When building a health tech startup, HIPAA compliance isn't just a nice-to-have—it's essential from day one. Choosing the right platform to handle sensitive patient data is critical, so let's explore what popular Platform as a Service (PaaS) providers get wrong—and occasionally right—about HIPAA compliance.

What is a Platform as a Service (PaaS)?

Platform as a Service (PaaS) providers offer cloud-based environments designed to support the entire lifecycle of building, deploying, and managing applications. These platforms allow startups to avoid the complexity of building and managing infrastructure, so they can focus on developing their core products.

What is HIPAA Compliance?

HIPAA compliance refers to meeting the requirements set forth by the Health Insurance Portability and Accountability Act (HIPAA), designed to protect sensitive patient health information (PHI). Compliance involves secure handling of PHI, implementing robust security protocols, signing Business Associate Agreements (BAAs), and ensuring technical safeguards like encryption, auditing, secure backups, and intrusion detection are in place.

Learn more about HIPAA Compliance: https://www.aptible.com/blog/hipaa-compliance-guide-for-startups

The Compliance Gap: How Major PaaS Providers Handle HIPAA

Heroku: Compliance as a High-Cost Add-on

Heroku provides HIPAA compliance through its "Heroku Shield" offering, including Private Spaces and Shield Private Spaces. However, these features are available exclusively to Heroku Enterprise customers, meaning Enterprise-level pricing. While Heroku doesn't provide transparent pricing details for its Shield offerings, online sources suggest costs often range between $350 and over $5,000 per month—just to get started.

Compliance shouldn’t be an exclusive, high-cost luxury—it should be accessible to startups from day one.

HIPAA with Heroku Shield:

Render: No HIPAA Compliance/BAAs Available

Despite customer demand, Render no longer offers BAAs to support HIPAA compliance, making it fundamentally unsuitable for healthcare startups. Companies choosing Render risk future complications, expensive migrations, or costly workarounds to ensure compliance.

HIPAA with Render:

Vercel: BAAs as a High-Cost Add-on

Like Heroku, Vercel offers BAAs exclusively to Enterprise customers. However, their support does not stop there. Under their Shared Responsibility Model, most security and compliance requirements are the customer's responsibility.

HIPAA with Vercel:

Railway: BAAs as a High-Cost Add-on

Like Heroku, Railway follows a shared responsibility model for HIPAA compliance, offering Business Associate Agreements (BAAs) only to customers committing to significant monthly spend thresholds ($1,000/month or more). While their shared responsibility model isn't publicly available, Railway states they provide guidance—but the operational burdens of encryption, key management, and access control remain with the startup.

HIPAA with Railway:

Aptible: Compliance Built-in from Day One

Unlike the platforms mentioned above, Aptible treats HIPAA compliance as fundamental, not premium. Aptible signs BAAs as part of its baseline Production plan ($499/month), which includes everything your startup needs to handle PHI securely: centralized identity and access management (IAM), platform activity logging, automated backups, encryption, network segregation, intrusion detection and monitoring, DDoS protection, host hardening, and more. Learn more about HIPAA on Aptible here.

Learn more about Aptible's security features here.

HIPAA with Aptible:

The Real Cost of Choosing a Platform That Doesn't Fully Support HIPAA

Choosing a platform that does not fully support all the requirements of HIPAA introduces serious and often hidden risks for your startup:

• Requiring a Migration: When compliance isn't built in from the start, your startup eventually faces a costly and disruptive migration. Switching platforms mid-growth can lead to downtime, lost momentum, and operational headaches.

• Delayed Launches: Compliance gaps mean your development timelines are unpredictable, delaying your ability to quickly launch, iterate, and scale your product.

• Unexpected Expenses: Platforms that treat compliance as a premium add-on or leave critical compliance responsibilities up to you generate unforeseen costs—pulling critical resources away from product innovation and business growth.

A Better Approach: Built-in Compliance

At Aptible, we believe HIPAA compliance shouldn't slow you down or price you out. Compliance should be foundational, affordable, and accessible from day one. Choose a platform that takes compliance as seriously as you do.

Sign up for a free trial today to get started with HIPAA right away.