What is HITRUST and why do hospitals require it?
March 6, 20262 min readBeyond SOC 2
What Is HITRUST?
HITRUST CSF (Common Security Framework) is a comprehensive security framework that harmonizes requirements from multiple standards — HIPAA, NIST 800-53, ISO 27001, PCI DSS, and others — into a single assessable framework. Unlike HIPAA (which is self-attested), HITRUST provides formal certification through an authorized assessor.
Why Hospitals Require HITRUST
| Reason | Explanation |
|---|---|
| HIPAA gaps | HIPAA is self-attested — anyone can claim compliance. HITRUST proves it. |
| Risk reduction | Hospitals face severe penalties for data breaches. HITRUST reduces their vendor risk. |
| Insurance requirements | Some malpractice insurers require vendors to have HITRUST certification |
| Industry standard | Large health systems have standardized on HITRUST for vendor evaluation |
| Regulatory alignment | HITRUST maps to multiple regulatory requirements in one assessment |
HITRUST vs. SOC 2 vs. HIPAA
| Factor | SOC 2 | HIPAA | HITRUST |
|---|---|---|---|
| Cost | $10K-$25K | ~$5K (policies + BAA) | $50K-$150K |
| Timeline | 3-6 months | 1-3 months | 6-12 months |
| Certification | Report (no cert) | Self-attestation | Formal certification |
| Validity | 12 months | Ongoing obligation | 2 years |
| Healthcare-specific | No | Yes | Yes |
| Auditor | CPA firm | Self (or consultant) | HITRUST-authorized assessor |
When to Pursue HITRUST
Most SaaS startups don't need HITRUST immediately. The typical path:
- Start with SOC 2 — covers general security controls, accepted by most buyers
- Add HIPAA compliance — if you handle PHI, sign BAAs with healthcare customers
- Pursue HITRUST — when large health systems require it as a condition of doing business
HITRUST is worth the investment when you're selling to hospital systems with 500+ beds, large health plans, or government healthcare contracts. For smaller healthcare buyers, SOC 2 + HIPAA is usually sufficient.