Taking the medical associations of the Suqian first people's hospital as an example, The paper investigated and analyzed the operation situation of two-way referral and the cognition of medical staff on two-way referral in the medical associations constructed by public and private hospitals through a questionnaire survey.Meanwhile, in-depth interviews were conducted with hospital managers. It is found that there are some problems in the medical association established by public hospitals and private hospitals, such as the weak publicity of two-way referral, the biased understanding of two-way referral by medical institutions, the limited implementation of two-way referral, and the imperfect operation mechanism of medical consortium. It is suggested to strengthen the publicity of two-way referrals, clarify the standards of two-way referrals, improve the operation mechanism of medical association, and promote the in-depth development of medical association.