Japan debates long-term care compensation revisions

Discussions are underway regarding the next revision of long-term care compensation in Japan, focusing on improving working conditions for care managers and restructuring service incentives.

Industry advocates are calling for an increase in basic compensation for in-home care and prevention support services to address rising inflation and wage gaps with other sectors. There is a strong push to expand treatment improvement additions to match those of other care staff and to ensure that compensation can cover operational costs like ICT equipment and utilities. Concerns have been raised regarding the severe shortage of care managers, with a job opening ratio of 8.24.

Simultaneously, the Ministry of Health, Labour and Welfare is reviewing the “Specific Office Addition” requirements. A key point of contention is the “40% rule,” which requires a certain percentage of users to have high care needs (Level 3 or higher) for offices to receive higher compensation. Critics argue this rule creates inequities and discourages the support of patients with milder needs. Potential solutions being discussed include merging different levels of additions or relaxing requirements for 24-hour contact systems to reduce the burden on staff while maintaining elderly safety.