OBJECTIVE： To study the implementation of scoring diseases payment under the control of total budget in some areas of China， and provide reference for the further improvement of the payment. METHODS： Based on the operation process of scoring disease payment in the control of toal budget， the specific practices of Huaian， Nanchang， Zhongshan and Taiwan area， were compared. RESULTS： It showed differences in the control and allocation of total budget， the establishment of scoring diseases， the setup of adjustment coefficient， the development of balance methods， the complementary mechanism and the monitor examination setting. CONCLUSIONS： Whether to classify the diseases according to diagnosis and treatment methods， how to setup adjustment coefficient appropriately， how to reimburse the patients in stages and how to strengthen supervision are worthy of further thinking and exploring.