Innovative treatment network for migraines, headaches and facial pain, cranial neuralgia and neuropathic pain

Barmer Health Insurance, with approximately 9.4 million insured members, is one of the two largest health insurance funds in Germany. Effective January 1, 2018, Barmer Health Insurance joined the Integrated Care Agreement for migraine, headache and facial pain, cranial neuralgia, and neuropathic pain (IV-K) pursuant to Section 140a of the German Social Code, Book V (SGB V), between the Kiel Pain Clinic and Techniker Krankenkasse (TK). This provides Barmer Health Insurance members with access to an innovative, nationwide headache treatment network.

To overcome the sectoral barriers and medical specialty boundaries that perpetuate headaches, the nationwide headache treatment network was initiated in 2007. It represents a milestone for the care of headache patients. For the first time, it enables nationwide, cross-sectoral and interdisciplinary networking of outpatient and inpatient therapy. Close collaboration, increased knowledge, improved information exchange among all involved parties, and joint work using clearly defined treatment pathways form the basis for modern and efficient treatment outcomes.

The supply chain will be significantly improved. Patient benefit is the focus of the network:

  • Orientation of services to the needs of patients
  • optimized treatment based on current scientific knowledge
  • cross-sectoral, specialized treatment pathways
  • direct implementation of international scientific findings for healthcare provision
  • organized treatment chain
  • ongoing evaluation
  • Nationwide follow-up care for patients living far away via video consultation
  • Exchange among those affected through digital self-help communities

Patient satisfaction with the integrated care provided by the nationwide headache treatment network is very high. Scientific evaluation shows that pain is sustainably relieved, quality of life is restored, the ability to work is reinstated, and costs are reduced. The network has received numerous awards, including recognition as the best implementation of integrated care nationwide.

Care within the nationwide headache network

A nationwide network of outpatient and inpatient pain therapists in private practices and hospitals works hand in hand to provide optimal pain relief across disciplines and sectors using state-of-the-art methods. For therapy-resistant conditions, highly intensive, supraregional, and interdisciplinary inpatient treatment is available at the Kiel Pain Clinic. This concept offers, for the first time, nationwide coordinated treatment without the limitations of specialty boundaries or bureaucratic reimbursement systems.

Here's how you can participate: Information about the treatment process can be found here .


New approaches in pain therapy

Medical focus

The treatment network is geared towards the specialized care of severely affected patients with chronic migraine and headache disorders. It encompasses all serious and complex primary and secondary headache disorders, as well as head and facial neuralgia. It focuses on additional serious and complex comorbidities, such as medication overuse, medication intolerances, psychological and social complications, and organ damage.

The supply needs

Migraines and chronic headaches affect around 54 million people in Germany and are the number one widespread health problem. According to the WHO, they rank third among the most disabling diseases in the world. The EU considers them to be among the three most expensive neurological disorders. Nationwide, more than three billion individual doses of painkillers are taken annually, 85% of them for headaches.

The treatment of headaches exemplifies how the sectorally fragmented healthcare system, based on collective bargaining agreements, can itself contribute to illnesses becoming chronic and pain persisting indefinitely. Traditional standard care for headache patients takes place in segregated sectors of the healthcare system. Many sufferers with chronic headaches resort to self-treatment outside the professional system due to its perceived lack of effectiveness. They seek information about various treatment options for migraines and headaches from friends, acquaintances, the popular press, the internet, and pharmacies. Dissatisfied with medical treatment, they often abandon professional therapy and, disappointed, turn to alternative methods. Over months and years, the headache condition becomes even more chronic, and serious organ complications, often resulting in severely debilitating psychological consequences, lead patients back to expensive medical treatment.

This results in very high direct and indirect costs. The individual consequences are severe. High follow-up costs also arise from the treatment of late complications such as mental illnesses, kidney failure, liver damage, gastrointestinal ulcers, and damage to the cardiovascular system.

All the knowledge developed nationally and internationally for the treatment of migraines, headaches, and chronic pain is made directly available to patients through integrated care within the standard healthcare system. Collaboration between innovative health insurance companies and specialists has enabled significant advances in care nationwide, extending beyond standard services. These advances will be maintained and expanded.

The Kiel Pain Clinic

The Kiel Pain Clinic was founded in 1997 as a scientific model project at the University Hospital of Kiel by Prof. Dr. Hartmut Göbel and initially supported by the AOK (a major German health insurance provider). Following successful scientific evaluation by the health insurance companies, the concept was adapted for nationwide care in 2007 in cooperation with the Techniker Krankenkasse (a major German health insurance provider), creating an innovative treatment network with over 450 independent pain therapists across Germany. The approximately 50 member health insurance funds of the BKK (a regional association of company health insurance funds) Northwest are also contractual partners. Today, the nationwide center collaborates with regional pain therapists in private practices and hospitals within the framework of multimodal pain therapy, employing coordinated treatment plans.

To ensure sustainable care for all patients, the center was included in the Schleswig-Holstein state hospital plan at the end of 2013. In addition, according to a care agreement pursuant to Sections 108 No. 3 and 109 of the German Social Code, Book V (SGB V), the center provides acute inpatient treatment (Section 39 Paragraph 1 SGB V) for insured persons of all health insurance funds residing outside of Schleswig-Holstein for the following indications: chronic pain due to diseases of the central, peripheral, and autonomic nervous systems, including the muscles, within the framework of neurological-behavioral medicine treatment procedures.