The reimbursement roadmap: how digital health gets paid in Europe

Digital health companies love to talk about engagement metrics, downloads, and waitlist size. Investors have heard it all before. What they really want to know is: how does this become a reimbursable, recurring revenue line? In Europe, the answer is no longer theoretical. Multiple countries now have statutory frameworks that pay digital health providers a fixed monthly fee per patient — no hype required.

France's LATM: tiered reimbursement for telemonitoring

France introduced the LATM (Liste des Activités de Télésurveillance Médicale) through the 2022 Social Security Financing Law, replacing the earlier experimental ETAPES programme with a permanent reimbursement nomenclature. The framework covers five therapeutic areas — respiratory insufficiency, renal insufficiency, cardiac insufficiency, diabetes, and implantable cardiac devices — and pays digital solution providers a monthly technical fee per monitored patient.

The rates are tiered by clinical benefit. A solution demonstrating organisational benefit alone earns €50 per patient per month. Prove quality-of-life improvement and the rate rises to €73.33. Reduce morbidity and it reaches €82.50. Demonstrate a mortality reduction and reimbursement peaks at €91.67 per patient per month. These are real, recurring revenues backed by France's national health insurance, not grant funding or pilot budgets.

Critically, the LATM compensates two parties per patient: the technology provider receives the technical fee, and the supervising healthcare team receives a separate operator fee (€28/month for most conditions). This dual-payment model ensures clinical oversight accompanies every digital intervention — a structural incentive that aligns business viability with patient safety.

Germany's DiGA: the app-on-prescription model

Germany's Digital Healthcare Act (DVG), effective since 2020, created the world's first statutory fast-track for prescription digital therapeutics. The BfArM (Federal Institute for Drugs and Medical Devices) evaluates applications within three months. Approved apps — called DiGAs — are fully covered by statutory health insurance with zero patient copay.

The model is commercially attractive: during the provisional listing period (up to 24 months), manufacturers set their own price. After permanent listing, prices are negotiated with the GKV-SV. As of mid-2025, roughly 59 DiGAs are reimbursed across conditions including depression, diabetes, insomnia, anxiety, and cancer. Germany proved that digital therapeutics can sit alongside pharmaceuticals in the reimbursement system.

The UK: commissioning, not reimbursement

The UK takes a different approach. There is no national per-patient reimbursement rate for digital health. Instead, NHS adoption runs through a commissioning model where individual trusts and Integrated Care Boards decide what to purchase. The Digital Technology Assessment Criteria (DTAC) and NICE Evidence Standards Framework set the bar for clinical safety, data protection, and evidence quality, but passing these assessments does not guarantee revenue.

Where the UK does offer a structural opening is Social Prescribing. Every Primary Care Network with 30,000+ patients is reimbursed for employing a social prescribing link worker through the Additional Roles Reimbursement Scheme. These link workers refer patients to non-clinical services — including digital tools — for conditions like loneliness, anxiety, and chronic disease self-management. For digital health companies, this creates an adoption channel: if your solution addresses the conditions link workers manage, you gain a funded referral pathway into primary care.

Belgium's mHealth validation pyramid

Belgium's NIHDI operates a four-level validation pyramid for mobile health applications. Apps progress from basic CE certification (M1) through reimbursement admissibility (M2) to temporary (M3−) and permanent (M3+) financing. As of early 2025, eight apps have reached permanent reimbursement status, currently focused on remote monitoring in chronic heart failure. The framework is expanding under Belgium's eHealth Action Plan 2025–2027.

What this means for Kindline

We are building Kindline with these frameworks in mind from day one. Our voice AI handles patient communication workflows — appointment scheduling, triage, follow-up — that sit at the intersection of telemonitoring and care coordination. In France, this positions us within the LATM's organisational and clinical benefit tiers. In Germany, the DiGA pathway offers a direct route to prescription-based reimbursement. In the UK, our integration with primary care workflows aligns naturally with social prescribing referral patterns.

The path to sustainable digital health revenue in Europe is not about viral growth or consumer hype. It is about meeting regulatory evidence standards, demonstrating measurable clinical benefit, and plugging into reimbursement codes that already exist. The infrastructure is there. The question is whether your product is built to use it.