M Griffin1, W F Panak. 1. College of Nursing, University of Rhode Island, Kingston 02881-0814, USA.
Abstract
OBJECTIVE: To examine the costs and outcomes of infertility-related services in Massachusetts during a time of expanded use of assisted reproductive technology (ART). DESIGN: Cost data were obtained from the Massachusetts Department of Insurance Rate-Setting Commission and 9 large group insurance plans for the period 1986-1993. Utilization and success rates of ART were examined, and the cost per live delivery with the use of ART in 1993 was estimated. SETTING: The state of Massachusetts, in which access to infertility-related services has been mandated by law since 1989. PATIENT(S): The study population consisted of 8 large health maintenance organization plans and the Blue Cross/Blue Shield indemnity plan. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Per capita infertility-related expenditures, infertility-related expenditures as a percentage of total expenditures, live deliveries per initiated ART cycle, and cost per live delivery. RESULT(S): Expenditures for infertility services increased at a rate similar to or slower than inflation during the years 1988-1992. Increases were slowest in health maintenance organizations, probably as a result of provider arrangements. Infertility services accounted for 0.41% of total expenditures within the indemnity plan in 1993 (approximately $1.71 per contract-month). Examination of ART utilization showed no evidence of overutilization by patients with a low chance of success. The cost per live delivery with the use of ART in 1993 was $59,484. CONCLUSION(S): Mandated infertility coverage was associated with increased use of ART but not with excessive increases in consumer cost for infertility insurance coverage.
OBJECTIVE: To examine the costs and outcomes of infertility-related services in Massachusetts during a time of expanded use of assisted reproductive technology (ART). DESIGN: Cost data were obtained from the Massachusetts Department of Insurance Rate-Setting Commission and 9 large group insurance plans for the period 1986-1993. Utilization and success rates of ART were examined, and the cost per live delivery with the use of ART in 1993 was estimated. SETTING: The state of Massachusetts, in which access to infertility-related services has been mandated by law since 1989. PATIENT(S): The study population consisted of 8 large health maintenance organization plans and the Blue Cross/Blue Shield indemnity plan. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Per capita infertility-related expenditures, infertility-related expenditures as a percentage of total expenditures, live deliveries per initiated ART cycle, and cost per live delivery. RESULT(S): Expenditures for infertility services increased at a rate similar to or slower than inflation during the years 1988-1992. Increases were slowest in health maintenance organizations, probably as a result of provider arrangements. Infertility services accounted for 0.41% of total expenditures within the indemnity plan in 1993 (approximately $1.71 per contract-month). Examination of ART utilization showed no evidence of overutilization by patients with a low chance of success. The cost per live delivery with the use of ART in 1993 was $59,484. CONCLUSION(S): Mandated infertility coverage was associated with increased use of ART but not with excessive increases in consumer cost for infertility insurance coverage.
Authors: Benjamin J Peipert; Melissa N Montoya; Bronwyn S Bedrick; David B Seifer; Tarun Jain Journal: Reprod Biol Endocrinol Date: 2022-08-04 Impact factor: 4.982