Main goals of the introduction of new payment systems in healthcare institutions considered mainly the strengthening of motivation of health workers to provide quality medical care, and only then - to create conditions for the inflow of skilled young professionals. Thus, in the article the question of implementation of the employment contract in the form of an effective contract in the state budgetary institution of the Republic of Sakha (Yakutia) «The medical center of Yakutsk» is presented. Developed new job descriptions, performance criteria, evaluation of functions of the medical staff. Mechanisms accounting and implementation of social guarantees for health care workers are offered. Based on the study formulated recommendations will enable efficient use of labor resources and consequently pay wages higher than the average in the health care system.