The audit, conducted by multiple regions, revealed widespread billing issues. According to Norrländska Socialdemokraten, regional councilor Linda Jonsson (V) said the region has difficulty allocating resources to investigate invoices sent from Kry to Region Norrbotten. Last year, Region Norrbotten spent 21 million SEK on out-of-region care with digital healthcare providers.
Jonsson is closely following the work of larger regions that may provide guidance, and she called for a national initiative to investigate the billing of digital healthcare providers in all regions. Residents of Östergötland made 120,000 online doctor visits last year, costing the region over 40 million SEK. A Swedish Radio investigation found that Kry introduced a bonus system that favors fast doctors.
The region has difficulty allocating resources to investigate invoices sent from Kry to Region Norrbotten.
Online doctors can increase profitability by having shorter patient visits and more patients per hour because they are paid per visit through out-of-county reimbursement. According to SVT Östergötland, Kry's CEO Kalle Conneryd Lundgren denied that the system pressures doctors to rush, stating they do not reward speed at the expense of quality and have strong quality control. Regional councilors have expressed outrage over online doctors receiving bonuses for speed.
Patient perspectives vary: according to SVT Östergötland, Elisabeth Dahlström called the bonus system deplorable but not surprising given market incentives, while Jennifer Lundby said she has received better and faster help from digital providers, with appointments within 5 minutes to an hour. In Norrbotten, only nurses receive a shift supplement of 2,500 SEK per month, while other healthcare workers such as assistant nurses, orderlies, care assistants, and ambulance staff do not. The supplement was introduced to attract more nurses to permanent employment in round-the-clock operations and is an addition, not part of base salary.
I am closely following the work of larger regions that may provide guidance.
Tony Berglund, an orderly in forensic psychiatry, expressed anger that other shift workers do not receive the supplement. According to TV4 Nyheterna, Marianne Engberg, chair of Kommunal's Region Norrbotten section, described it as infuriating that nurses are valued 2,500 SEK more for working the same shifts. Region Norrbotten points to other initiatives like doubled unsocial hours compensation for all, but says the strained economy—with a 183 million SEK deficit last year—makes it difficult to meet demands for equal shift supplements.
According to TV4 Nyheterna, regional councilor Camilla Friberg (S) said it is not currently under discussion to remove the nurses' supplement, and it is easier to add supplements than remove them. Kommunal says the fight for equal shift supplements continues. A project officially launched in June with Karolinska University Hospital as the Swedish lead partner, managed by WHO and funded by the European Commission’s Technical Support Instrument.
All regions have had some share of incorrect billing from digital healthcare providers.
The project aims to develop a financially sustainable reimbursement model that promotes prevention and digital care. Christophe Pedroletti, CEO of Karolinska University Hospital, stated that the project is about ensuring people receive the right care at the right time in the right place, and that care may come to the patient rather than the patient to care. The current reimbursement model is largely based on the number of patient visits, which does not align with the shift towards digital and preventive care.
Hospitals are paid per physical visit, creating few financial incentives to invest in digital solutions or remote care. Fewer patient visits could free up resources and improve outcomes but result in reduced revenue under the current system. According to a 2025 report from Region Stockholm, the number of people aged 85 and older is expected to grow by 73 percent in the coming years, while the prevalence of chronic and complex conditions is rising and resources are not.
I hope the tablets will be introduced everywhere as soon as possible.
Tomas Zapata, WHO/Europe project leader, said many innovative services like Karolinska@home are not reimbursed because they don't take place within hospital walls. The 24-month project started with a five-day launch event in Stockholm from June 9–13, bringing together stakeholders to map the current situation and identify barriers and opportunities. In Norrbotten, technology and innovation are advancing locally.
At two wards at Sunderby Hospital, tablets are being tested to enable a mobile working method in patient contacts. se, nurse Minna Åhl Nilsson hopes the tablets will be introduced everywhere as soon as possible. All six new CT scanners in the region are now in place, with Kiruna Hospital receiving the latest technology including cardiac CT capability.
Mental health issues exist among hunters, and knowledge about how to support and act as a fellow human is too low.
Ambulance nurse Johan Sparrevik is researching when ambulance personnel can provide help on-site instead of transporting patients to hospital, including for children. Mental health services are also expanding. se, unit manager Göran Nilsson described magnetic stimulation as a new complementary treatment for moderate to severe depression in Norrbotten, with good experiences from elsewhere.
Trygghetsteamet is a county-wide team within child and adolescent psychiatry in Norrbotten providing acute support to children, youth, and their families. se, Daniel Widman, chairman of Jägareförbundet Norrbotten, said mental health issues exist among hunters, and knowledge about how to support and act as a fellow human is too low. Workforce challenges persist.
Magnetic stimulation is a new complementary treatment for moderate to severe depression in Norrbotten, with good experiences from elsewhere.
There is an acute shortage of audiologists, especially in northern Sweden. Örebro University has started a distance education program for audiologists with Luleå as one of the study locations. Jira Pimsena and Emma Nordström are students in the distance audiology program and look forward to the profession.
Cultural and community health initiatives are underway. Kultur på Recept is a nine-week program where groups of 8–12 people participate in cultural activities twice a week for about two hours per session. There is a proposal for a new regional cultural plan, and Region Norrbotten is seeking public input.
Many innovative services like Karolinska@home are not reimbursed because they don't take place within hospital walls.
The Norrländska Geriatrikdagarna conference was held on May 7–8 in Luleå with nearly 200 participants from regions and municipalities in northern Sweden. On Handens dag (May 5), Region Norrbotten's infection control unit awarded the Hygiene Prize for 2026 for work strengthening compliance with basic hygiene routines. The reduced reimbursement rate and audit findings have raised questions about the future of digital care.
The specific criteria used to determine that over half of Kry's visits lacked grounds for reimbursement have not been disclosed. It remains unclear how the cut to 435 SEK will affect the availability and quality of digital healthcare services in Norrbotten. The total amount of incorrect billing from digital providers across all regions is unknown, and national actions are still being debated.
It is infuriating that nurses are valued 2,500 SEK more for working the same shifts.
Details of Kry's bonus calculation and quality controls have not been made public. The WHO-led project's concrete outcomes and implementation timeline across Sweden are yet to be determined.
It is not currently under discussion to remove the nurses' supplement, and it is easier to add supplements than remove them.
The bonus system is deplorable but not surprising given market incentives.
I have received better and faster help from digital providers, with appointments within 5 minutes to an hour.
We do not reward speed at the expense of quality and have strong quality control.