QUANTITATIVE INVESTIGATION OF INFORMATION SECURITY CHALLENGES IN U.S. HEALTHCARE PAYMENT ECOSYSTEMS

Abstract

This study quantitatively examines information security challenges in U.S. healthcare payment ecosystems and empirically links security control maturity, incident-response capability, and organizational context to measurable payment outcomes—resilience, fraud-loss exposure, and stakeholder trust. Integrating a systematic literature review (2005–2020) with a cross-sectional survey of 124 organizations (providers, payers, clearinghouses, and vendors), the research operationalized constructs such as threat exposure, vulnerability, control maturity, compliance posture, and incident-response capability using five-point Likert scales. Findings indicate that control maturity is the strongest predictor of payment resilience (β = .36, p < .001) and stakeholder trust (β = .28, p < .001), while higher maturity and response capability jointly reduce fraud-loss ratios (β = −.24, p < .001; β = −.17, p = .006). Mediation analysis confirms that incident-response capability partially offsets the detrimental effect of threat exposure on resilience (indirect α×β = −.04, 95% CI [−.08, −.01]). Moderation tests reveal that maturity’s payoff is amplified in larger and cloud-forward organizations and weakened in vendor-dense ecosystems, underscoring the role of automation and interorganizational governance. Complementary anomaly-detection pilots achieve practical precision (0.77) and recall (0.70), demonstrating the viability of analytics-based monitoring in reducing fraud losses. The integrated model explains 29–42% of outcome variance, supporting a socio-technical interpretation in which security maturity and rehearsed response routines form the foundation of resilient, low-loss, and high-trust payment operations. The study contributes validated constructs, a transparent measurement framework, and actionable pathways for CISOs, enterprise architects, and revenue-cycle leaders to strengthen payment-system security and reliability through institutionalized control maturity, incident preparedness, and vendor governance.