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Specified health diagnosis and specified health guidance
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Specified health diagnosis and specified health guidance

Specified health diagnosis services are provided for all insured persons and dependents aged 40-74. Specified health diagnosis is intended to identify persons requiring specified health guidance to decrease the numbers of people having, or at risk for, metabolic syndrome.

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  • You become eligible for specified health diagnosis on reaching 40 years of age.
  • People eligible for specified health guidance are provided with a variety of motivational information and advice to help them live healthier lifestyles on their own.

Objectives of specified health diagnosis and specified health guidance

Until now, the goals of health diagnosis and health guidance have been early identification and treatment of sickness.

By focusing on visceral-fat obesity, specified health diagnosis and specified health guidance are intended to decrease the numbers of those who suffer from, or are at risk for, lifestyle-related conditions such as diabetes, through providing health guidance to help them improve the living habits that cause visceral-fat obesity (i.e., disease prevention). Since lifestyle-related conditions progress with no visible symptoms, specified health diagnosis is considered to be an excellent opportunity to review the individual's living habits, then health guidance is provided to help the individual change his or her behavior.

Specified health diagnosis

Specified health diagnosis comprises health screenings intended to identify those who require health guidance to prevent lifestyle-related conditions, by focusing on visceral-fat obesity. It employs checkup items intended to identify accurately people eligible for specified health guidance, for example by adding abdominal girth measurement to identify the state of buildup of visceral fat.

Specified health diagnosis is available for all members aged 40-74 (including those turning 75 during the fiscal year), both insured persons and dependents.

Based on the results of specified health diagnosis, persons eligible for specified health guidance are identified by level (i.e., those eligible for motivational support and those eligible for active support) in accordance with their risk levels, by focusing on the degree of visceral fat buildup and numbers of risk factors. (This is called ranking.)

All those who have undergone specified health diagnosis are provided with information suited to their own individual circumstances, based on the results of the diagnosis. This information is provided at the same time they are notified of the results.

Ranking steps

Specified health guidance

Specified health guidance is provided for people eligible for motivational support or proactive support as a result of ranking.

The goals of specified health guidance are to enable eligible persons to be aware of their own health conditions and make voluntary efforts, on a continual basis, to improve their own living habits. People eligible are provided with a variety of motivational information and advice to help them live healthier lifestyles on their own.

Motivational support: Provides support to encourage improvements in living habits, in principle one time.

An action plan is prepared with the guidance of doctors, health nurses, and a senior nutritionists, and specialists provide motivational support for efforts to improve living habits, in principle one time. Evaluations are performed to determine whether results have been achieved as planned.

[Examples: individual support, group support, etc.]

Proactive support: Provides continual support in multiple sessions, over three months or longer.

An action plan is prepared with the guidance of doctors, health nurses, and a senior nutritionists. Specialists provide regular, continual support for efforts to improve living habits, over a period of three months or longer. Evaluations are performed to determine whether results have been achieved as planned.

[Examples: individual support, group support, telephone support, email support, etc.]

If you are eligible for active support for two consecutive years and your health conditions in the second year improve* compared to the first year, you may switch to motivational support as specified health guidance in the second year.

  • *BMI of less than 30: abdominal girth improved by 1 cm or more and weight by 1 kg or more; BMI of 30 or more: abdominal girth improved by 2 cm or more and weight by 2 kg or more

ColumnStart with a health examination

Each insurer makes support payments to the medical care system for the advanced elderly for people aged 75 and above. These support payments may rise or fall depending on assessment of multiple indicators, such as the decrease in the percentage of persons eligible for specified health guidance, as well as the rates of providing specified health diagnosis and specified health guidance. The rate of such rise or fall is being increased in stages to reach the legal maximum of 10% by fiscal 2020.

Since routine health exams can have long-term consequences for the financial status of a health insurance association, all insured persons and dependents are reminded to undergo annual health screenings, in addition to practicing healthy living habits on a daily basis.

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