The reform of payment method by diagnosis-intervention packet (DIP) is an important part of deepening the reform of medical insurance payment method, and it is an original payment method in line with China's national conditions. Taking Rice-Horn model as the framework, on the basis of the literature analysis, the payment dilemma was studied from six dimensions, including the policy objectives and standards, policy resources, communication between organizations and coercive behavior, the characteristics of the executive, political economic and social environment and the preference. Some suggestions are put forward from four aspects, including the perfect laws and regulations, improving the executive attention, improving executive execution ability, and optimizing the execution environment.