By Sean Dowling, VP & Head of HITRUST, vCISO and Federal Services at Accorian

For organizations pursuing HITRUST certification, the journey promises a structured path to compliance, risk reduction, and market credibility. Yet many underestimate what’s required to get there, and what it costs to do it wrong.

Poor planning in HITRUST adoption leads to ballooning timelines, budget overruns, and staff fatigue. But, when done strategically, the returns can be exceptional: according to Enterprise Strategy Group (ESG), organizations that properly implement HITRUST experience 464% ROI, with 63% increased operational efficiency and significantly reduced breach and compliance costs.

This article explores the hidden costs of poor HITRUST planning and how to avoid them through proper scope management, resourcing, and execution.

Where HITRUST projects go off track

Organizations often stumble into the same traps early in the HITRUST journey. The most common causes of budget and timeline overruns include the following.

Scope creep

When organizations fail to define clear technical and business boundaries, they include too many systems, processes, or geographies, leading to unnecessary complexity.

• Hidden costs: Increased number of controls, inflated assessment scope, and excessive evidence requirements.
• Pro tip: Start with a clearly defined scoping questionnaire and limit scope to the most critical systems (especially in first-time certifications).

Unrealistic timelines

Many teams underestimate the time needed for remediation, policy development, and evidence collection, especially across five HITRUST maturity levels (Policy, Process, Implemented, Measured, Managed).

• Hidden costs: Missed deadlines, overtime expenses, and failed validations requiring retesting.
• Pro tip: Include buffer time for control testing, policy revisions, and sample evidence validation. ESG reports show that HITRUST preparation can drop from 90 to 60 days with good planning.

Underestimating internal resource requirements

Without clear internal ownership, HITRUST projects may drain unallocated IT and compliance resources.

• Hidden costs: Productivity loss, staff burnout, and reduced engagement in both security and business operations.
• Pro tip: Assign a dedicated HITRUST project manager and allocate at least 15% FTE across 4–5 key stakeholders (e.g., IT, HR, Security, Compliance) to maintain momentum.

Cost categories often overlooked in HITRUST planning

What the ESG report reveals about the real economics of HITRUST

Operational efficiency gains

• 30% reduction in audit preparation time
• 63% increase in operational efficiency through reusable documentation and streamlined evidence management
• Eliminated redundant audits as HITRUST certification often replaces client-initiated audits

Risk avoidance

• Up to $9.77M in potential breach-related cost savings (based on Ponemon/IBM data)
• Reduction in cyber insurance premiums by 25% for organizations with HITRUST certifications
• Improved incident response and threat readiness, leading to measurable reductions in unplanned downtime costs — up to $9,000/minute

Revenue enablement

• Clients directly attribute up to 50% of revenue growth to HITRUST certification.
• Customers see accelerated RFP cycles and reduced procurement friction.
• Certification is increasingly required for vendor selection in healthcare and other regulated sectors.

How to build a realistic project plan

Step 1: Conduct an expanded gap assessment

Include control-by-control analysis tied to HITRUST CSF v11.5 (or your applicable version), validate maturity level coverage, and prioritize remediation actions by risk and effort.

Step 2: Define scope with surgical precision

Use HITRUST’s scoping worksheet and threat catalog to define the minimum viable scope — limiting unnecessary business units, cloud assets, or legacy systems.

Step 3: Develop a budget and timeline aligned to remediation reality

Factor in remediation lead time (especially for technical changes like MFA, FIPS encryption, etc.), and allow for 60–90 days of control operation before final assessment fieldwork.

Step 4: Use HITRUST for framework consolidation

ESG’s data reveals that HITRUST customers witness 80% overlap with HIPAA and 60% with PCI and SOC 2 while completing documentation. Take advantage of this to unify evidence collection.

Conclusion: A structured investment beats reactive spending

HITRUST certification, when approached strategically, offers undeniable value, from revenue growth to measurable risk reduction. But organizations must avoid the temptation to “audit their way to compliance.”

The ESG report affirms what experienced assessors already know: success requires structure, stakeholder alignment, and operational readiness. With a potential 464% ROI, HITRUST is not just a cost of doing business — it’s a business accelerator when done right.

HITRUST ROI snapshot