Vaud Builds Swiss Digital Health Pilots With the Insurer Inside, Designed for Reimbursement

TLDR: Digital health pilots designed with the insurer at the table from the first protocol, and scored on one shared matrix, produce the evidence a payer needs to fund them.

Vaud’s Pilot Factory runs three hospital pilots with the insurer inside each one

Swiss digital health reimbursement has a new test bench in the canton of Vaud. The Future of Health Grant (FoHG) was founded in 2022 by the innovation park of the École polytechnique fédérale de Lausanne (EPFL) and the Swiss health insurer CSS. On 7 September 2026 its Pilot Factory launched three hospital pilots and selected six new startups from 606 applicants. Every one of the three pilots names CSS as a partner.

The first pairs BeWe with CSS on a digital neuro-coaching tool that uses neuroscience and gaming to reduce food cravings. The second brings DigeHealth into the University Hospital of Lausanne (CHUV) with CSS. It listens to gut sounds to detect post-surgical bowel obstruction early, and the pilot is co-funded by the Canton of Vaud through its SyNNergy programme. The third places Bonescreen at the Ensemble Hospitalier de la Côte (EHC) with CSS. Its software applies AI to existing computed tomography (CT) scans of the spine to detect bone disease.

In the conventional sequence, an insurer meets a digital health product at the end of its journey, when a finished study arrives with a price attached. In Vaud the insurer sits at the pilot table from the start, alongside the hospital that generates the data. The evidence is then built around what the payer needs to see, and the protocol can still be shaped around it.

Six startups from 606 applicants join a funnel that has seen four solutions reimbursed or insured in four years

The programme funds by maturity. Level 1 (“Ignition”) carries CHF 10,000 over three months, Level 2 (“POC”, proof of concept) CHF 30,000 over six months, and Level 3 (“Validation”) CHF 50,000 over twelve months. Each startup can receive up to CHF 90,000 of non-dilutive funding. The September intake places Entrelacs, Kodia and NeuroTreasure Solutions at Level 1, Healium at Level 2, and DeepPsy and Prevision Medicine at Level 3.

FoHG reports more than 700 applications a year, 50 startups supported, four solutions reimbursed or insured, and more than CHF 76 million raised from investors by its alumni over four years. Selection admits roughly one applicant in a hundred. Reimbursement or insurance cover then reaches four of the fifty, or 8 per cent. Investor capital flows far more readily than payer money, which is why the pilot design, more than the grant, decides the outcome.

Switzerland’s 2026 tariff reform and first app listing give pilots three payment routes

The pilots arrive in the year Switzerland replaced its outpatient tariff. On 30 April 2025 the Federal Council approved the replacement of TARMED, the national outpatient tariff in force for roughly 20 years. Its successors, the TARDOC fee-for-service structure and a structure of outpatient flat rates, took effect on 1 January 2026, with refinements authorised through 31 December 2028. Kodia exists because of that change. Its software checks TARDOC, outpatient flat-rate and diagnosis coding before a case is billed, using the International Classification of Diseases (ICD-10), and a coding professional keeps the final judgement.

On 1 July 2026, Deprexis became the first digital health application reimbursed through the federal list of aids and devices (MiGeL). It is a self-management programme delivering cognitive behavioural therapy for depression. Basic insurance pays up to CHF 193.32 per 90-day licence, on prescription by psychiatrists and a defined set of specialists, and the listing is under evaluation until 30 June 2029. Digital therapeutics for cognitive recovery or mental-health measurement now have a named Swiss precedent. Germany built its own prescription and reimbursement pathway through the digital health applications (DiGA) programme years earlier.

The MiGeL route has a defined procedure. Any interested party can request a new listing from the Federal Office of Public Health (FOPH), first with a notification form and then with a full application. The Federal Commission for Analyses, Aids and Appliances (EAMGK) reviews the file and recommends, and the Federal Department of Home Affairs decides by amending the ordinance. The legal test is effectiveness, appropriateness and cost-effectiveness, and the process often takes several years. Supplementary insurance moves faster through private negotiation, and FoHG calls cover there a credibility milestone toward inclusion in basic insurance. That is ground an insurer such as CSS covers directly.

