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Introduction. In the conditions of COVID-dependent socio-economic space, martial law, energy and economic crisis threats, it is important to support and ensure resistance to challenges, search for new opportunities for business initiatives, in particular for the health care system of Ukraine. Problem Statement. In the process of reforming the health care system of Ukraine, in addition to changes in the eco-environment of medical organizations, the medical sector has faced a number of crises which are the trigger for the implementation of a radically new approach to conducting business. The use of an entrepreneurial pillar will lay the foundation for the implementation and management of strategic changes in the medical sector. The purpose of the article is to determine the prerequisites for reforming the health care system of Ukraine and the inertial direction of its development in modern economic conditions. Materials and methods. In the process of writing the article, methods of general scientific, empirical and theoretical knowledge were used. They found their place in considering the historical stage of the health care system, providing comparative characteristics, the analysis of current eco-environment situation and so on. Results. The article considers the goals of the health care system and its relevance at the macro, meso- and micro levels, archaic formation and historical formation of the preconditions for the formation of the modern health care system of Ukraine, as well as prospects for its development. An analysis of the world health care systems, comparative characteristics, opportunities and threats of their use. Emphasis is placed on current trends and expertly predicted changes in the living environment of society, its service sector and producers, which require special attention in the areas of nature protection, life and health of the population of each country. The existing pillars and the mechanism of leverage control to influence the blocks of internal goals of the organization, within the implementation of the external goal of the world approved by the WHO, and the block of consumer needs are emphasized. The importance of further direction of reform and ways of flexible response in the conditions of existential challenges of the ecological environment is substantiated. Conclusions. Healthcare facilities in Ukraine need to introduce an established pattern - organizational and management mechanism - for the efficient use of financial resources and strategic development.