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Purpose– The purpose of this paper is to analyse the way in which the factors influencing a transformation towards or away from modularity, according to general modular systems theory, appear in the context of health services, and the extent to which the special characteristics of health services might support or prevent its application.Design/methodology/approach– The arguments constructed in the study are based on the theme of modularity, reflected against the special characteristics of health services identified in the context of health economics.Findings– The results include 11 proposition pairs that direct health services both towards and away from modularity.Research limitations/implications– Health services are highly heterogeneous in nature and the authors illustrate this with a wide range of examples from elderly care as the authors discuss the application of modularity in this context. Nevertheless, the authors recognise that modularity might suit some health services better than others. The findings provide potentially important information to health service managers and providers, enabling them to understand how modularity would benefit health service provision and where contradictions are to be expected.Originality/value– This study contributes to the discourse on service modularity in general, and complements the literature on modularity with reference to both public and private health services.