In general, a provider or facility must consider at least two kinds of risk under their HITECH/HIPAA compliance governance strategy. One is clearly compliance risk (i.e. the risk of fines under HITECH's Enhanced Enforcement-Subtitle D).
The other type of risk, business risk, may ultimately be more damaging. In short, what is your reputation worth? We are living on Internet time and any significant (or insignificant) breach related to PHI is going to make national headlines.
Not only are you now required to provide notification (if the PHI is "unsecured") but your patients, partners, and federal/state agencies are all going to hear about it. In addition, your EHR incentive payments may be put at risk.
The graphic below summarizes this perspective:
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