Luigi Pavia, who leads our Ecosystem Engagement & Partnerships, examines how the themes of access and reimbursement of digital health solutions have been explored in various editions of Frontiers Health.

In this article, we embark on a comprehensive exploration of the pivotal discussions and insights garnered from the various sessions at Frontiers Health editions, specifically delving into the nuanced realms of digital health solutions reimbursement and the health insurance space. As Frontiers Health served as a dynamic platform bringing together experts and thought leaders in the healthcare and innovation sectors, our focus is on distilling key takeaways and noteworthy trends that emerged during sessions dedicated to navigating the intricacies of reimbursement models and the evolving landscape of health insurance. Through an insightful examination of these discussions, we aim to unravel the forefront of advancements, challenges, and debates to navigate efficiently through some of crucial issues for the future of health, in terms of accessibility and sustainability.

Since our last 2023 edition, running back to 2016, when “ehealth” was the buzzword, we at Frontiers Health gathered hundreds of experts to focus on the concept of reimbursement.

We were and are aware that closing the divide between innovation and regulation poses a significant obstacle in the realm of health innovation, yet it is essential for progressing the healthcare system and transforming how individuals are engaged, addressed, and treated, all while managing costs effectively.

Frontiers Health 2023

FH23, held in Rome and online, posed a special attention to the payor perspective, related to the comprehensive exploration of the concept of “value”. The discussion was wide, and encompassed various crucial aspects, including frameworks, payornomics (the economics of payors), negotiation strategies, and the illumination of real-world case studies.

That’s why we worked with the team at Vitality to deliver a session that encouraged in-depth discussions, enabling participants to delve into the intricacies of the topics covered, while creating a collaborative and insightful environment for meaningful exploration and learning.

• Watch the session: Value: A Payor Perspective

Digital Therapeutics (DTx) are now gaining reimbursement approval in an increasing number of countries worldwide, presenting a historic opportunity for Digital Health startups, investors, and the entire ecosystem. However, the approval processes for DTx are currently fragmented and subject to individual state definitions. Each approval process comes with specific requirements for evaluating medical safety, certifications, data security, and privacy.

For this reason, FH23 was strongly focused on representing such a complexity while advocating and championing a unique global movement to harmonize the processes. To pursue such an ambitious goal, the 2023 edition was conceived to cover strategic topic further extensively, by organizing dedicated side events and gatherings.

For the first time the “Italian Summit” was held in the framework of the global conference, providing a strategic occasion of discussion among key stakeholders engaged in scaling, implementing, and shaping reimbursement procedures for digital health solutions. National and local institutions, HCPs and scientific societies, patient associations, life sciences industry players and interdisciplinary innovators met to share experiences and strategies for scaling the digital health transformation of the National Healthcare Service.

• Watch the session: Italian Summit

In addition, we hosted a masterclass offering a comprehensive overview of the distinct requirements outlined by various regulatory pathways in the EU, UK, and the US (DVG vs. PECAN vs. DTAC vs. US). The session included the presentation of case studies, exploring the roadmaps of these companies and how they addressed challenges related to data protection and security.

• Watch the session: DTx: how to build a practical regulatory roadmap to get reimbursed in the EU, UK, and US

To dive deep into practical insurance offering in the health space, we teamed up with UniSalute, that presented their health insurance initiatives and discussed the evolving customer experience, and how to streamline doctor-patient interaction models. Much attention was paid to Remote Patient Monitoring, Digital Mental Health, and Virtual Care.

• Watch the session: SiSalute and Davinci Salute: innovation in the UniSalute insurance offering and the introduction of digital health in health services

Day 3 of FH23 hosted the “2023 Digital Medicine & DTx Global Policy Summit”, that united subject matter experts, policy makers and industry leaders from Europe, United States and APAC to focus on best practices, harmonization, access and reimbursement processes and strategies for systemic integration of digital medicine. The Digital Medicine & DTx Global Policy Summit has been promoted by Healthware Group and Digital Therapeutics Alliance, in collaboration with APACMed.

• Watch the session: Digital Medicine & DTx Global Policy Summit 2023 at Frontiers Health

Frontiers Health 2022

The 2022 edition of our global conference focused on the need for an expansive growth of digital therapeutics and enhancing patient care by establishing an internationally recognized assessment pathway for implementation across European countries. At such extent, we put together a panel that started discussing about the concept of establishing a “Super DiGA pathway” and drawing inspiration from the well-established best practices in Europe, while also exploring, charting, and providing insights into fresh and evolving routes that policymakers could utilize for shaping and redefining market access for Digital Therapeutics (DTx).

