Telemedicine permanently reimbursed in Belgium as of Aug. 1

Screen care is also covered by the new telemedicine scheme.

The National Institute for Sickness and Disability Insurance in Belgium has published an article stating that a new reimbursement scheme will be introduced on 1 August regarding 'remote consultation by doctors'.

Screen care is also covered under the new telemedicine scheme

The National Institute for Sickness and Disability Insurance in Belgium has published an article stating that a new reimbursement scheme will be introduced on August 1 regarding 'remote consultation by doctors'.

During the corona crisis, many healthcare facilities relied on telehealth for certain treatments. This marked the breakthrough of online healthcare consultations, but also meant a breakthrough in terms of the reimbursement system in Belgium. A temporary regulation came into force, under which it was possible for patients to be reimbursed for a video consultation. This temporary scheme will now be converted into a permanent reimbursement scheme from 1 August.

No limit on number of reimbursed consultations

No limit on number of reimbursed consultations.

Telephone consultations and video consultations will be reimbursed without limit from August this year. However, there are some conditions attached:

• with doctors with whom the patient already has a treatment relationship
• with a specialist to whom the patient has been referred
• with an organised general practitioner on call

Higher reimbursement for video consultations

There will be higher reimbursements for video consultations than telephone consultations. Patients will also have to start paying for part of the treatment themselves (personal share/premium). The application of third-party payment will remain mandatory.

What screen care platforms may be used

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The platform used must meet a number of conditions:
-communication will be via end-to-end encryption
-communication will not be stored on the platform
-If the platform includes other functions in addition to the possibility of video or audio communication, including the exchange of documents, these will be offered in such a way that users can comply with the applicable legal provisions, as described on the eHealth website

Of course, Webcamconsult meets these requirements and is already widely used in Belgium.

Reflections from Belgian healthcare specialists

We asked a number of leading healthcare specialists from Belgium to comment on the news:

Bart Degryse, Project Manager Care Switchboard and Care Innovation Wit-Gele Kruis, "Belgium is limping along behind in terms of telehealth and is trying to make up for it in a piecemeal fashion. Our neighbouring countries were already doing this before the Corona crisis. Hopefully, reimbursement will not be limited to GPs and specialists and other healthcare disciplines will also be able to make more frequent contact with their clients via this route.

The challenge remains to see telehealth more broadly than merely providing teleconsults with clients as part of a medical consultation. Teleconsultation is only one of the ways to facilitate 'care or distance', for example ikv home hospitalisation. To structurally expand telehealth, new care models and forms of financing are urgently needed.  Here, a multidisciplinary approach and cooperation with all care actors will be one of the decisive factors to realise this successfully."

Philipsychology

Philippe Bocklandt, lecturer and research assistant online help Arteveldehogeschool - Social Work programme: "Belgium remains a complicated country in terms of the organisation of welfare work and healthcare. Much of healthcare is regulated by 'Belgium' and financed through care-per-performance. Partly by the government and partly by the patient. So in that context, there is now - fortunately - a structural arrangement for video calls in doctors. Such an arrangement has also been worked out for psychologists, for example ... albeit again with different (peripheral) conditions.

Welfare work, in turn, is largely regulated at 'Flemish level' ... there too, video conversations are reluctantly being recognised as client contacts in, for example, general welfare work, youth care, home care, from facilities for people with disabilities. But again, each 'agency' often sets its own conditions.

So we are a step ahead ... really. But it remains a tangle. Organising a multidisciplinary consultation with the client, a health insurance worker, a home care worker and a GP. It's not easy when you have to take all the conditions and payment arrangements into account. So there is still work to be done."

Sofie Staelraeve founder of healthcare consultancy dashplus: "Indeed, there will finally be an arrangement that can create trust and further evolution among doctors. After all, patients already embrace video consultations, but doctors are still often too hesitant. Real-life insights, training and experience can now be deployed in Belgium. And that is much needed, because the debate on digital care was still too much stuck in clichés and fears: it would take away contact with the patient, lead to abuse and extra costs, limit the role of the doctor. While experiences abroad show that none of that is the case.

However, we will continue to feel the pressure of increasing healthcare demand on the one hand and a shortage of GPs and specialists on the other in the coming years. Telehealth is a quality and efficient solution to this. Not the only one, but a very important one.

I am therefore convinced that the new scheme will have to evolve further:

• to all healthcare professionals. Just think of the huge need for mental help, for example
• to all Belgians: a lot of people already live in areas with patient stops or a shortage of GPs. They should also be able to have a teleconsultation, without having to pay for it out of pocket
• with completely equal reimbursement between physical and digital consultations

Minister of Health Frank Vandenbroucke has also announced further evolutions as part of his 'new deal for GP practices', so changes are still to come. Digital working is part of a modern and sustainable system in healthcare, as in other sectors. They are two sides of the same story, and should be aligned."

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