32nd Edition: Navigating the Complexities of Acute Care Hospital Options in the 2026 (Reiwa 8) Medical Fee Revision – Choosing Between New Acute Care Hospital A, B, and Comprehensive Inpatient Fees – PwC

Key Takeaways

The 2026 (Reiwa 8) medical fee revision will complicate the choices for acute care hospitals. The newly established categories of “Acute Care Hospital A” and “Acute Care Hospital B,” along with the introduction of “Comprehensive Inpatient Fees,” will impact hospital management. PwC highlights the need for mid-to-long-term management and succession strategies, leveraging economies of scale through group formation, and utilizing tax schemes including transitions to specific medical corporations and social medical corporations, in light of this revision.

M&A Medical Editorial Department’s Perspective

The establishment of “Acute Care Hospital A” and “Acute Care Hospital B” and the introduction of “Comprehensive Inpatient Fees” in this medical fee revision go beyond mere categorization; they can directly influence the management strategies of hospitals providing acute care. Specifically, the finer segmentation of functions previously treated uniformly as acute care will inevitably lead to changes in the revenue structures corresponding to each hospital’s function. For example, small to medium-sized acute care hospitals not specializing in highly acute care will face challenges in maintaining facility standards and distributing the burden of capital investment while considering the application of the newly established categories and comprehensive inpatient fees. In this regard, group formation through M&A can be an effective option for enjoying economies of scale and strengthening the management base. Furthermore, business succession strategies that consider the utilization of tax schemes, particularly transitions to specific medical corporations or social medical corporations, will be key to enhancing sustainability under this increasingly complex fee system.

Points Raised by This News

• The impact of establishing “Acute Care Hospital A” and “Acute Care Hospital B” on hospital functional differentiation and revenue structures.
• The changes brought about by the introduction of comprehensive inpatient fees on inpatient acceptance policies and treatment processes.
• Challenges for small to medium-sized acute care hospitals in maintaining facility standards and distributing capital investment burdens.
• The potential for economies of scale through group formation and improved management efficiency through the utilization of tax schemes.

Practical Questions Arising from This News

• Which category, “Acute Care Hospital A” or “Acute Care Hospital B,” is my hospital likely to fall under?
• What will be the approximate impact on current revenue if comprehensive inpatient fees are introduced?
• What are the specific advantages and disadvantages of considering group formation or changes in corporate status?

If You Feel “Should I Consult Too?”

Medical institution managers who are concerned about how their hospital’s management strategy and revenue structure will change due to the finer segmentation of acute care hospital categories and the introduction of comprehensive inpatient fees in the 2026 medical fee revision are encouraged to consult with experts. In particular, when considering maintaining facility standards, capital investment, and future business succession, group formation through M&A and the utilization of tax schemes can be effective options. Early consultation is crucial to accurately understand the revision details and formulate the optimal strategy for your hospital.

M&A Medical (CentralMedience Inc.), as an M&A support institution certified by the Small and Medium Enterprise Agency, supports the business succession of medical corporations, hospitals, and clinics on a full success fee basis. Consultations are handled with strict confidentiality. Free consultations are available here.