With medical outsourcing, elderly care, and childcare services spanning hundreds of sites and 30,000+ staff, Solasto keeps hospitals humming and communities supported—making everyday care feel a little more human.
Before we begin, Japan is the most rapidly aging country in the world: roughly 30% of the population is over 65, and average life expectancy is approaching 85. These shifts—enabled in large part by advances in medicine—have driven demand for administrative support, nursing, and day services, but they also place significant burdens on medical institutions and training schools. At the same time, they create opportunities to improve efficiency and reduce workload in care settings. In this context, what do you see as Japan’s main challenges, and what solutions are needed?
From a macro perspective, Japan’s demographic transformation has been unfolding for decades. Medical progress has steadily extended the lives of older adults, and as society has grown more affluent, we have built increasingly sophisticated systems to support life in older age. Around the year 2000, however, it became clear that the medical system alone could no longer address aging—fiscally or structurally. Japan therefore established the long-term care insurance system to complement healthcare and, equally importantly, to build a nationwide understanding that supporting an aging society is a collective responsibility.
Solasto’s history is intertwined with this evolution. Sixty years ago, when Japan created large national and public hospitals, the law limited hospital ownership to licensed physicians. Yet physicians alone cannot run hospitals. Solasto emerged to provide comprehensive medical administrative services—supporting a substantial portion of hospital operations—and we have matured alongside Japan’s healthcare system. When long-term care insurance began in 2000, it was a natural extension for us to contribute there as well. We regard our medical administration and our care services as inseparable and mutually reinforcing.
Our biggest challenge is the long-term sustainability of both the health and long-term care systems. They rely heavily on public finances—tax revenues and social insurance—and we must ask now whether that model will remain viable. The second challenge is the shrinking workforce. Over time, fewer working-age people will need to support more older adults. Our response is to raise productivity: work that today requires 100 people should be accomplished by 90—or even 80—by eliminating waste and assigning routine, non-human tasks to IT and automation. People should devote their time to the human work only people can do.
There are voices arguing Japan should reform hospital governance—specifically, separating physicians from management and ownership. What is your stance?
We are fully aware of those opinions. Our position, however, is pragmatic: focus on maintaining and improving the current framework while addressing its weaknesses. Reform will take time, and in the meantime our job is to help the existing system function better and more sustainably.
How does Solasto’s role differ between healthcare and long-term care, and how does that shape your approach to policy and operations?
In healthcare, we do not operate hospitals; we support them. In long-term care, we operate facilities. That difference matters. In hospitals, our emphasis is on improving operations and supporting large and small institutions alike. In long-term care, as an operator, we also make proposals to improve the system itself—offering models of what high-quality care should look like and using those examples to inform policy discussions and system design.
You touched on workforce shortages. Beyond technology, how will you practically achieve the goal of doing today’s work with fewer people?
Technology is the primary driver, but the real lever is disciplined operational improvement. We systematically identify tasks that do not require human judgment and reengineer them—standardize, digitize, and, where appropriate, automate—so that people can concentrate on patient- and resident-facing work. That is how we move from 100 to 90 or 80 people without compromising quality.
Many companies view foreign workers mainly as a way to fill domestic labor gaps. How do you view international talent?
Our perspective is broader. We see international engagement as a two-way exchange—of people and know-how—so that the operating models we build in Japan can eventually be adapted to other countries. Using foreign talent solely as a stopgap for labor shortages misses that larger opportunity.
Solasto has focused on Japan for six decades. As you consider taking your technologies and operating models abroad, will you rely on partnerships or seek equity ownership?
We do not feel compelled to take equity. Our preference is partnerships and alliances in which local counterparts leverage our know-how to fill gaps in their systems, and we extend Solasto’s business from Japan to overseas. That approach aligns interests and scales faster.
For leaders overseas—CEOs and public-sector decision makers—how would you describe Solasto’s concrete value proposition?
Systems differ across countries, so we don’t presume that Japan’s frameworks can be exported wholesale. Institutions, cultures, and practices vary. What we offer is a modular toolkit: we map the processes and pain points we’ve addressed in Japan, present the corresponding solutions, and then—together with local partners—decide what to adopt, what to adapt, and what to co-develop. Much of the value lies in operational excellence: optimizing patient and administrative flows, standardizing back-office work, and selectively automating tasks so clinicians and caregivers can focus on people.
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Introducing robotics, telemedicine workflows, or AI can face resistance—especially among older patients and veteran staff who are reluctant to change familiar routines. How do you ensure smooth adoption?
We pursue two parallel paths. First, we start with natural champions—young physicians, digitally savvy nurses, progressive care-home staff—who are eager to try new tools. Adoption there is quicker. Second, for colleagues who value traditional methods or feel uneasy with technology, we do not impose change. We rely on peer-to-peer influence and visible early wins. As champions demonstrate shorter wait times, fewer errors, or lighter paperwork, resistance eases. It still takes time. We have built and proposed multiple productivity tools for hospitals and care facilities, but adoption requires persistent support and training.
How important is developing proprietary systems and solutions as a source of differentiation?
