Objective: The paper explores the payment characteristics of different disease groups under DRG payment and carries out the settlement management scheme of classified management. Methods: The DRG grouping principle and settlement management method was further studied and analyzed, and the disease groups were divided into total amount control disease groups, key supervision disease groups and key incentive disease groups, etc. The classification management scheme was formed by combining the horizontal and vertical comparison of some efficiency indicators during the DRG operation. Results: The total amount control disease groups achieved the control of irrational increase in the number of inpatients in the relevant disease groups by means of total amount control. The key incentive disease groups were supported from the perspective of clinical technology development and medical insurance settlement management, ensuring the initiative of medical institutions to treat patients and improve technology.