• Watch the session: Digital Health and European Healthcare Systems

Frontiers Health 2021

At FH21 we talked about the adoption of new and innovative approaches that revolutionizes the way insurance companies operate. The integration of digital technologies is pivotal, reshaping how these companies interact with and support their members. The industry experts foresee a surge in collaborations between insurers and insurtech companies in the coming years. These partnerships are set to redefine the insurance landscape, shifting it from an industry primarily focused on regulations and policies to one centered around prioritizing customer needs. It is crucial, however, for insurers to not merely incorporate new technology but to translate partnerships with insurtechs into viable business models. Establishing a successful ecosystem of digital solutions and services extends beyond a signed partnership agreement, demanding a comprehensive and strategic approach.

Within this framework at FH21 a session, organized by Research2Guidance, was held with the aim to look at how insurances and insurtech innovators have successfully managed the end-to-end business integration of digital health offerings with insurance products to achieve a connected digital business organization. We put together senior representatives from insurance companies as well as insurtech providers to get insight into their projects and implementations.

• Watch the session: Innovation & Partner Integration: How are insurance incumbents driving innovation by building digital health ecosystems

Through the years, the Digital Therapeutics Alliance, whose first European unveil happened right at FH17, strongly committed, with its members, to crystalize the official definition of a digital therapeutic and to work on precise clinical evidence requirements. In our 2021 edition, their attention shifted to product commercialization and scalability, so they proposed a session where panelists explored subjects as including regulatory and reimbursement strategies, safeguarding data and patents, and factors influencing global scalability.

• Watch the session:Digital Therapeutics: Moving Beyond the Basics

Reimbursement and harmonization among national policies for the implementation of digital health technologies was at the core of another FH21 session too. An international group of experts discussed how existing policies like DVG in Germany were performing and updated about up and coming legislation in France as well as perspectives for Italy to paint the beginning of a pan-European path to regulating Digital Medicine and Digital Therapeutics.

• Watch the session: DTx and National Health Systems

Frontiers Health 2020

Collaborating with payors presents both opportunities and challenges. The significant opportunity lies in securing partnerships with reputable, major brands, ensuring scalability, and achieving financial sustainability. However, challenges arise within the payor environment, encompassing aligned objectives, product compatibility, effective commercial agreements, and successful implementation. The pace at which larger organizations operate may also pose challenges, potentially misaligning with your pace or runway.

For this reason, at FH20 we hosted a masterclass dedicated to Showcasing Value Propositions to Payors. The session was conceived to touch base five points:

1. Researching and comprehending how your offering can enhance value for an insurer and understanding potential points of agreement or disagreement.
2. Defining the desired short and long-term relationship with a payor, acknowledging its potential evolution.
3. Creating an outstanding first impression to set the stage for successful collaboration.
4. Ensuring that deals are commercially viable for both parties involved.
5. Navigating the complexities of implementation, often considered the most challenging phase.

• Watch the session: Demonstrating value to payors: How to plan your approach [Masterclass]

Once the federal government in Germany passed the new law on Digital Health (DVG) that we anticipated at FH19, app developers and providers were allowed to introduce their solutions quickly and hence to provide a boost to digital innovation in the German healthcare sector. We decided to host a session to provide a “stock-check” and an impression of first experience with the fast-track application process, its benefits, but also its hurdles. It also addressed healthcare stakeholders’ plans for supporting app providers in the application process, as well as their strategies for using approved health apps for their client offerings, value propositions and business processes. Due to the pandemic, the session was held at the premises of our Berlin Local Hub, organized by Research2Guidance.

• Watch the session: A Fast-Track market entry for digital health apps in Germany: turning point or flash in the pan – what happens after listing?

FH20 also provided the opportunity to introduce a new approach to empower wellbeing and engagement through Insurance. In a session curated by Virgin Pulse, the starting point was that each company faced the dilemma of whether to develop solutions in-house (maintain control) or buy them from external sources (delegate control). Leveraging existing partner ecosystems is also a key consideration. Since every situation is unique, there’s no one-size-fits-all answer, and the overall objective of the session was to examine various cases and understand the most effective approaches.

• Watch the session: A new approach to empower wellbeing and engagement through Insurance. Pain points and solutions for the daily dilemma of insurers: Build or Buy [Masterclass]

As an ideal continuation of this session, we also hosted a masterclass gathering investors, founders, and experienced leaders of reimbursed services to delve deeper into questions like how to identify potential end users, and many others.

