According to the FBI, the industry ranked as the top targeted sector for cyber threats in 2025, with 460 known ransomware attacks and 182 data breaches. Cybercriminals target healthcare because patients’ protected health information (PHI) is central to proper patient care. A single compromise can cause a long list of issues for a healthcare organization, and unfortunately, the healthcare industry has numerous threat vectors.

Hackers know that disabling a health network can make it difficult for healthcare organizations to properly treat patients. That’s why it's not unheard of for a covered entity to pay a ransom to have its systems restored, even though there are signs that organizations making payments is changing.

Financial gain remains the primary motivation behind healthcare data theft because of the opportunity for multiple forms of fraud. Criminal marketplace pricing clearly demonstrates the demand: a driver’s license reportedly sells for about $20, while a complete identity package can sell for $1,000. Stolen PHI can be used for identity theft and to impersonate patients needing medical services.

Related: HIPAA compliant email: The definitive guide (2026 update)

 

What is phishing?

Phishing attacks are fraudulent emails, text messages, phone calls, or websites designed to trick people into sharing sensitive information, installing malware, or taking actions that expose themselves or their organizations to cybercriminals. The idea is to get individuals to share something they shouldn’t or to do something that makes it easier to compromise a system. Given how overworked and tired healthcare staff is, the tactic works well within the healthcare industry.

An online portal by IBM explains that phishing is effective because it persuades recipients to “click a malicious link, download an attachment or reveal confidential information.” Recent data from the FBI states that phishing is the most frequently reported cybercrime, with more than 300,000 complaints filed. The Ponemon Institute adds that the cost of phishing quadrupled between 2015 and 2021, with costs reaching $14.8 million in 2021.

The impact of phishing attacks can be severe, leading to identity theft, financial fraud, malware deployment, and data breaches that affect an entire organization. In 2019, the FBI noted that Americans lost $57 million to phishing attacks, with business losses often far exceeding that amount. Such attacks also cause damage beyond financial loss, including privacy violations and long-term disruption to organizations.

 

Email phishing

Email is the most common entry point for theft and impersonation attacks that give cybercriminal groups access. A Paubox report recently stated that 170 email-related breaches were reported to the U.S. Department of Health and Human Services (HHS) in 2025, exposing the data of more than 2.5 million individuals. Email phishing, also known as email spoofing or email impersonation, uses fake email sender information, fake designs, and fake content to craft messages that look like they come from credible, trusted sources, such as:

  • Bank
  • Utility companies
  • Business associates
  • Other healthcare organizations
  • Someone at your organization

Such messages are typically crafted to induce panic or quick action or lean into sensitive topics. Appointment reminders, patient follow-ups, internal alerts, and external correspondence all move through email systems, giving attackers many chances to blend into everyday traffic.

As with most email scams, even one out of a million successful messages makes an attacker’s effort worthwhile. Although tactics continue to change, the goal remains the same: attackers impersonate trusted sources to gain access and wreak havoc.

More about: How phishing kits fuel credential theft in healthcare

 

What is new about phishing?

Initially, phishing emails were easy to recognize because they typically featured bad spelling, poor grammar, and terrible graphics. Today’s phishing messages are so well crafted, they sometimes trick even skeptical, security-conscious users. Attackers operating at scale no longer just send phishing emails. They use multilayered tactics that outsmart traditional filters and easily trick victims into handing over credentials. Hackers send phishing messages in ways designed to take advantage of how organizations react.

Bulk phishing has become a widely used method because scale works in the attackers’ favor. Large volumes of identical emails that impersonate retailers, banks, delivery services, or internal teams rely on the fact that only a small percentage of recipients need to respond for the campaign to succeed. Attackers also seem to be leveraging other new techniques to make phishing harder to detect, such as:

  • PDF attachments
  • QR codes
  • Calendar-based phishing

More concerning is the rise in infrastructure designed specifically to fool detection systems. Some phishing pages now include CAPTCHA chains to block automated scans, or mimic live authentication systems by interacting directly with real APIs. Once compromised, attackers can access user accounts with little to no immediate warning.

