Off - site medical treatment is a beneficial policy arrangement under China’s medical insurance system. However，in the operation process，off - site medical treatment is facing problems such as chaotic treatment order，frequent switching costs risks，difficulties in medical insurance fund cost control，major regulatory challenges，and fragmentation of management. There are many inconsistencies with the reform of DRG / DIP payment methods. By systematically analyzing the problems existing in the implementation of off-site medical treatment，this paper discusses the potential influencing factors of existing problems on the reform of DRG / DIP payment methods and puts forward strategies and suggestions to address these challenges to provide a practical reference for accelerating the implementation of DRG / DIP payment in off-site medical treatment.