Inpatient care follows a third logic. Under the Swiss diagnosis-related groups system, SwissDRG, in force since 1 January 2012, an inpatient stay is paid as a case-group cost weight multiplied by a negotiated base price. The hospital keeps the margin when a stay runs shorter and absorbs the cost when it runs longer. DigeHealth reports that post-operative ileus affects one in four major surgeries. Under a flat case rate, earlier detection reads first as hospital margin. That makes the CHUV finance office as relevant a buyer as the insurer.

One evaluation matrix turns separate pilots into a portfolio an insurer can rank

The Pilot Factory scores every solution on a standard evaluation matrix covering quality of patient care, impact on caregivers and costs, producing impact scores that compare across solutions. A gut-sound monitor, a bone scan reader and a craving coach then sit on one scale, and CSS can rank them against each other on shared criteria.

Kainjoo has applied the same logic at national scale. The FOPH’s DigiSanté programme spans more than 50 interconnected initiatives. For it, Kainjoo introduced a structured prioritisation matrix and a risk-based performance framework that assessed every programme against feasibility, scalability and impact. For a funder with many candidates, comparability decides where the money goes. A single pilot with an excellent result loses to a portfolio of good results that a finance committee can read side by side.

The matrix also scores caregivers. Caregiver impact measures the nurse, the physiotherapist and the relative at home. In a Swiss system where staffing pressure is a daily operational fact, a solution that frees caregiver time gives the hospital director a reason to adopt it before any tariff code exists.

DigeHealth moved from a proof-of-concept grant to a payer-backed hospital pilot in about nineteen months

DigeHealth entered FoHG in the spring 2025 cohort at Level 2, announced on 27 February 2025. By September 2026 it was running a CHUV pilot with CSS. Prevision Medicine is a spinoff of the Swiss Federal Institute of Technology in Zurich (ETH Zurich). It joined the spring 2026 cohort at Level 2 in March and appears at Level 3 six months later. Applications keep rising, from 243 in spring 2025 to 352 in spring 2026, and 606 for the September intake. For a life-sciences partner, DigeHealth’s path is a planning reference: one startup took about nineteen months from a proof-of-concept grant to hospital data with a payer at the table.

Pharma and medtech teams can use the Vaud model as a template for beyond-the-pill programmes

Takeda and Pfizer appear among FoHG’s supporting partners, and the Pilot Factory explicitly brings healthcare providers, patient associations, pharma companies, insurers and innovators into the same pilots. Three design choices follow for a life-sciences company running patient-support or companion-app programmes in Switzerland.

Endpoints follow the budget that captures the saving. A tool that shortens an inpatient stay speaks to the hospital under SwissDRG. Preventing a fracture or a failed treatment cycle speaks to the insurer. A stand-alone therapeutic goes to the MiGeL listing process. Each route asks for different evidence, and Exhibit 2 shows how far apart those asks sit.

CSS insures 1.7 million people with CHF 7.56 billion in premium volume, and its presence in all three pilots writes its evidence requirements into the design from day one. That is the moment for the payer’s scoring frame. A pharma-sponsored programme gains the same advantage by inviting the insurer and the hospital finance function into endpoint selection, and by reporting caregiver time alongside clinical outcomes.

A programme scored on quality, caregiver impact and cost can be compared with every other solution competing for the same budget, which is the comparison a payer runs in any case. Building it in from the start turns a pilot into a reimbursement file.

Switzerland now has the tariff structures, the first digital-application listing and, in Vaud, a pilot mechanism with the insurer in the room. Companies that design their evidence around all three give their pilots the strongest case at the payer’s decision table. Kainjoo .life applies the prioritisation and performance framework it built for DigiSanté to life-sciences teams planning Swiss pilots, and takes enquiries through its contact page.

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