Strengthening Data Security in Healthcare Benefits Administration: The Role of HITRUST-Certified Systems

American businesses are no stranger to cyberattacks, with notable breaches causing significant disruptions across various industries, including healthcare conglomerates like Change Healthcare and the ransomware attack on Mr. Cooper, a major mortgage loan company, that risked data on more than 14 million current and former clients. Organizations of all sizes strive to stay ahead of threat actors to prevent future attacks. This challenge is incredibly daunting for small businesses in the healthcare sector, which are more vulnerable to the severe impacts of data breaches.

A 2023 Cyber Readiness Report from Hiscox found that 41% of SMBs were victims of at least one successful cyberattack in the past year. The situation is further complicated because HR departments within these SMBs handle a significant amount of sensitive employee information. The challenges can be particularly daunting for small offices with limited resources, where one person might juggle HIPAA compliance, security, and HR responsibilities.

According to IBM’s 2024 Cost of a Data Breach report, when organizations suffered from a high-level shortage of security skills, the average breach costs were USD 5.74 million. This highlights a critical issue for SMBs, which often lack dedicated security and IT departments, making them susceptible to high costs. Such a financial burden would undoubtedly threaten their stability. Unfortunately, the damage extends beyond revenue loss; businesses face long-term repercussions from legal ramifications, insurability issues, reputational damage, and regulatory investigations. Staff morale can also suffer, potentially leading to expensive turnover. This clearly shows that stringent controls and protocols are essential to safeguard against cybercrime.

How can healthcare organizations navigate the complexities of benefits administration while maintaining robust data security and privacy measures? Many are turning to the HITRUST Common Security Framework or HITRUST CSF.

HITRUST Certification: Increased Security and Streamlined Compliance

Initially designed for healthcare organizations, HITRUST certification now applies across industries, enabling companies to demonstrate their adherence to strict standards for protecting sensitive information, especially health-related data. The HITRUST CSF incorporates and leverages various leading security and privacy standards and frameworks, including NIST, FTC, CMS, state legislation, and industry standards. This comprehensive framework offers a solid layer of oversight and helps prevent significant losses from security breaches due to noncompliance and inadequate safeguards.

Here’s how HITRUST certification benefits SMBs, associations, and multiple employer groups:

• Comprehensive Compliance: HITRUST certification ensures adherence to various regulatory requirements, including HIPAA and GDPR, simplifying business compliance efforts and saving time and resources
• Targeted Controls: HITRUST certification helps organizations identify the most relevant controls from thousands of existing requirements and frameworks, such as those from the National Institute of Standards and Technology (NIST); this simplifies the implementation process, allowing businesses to focus on the controls that matter most to their needs
• Partnership with Experts: For businesses with limited support staff, partnering with a HITRUST-certified vendor provides access to a team of experts equipped to implement and maintain stringent security protocols – this partnership frees internal resources to focus on core business functions that keep offices running and providing services; collaborating with HITRUST-certified experts also offers the guidance necessary to mitigate benefits administration challenges, prove compliance with regulations and standards, and protect against cybercriminals
• Continuous Improvement: Cybercriminals are constantly evolving their methods to increase their chances of success – to stay ahead of this threat, organizations also need a system that evolves. HITRUST certification requires rigorous validation of existing controls every other year and an interim assessment testing a sample of critical controls within one year of certification; HITRUST CSF framework is regularly updated to ensure your security environment, partner systems, and processes align with the latest security standards and emerging threats

Taking the Next Step

Establishing a partnership with a HITRUST-certified vendor or utilizing HITRUST-certified systems offers small businesses a solution that goes beyond mere regulatory compliance. It provides a level of assurance that stringent controls are in place to protect their most vulnerable data from cybercriminals. While SMBs may struggle to implement these resources independently, many can partner with Association Health Plans, Trusts, and other multiple employer groups that often have access to HITRUST-certified systems and processes. This collaboration provides increased peace of mind and significantly reduces the risk of data breaches, ensuring a more secure environment for employee data.