Against the backdrop of deepening the reform of medical service prices in China, since 2021, the National Healthcare Security Administration has issued a series of medical service price project approval guidelines to guide the unified and standardized medical service price project in various regions, enhance comparability and fairness of medical service, further improve the quality of medical services, and promote the high-quality and sustainable development of China’s healthcare system. This study adopts a combined approach of policy document analysis and case studies to examine the guidelines’ impacts on the operation and management of public hospitals, focusing on project integration, standardized pricing, emphasis on service outputs, recognition of technical complexity, and support for innovation. Based on these findings, the paper proposes countermeasures such as refined cost accounting, strengthened staff training, improved information management, and promotion of technological innovation. The study’s novelty lies in analyzing the guidelines from the perspective of hospital operations and offering actionable strategies. However, the lack of large-scale quantitative data and reliance on limited cases may affect the generalizability of its conclusions.