Modern healthcare in the Russian Federation is built on the principles of the Semashko healthcare system while integrating contemporary organizational and digital solutions. The article analyzes the current healthcare model as a key instrument for achieving the National Development Goal “Preservation of population, health promotion and improvement of people’s well-being.” The governance structure is described at federal and regional levels, including the roles of the Ministry of Health, federal regulatory and insurance institutions, national medical research centers, and regional health authorities. Particular attention is paid to the vertically integrated network of public healthcare providers and the three‑tier system of medical care organization, ensuring stepwise accessibility of primary, specialized, and high‑tech care across 89 regions of the country. The mixed budget‑insurance financing model, with compulsory health insurance as a core mechanism, and the State Guarantees Program are presented as key tools for securing free medical care and program‑target management of resources. The preventive orientation of the system, including measures for the working population, and the rapid development of digital health technologies are highlighted as essential drivers of efficiency and quality. The article concludes that the modern Russian healthcare model combines continuity with historic principles and innovative approaches to meet current demographic and epidemiological challenges.