Downward Revision of Medical Reimbursement Rates

「The medical fee revision was finalized at a positive 3.09% for the basic fee and a positive 2.22% in total, including drug prices. This is the first time in 30 years that the basic fee has been raised by more than 3%, and the first overall increase in 12 years. In addition, although nursing-care fees were not due for revision this year, an extraordinary 2.03% revision was implemented to improve the treatment of workers and address rising prices.」

「The healthcare and long-term care environment remains difficult, as the increases from the positive medical and long-term care fee revisions implemented the previous year were absorbed by continued increases in prices and labor costs, making no contribution to improving operating conditions at healthcare and long-term care institutions and further worsening operating indicators.」

「Although the basic medical service fee and long-term care fees were revised upward by +0.88% and +1.59%, respectively, a large portion was allocated to improving compensation for workers, so the funds effectively available to improve operating conditions are considered limited.」

「This fiscal year is a year of the simultaneous revision of medical service fees and long-term care fees. The basic medical service fee was revised upward by +0.88% and long-term care fees by +1.59%, so both revisions were positive, and the difficult operating environment is expected to ease gradually.」

「Next fiscal year will be a year of the simultaneous revision of medical service fees and long-term care fees. Although a revision addressing the increasing costs is expected, the difficult environment is expected to continue until it is implemented.」

「For the simultaneous revision of medical service fees and long-term care fees scheduled for next June, an increase in the basic fee components is under consideration as a measure, and attention is focused on the revision rates.」

「The medical service fee revision implemented this April increased the basic fee component by 0.43%, marking another upward revision following the previous one.」

「Although this April's medical service fee revision included a 1.37% reduction in drug prices and other components, the basic medical service fee was increased by 0.43% with measures to address the COVID-19 pandemic, representing a revision aimed at institutionalizing support rather than relying on general expenditure funding.」

「The medical service fee revision scheduled for this April during the COVID-19 pandemic included a 1.37% reduction in drug prices and other components, while the basic medical service fee was revised upward by 0.43%, including measures to address the pandemic such as improving compensation for nursing staff exhausted by COVID-19.」

「In the April revision of medical and long-term care fees, long-term care fees were revised upward by 0.70%. Meanwhile, the revision of drug prices, previously conducted biennially, became annual beginning with this revision and was reduced by an amount equivalent to approximately ¥430 billion in medical spending.」

「The long-term care fee revision scheduled for implementation this April was an upward revision of 0.70%. Meanwhile, the revision of drug prices, previously conducted biennially, became annual beginning this April and was reduced by an amount equivalent to approximately ¥430 billion in medical spending.」

「Most medical facilities saw their operating environment deteriorate significantly as patient numbers fell sharply. Government support, including special medical service fees and free distribution of medical supplies, has not yet produced sufficient results, and additional action is urgently required.」

「Against this backdrop, the impact on the medical-wear market during the cumulative second quarter of the consolidated fiscal year is considered to have been minor because the fee revision rates were broadly in line with expectations. However, medical institutions were thrown into confusion by their response to the rapidly expanding COVID-19 pandemic, and the market environment was affected by delays in scheduled deliveries.」

「As this was a consecutive revision following the April 2018 fee revision, and an unusual October revision, the market appears to have experienced some disruption.」

「In the healthcare and long-term care industries, there is considerable uncertainty over how the policy of reducing drug prices and the reflection of the October consumption tax increase in medical service fees and long-term care fees will affect operating conditions, and the industry is expected to remain in turmoil.」

「In the environment surrounding healthcare and long-term care, the simultaneous revision of medical service fees and long-term care fees in April last year led to a marked increase in bed reorganization, and steady progress appears to be being made toward establishing a supply system based on new functional differentiation and coordination in healthcare and long-term care. Meanwhile, active discussions are under way regarding revisions to medical service fees and long-term care fees and drug prices associated with the consumption tax increase scheduled for October this year, and attention is focused on developments.」

「In the environment surrounding healthcare and long-term care, bed reorganization has progressed since the simultaneous revision of medical service fees and long-term care fees in April of the previous year, and steady progress appears to be being made toward a new healthcare and long-term care supply system. At the same time, active discussions are under way regarding revisions to medical service fees and long-term care fees and drug-price revisions associated with the consumption tax increase scheduled for October this year.」

「Although the disruption from this April's simultaneous revision of medical service fees and long-term care fees is beginning to settle, active discussions are already under way from various perspectives ahead of revisions to fee levels to address the consumption tax increase scheduled for October 2019. In addition, a shift from biennial to annual revisions of drug prices is being considered, and attention is focused on how this will unfold.」

「The six-year simultaneous revision of medical service fees and long-term care fees was implemented in April, with medical service fees revised downward by 0.9% and long-term care fees revised upward by +0.54%.」

「However, the simultaneous revision also brought major changes to reforms extending beyond the boundary between healthcare and long-term care, including the establishment of long-term care medical facilities, and appears to have caused some confusion.」

「Although the medical service fee revision rate was a negative 0.9%, the basic fee component was revised upward by more than in the previous revision, so the market response was relatively measured and the overall impact appears to have been minor. The long-term care fee revision rate also turned positive at +0.54%, from a negative revision previously, resulting in an outcome that is expected to improve conditions at strained long-term care facilities.」

「In the environment surrounding healthcare and long-term care, active discussions are under way from various perspectives ahead of next April's scheduled six-year simultaneous revision of medical service fees and long-term care fees. As the next simultaneous revision will take place immediately before 2025, when the entire baby-boomer generation will become late-stage elderly, this revision is viewed as the final opportunity for major, fundamental institutional changes extending beyond the frameworks of healthcare and long-term care, and attention is focused on how it will unfold.」

「The healthcare and long-term care industries are entering a year of the biennial simultaneous revision of medical service fees and long-term care fees. Major institutional changes are also under consideration from the perspective of functional differentiation and coordination, and the market is expected to become increasingly uncertain.」

「In April, measures including revisions to the prices of certain high-value products were implemented to limit the increase in social security spending in fiscal 2017 to ¥500 billion. However, the impact on the market is considered to have been limited. Discussions have also begun to intensify ahead of the simultaneous revision of medical service fees and long-term care fees scheduled for next April.」

「The impact of the temporary revision to long-term care fees implemented in April to improve treatment for care workers, as well as the revision of certain drug prices, was also limited.」

「In the environment surrounding healthcare and long-term care, active discussions are currently under way from various perspectives on measures including raising the out-of-pocket cost ceilings for high-cost medical care and revising the drug-price component of medical service fees annually, with the aim of limiting the annual increase in social security spending to ¥500 billion.」

「The medical reimbursement schedule was revised in April this year, resulting in a negative revision of 0.84%. Although the overall revision was negative to restrain the growth of total social security spending, the basic medical reimbursement rate was increased by 0.49%, which is viewed favorably as supporting the development of a community-based integrated care system.」

「The medical reimbursement schedule was revised in April. The basic medical reimbursement rate was increased by +0.49%, while drug prices and other items decreased by △1.33%, resulting in a total negative revision of △0.84%. However, the increase in the basic rate to improve the quality of medical care under the community-based integrated care system is considered highly commendable.」