Digital health reimbursement: A scoping review of global lessons and policy implications

Background: Digital health technologies have expanded access to healthcare services by improving disease management and reducing unnecessary hospitalizations. A major challenge, however, is designing appropriate reimbursement mechanisms for these technologies. Ensuring such mechanisms not only leverages their benefits but also maintains the financial sustainability of health systems. Objective: This study aimed to identify reimbursement processes, classification methods, assessment frameworks and criteria used, pricing mechanisms, organizations involved in the digital health reimbursement process, and the technologies covered by health insurance in selected countries from each continent (Europe, North America, and Asia). Methods: This study followed the Joanna Briggs Institute (JBI) framework. A systematic search was conducted in Web of Science, Scopus, PubMed, and grey literature sources (e.g. government reports and health organization websites), with no language restrictions, from 1 January 2000 to 9 February 2025. Data extraction focused on reimbursement processes, classification approaches, evaluation criteria, pricing mechanisms, key stakeholders, and insured digital health technologies. Conclusion: Developing transparent reimbursement frameworks, coordinating stakeholders, and integrating digital technologies into insurance systems are essential. Learning from successful frameworks-such as Germany's DiGA, telemedicine in the USA and Canada, and China's digital health policies-can enhance equitable access and financial sustainability. Establishing digital health technology assessment (DHTA) guidelines, investing in digital health literacy and infrastructure, and implementing supportive regulatory policies are critical prerequisites.