 

Artificial intelligence and phishing

Advanced technologies, like AI, have helped phishing attacks grow. Generative AI has accelerated the phishing problem considerably. Instead of writing one phishing message at a time, attackers can now use AI to quickly draft, rewrite, and tailor emails so they closely match normal workplace communication. The use of AI has removed the cost constraint that previously limited how many convincing messages an attacker could produce.

The emphasis on scalability also means attackers can send large volumes of convincing messages at once, and even small gains in realism can lead to more replies, more stolen credentials, and longer access to compromised inboxes. Moreover, as AI agents process more of our email (e.g., summarizing, filtering, or even writing back for us), prompt injection leverages the limitations of machines. Prompt injections evade the defenses built into big language models. Attackers don't need to trick humans anymore. They can just trick the AI.

 

Cybersecurity strategies for HIPAA compliance

Preventing ransomware attacks requires a comprehensive cybersecurity approach. There are several tactics that could be used effectively by healthcare organizations when creating a layered, consolidated security system.

  1. Establish up-to-date policies and procedures
  2. Keep systems, software, and security features aligned with advanced technologies
  3. Implement a program to identify cyber vulnerabilities
  4. When creating a business associate agreement (BAA) with third parties, address their cyber measures as much as your own
  5. Use continuous employee awareness training
  6. Ensure proper technological safeguards, such as data encryption
  7. Utilize strong access controls like mandatory passwords and multifactor authentication
  8. Apply endpoint protection and secure gateways along with antivirus software and firewalls
  9. Keep communication channels secure
  10. Perform risk assessments and penetration tests regularly
  11. Create data backup and disaster recovery plans in case of an incident
  12. Regularly audit and monitor systems
  13. Have an incident response plan ready in case it is needed

HIPAA compliance regulations aim to protect health information. Adhering to HIPAA standards with a defensive approach helps providers protect privacy, leading to stronger systems and better patient outcomes.

 

Leveraging advanced cybersecurity strategies

While criminals can exploit weaknesses with advanced technology, healthcare organizations can invest in solutions that provide real-time threat detection and response capabilities. Generative AI can create new outputs based on patterns learned from existing data. In healthcare, generative AI allows advanced data analysis, predictive modeling, and automation. Implementing such strategies can help healthcare organizations use the benefits of advanced technologies without compromising patient privacy.

 

How Paubox defends against phishing

Paubox email suite is a HIPAA compliant email solution designed for healthcare organizations to securely communicate PHI without disrupting workflow. Paubox protects healthcare organizations from phishing attacks using a multi-layered inbound email security system that blocks threats before they reach users’ inboxes. Its inbound email security uses generative AI to analyze message behavior, tone, and intent, helping detect sophisticated phishing emails that appear legitimate instead of relying only on traditional spam filtering.

The platform also includes ExecProtect and ExecProtect+, patented features that prevent impersonation by detecting display name spoofing and blocking emails pretending to be executives or trusted staff. Incoming emails are scanned for malware, malicious links, fake domains, and other warning signs, with suspicious messages automatically quarantined to prevent credential theft, unauthorized access, and exposure of PHI while supporting HIPAA compliant communication.

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FAQs

Why does email continue to appear in so many healthcare incidents?

Clinical coordination still relies heavily on email. Referrals, patient updates, vendor communication, and administrative decisions move quickly through inboxes, especially in time-pressured environments.

 

What is the difference between bulk phishing and weaponized phishing volume?

Bulk phishing tries to trick as many people as possible with one campaign. Weaponized phishing volume uses a flood of messages to overwhelm security teams, creating cover for a smaller number of targeted attacks.

 

How do real-time phishing sites bypass MFA?

They intercept credentials and immediately pass them to the legitimate service, prompting real MFA challenges. Users who enter their codes help the attacker log in successfully before the session expires.

 

What steps should organizations take immediately after detecting a breach?

Isolate affected systems, preserve forensic evidence, disable compromised accounts, alert incident response teams, and notify regulators if sensitive data is involved.