This post is for: Health and human services officials, state-based exchange directors, Chief Information Officers (CIOs), security officers, and procurement leaders looking to pass audits and stay compliant without exhausting staff or resources.
For a long time, compliance and security in health and human services (HHS) and state-based health insurance exchanges (SBEs) could be managed as episodic events, but that’s no longer the reality. Today, compliance is a high-stakes responsibility that demands ongoing attention, specialized expertise, and rapid response. Regulatory frameworks like HIPAA, IRS 1075, CMS MARS-E, and NIST-aligned controls continue to evolve, while expectations around audit readiness and remediation timelines have tightened significantly.
In Vimo’s work supporting states with SaaS solutions and day-to-day operations across Medicaid systems, Affordable Care Act (ACA) marketplaces, child welfare, SNAP, and child care subsidy programs, we’ve seen firsthand how audit and security expectations have changed, how most state systems weren’t built for today’s demands, and how the burden of managing this can disrupt staff morale and program outcomes. For us, this raised a deeper question about what actually drives compliance outcomes and why well-intentioned teams were still struggling to keep pace. What we found is that compliance has more to do with IT solution architecture and vendor accountability than with state effort.
The Changing Compliance Landscape
Example: CMS Medicaid Audits
Historically, states have had flexibility in how quickly CMS Medicaid audit findings were addressed. Remediation timelines could stretch months or longer, and corrective action plans were accepted as progress. Today, however, high- and critical-risk findings generally require remediation within 5–10 business days, not months. Agencies are expected to demonstrate not just intent, but execution. Delays are no longer tolerated, and exceptions are rare. For many states, keeping pace has become increasingly difficult.
How Does Solution Architecture Change Compliance Outcomes?
Operating systems that were developed piecemeal or “glued together” over time often lack consistent security controls, integrated monitoring, or clear ownership for compliance updates. They also tend to rely on external tools or staff heroics to stay compliant. As a result, security gaps are harder to detect, audit evidence may be incomplete or difficult to locate, and fixes may require significant time and effort, creating a source of stress and a drain on state resources. In our experience, a well-built architecture with compliance updates managed by the IT vendor is a real force-multiplier. Here’s how.
A Solid Architecture Built In – Not Bolted On – Improves Audit Readiness
Across Vimo’s years of supporting state HHS programs with audits, policy changes, and evolving security requirements, one lesson has become clear: compliance is far easier to maintain when security is designed into the architecture from the start, rather than added on later. In practice, we’ve found that systems built as multi-tiered, true SaaS solutions – hosted across separate environments – make it easier to apply security controls consistently and adapt as requirements change.
We’ve also learned that embedding core security and compliance capabilities directly into HHS IT platforms leads to notable benefits. This approach reduces the need for states to source, integrate, and maintain multiple third-party tools, but it also makes it easier to incorporate audit readiness into daily program practice, rather than treating it as a separate, resource-intensive activity. The result is a lower operational burden for state teams, more reliable audit evidence, and a compliance posture that is easier to sustain over time. We offer examples based on our experience below.
Embedded identity and access management tools save staff time and effort.
In each of Vimo’s state projects, we’ve seen how identity and access management (IAM) tools play a central role in maintaining compliant systems and overall security posture. When access controls are fragmented or manually managed, audits become harder to support and staff time is quickly consumed by access reviews and remediation. Applying this understanding, we design Vimo solutions with centralized identity and access management embedded directly into our platforms – supporting single sign-on, integration with existing agency systems, role-based access, and clearly defined boundaries aligned with the principle of least privilege. For our state partners, this approach has improved control and audit traceability while reducing the manual effort required by state teams.
Built-in security monitoring and auditability simplify compliance activities.
We’ve also learned that relying on separately procured Security Information and Event Management (SIEM) tools often adds cost and operational complexity to state systems without necessarily improving audit outcomes. When monitoring and logging are disconnected from the core system, security events are harder to correlate, evidence is harder to assemble, and audit responses become more reactive.To avoid these issues, Vimo embeds SIEM capabilities directly into our solutions, allowing security events to be logged, monitored, and traced across the platform. This simplifies responses to audits, security reviews, and compliance inquiries, reducing last-minute effort for state teams. We’ve also found that limiting access to security monitoring and audit tools to a small number of authorized personnel further strengthens oversight, protects audit integrity, and reduces access risks.
When Compliance Is a System Outcome, States Can Focus on What Matters
Across states and programs, regulatory uncertainty is one of the biggest sources of operational stress. New requirements often arrive on compressed timelines, triggering unplanned work, new procurements, and rushed system updates – and generally placing extra work onto already-stretched state teams.
With the goal of reducing this source of stress, Vimo has built ongoing security and compliance management directly into our product lifecycle. Updates driven by federal policy changes are treated as part of the solution, not exceptions or add-ons. For example, we are currently working with our state Medicaid partners to meet H.R. 1 community engagement (work) requirements, with no additional procurement or licensing required. This shared accountability model ensures that states are not left to interpret, design, and implement compliance changes on their own, alleviating stress, risk, and resource drain.
The Result: Consistent Compliance with Fewer Fire Drills
By embedding security, compliance, and audit readiness into the core architecture of state IT solutions, Vimo has helped states significantly reduce instances of missed issues and delayed remediation, the cost of external consultants and tools, and the operational demand on already-busy staff. Just as importantly, when findings do occur or updates are needed, states are not left to manage them alone. Our team works with states to address issues quickly and effectively, transforming the recurring fire drill of compliance into a manageable, predictable process.
What Should States Look for in Compliant, Secure Systems?
As agencies evaluate Medicaid compliance software and modern SaaS platforms for government IT agencies, there are a few critical questions we recommend asking:
- Are security and compliance built into the architecture – or bolted on later?
- Who is responsible for keeping the system aligned with federal requirements?
- How quickly can high-risk findings be identified and remediated?
- How much of the burden falls on state staff?
The answers to these questions determine if security and compliance will become constant sources of state stress or quietly well-managed functions.
CIO Takeaways
- Compressed audit timelines expose architectural debt.
- Compliance is cheapest when it’s designed in – not layered on.
- Fragmented tools create audit risk, not protection.
- Vendor-managed compliance is the real force multiplier.
- The goal isn’t zero findings – it’s predictable remediation.
- Staff morale is a compliance outcome.
In short, modern audits don’t fail states; legacy architectures do. Modern architectures designed for security and compliance offer states a more reliable, peaceful path forward.
Interested in continuing the conversation about approaching compliance with shared accountability? Download our Architecture and Compliance CIO Talking Points or CIO Takeaways Handout, or reach out to us at info@vimo.com.
In the next post in this series, we’ll explore how solution architecture can increase overall cost predictability and reduce surprise operational hurdles – and why those factors matter just as much to long-term program success.
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