The health ministry plans to build the cost of travel and canceled visits into a flat monthly fee for home-visit nursing care in depopulated mountain areas, it told a social security council panel on Friday. The aim is to keep providers in business where patients are few and far between.
Home-visit nursing — 訪問介護 (hōmon kaigo) — is paid at present per visit delivered. In mountain areas losing population, patients' homes are scattered, so staff spend long stretches on the road between them. With fewer patients to serve, a single cancellation can unsettle a provider's finances, the ministry said.
The ministry wants to let providers in those areas choose a monthly flat fee instead, so that home-visit nursing survives in places where it is thinning out. Providers would pick either the flat fee or the existing per-visit rate.
What the fee would cover
The ministry said it would set the fee's details based on the average income of offices that visit detached houses in mountain areas, along with the cost of travel and cancellations. Travel costs would include gasoline, vehicle upkeep and the labor cost of long drives.
It also proposed splitting the fee into several tiers according to the patient's level of care need, the number of visits and the type of service.
Providers that stay on per-visit payment and travel house to house would still see travel costs reflected, through an add-on to the nursing-care fee, the ministry said.