In Japan, all-payer rate setting under tight government control has proved to be an effective approach to containing costs

Naoki Ikegami, Gerard F Anderson

Research output: Contribution to journalArticle

Abstract

In Japan's health insurance system, the prices paid by multiple payers for nearly all health care goods and services are codified into a single fee schedule and are individually revised within the global rate set by the government. This single payment system has allowed total health care spending to be controlled despite a fee-for-service system with its incentives for increased volume of services; Japan's growing elderly population; and the regular introduction of new technologies and therapies. This article describes aspects of Japan's approach, as well as how that nation has expanded payment for inpatient hospital care based on case-mix. The result of the payment system is that Japan's rate of health spending growth has been well below that of other industrial nations. The percentage of gross domestic product spent on health increased from 7.7 percent in 2000 to 8.5 percent in 2008, compared to an increase from 13.7 percent to 16.4 percent in the United States. Japan's approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population-all while restraining the growth of health care spending.

Original languageEnglish (US)
Pages (from-to)1049-1056
Number of pages8
JournalHealth Affairs
Volume31
Issue number5
DOIs
StatePublished - May 2012

Fingerprint

Japan
Costs and Cost Analysis
Delivery of Health Care
Fee Schedules
Government Regulation
Gross Domestic Product
Technology
Fee-for-Service Plans
Diagnosis-Related Groups
Health
Health Insurance
Growth
Insurance
Population
Health Services
Motivation
Inpatients
Therapeutics

ASJC Scopus subject areas

  • Health Policy

Cite this

In Japan, all-payer rate setting under tight government control has proved to be an effective approach to containing costs. / Ikegami, Naoki; Anderson, Gerard F.

In: Health Affairs, Vol. 31, No. 5, 05.2012, p. 1049-1056.

Research output: Contribution to journalArticle

@article{463c4f3b833e448bb8ec18d49f6e2f6f,
title = "In Japan, all-payer rate setting under tight government control has proved to be an effective approach to containing costs",
abstract = "In Japan's health insurance system, the prices paid by multiple payers for nearly all health care goods and services are codified into a single fee schedule and are individually revised within the global rate set by the government. This single payment system has allowed total health care spending to be controlled despite a fee-for-service system with its incentives for increased volume of services; Japan's growing elderly population; and the regular introduction of new technologies and therapies. This article describes aspects of Japan's approach, as well as how that nation has expanded payment for inpatient hospital care based on case-mix. The result of the payment system is that Japan's rate of health spending growth has been well below that of other industrial nations. The percentage of gross domestic product spent on health increased from 7.7 percent in 2000 to 8.5 percent in 2008, compared to an increase from 13.7 percent to 16.4 percent in the United States. Japan's approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population-all while restraining the growth of health care spending.",
author = "Naoki Ikegami and Anderson, {Gerard F}",
year = "2012",
month = "5",
doi = "10.1377/hlthaff.2011.1037",
language = "English (US)",
volume = "31",
pages = "1049--1056",
journal = "Health Affairs",
issn = "0278-2715",
publisher = "Project Hope",
number = "5",

}

TY - JOUR

T1 - In Japan, all-payer rate setting under tight government control has proved to be an effective approach to containing costs

AU - Ikegami, Naoki

AU - Anderson, Gerard F

PY - 2012/5

Y1 - 2012/5

N2 - In Japan's health insurance system, the prices paid by multiple payers for nearly all health care goods and services are codified into a single fee schedule and are individually revised within the global rate set by the government. This single payment system has allowed total health care spending to be controlled despite a fee-for-service system with its incentives for increased volume of services; Japan's growing elderly population; and the regular introduction of new technologies and therapies. This article describes aspects of Japan's approach, as well as how that nation has expanded payment for inpatient hospital care based on case-mix. The result of the payment system is that Japan's rate of health spending growth has been well below that of other industrial nations. The percentage of gross domestic product spent on health increased from 7.7 percent in 2000 to 8.5 percent in 2008, compared to an increase from 13.7 percent to 16.4 percent in the United States. Japan's approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population-all while restraining the growth of health care spending.

AB - In Japan's health insurance system, the prices paid by multiple payers for nearly all health care goods and services are codified into a single fee schedule and are individually revised within the global rate set by the government. This single payment system has allowed total health care spending to be controlled despite a fee-for-service system with its incentives for increased volume of services; Japan's growing elderly population; and the regular introduction of new technologies and therapies. This article describes aspects of Japan's approach, as well as how that nation has expanded payment for inpatient hospital care based on case-mix. The result of the payment system is that Japan's rate of health spending growth has been well below that of other industrial nations. The percentage of gross domestic product spent on health increased from 7.7 percent in 2000 to 8.5 percent in 2008, compared to an increase from 13.7 percent to 16.4 percent in the United States. Japan's approach confirms that enlightened government regulation can maintain access to care, avoid rationing, make use of the latest technology, and allow for multiple insurance plans and an aging population-all while restraining the growth of health care spending.

UR - http://www.scopus.com/inward/record.url?scp=84862489353&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862489353&partnerID=8YFLogxK

U2 - 10.1377/hlthaff.2011.1037

DO - 10.1377/hlthaff.2011.1037

M3 - Article

C2 - 22566445

AN - SCOPUS:84862489353

VL - 31

SP - 1049

EP - 1056

JO - Health Affairs

JF - Health Affairs

SN - 0278-2715

IS - 5

ER -