Swedish regions tighten rules for digital healthcare providers after criticism

Sweden’s regions and municipalities have introduced stricter guidelines on which patient visits digital healthcare providers can bill for, following an investigation by public broadcaster Sveriges Radio that revealed some doctors were seeing up to 100 patients a day.

The new rules, agreed upon in an emergency meeting on Wednesday, prohibit digital providers from charging regions for consultations where patients receive only self-care advice that could have been provided by the national health advice line 1177. Providers may also no longer bill for prescription renewals without a new documented medical assessment, nor for visits where the sole outcome is a referral to in-person care.

Anna-Lena Hogerud, chair of the Swedish Association of Local Authorities and Regions’ (SKR) healthcare delegation, called the update necessary but expressed frustration over the need to define “qualified care” for digital providers.

“It shows there is something wrong with the business models and healthcare offerings of these companies,” Hogerud said in a statement.

The investigation by Sveriges Radio found that high patient volumes—including cases where digital doctors handled minor issues better suited for nurse advice—raised concerns about care quality. Digital providers are paid per consultation under Sweden’s inter-regional reimbursement system, creating financial incentives for short, high-volume visits.

In response to the findings, digital healthcare provider Kry stated it does not prioritise speed over quality and has “extensive quality controls” in place.