## Main Points of the Basic Policies of the FY2014 Revision of Reimbursement of Medical Fees

December 6, 2013

Health Care Insurance Subcommittee, Medical Social Security Council

Medical Care Subcommittee, Medical Social Security Council

## Basic understanding

○ Aiming to rebuild the medical care system and establish an integrated community care system through distribution/reinforcement and cooperation of medical institution functions, including inpatient/outpatient medical care, and enhancement of in-home medical care, etc.

## Priority issues

Functional division/strengthening and cooperation of medical institutions and enhancement of in-home medical care, etc.

Functional division/strengthening and cooperation of medical institutions, including inpatient/outpatient medical care, and enhancement of in-home medical care, etc.

## Perspectives of the revision

- Perspective to appropriately assess the areas requiring enhancement

Promotion of cancer medical care and promotion of medical care for mental disabilities, etc.

● Perspective to realize safe, reliable, and high quality medical care that is understandable and convincing to patients, etc. Promotion of medical safety measures and provision of patient data, etc.

● Perspective to reduce burden of medical professionals

Efforts to reduce burden of medical professionals and promotion of functional division of emergency outpatient treatment, etc.

● Perspective to improve the areas that can be made more efficient

Promotion of generic drug usage, etc.

## I ssues for the future

Rebuilding the medical care system according to the medical needs of a super aged society with a declining birthrate and building an integrated community care system cannot immediately be completed, and requires continued efforts in distribution/reinforcement and cooperation of medical institution functions, including inpatient/outpatient medical care, and enhancement of in-home medical care, etc., including discussion of an appropriate medical fee system for providing high-quality medical care, after the FY2014 revision of reimbursement of medical fees towards 2025.

## Priority Issues of and Responses to the FY2014 Revision of Reimbursement of Medical Fees

## Priority issues

“Basic policies” of the Social Security Council

• Functional division/strengthening and cooperation of medical institutions and enhancement of in-home medical care, etc.

## Responses to priority issues

Priority issue: Functional division/strengthening and cooperation of medical institutions and enhancement of in-home medical care, etc.

1. Inpatient medical care

[1] Clarification of functions of hospital beds for the highly acute phase and general acute phase and assessment according to their functions

[2] Securing service providers for patients requiring long-term medical treatment and functional division of hospital beds for the acute phase and long-term recuperation

[3] Enhancement of hospital beds for the post-acute phase and recovery phase and assessment according to their functions

[5] Assessment of inpatient medical care at clinics with beds

2. Promotion of division/cooperation of outpatient medical care functions

[1] Assessment of family doctor functions

[2] Appropriate prescription fees, etc. at large hospitals with low incoming/outgoing referral rate

3. Ensuring that there are medical institutions that take the role of providing in-home medical care, and promotion of high-quality in-home medical care

4. Assessment of mutual cooperation between medical institutions and medical/long-term care cooperation