The report analyzes the role of insurance medical organizations (IMOs) in the Russian system of compulsory health insurance (CHI). Consumers of health services and the management of budgetary medical institutions are considered as key interest groups. To identify the positions of consumers, the concept of "exit", "opinion" and "loyalty" of A. Hirschman is used. We analyze the expert opinions of the graduates of the Presidential Program "Management in Health Care" in order to determine the positions of heads of medical institutions.