Outpatient maintenance treatment of chronic diseases and some special diseases increasingly constitutes a heavy burden on patients, and it is in urgent need for healthcare security to play a fuller role in regulation and guarantee. At present, the outpatient guarantee system of chronic and special diseases is mostly in the stage of prefecture-level coordination. With the increase of medical treatment in different places, the large policy differences affect the convenience, and it is urgent to be standardized and unified at the provincial level. This paper analyzes the main contents, achievements and enlightenment of standardizing and unifying the outpatient guarantee system of chronic and special diseases in Guizhou Province. On this basis, this paper puts forward system improvement suggestions around optimizing the management path of healthcare security chronic and special diseases, so as to promote the transformation of healthcare security chronic and special disease management from unilateral cost control to doctor-patient insurance collaborative health management mode. The study aims to provide reference for the standardization of the outpatient guarantee system in other provinces.