Continuous improvement is central. Small teams reflect daily on what happened and how to improve tomorrow. We apply the same discipline in medical and care settings. Across our hospital sites and care facilities, more than 30,000 employees work every day. We expect them to identify even small improvements—lower costs, raise productivity, elevate service quality—and we’ve done that for 60 years. That cadence of daily problem-solving is a core competitive advantage.
You mentioned an internal platform that spreads those improvements. How does it work, and what’s next?
We built “solavis”, an internal platform that captures and shares improvements and lessons learned in real time—both at headquarters and on the frontline. It enables rapid dissemination of best practices and, just as importantly, “what not to do,” reducing regional variation. While not yet universal, it has already lifted quality and productivity meaningfully in our medical business. Our next step is to extend solavis across our eldery care business, and we expect that framework to be in place in the near term.
Japan’s medical billing is notoriously complex. What is your approach, and what role does remote or centralized work play?
Billing is governed by extremely detailed and frequently updated rules. Our role is twofold: ensure hospitals bill strictly in line with the rules, and help them receive appropriate reimbursement for the care they deliver. This work is well suited to centralization. Concentrated teams of specialists can collaborate, cross-check, and keep pace with regulatory changes more effectively than isolated on-site teams. We are therefore building centralized billing centers—while working with hospitals and government stakeholders to secure the necessary approvals and demonstrating robust safeguards for sensitive data.
Have you digitized the rules themselves to support that centralization?
Yes. We have converted the voluminous rulebooks into a searchable knowledge base that lets our staff navigate categories, compare coding choices, and apply the correct rules using both current standards and historical data. As people nationwide use the system, their questions and edge cases are aggregated, enabling an AI-driven, frequently updated Q&A that captures real-world know-how.
Do you intend to sell that data to others, or the system itself?
We launched a knowledge application named “solabell” in September this year. As external users adopt the platform, de-identified, privacy-compliant usage will naturally enrich the knowledge base. Our aim is a solution that continuously learns while rigorously protecting information security and patient privacy.
Beyond quantitative KPIs, how do you convert qualitative inputs—complaints, competitor moves, feedback from hospital directors—into better performance? And can other users benefit from those insights?
At headquarters, a dedicated team oversees “solavis”. Field inputs—from competitor activity and requests by hospital leadership to patient feedback—are automatically categorized. Specialists review the feed daily, extract the most material issues, and propose concrete actions. Those proposals are shared across quality, operations, and sales so we can decide what to do immediately and what to schedule for the next month. In short, qualitative signals are turned into a prioritized action plan that drives daily work and near-term improvements. As we expand access to selected modules externally, partners can also benefit from the accumulated operational know-how in a structured, confidential way.
Turning to investors: foreign institutions hold a meaningful share of your stock, and FY2024 revenue was approximately ¥137 billion. How do you plan to attract global investment as you enter the next phase of growth?
Domestic or international, investors look for durable value creation. We focus on improving results and executing against clear, credible objectives. We have laid out a five-year medium-term plan with specific targets and strategies, and we will communicate our progress transparently.
In Medical Business, we focus on large national and public hospitals. It’s a concentrated market—two companies, including Solasto, account for roughly 80% share. Historically, competition has centered on price, and we have grown steadily in scale. Going forward, we will continue to expand, but our priority is to raise the value we deliver—reflected in better unit economics—not merely add volume.
In Eldery care Business, revenue and costs are largely set by the care-insurance framework. We have grown through M&A and will continue selectively. The bigger lever is to lift added value: streamline headquarters and supervisory functions to raise productivity, and build adjacent services outside the strict boundaries of the reimbursement schedule. That combination supports growth and margin improvement.
You’ve hinted at a more proactive role with hospitals—beyond the functions they already outsource. What does that look like in practice?
We intend to partner more deeply with hospital management to improve operating results. In the past, we mainly handled discrete outsourced functions. Now we proactively propose end-to-end improvements: redesign patient flow from reception to discharge and payment, advise on administrative layouts, support the selection and implementation of IT systems, and, where appropriate, take on broader responsibilities. By reducing waste and allowing physicians and nurses to focus on patients, we believe hospitals can strengthen their finances while Solasto grows—often by doing more with fewer people through higher productivity.
Does that imply expanding headcount to take on more work, or the opposite?
The opposite. Our aim is to increase the scale of our business while ultimately reducing the number of people required per unit of work. Higher productivity is the engine that allows us—and our clients—to do more without simply adding staff.
When did this shift begin, and how are you ensuring investors understand it?
We began this business-model shift about a year ago. We recognize we still need to explain our ambitions, plans, and progress more widely. We will use opportunities like this to communicate clearly and regularly so investors can evaluate our execution over time.
What would you say Solasto’s strengths?
Two points define us. First, we are a company that directly supports national healthcare and long-term care systems—critical social infrastructure that will remain essential as long as societies exist. Second, we can do that while expanding our activities and increasing returns to our shareholders. In other words, we align social mission with business performance. That is our model, and it gives us substantial runway for the future.
For more information, visit their website at: https://www.solasto.co.jp/en/company/profile/
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