You sell software to hospitals, payers or digital health companies. One prospect asks for your SOC 2 report. Another asks whether you are HITRUST certified. A third sends a questionnaire that mentions both and HIPAA besides. You have budget for one major assessment this year, and you need to know which.
The two are not interchangeable, and neither is a HIPAA certification. They answer the same underlying question for a buyer, "can we trust this vendor with our data?", in different forms. Which form a buyer accepts is set by their vendor risk program, not by the merits of either framework.
This article sets out how the two differ, what healthcare buyers tend to weigh, and how to decide.
How the two differ
| SOC 2 | HITRUST (e1, i1 or r2) | |
|---|---|---|
| Who issues it | A licensed CPA firm, under AICPA attestation standards | HITRUST, after an authorized assessor tests and HITRUST reviews |
| Form of result | An auditor's report with an opinion | A HITRUST report and, if criteria are met, a certification |
| What you are measured against | The trust services criteria, using controls you define | HITRUST's prescribed requirement statements |
| How results are expressed | Opinion plus control descriptions, tests and exceptions | Scores per requirement statement and domain |
| Time covered | Type I at a point in time, Type II over a period | Certification valid for one year (e1, i1) or two (r2) |
| Healthcare mapping | Not built in; HIPAA can be mapped or added | HIPAA among the authoritative sources the CSF draws on |
Criteria-based versus prescriptive
This is the difference you feel most during the work. SOC 2's trust services criteria describe outcomes, such as restricting logical access or detecting security events. You design controls that meet them, describe those controls, and the auditor tests what you described. Our overview of the trust services criteria covers what each category asks.
HITRUST tells you the requirement. Your job is to show that each requirement statement is met across your scope. You have less freedom to describe your controls your own way, and the buyer gets a more uniform result to compare across vendors.
Opinion versus score
A SOC 2 Type II report says whether your controls were suitably designed and operated effectively over the period, and lists any exceptions the auditor found. A buyer reads the opinion, then reads the exceptions. Our article on Type I versus Type II explains why most buyers want the latter.
A HITRUST result is expressed as scores. In an r2, each requirement statement is scored across maturity levels from policy to managed. A buyer sees not only whether a requirement was met but how thoroughly it is documented and measured.
Why healthcare buyers ask for HITRUST
The CSF was built with healthcare in mind and harmonizes the HIPAA Security Rule with other sources. For a buyer managing many vendors, that offers two practical advantages.
Uniformity. Every HITRUST assessment of the same type tests the same requirement statements, or in an r2 a set derived from declared scoping factors. A vendor risk analyst can compare two vendors without reading two differently structured reports.
Third-party quality review. HITRUST reviews the assessor's work before issuing anything. Some buyers value that extra layer when they cannot review every report in depth themselves.
Some health systems and payers name HITRUST in contracts or vendor policies for vendors that handle protected health information at scale. Others accept a SOC 2 Type II, sometimes with a HIPAA mapping or questionnaire alongside it. Practice varies widely, which is why the only reliable answer comes from the buyer.
Why many still accept SOC 2
SOC 2 has advantages that matter to buyers outside a pure healthcare context.
Broad recognition. Security teams across industries know how to read a SOC 2 report. If you sell to healthcare and to other sectors, one report serves both.
Operating effectiveness over a period. A Type II report describes how controls actually ran across months, with exceptions disclosed. Some buyers find that more informative than a maturity score.
Flexibility. Because you define the controls, the report describes your environment as it is, not as a prescribed list expects it to be.
If you are early in selling to healthcare and your buyers are a mix, a SOC 2 Type II is often the faster route to something most of them will accept.
Neither one is HIPAA compliance
This deserves its own line because it is the most common misunderstanding. HHS does not certify HIPAA compliance, and no third-party report confers it. A SOC 2 report or a HITRUST certification is evidence that a defined set of controls was examined. Whether your safeguards meet the HIPAA Security Rule, and whether a business associate agreement is needed, are separate questions. Confirm legal interpretations with counsel.
What either can do is support your HIPAA program. The HITRUST CSF incorporates HIPAA Security Rule requirements into its requirement statements. A SOC 2 can be mapped to the Security Rule, or a CPA firm can report on HIPAA-related criteria as additional subject matter alongside the trust services criteria. The HIPAA framework page summarizes what the Security Rule asks for.
Deciding which to pursue
Work through these in order.
Ask the buyers in your pipeline. Not "do you accept SOC 2?" but "what does your vendor risk policy require for a vendor handling our data, and which assessment types satisfy it?" Get the answer in writing.
Read what is already signed. Contracts and security addendums sometimes name a framework, a timeframe or both. Those are obligations, not preferences.
Look at your sales mix. If most revenue comes from healthcare buyers who name HITRUST, start there. If healthcare is one sector among several, a SOC 2 may serve more buyers first.
Size the HITRUST option. If HITRUST is required, find out which type. An i1 may satisfy a buyer who wrote "HITRUST" without specifying. Our comparison of e1, i1 and r2 explains the differences.
Plan for both if you need both. Many vendors end up with both over time. The controls overlap heavily, so the second assessment costs less than the first if you plan for reuse.
Running both without doing the work twice
The control overlap between HITRUST and SOC 2 is large. Access control, change management, logging, vulnerability management, incident response, vendor management and training appear in both, under different names and with different levels of prescription.
To keep the second assessment from becoming a second program:
Map once. Keep one control set, mapped to both the trust services criteria and the HITRUST requirement statements. Our article on control overlap between frameworks explains how to structure that mapping.
Write to the stricter standard. HITRUST's requirement statements are usually more specific. A policy written to satisfy HITRUST will normally satisfy SOC 2 as well. The reverse is less reliable.
Collect evidence once. The same access review, scan report or training record can serve both, provided it covers both scopes.
Align scope where you can. If the two assessments cover different systems, every shared control needs evidence for the union of both scopes.
A CPA firm can also issue a SOC 2 report that addresses HITRUST CSF requirements as additional criteria. Whether that combined form satisfies a given buyer is, again, a question for the buyer.
How TrustLynce helps
TrustLynce maps one set of controls across SOC 2, HIPAA and HITRUST, so a single piece of evidence counts toward each framework that needs it (compliance automation). The Trust Center lets healthcare buyers request your report under NDA, with an access log of who viewed it.