Abstract: At present, the policy operation of compact county medical community in our country is facing difficulties. In order to deeply analyze the difficulties existing in the policy operation of compact county medical community, the six factors of Meter–Horn model are used: policy objectives and standards, policy resources, organization communication and operation activities, operating organization characteristics, operating environment and operator value orientation are analyzed as a framework. Dilemmas of policy operation include: a wide range of policy objectives, a long time for implementation of policy standards, low efficiency in the allocation of health resources, medical insurance payment baton is weak, graded diagnosis and treatment are not smoothly referred up and down, information construction is not well suited, grassroots medical institutions have insufficient capacity, and the coordination of the " medical, medical insurance, medicine " linkages is low. It is necessary to solve the dilemma of the policy operation of compact county medical community. Making recommendations: formulate specific and feasible policies, optimize the allocation of medical resources, realize information exchange and sharing, improve the primary medical capacity, strengthen medical insurance reform, to promote compact county medical community stable construction and long-term development.