• Watch the session: Got reimbursement? Your next challenges [Masterclass]

Frontiers Health 2019

Asia is among the pioneers when it comes to the convergence of digital health and insurance. We continued to investigate the topic, by hosting the panel The Insurance dilemma, where we examined how innovators collaborate to bring new digital health solutions across the insurance value chain, taking into consideration the vastly different insurance sector in Asia as compared to the West.

• Learn more at:The Insurance dilemma

Anyway, 2019 was a defining year for the European reimbursement scenario. In fact, after experiencing a prolonged period of stagnation, the German healthcare system set itself on the verge of ushering in a new era by opening its expansive public health market to digital innovations. Pending parliamentary approval in the coming weeks, the Digital Healthcare Law (DVG) was holding the potential to facilitate the entry of digital applications, certified as medical products with a CE mark, into the German public healthcare market. These applications could have been prescribed to a substantial population of up to 73 million Germans, provided they meet specific criteria. We had the opportunity to host our longstanding friend, Henrik Matthies, at the time Managing Director at health innovation hub (hih), to elucidate the underlying concept of DVG, shedding light on the established criteria.

• Learn more at: DVG – Germany’s jumpstart into digital health [Deep Dive]

Frontiers Health 2018

The advent of high-quality digital technologies, particularly apps, sensors, and artificial intelligence (AI), has facilitated the development of novel digital business models, gaining traction among members. These models fundamentally alter the interaction between insurers and patients. Digital insurers can redefine the trust dynamic with patients, delegate significant portions of their value chain to members, and acquire more in-depth insights into their clientele. Considering this, at FH18 we organized a masterclass, curated by Research2Guidance in partnership with Healthware, in order to present, discuss and critically assess new business models for payers that had a potential to disrupt the health insurance industry. The session shed lights on payers in USA and ASIA, that were leading the digital transformation, then explored a series of principle business models that represented a new way of organizing and delivering health insurance business.

• Learn more: Disruptive digital business models for the health insurance industry [Masterclass]

Frontiers Health 2017

At FH17 we continued to explore the converge between insurance and digital health hosting a session dedicated to “Insurers – the new “B” in B2B2C”, where a well-mixed panel of speaker discussed about how the role of insurance in the digital health space was evolving as technology continued to play a significant role in healthcare. We agreed on the fact that insurance in the digital health space is not just about covering medical expenses but also involves leveraging technology to improve the overall quality of care, enhance risk assessment, and promote preventive measures, ultimately leading to a more efficient and patient-centric healthcare system.

Frontiers Health 2016

One of our guiding themes back in 2016 was reimbursement and business models. We were convinced that non-revenue generating clinical pilots were not enough to demonstrate business potential. To be successful, business plans needed to consider various revenue models towards reimbursements, strategic relationships with insurers and more. And we organized specific conference segments to expand more on these considerations.

At FH16 the debate developed around the idea that in markets characterized by stringent regulations, resistance to change is ingrained in the system and can only be overcome from within. Thus, the importance of reimbursement comes out as a key element for achieving sustained success and opening the door to further transformations. Tinnitracks, being the pioneer therapeutic app to receive reimbursement from a statutory health insurance, has traversed the challenging path to establish itself as a platform for future eHealth solutions.

• Learn more at: Reimbursement – Road to Success in a Regulated Market?

That edition the idea that Digital Health was poised to play a pivotal role in shaping the future of Health Insurance was sounding, introducing innovation and novel business strategies dedicated to enhancing people’s health and well-being.

In a collaborative effort, EY and Healthware established a groundbreaking program aimed at assisting the insurance industry in identifying, defining, implementing, and delivering innovation across every facet of their operations. To internationally present this program EY and Healthware curated a masterclass as an initial step toward providing sustainable health solutions, generating added value for investors, and reshaping the insurance industry itself.

• Learn more at: The Future of Health Insurance

What to expect at FH24?

The insights gleaned from Frontiers Health sessions focusing on reimbursement and health insurance illuminate the transformative journey unfolding within the health innovation landscape. As we delve into the intricate intersections of innovation, financing models, and accessibility, the evolution of these crucial aspects becomes evident.

To stay at the forefront of this dynamic evolution, we encourage you to follow Frontiers Health on our website and social media channels. Additionally, don’t miss the opportunity to register for FH24, where you can continue to explore and engage with the ongoing dialogue, shaping the future of healthcare. Join us in navigating the ever-changing landscape and contributing to the collective vision of a healthier and more accessible future.