Framework: HITRUST

The PRISMA model, or Privacy and Security Maturity Model, is the foundation of HITRUST’s scoring and evaluation process. It measures how well a control is implemented through five maturity levels: Policy, Procedure, Implemented, Measured, and Managed. Each level builds upon the previous one, forming a continuous improvement cycle that reflects both compliance and operational excellence. For candidates preparing for HITRUST-related exams, understanding PRISMA is critical because it determines how assessors rate control effectiveness and where improvement efforts should focus. The model doesn’t just ask whether a control exists—it evaluates whether it is institutionalized, repeatable, and self-improving.

In practice, PRISMA helps organizations move from reactive compliance toward proactive risk management. A control with only a defined policy may meet minimal requirements but lacks assurance of consistent operation. Conversely, a Managed-level control demonstrates evidence of monitoring, feedback, and corrective actions. Candidates should be able to identify examples of how PRISMA levels influence scoring outcomes and certification eligibility. For example, i1 assessments generally require implementation-level maturity, while r2 assessments evaluate through Managed maturity. Grasping this structure ensures that candidates can analyze both exam scenarios and real assessments with a maturity-driven mindset.
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