Background <p>Compact county medical communities (CCMCs) have emerged as a key strategy to strengthen primary healthcare delivery in China. The objective of this study was to assess the impact of the global capitation prospective payment (GCP) reform on CCMCs performance.</p> Methods <p>This research collected data from 2018 to 2022 across three pilot regions in China. Using interrupted time series analysis (ITSA), we assessed how the implementation of GCP affected CCMCs development.</p> Results <p>The ITSA results show that the average length of stay at the lead hospital decreased by 0.105 days (<i>P</i> &lt; 0.001) after the reform in pilot A, while the average hospital cost increased by 62.272 yuan per month (<i>P</i> &lt; 0.05). The lead hospital in Pilot B had a decrease in average inpatient costs of 54.203 yuan per month (<i>P</i> &lt; 0.001). Conversely, Pilot C’s the lead hospital had an increase in average inpatient costs of 26.610 yuan per month (<i>P</i> &lt; 0.001), and the average length of stay at the lead hospital increased by 0.028 days (<i>P</i> &lt; 0.05).</p> Conclusion <p>GCP has reasonably promoted the benign development of CMCCs. However, the diversity of strategies and operations has resulted in a different focus on effectiveness. Based on local resource endowments, future reforms should pay more attention to the synchronization of payment reforms and organizational changes.</p>