The health care alliance in county is a kind of vertically integrated medical service system. It is conductive to improve the overall efficiency of the county medical service，achieve tiered health care system，optimize regional health resources and enhance the capacity of primary health care services. The paper takes Tianchang county，Anhui province as a case study. It investigates and analyzes how the local take measures to carry out the health care alliance reform in organization structure，interest distribution，health human resources construction，information construction，division and coordination mechanism，medical service pattern，etc.，and provides similar China’s counties with a case study to be used for reference.