The healthcare industry remains a prime target for hackers, with more breaches occurring in healthcare than in any other industry. A study released last year found that ransomware has exposed over 375 million health records since 2010. That number continues to grow today, and ransomware persists as a prominent threat to healthcare providers now and in the future.

With advances in technologies such as artificial intelligence (AI), ransomware in 2026 has become more troublesome for hospitals and clinics. Modern ransomware attacks are considered to be more sophisticated, faster, and scalable. Healthcare organizations need to understand how cyberattackers are using ransomware in 2026 to be able to properly block and prevent possible consequences.

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

 

Healthcare is the most targeted sector

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.

 

What is ransomware?

The Cybersecurity and Infrastructure Security Agency (CISA) defines ransomware as malware used to deny access to systems or data until a ransom is paid, while the FBI Internet Crime Complaint Center (IC3) adds that it is software that “prevents you from accessing your computer files, systems, or networks and demands you pay a ransom for their return.” Ransomware is one of the most common and disruptive healthcare data security threats.

The start of ransomware dates to the 1980s, but there was a sharp increase in healthcare-focused attacks beginning in 2016. In 2019, victims saw a rise in double extortion (see below), where hackers not only encrypted files but also threatened to release stolen data. By 2021, ransomware was responsible for one-third of all reported healthcare breaches.

Thousands of hospitals and healthcare organizations have fallen victim to ransomware attacks, resulting in substantial losses. The impact of ransomware goes beyond lost or exposed encrypted files because it can disrupt operations, reveal sensitive information, and create lasting financial and regulatory issues for an organization.

 

Examples of ransomware

Ransomware-as-a-service (RaaS): cybercriminals sell/loan ransomware infrastructure to other cybercriminals to carry out attacks. Group known to operate RaaS platforms: LockBit.

Targeted ransomware (big-game hunting): cyber groups target large, high-value organizations (such as hospitals) after weeks of planning. Group known to use targeted ransomware: SamSam group.

Supply chain ransomware: attackers target weak vendors (i.e., business associates) to gain access to numerous other organizations to spread ransomware. Group known for supply chain ransomware: REvil.

Double extortion ransomware: hackers encrypt and exfiltrate data to add an extra layer of pressure. Groups known to use double extortion: Maze.

Triple extortion ransomware: cybercriminals encrypt and exfiltrate data while adding a third layer of pressure to have a ransom paid, such as encrypting/locking more than just data or threatening another attack. Groups known to use triple extortion: BlackCat.

 

What is new about ransomware?

Malicious attackers continue to emerge and evolve, and ransomware has moved beyond basic file locking to system locking, data theft, and extortion. In fact, IC3 identified 63 new ransomware variants in 2025, averaging 5.25 new variants per month, with the top 10 accounting for 56% of all reported ransomware incidents. The five most reported ransomware variants in 2025 were:

  • Akira
  • Qilin
  • INC Ransom
  • BianLian
  • Play

The report found that these new attackers tend to target sectors with low tolerance for operational downtime, such as the healthcare industry. They are even expanding across large organizations and mid-sized businesses, along with smaller clinics, with increasingly larger ransom payments and deeper operational impact.

Furthermore, the IC3 annual report documented the growing use of AI by cybercriminals to generate convincing phishing emails, synthetic video content, and voice cloning on a massive scale. Alarmingly, it can be used by attackers at every stage of an attack, from targeting to initial access and to the actual development of malware tools. Artificial intelligence makes it easier for hackers to hit numerous organizations at once with a single tool.

Read more: 86% of phishing campaigns now use AI as attacks expand beyond email

 

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, especially possible double or triple extortion
  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 is a machine learning model that 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.

Paubox Email Suite is a HIPAA compliant email solution designed for healthcare organizations to securely communicate PHI without disrupting workflow. Paubox seamlessly encrypts all outbound emails, delivering them directly to recipients’ inboxes. It integrates with existing email platforms like Google Workspace and Microsoft 365, ensuring seamless security while maintaining ease of use. Moreover, its generative AI offers a secure email solution for organizations seeking a cybersecurity option tailored to one of their most vulnerable outputs.

 

FAQs

What is the connection between ransomware and HIPAA compliance?

A ransomware attack that encrypts or exfiltrates PHI is presumed to be a HIPAA breach unless the organization can demonstrate a low probability that the information was compromised. That triggers the Breach Notification Rule notification to affected individuals within 60 days, media notification in affected states for breaches over 500 individuals, and reporting to the Department of Health & Human Services’ (HHS) Office for Civil Rights (OCR). The department has increasingly used ransomware investigations to assess whether organizations had adequate security controls in place before the attack.

 

What are indicators of a possible ransomware infection?

Early warning signs can include unexpected system slowdowns, unauthorized account creation, changes to file extensions, and disabled security tools.

 

How does a rural hospital protect itself with limited resources?

Priority goes to the highest-impact basics: MFA on all remote access systems, offline backups tested regularly, and pre-delivery email filtering that stops phishing before it reaches staff. These three controls address the most common entry points compromised credentials via phishing, unpatched remote access vulnerabilities, and email-delivered malware without requiring a large security team to maintain.

 

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 makes email the primary entry point for ransomware in healthcare?

Healthcare relies on email more heavily than most sectors for referrals, lab results, scheduling, billing communications, and coordination between providers. That volume creates more opportunities for a malicious message to reach someone moving quickly, and it creates more scenarios where an urgent-looking email feels credible. Microsoft Threat Intelligence found 93% of malicious activity observed across 13 hospital systems was email-based.

 

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.