New publication: Who pays for a voice assistant in dementia care?

Rasita Vinay (IBME) and colleagues map reimbursement pathways for digital assistive technologies in the Swiss healthcare system.

Digital assistive technologies are widely promoted as part of the response to rising dementia prevalence, yet they seldom arrive with a workable account of who benefits, who pays, and what evidence would justify coverage. A new open-access article in Health Policy and Technology takes up that gap.

Using GRACE — an embodied voice assistant for people with early dementia, developed as a non-commercial research prototype — as an empirical case, Rasita Vinay, Leonie Staub and Tobias Kowatsch examine how stakeholder evidence can be translated into setting-specific reimbursement and implementation pathways. The study draws on 23 semi-structured interviews with healthcare experts, professional care staff, insurance sector experts and one informal caregiver, analysed through codebook-informed thematic analysis and the Business Model Canvas.

Stakeholders anticipated value for people with dementia in companionship, cognitive activation, orientation and daily structure, alongside relief for caregivers. A pivotal finding was that home and institutional care were expected to carry different requirements and therefore different payer logics, suggesting a product split by care setting. Financing emerged as the dominant barrier: basic mandatory insurance was seen as slow, costly and biased toward curative care, while out-of-pocket purchase, shared institutional ownership and supplementary or hybrid arrangements appeared more feasible in the near term.

The authors propose an exploratory phased pathway beginning with equitably safeguarded out-of-pocket deployment in home care, moving toward supplementary, hybrid and potentially basic insurance as evidence accumulates. Equity safeguards are treated as a condition of the first phase rather than a later refinement. Because participants viewed a video demonstration rather than using the system, and people with dementia were not interviewed, the findings describe stakeholder expectations and require validation with intended users and their families.

The work originated in Leonie Staub's master's thesis at the Department of Informatics, University of Zurich.

Vinay, R., Staub, L.F., Kowatsch, T. (2026). Stakeholder-perceived value and reimbursement pathways for a voice assistant in dementia care: evidence from Switzerland. Health Policy and Technology, 15, 101305. https://doi.org/10.1016/j.hlpt.2026.101305

Open access financed by the University of Zurich.