While elder fraud continues growing across industries, surges in Medicare and healthcare fraud are pointing to a broader systemic issue: the healthcare system’s internal communication frameworks are overburdened and fragmented. Unlike patient‑facing communication systems, the core challenge lies in exchanges between hospitals, health systems, labs, and insurance providers, which were never built for the speed, volume, or compliance demands of today.
Older adults are most likely to fall victim to scams, with elder fraud costing individuals aged 60+ more than $5 billion in financial loss. Within healthcare, that risk is amplified by the siloed systems originally created to protect patient information but are now strained to the point where delays and communications gaps directly impact organizations, from hospitals to insurers to lab systems such as employee health record (EHR) integrations.
Modern fraud schemes exploit these administrative gaps, and paired with shifting Medicare and Medicaid requirements, each of these entities face mounting pressures to communicate more quickly, more frequently, and more securely. Modernized communications are offering these organizations a path forward by enabling secure yet interoperable information exchanges that support these systems to meet rising volume and speed requirements without compromising compliance.
The true perpetrator: strained healthcare communications systems
Research shows that U.S. hospitals’ poorly performing IT systems and the compounding inefficiencies and system downtimes have led to an estimated $8 billion in annual losses. When it comes to healthcare communication infrastructure, these issues often stem from extreme restrictions that force hospitals into siloed systems for communication that inherently don’t communicate with one another. This fragmentation slows exchanges between providers, insurers, and lab platforms which complicates billing accuracy, prior authorization workflows, and compliance updates.
With changes to Medicare, Medicaid, HIPAA, and more, these already fragile systems are going to be increasingly crippled during periods where compliance requirements are only accelerating.
Volume and speed maintaining pace with trust
Healthcare organizations need enterprise communications tools that increase speed, volume, and efficiency, particularly for exchanges between hospitals, insurance companies, labs, and EHR systems. With this many stakeholders involved, healthcare leaders must focus on strengthening their operational and administrative messaging and data flow across the ecosystem. This will enable organizations to remain in compliance while breaking down silos of communication.
By implementing quicker healthcare communications delivered in higher volumes, organizations are instilling trust among stakeholders by proving that they are reliable and transparent when it comes to key information exchanges. Without them, information gaps persist – leaving providers, patients, and payers out of the loop when it comes to decision making, urgency, and clarity.
Chipping away at stakeholders’ confidence, information gaps – such as ambiguities regarding a patient’s insurance coverage – create a sense of mistrust in healthcare. Modern frameworks improve consistency, predictability, and accuracy, restoring confidence among stakeholders while reducing administrative burdens.
Reducing risk with modernized communication frameworks
Cloud technologies provide a cushion for healthcare organizations who have notoriously been overburdened by strained communication systems. Cloud-based solutions enable real-time, secure data sharing through centralized platforms, such as a compliant mailbox that enables faxes to be sent, received, and processed via a web browser.
These tools break down silos while offering flexibility to scale as regulatory demands evolve within a short time and without a large expenditure of resources. Not all data centers are created equally, however. In the case of healthcare organizations, providers with their own auditable data centers are more suitable for such sensitive patient data, compared to hyperscale data centers that can lead to delays in compliance reporting.
Whenever possible, healthcare organizations should evaluate specialized communications tools to support secure messaging in these environments. A strong partner should be able to integrate diverse systems, provide full implementation support, and deliver guaranteed Service Level Agreements (SLAs). When selecting specific cloud communication services, companies should also ensure that the provider has industry-relevant certifications such as HITRUST and SOC2, the latter of which also complies with industry standards such as HIPAA to meet highest data protection requirements.
Cloud connectivity also allows organizations to consolidate scattered data into a single secure environment—giving hospitals, insurers, and lab systems timely insights that support compliance, decision‑making, and operational efficiency.
Uwe Geuss
Uwe Geuss is Chief Technology Officer of Retarus.
