Based on the Meter - Hom model，the implementation dilemma of the outpatient medication guarantee policy for chronic diseases in Nantong was analyzed through a qualitative interview to provide a reference for improving the effective implementation of the policy. Our study indicated that one year following the launch of the outpatient medication guarantee policy for hypertension and diabetes，the policy filing rate was only 7% and 14% ，respectively. This suggests that the target population did not fully benefit from the welfare policy. According to qualitative interviews，the main obstacles to policy implementation were: unclear objectives and standards of policy implementation；lack of understanding of the outpatient medication guarantee policy among executing agencies and insured residents；shortage of human resources，and insufficient hardware environment for policy implementation in primary health care institutions，and the single top-down administrative policy implementation method and so on. Thus，the following optimized paths were proposed to improve: enhance the top - level design and refine the policy implementation objectives；broaden the publicity and promotion of policies through multiple channels to improve the compliance of policy implementation；strengthen the linkage between medical insurance departments and primary health care institutions.