Japan should boost fees for home-based medical services: panel

February 7, 2018

Tokyo- Japan should boost fees paid under the national health insurance scheme for home-based medical services, such as remote consultations via video chat and home visits by doctors, a government panel said Wednesday.

The Central Social Insurance Medical Council proposed the measure in a policy report to health minister Katsunobu Kato on the planned fiscal 2018 revisions to government-administered medical fees.

The panel also recommended an increase in fees paid to regular family doctors, as it recognizes their importance in providing initial consultations and introducing patients to specialists.

Government-administered medical fees are basically reviewed every two years. The fees include remuneration to doctors and pharmacists as well as prescription drug prices.

The health ministry estimates that the number of patients who receive home-based medical treatment will jump more than 1.5 times from the current level to one million in 2025, by which all baby boomers born between 1947 and 1949 will be aged 75 or older.

The ministry aims to promote the use of remote medical services by raising the fees, as a growing number of patients are likely to become unable to visit hospitals frequently, officials said.

The panel recommended that new fees be established to facilitate cooperation among medical institutions to provide home-based services in which doctors regularly visit patients. The step is intended to make it easier to attend patients with various diseases and provide home-based services around the clock.

In order to clarify the division of roles between large hospitals and family doctors, the panel proposed introducing add-on fees for initial consultations, including referral to specialists, to medical institutions with family doctors that accept patients out of hours.

The panel called for expanding the range of large hospitals allowed to charge additional fees for visits by patients with no referral from their regular doctors, to institutions with 400 beds or more from the current level of 500 beds or more.

The amount of the extra fees should be kept unchanged at 5,000 yen or more on initial visits and 2,500 yen or more on second and later visits, according to the panel.

Japan is expected to see a decrease in the number of acute-stage patients, while patients with chronic diseases are seen increasing in line with the aging of the population.

The panel therefore proposed tightening the criteria for setting fees for beds used for emergency and acute-stage patients to whom more nurses are allocated.

Fees should be decreased for large-scale drug stores, mainly chain stores, that focus on prescription drugs for certain hospitals located nearby, the panel said.

To help improve working conditions for doctors, particularly pediatricians, obstetricians and gynecologists, the panel proposed that a combination of two or more part-time doctors who work at least three days a week for a total of 24 hours be regarded as equal to a full-time doctor.

The panel examined details of medical service fee changes, following a government decision late last year to cut the overall medical fees by 0.9 percent from the current level in the fiscal 2018 revisions. Jiji Press