The hierarchical healthcare system plays a vital role in guiding residents to seek healthcare in an orderly manner and achieving the effective allocation of healthcare resources. Jinzhai County has promoted the construction of a hierarchical healthcare system through a series of measures, including strengthening Party leadership over medical reform, effectively implementing the referral system, building a new integrated medical-preventive framework, facilitating the downward deployment of healthcare professionals to primary care facilities with talent development, increasing financial support and incentives, and accelerating the digitization of the healthcare service network. These practices in Jinzhai County are highly representative and offer valuable insights for other counties. To address existing challenges in the implementation of the hierarchical healthcare system, improvements should focus on the following areas, including clarifying the functional roles of medical institutions at all levels, refining coordination mechanisms between tertiary hospitals and county-level hospitals, enhancing the service capacity of primary healthcare facilities, leveraging the guiding role of medical insurance, and expanding the scope of health services.