Insurance mandates and trends in infertility treatments

Henne, Melinda; Bundorf, M. Kate

doi:10.1016/j.fertnstert.2007.01.167

Cited by 115 publications

(122 citation statements)

References 8 publications

Supporting

Mentioning

117

Contrasting

Order By: Relevance

“…The decrease in multiple births in states with mandated coverage for ART may reduce long-term costs, but it has been suggested that the reduction might be due to the fact that people with poorer prognoses undergo treatment in those states, lowering the number of babies born whether or not rates of embryo transfer are affected [20,30]. Moreover, stricter regulation of ART protocols and more stringent enforcement of ASRM guidelines could prove just as effective at limiting the number of embryos implanted as mandating insurance coverage.…”

Section: Would Mandated Insurance Coverage Achieve These Goals?mentioning

confidence: 99%

Who Pays? Mandated Insurance Coverage for Assisted Reproductive Technology

2014

Virtual Mentor

View full text Add to dashboard Cite

Section: Would Mandated Insurance Coverage Achieve These Goals?mentioning

confidence: 99%

Who Pays? Mandated Insurance Coverage for Assisted Reproductive Technology

2014

Virtual Mentor

View full text Add to dashboard Cite

“…To increase access to services and reduce financial burden, 15 states have adopted insurance mandates requiring that private insurers provide coverage for infertility treatments (2)(3)(4)(5). However, the scope of the mandates is variable with respect to the type of services covered, patient requirements, and exceptions (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…In addition to expanding access to infertility services, mandated coverage of ART may lessen the financial pressure to conceive in one cycle, thereby leading to a reduction in the number of embryos transferred per cycle and a consequent decline in multiple births (1,2,8). Studies of insurance coverage and fertility outcomes using clinic data showed increased use of infertility services in states with comprehensive or limited mandates compared with states with no coverage (2, 9).…”

Section: Introductionmentioning

confidence: 99%

“…It has been noted that states with comprehensive mandates transfer fewer embryos per cycle than those without mandates (2,3,7,9,11), although variations by age have been observed (12). The association between mandate status and multiple births (twins, triplets, and higher order births) is inconsistent, with some studies showing lower rates of multiple birth in states with comprehensive mandates compared with nonmandate states (2, 3) and others indicating an effect for triplet or higher order gestations only (7,9,11).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Embryo transfer practices and perinatal outcomes by insurance mandate status

Boulet

Cohen²,

Bailey

et al. 2013

Fertility and Sterility

View full text Add to dashboard Cite

Objective-To use linked assisted reproductive technology (ART) surveillance and birth certificate data to compare ET practices and perinatal outcomes for a state with a comprehensive mandate requiring coverage of IVF services versus states without a mandate. Design-Retrospective cohort study. Setting-Not applicable.Patient(s)-Live-birth deliveries ascertained from linked 2007-2009 National ART Surveillance System and birth certificate data for a state with an insurance mandate (Massachusetts) and two states without a mandate (Florida and Michigan). Intervention(s)-None.Main Outcome Measure(s)-Number of embryos transferred, multiple births, low birth weight, preterm delivery. Result(s)-Of

show abstract

“…1,2 In the United States, states such as Massachusetts with ART-coverage insurance mandates have reported higher ART utilization rates. 3 Previous research described associations between ART, subfertility, and risks of adverse perinatal outcomes, including multiple birth, preterm birth, low birth weight, small for gestational age, and long-term disability. [4][5][6][7][8][9][10][11][12] Children with these adverse outcomes are at increased risk of poor developmental and behavioral outcomes and are specifically in need of Early Intervention (EI) programs.…”

mentioning

confidence: 99%

Assisted Reproductive Technology and Early Intervention Program Enrollment

et al. 2016

View full text Add to dashboard Cite

We examined the prevalence of Early Intervention (EI) enrollment in Massachusetts comparing singleton children conceived via assisted reproductive technology (ART), children born to mothers with indicators of subfertility but no ART (Subfertile), and children born to mothers who had no indicators of subfertility and conceived naturally (Fertile). We assessed the natural direct effect (NDE), the natural indirect effect (NIE) through preterm birth, and the total effect of ART and subfertility on EI enrollment. METHODS:We examined maternal and infant characteristics among singleton ART (n = 6447), Subfertile (n = 5515), and Fertile (n = 306 343) groups and characteristics associated with EI enrollment includingpreterm birth using χ 2 statistics (α = 0.05). We estimated the NDE and NIE of the ART-EI enrollment relationship by fitting a model for enrollment, conditional on ART, preterm and the ART-preterm delivery interaction, and covariates. Similar analyses were conducted by using Subfertile as the exposure. RESULTS:The NDE indicated that the odds of EI enrollment were 27% higher among the ART group (odds ratio NDE = 1.27; 95% confidence interval (CI): 1.19 ̶ 1.36) and 20% higher among the Subfertilegroup (odds ratio NDE = 1.20; 95% CI: 1.12 ̶ 1.29) compared with the Fertile group, even if the rate of preterm birth is held constant. CONCLUSIONS:Singleton children conceived through ART and children of subfertile mothers both have elevated risks of EI enrollment. These findings have implications for clinical providers as they counsel women about child health outcomes associated with ART or subfertility.

show abstract

Insurance mandates and trends in infertility treatments

Cited by 115 publications

References 8 publications

Who Pays? Mandated Insurance Coverage for Assisted Reproductive Technology

Who Pays? Mandated Insurance Coverage for Assisted Reproductive Technology

Embryo transfer practices and perinatal outcomes by insurance mandate status

Assisted Reproductive Technology and Early Intervention Program Enrollment

Contact Info

Product

Resources

About