Introduction. At the present stage there are prerequisites for the centralization of medical organizations at its various levels, taking into account the medical-demographic and medical-geographical characteristics of the population, the peculiarities of administrative-territorial division, and the availability of transport logistics. At the same time, in each region such measures have their own regional peculiarities, and the process of urbanization often leads to the need to revise the existing network of medical organizations. Formation of three-level systems of medical care in the regions and improvement of routing by profiles of medical care is an inevitable process of achieving the targets of the national projects. The increasing technological sophistication of the health care sector, which leads to an increase in the cost of creating conditions for the provision of specialized and high-tech medical care, necessitates the concentration of infrastructure and resources, including medical equipment and personnel. This article considers the options of centralization of medical organizations carried out in the constituent entities of the Russian Federation and formulates their main directions. Purpose: To examine the literature and regional practices on the centralization of health care organizations in the current context. Materials and methods of research. Literary data and normative-legal acts were analyzed, regional practices devoted to the issues of centralization of medical organizations in the subjects of the Russian Federation, as well as approaches to the centralization of health care resources in the provision of primary health care, specialized, including high-tech medical care were studied. The data of the federal statistical observation form No. 30 “Information about the medical organization” in the Russian Federation were used for the analysis. Research results. In the course of reviewing the examples of creation of district, inter-district and regional medical organizations, the main directions of unification of medical organizations implemented in different subjects of the Russian Federation were formulated. Discussion. At the moment in most regions there are processes of consolidation of medical organizations against the background of the ongoing transformation of health care systems in modern conditions, for which there are objective needs and prerequisites for improving the normative-legal regulation and studying the regional experience and achieved results, changes taking place in the subjects of the Russian Federation. Making decisions on the centralization of medical organizations at the level of the executive authority of the subjects of the Russian Federation in the field of health protection requires a balanced and scientifically sound approach, as it affects a number of areas and affects the formation of political and socio-economic agenda in the region. Conclusion. The directions of centralization of medical organizations are of interest for further study, because they have relevance and potential to improve the organization of medical care for the population, are closely related to the need to create optimal schemes of patient routing by profile of medical care, and are related to the issues of territorial planning in health care, management of financial and human resources, distribution of the volume of medical care and ultimately contribute to the improvement of the quality of medical care.