In the conditions of COVID-19 pandemic and during the post-pandemic period, it is important to provide the most rational financing of activities for delivery of health care. It demands development of the new organizational strategy based on knowledge of the developed structure and trends of the size of costs of medical care. The purpose – the analysis of structure and the size specific (per unit of volume) expenses on medical care in the medical organizations working in the system of obligatory medical insurance from 2011 for 2019. Technique and sources of information. Data on expenses on medical care are taken from nine summary reports on form No. 62 "Data on implementation of the Program of the state guarantees of rendering to citizens of the Russian Federation of free medical care" across Russia. The methods of the content analysis, descriptive statistics, information and analytical materials of the Russian and foreign authors placed on the Internet are used. Results. Specific weight of expenses from all sources on compensation of medical personnel averaged 65% of total costs for rendering types of medical care in 9 years that is significantly higher, than in economically safe countries. Specific weight of expenses on medicines increased from 13.3% to 14.7%. By all types of medical care, except for the ambulance, the specific weight of the public expenditures on compensation and on acquisition of medicines, above, than non-state that demonstrates rearrangement of a part of the most essential expenses arising at delivery of health care for a payment for the state treasury. Most increased the costs of delivery of health care rendered at the expense of means of compulsory health insurance – on average by 4.5 times. Costs of medical care per unit of its volume provided at the expense of means of budgets on average increased by 2.5 times. Total growth of the actual costs of unit of volume of medical care, was on average 3 times higher, than the inflation for the same period reflecting the cost of money. Conclusions. It is expedient to add assessment procedures of quality of medical care (medical insurance companies and the compulsory health insurances territorial funds) with examination regarding redundancy of appointment to the patient of these or those medical services and also to return to Roszdravnadzor function according to medical technologies. The new payment strategy directed to transition from a payment for medical services and separate cases of delivery of health care to the integrated payments taking into account all stages of delivery of health care – from policlinic before medical rehabilitation are necessary.