Ransomware response plans establish roles, communication protocols, technical response steps, and decision-making criteria before an attack occurs. Plans address isolation procedures, forensics preservation, law enforcement notification, stakeholder communication, and payment considerations. For example, a healthcare system's plan might prioritize patient safety, activate backup systems within four hours, and involve executive leadership and legal counsel in any ransom negotiation. Plans should address both encryption and data exfiltration scenarios, include tested backup restoration procedures, and account for regulatory reporting obligations. Regular tabletop exercises validate plan effectiveness. The decision to pay ransom involves ethical, legal, operational, and strategic factors beyond immediate data recovery.