Objective: Based on the empirical data of four major chronic diseases, to compare the two methods of calculating the benchmark capitation, and to provide methodological references for promoting the reform of the capitation payment mode of outpatient services with chronic diseases in China. Methods: The data of urban employees and urban and rural residents in Daxing District who suffer from the above four types of chronic diseases were collected to calculate the capitation rate by top-down and bottom-up methods, and compare the advantages and disadvantages of the calculation results and methods. Results: The capitation standard of hyper- tension, diabetes and cerebrovascular patients calculated from top to bottom was higher than that calculated from bottom to top. The capitation standard of ischemic heart patients with resident medical insurance calculated from bottom to top was lower, but no matter which method was used, the results calculated from employee medical insurance were higher than that of resident medical insurance. The bottom-up method was based on historical data, and the results were more realistic. Conclusion: The bottom-up method for cal- culating the headcount is relatively scientific and reasonable for China at this stage. After several years of trial implementation of capi- tation in the region, the top-down method can be used to calculate the capitation standard more conveniently and quickly.