By NextBestFitRedundant public infrastructure
Run the claims system on redundant public infrastructure with offline fallback.
No single point of failure for the national claims system.
Review ledgerHow this path connects
This path
Redundant public infrastructure
Creates or worsens
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Run claims on redundant public infrastructure with offline fallback
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Cyberattacks can halt payments and care
Redundant public claims infrastructure and an offline fallback avoid a single point of failure and allow care to continue during outages. Redundancy also leaves more systems to secure.
What it creates or worsens
- Raises spending or loosens control over it
Running redundant public claims infrastructure with an offline fallback is costly.
Who's affected
Who gains
- Hospitals, clinics, and care organizations
- Cyberattacks can halt payments and care: Cyberattacks disrupt claims and leave providers unpaid.
- People with employer coverage
- Cyberattacks can halt payments and care: Cyberattacks expose personal health data.
- Uninsured people
- Cyberattacks can halt payments and care: Cyberattacks expose personal health data.
- People with unaffordable deductibles or coinsurance
- Cyberattacks can halt payments and care: Cyberattacks expose personal health data.
- People who will need care in the future
- Cyberattacks can halt payments and care: Redundant public claims infrastructure and an offline fallback avoid a single point of failure and allow care to continue during outages. Redundancy also leaves more systems to secure.
Who loses
- Fraudulent operators and cybercriminals
- Cyberattacks can halt payments and care: Attackers profit from ransomware attacks on health systems.
- Taxpayers and public budgets
- Raises spending or loosens control over it: Public budgets pay the added spending.
Where it has been tried
- Change Healthcare attack (2024): AHA’s March 2024 survey of about 1,000 hospitals found 94% reported financial effects and 74% patient-care effects; among hospitals reporting cash-flow effects, nearly 60% reported revenue impacts of at least $1 million per day.Sources: American Hospital Association (2024)