transactions in the United States.  

Change Healthcare clearinghouse suffered a cyberattack in February 2024 that caused an outage for several weeks. Millions of dollars worth of medical transactions were delayed by this disruption, creating a huge disruption for providers until the services were restored. This incident exposed serious weaknesses in the current clearinghouse structure and highlighted concerns about the way it is set up.  

Decentralized clearinghouse systems must be implemented by healthcare organizations in order to diversify their transaction channels. Because the transaction information is spread among multiple clearinghouses, it can be processed even in the event of a cyberattack. Change Healthcare, Availity, Waystar, and Experian Health are examples of clearinghouses that have begun to embrace this decentralized strategy to provide uninterrupted transaction processing and maintain system stability.

Source: Orbit Healthcare