The systems and code that keep daily life moving tend to remain invisible, until they stop working. That’s what happened—on a spectacular scale—in February 2024, when a ransomware attack on Change Healthcare exposed just how much of American health care depended on a company that many patients, and even providers, had never heard of.
Physical therapist Joe Martin, for example, hadn’t known his billing company used Change’s technology. Then payments to his New York practice stopped arriving. Soon he was carrying cash from his other practice, in Florida, onto airplanes to make payroll, as Fortune’s Erika Fry reported in her illuminating account of the attack and its fallout.
“We are losing $25,000 a week in cash flow,” Martin told Fry, four weeks and $100,000 into the ordeal. He was hardly alone. Change, buried several layers inside UnitedHealth Group, touched between a third and half of America’s medical claims. Disabling this obscure intermediary had consequences throughout the health care system, leaving providers scrambling to submit paper claims, tap retirement savings, and keep their doors open.
“The actual commerce of the health industry just stopped, and no one seemed to care,” Boe Hartman, cofounder and chief technology officer of health care payments company Nomi Health, told Fry.
Two and a half years later, AI is adding speed to an already precarious cybersecurity situation. As Fortune’s Emily Forlini reported this week, researchers using AI uncovered critical vulnerabilities in PHP, a widely used programming language described as “the backbone of the internet.” The AI tools helped defenders find the flaws—but the technology can also help attackers exploit them. Cloudflare, an internet infrastructure and cybersecurity company, recorded tens of thousands of exploit attempts within 45 minutes of word getting out.
More troubling still: The underlying weakness wasn’t new. As cybersecurity company Wiz put it, the incident signaled that we’ve reached an AI inflection point: “The vulnerable code had been there for more than a decade–what AI changed was the ability to understand the weaknesses and turn them into a working exploit.”
The Change Healthcare catastrophe showed how quickly a digital disruption could become a financial crisis with real human consequences. Behind the software were people waiting for prescriptions, payments, and paychecks.
AI is accelerating the hunt for vulnerabilities in the hidden infrastructure we all rely on—and sharpening the race between those trying to fix them and those trying to exploit them. For the businesses and people caught in the middle, the stakes are perilously high.