Medcurity vs ONC SRA Tool: Which HIPAA Risk Assessment Is Right for You? (2026)

If you’re searching for HIPAA risk assessment software, the ONC SRA Tool is almost certainly one of the first things you found. It’s free, it’s from the federal government, and it carries the implied stamp of approval that comes with being published by HHS. But is it actually the right tool for your organization?

This comparison breaks down the real differences between Medcurity and the ONC Security Risk Assessment Tool — what each does well, where each falls short, and which one makes sense for FQHCs, community health centers, critical access hospitals, and small practices.

What Is the ONC SRA Tool?

The ONC Security Risk Assessment Tool is a free Windows desktop application published by the Office of the National Coordinator for Health IT in partnership with HHS and OCR. It was designed to help small and medium healthcare providers conduct a HIPAA Security Rule risk analysis by walking them through a series of questions about their technical, administrative, and physical safeguards.

The tool was first released in 2014 and has been updated periodically. It generates a PDF report summarizing your responses and identifying gaps, which can be used as documentation of your risk analysis process.

The ONC SRA Tool is widely used because: it’s free, it’s from the government, and it provides structured guidance through the Security Rule requirements.

What Is Medcurity?

Medcurity is a cloud-based HIPAA compliance platform built specifically for healthcare organizations. It guides users through a comprehensive security risk analysis aligned with NIST 800-30 and OCR’s methodology, then provides tools to track identified risks, manage remediation, generate audit-ready documentation, and maintain ongoing compliance — not just a one-time assessment snapshot.

Medcurity is purpose-built for the healthcare market, with particular strength in serving community health centers, FQHCs, critical access hospitals, and rural health organizations. Customers include Snohomish County Community Health Center, NATIVE HEALTH, Valley Wide Health Systems, and Clinicas de Salud del Pueblo.

Head-to-Head: ONC SRA Tool vs Medcurity

The Case for the ONC SRA Tool

The ONC SRA Tool genuinely earns its place in the HIPAA ecosystem. Here’s when it makes sense:

It’s free — and that matters

For a very small single-provider practice with minimal budget, $0 vs $499 is a real difference. The ONC tool produces documentation of a risk analysis process, which is better than having no documentation at all.

It’s endorsed by HHS and OCR

There’s no better “source of truth” for what OCR considers a valid risk analysis methodology than a tool built by HHS itself. If you follow the ONC SRA Tool questions carefully and document your responses, you’re working directly from the regulator’s own framework.

It’s useful for learning the framework

Even if you ultimately use different software for your compliance program, downloading the ONC SRA Tool and working through its questions is a valuable way to understand the full scope of the HIPAA Security Rule’s requirements. Many compliance officers use it as a study guide when they’re getting started.

The Limitations That Matter for FQHCs and Multi-Site Organizations

It’s a desktop app with no cloud storage

The ONC SRA Tool runs only on Windows desktop. Your assessment file lives on one computer. If that computer dies, your documentation dies with it. There’s no version history, no backup, and no way to access the assessment from another device. For an organization with multiple team members contributing to compliance — your IT coordinator, compliance officer, and CMO — this is a significant workflow problem.

Multi-site FQHCs have to run it multiple times

The ONC SRA Tool conducts one assessment per site. For a 10-site FQHC, that means 10 separate tool runs, 10 separate PDF reports, and no way to roll up risk findings into a single organizational risk register. The OCR expects your SRA to cover all locations where ePHI is created, maintained, received, or transmitted. Using the ONC tool for a multi-site organization means significant manual work to aggregate findings.

It doesn’t manage risk — it just identifies it

The OCR’s SRA methodology is a two-step process: first, identify and rate your risks. Second, implement a risk management plan to address them. The ONC SRA Tool handles step one but provides nothing for step two. You get a PDF report. What happens after that report is entirely on you — with no tracking, no deadline management, and no documentation of your remediation activities.

In OCR’s actual audit protocol, they check your risk analysis AND your risk management plan. If you can show you identified risks but have no documentation of how you addressed them, you’ve only done half the job.

The 2025 HIPAA updates aren’t fully reflected

The 2024-2025 HIPAA Security Rule updates introduced mandatory encryption, mandatory MFA, biannual vulnerability scanning requirements, and annual penetration testing. The ONC SRA Tool’s last major update was in 2023. It doesn’t fully address these new requirements in its assessment workflow, which means using it alone leaves gaps in your 2026 compliance documentation.

Which Tool Is Right for Your Organization?

Use the ONC SRA Tool if:

• You’re a single-provider practice with one location and no budget for paid software
• You want to understand the HIPAA Security Rule framework before purchasing software
• You have a compliance consultant who will supplement the tool output with their own documentation
• You’re doing a preliminary assessment to scope the work before engaging a consultant

Use Medcurity if:

• You operate more than one delivery site (FQHCs, CHCs, CAHs, multi-site practices)
• You need team collaboration — multiple staff contributing to the assessment
• You want your risk analysis and risk management plan in one integrated system
• You need to demonstrate year-over-year compliance improvement to OCR, your board, or HRSA
• You’re a community health center and want software used by other CHCs with references
• You want to be current on 2025 HIPAA Security Rule updates (encryption, MFA, scanning)
• You want to spend 10-20 hours annually on compliance rather than 40-80+

The Real Math: Free vs $499

The ONC SRA Tool is free in dollars but expensive in time. A multi-site FQHC using the ONC tool might spend 20-40 hours per site completing assessments manually. At a loaded labor cost of $30/hour for a compliance coordinator, that’s $600-$1,200 per site — or $6,000-$12,000 for a 10-site organization. Plus time to manually aggregate findings, create a risk management plan, and maintain documentation separately.

Medcurity at $499/year, with guided multi-site workflows, can reduce total compliance staff time by 60-80%. The math overwhelmingly favors Medcurity for any organization with more than 2-3 sites.

For a full cost breakdown, see: HIPAA Compliance Cost for FQHCs (2026)

What OCR Actually Looks For in an Audit

Many organizations use the ONC SRA Tool and believe they’re fully protected. The reality is that OCR’s audit protocol looks for more than just a completed SRA form. They look for:

1. A current, documented security risk analysis covering all ePHI across all locations
2. A written risk management plan identifying how you’ll address each identified risk
3. Evidence of actual implementation — not just documentation of intent
4. An audit trail showing your compliance posture over time, not just at one point
5. Remediation records for previously identified gaps

The ONC SRA Tool provides solid documentation for items 1 and 2 — but nothing for 3, 4, or 5. Medcurity covers all five.

For a deeper dive into the HIPAA SRA process, see: Best HIPAA Risk Assessment Tools: Buyer’s Guide

More Comparison Resources

• Medcurity CHC Security Risk Analysis Program
• HIPAA Compliance for Rural Hospitals
• HIPAA Compliance Cost in 2026
• Best HIPAA Risk Assessment Tools: Full Buyer’s Guide
• HIPAA Compliance for FQHCs: 2026 Guide
• Best HIPAA Software for Community Health Centers
• HIPAA Compliance Cost for FQHCs
• HIPAA Compliance for Community Health Centers
• HIPAA Compliance Software Comparison

Frequently Asked Questions