Abstract: As the core carrier of integrating medical resources at the county, township and village levels, the county medical community undertakes the important mission of improving the primary medical service system and achieving the goal of hierarchical diagnosis and treatment. Analyzing the implementation dilemma of the county medical community's medication convergence policy and revealing the deviation characteristics between the policy text and the implementation practice are of great significance to solve the problem of grassroots medication. Based on the Mitt-Horn model, this paper analyzes the implementation dilemma of the county medical community's medication convergence policy from the perspective of policy implementation. The study found that policy objectives and standards, policy resources, implementation methods and organizational communication, implementation agency characteristics, executor value orientation and external environment are the main factors restricting the convergence of county medical community medication. It is necessary to optimize policy objectives and standards, integrate policy resources, improve implementation methods, improve the level of grassroots pharmaceutical services, correctly guide the value orientation of the executive body, and improve the system environment for policy implementation.