Objective: The paper analyzes the risk of "increasing related weight" in DIP payment methods and the prevention and control strategies for "increasing related weight" behavior in DIP reform of Yichang City, and provides governance ideas for developing DIP payment methods in other regions. Method: The game theory was used to analyze the risk of "increasing related weight" in the DIP payment method, and the difference-in-difference model was used to compare the changes in the number of inpatients in public hospitals between Yichang City and non-pilot cities in Hubei Province from 2018 to 2022, so as to evaluate the effectiveness of the DIP reform in Yichang City on the prevention and control of "increasing related weight" behavior in public hospitals. Result: The game theory model shows that there is a risk of "increasing related weight" in DIP reform, and effective supervision can prevent "increasing related weight" behavior. There is no significant difference in the number of inpatients between public hospitals in Yichang City and those in non-pilot cities in Hubei Province after the DIP reform. Conclusion: Yichang City has to some extent curbed the occurrence of "increasing related weight" behavior through effective intelligent supervision mechanism as well as evaluation and punishment mechanism. It is suggested that other regions should pay more attention to the role of intelligent supervision mechanism as well as evaluation and punishment mechanism in the process of DIP reform.