Decoding StateRAMP: Fortifying Healthcare Cybersecurity in a Shifting Cloud Landscape

According to the HIPAA Journal, more than 100 million healthcare records were breached over the course of 2023. Though there were fewer breaches in total throughout 2023 compared to 2022, with the US Department of Health and Human Services receiving 541 individual breach disclosures from healthcare organizations, the magnitude of breaches has been increasing. Cumulatively, the top 11 biggest health data breaches of 2023 affected more than 70 million individuals.

The ever-present risks and consequences of health data breaches—from regulatory penalties to a loss of consumer trust—underscore the vital importance of keeping up with healthcare cybersecurity best practices, which include staying aware of shifts and evolution in the standards for the cloud platforms healthcare organizations rely on to improve productivity and deliver better patient outcomes.

In this blog, we’ll take a look at how StateRAMP safeguards the integrity of healthcare data and the individuals whose well-being relies on secure and resilient systems.

Exploring StateRAMP

Cloud platforms have become essential infrastructure for healthcare organizations the world over, demanding standardized measures to ensure that these platforms can be depended on to keep PHI secure for billions of patients. Established in 2011 by the US Office of Management and Budget (OMB), FedRAMP provided a standardized approach to security assessment, authorization, and continuous monitoring for cloud products and services across the federal government.

Following in FedRAMP’s wake, StateRAMP, a non-profit organization founded in early 2020, helps state and local governing bodies set common standards for cloud-based solution providers to protect sensitive information. The high sensitivity of Protected Health Information (PHI), of course, makes StateRAMP extremely relevant for healthcare providers.

The goal of StateRAMP is to implement proactive and continuous audit systems for vendors of cloud solutions at the state level, helping healthcare organizations ensure that the cloud-based tools they use on a daily basis are adequate to protect PHI from the ever-evolving landscape of cybersecurity threats.

StateRAMP is similar to SOC 2 in that both define frameworks for addressing the security of data stored in the cloud, including mandating the need for regular compliance audits. However, StateRAMP is specific to the public sector and SOC 2 is more general and applies to a wider range of both public and private organizations.


StateRAMP was designed to build off of the federal entities’ past experience with FedRAMP to develop a new security review program that specifically met the needs of state and local governments. While both are built on NIST 800-53 Rev. 4 standards and require 3PAO audits, FedRAMP is a federal government program funded by the OMB and solely acts as a reviewing body, whereas StateRAMP is a 501c(6) focused on promoting cybersecurity best practices through education, advocacy, and policy development that has led states to develop their own RAMP standards, such as TX-RAMP.

Ensuring Healthcare Cybersecurity Compliance With StateRAMP

StateRAMP helps state and local governments develop cybersecurity review policies for cloud vendors to prevent and mitigate the harm from data breaches and cyber attacks on cloud infrastructure.

If your healthcare organization shares PHI with public agencies, you may be required to adhere to your state’s relevant StateRAMP policies in addition to other cloud security frameworks such as SOC 2. It’s important for organizations, especially public healthcare organizations, to stay informed about the impact of StateRAMP policies on their operations and be prepared to act in compliance with its requirements.

Like FedRAMP, which categorizes cloud services into different impact levels (low, moderate, and high) based on the sensitivity of the data they handle, compliance levels in StateRAMP range from low to high. In the healthcare world, state and local organizations such as state-run hospitals and community centers bear the responsibility for ensuring the cloud solutions they procure are compliant.

Non-compliance (i.e. choosing a cloud vendor that does not meet the appropriate level of compliance for the sensitivity of the data it handles) may include potential fines, but the most common consequence is that a non-compliant vendor may be dropped during renewals.

Healthcare Cybersecurity From State to State

The standardized approach for security assessment varies from state to state. For example, TX-RAMP, the Texas Risk and Authorization Management Program, sets the state of Texas’s cybersecurity compliance standards for any cloud product or service that transmits data to Texas state agencies. While Texas RAMP principles in general are built on the same foundation as StateRAMP, it maintains its own specific requirements for obtaining and renewing certifications for cloud providers that work with government organizations.

Dive Deeper Into StateRAMP with Byteworks and ActZero

If you’d like to learn more about healthcare regulations and compliance in the age of StateRAMP, we invite you to take a deep dive into StateRAMP and the compliance obligations of healthcare organizations under its new standards for cybersecurity with our on-demand webinar.

You’ll delve into the obligations of cloud providers and healthcare organizations under StateRAMP with a special guest from Act Zero, an industry leader in endpoint protection and one of Byteworks’ industry partners for cybersecurity solutions:

Ensure PHI Protection With Byteworks

Third-party cybersecurity support is an essential factor for healthcare organizations to ensure sufficient protection of their PHI and prevent the breach of patient data. At Byteworks, we offer comprehensive healthcare cybersecurity services to ensure the protection of PHI, including:

  • Sourcing and vetting cybersecurity solution vendors, including cyber insurance to insulate your organization from the financial, legal, and reputational risks of data breaches and cyberattacks
  • Conducting vulnerability assessments of your cloud and onsite infrastructure
  • Helping ensure that cloud vendors meet any relevant StateRAMP or FedRAMP requirements
  • Implementing leading security solutions, including endpoint protection and access/identity management
  • Cost-effective managed cybersecurity services that fit your needs and budget like a glove

Get started today. Schedule a meeting with a cybersecurity expert or explore cybersecurity services from Byteworks.

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