Ever heard of the “million-dollar baby”? That’s not far-fetched, especially when millions of uninsured men and women attempt to have a family without the consideration or knowledge of cost or best practices in fertility medicine. Many women have serious health complications with fertility treatment–all paid for by the employer’s insurance plan. Others run out of money for fertility treatments before they get pregnant. Still, others miss work because of too many fertility tests or become depressed because of the endless costs and complications of trying to get pregnant.
Employers Incur the High Costs of Pregnancy
Employers actually foot the bill for the “million-dollar baby” as they incur the high costs of pregnancy-related healthcare. Pregnancy and neonatal claims are often employers’ highest ticket items. Increased utilization of high-cost diagnostics, increases in preterm births, multifetal pregnancies and high rates of cesarean sections are making employees aware of the need to focus on pregnancy-related costs. Beyond the direct medical costs of pregnancy, employers contend with real issues, including: [1]- Absenteeism
- Loss of institutional knowledge due to retention problems following pregnancy[2]
- Short- and long-term disability
1. Managed Fertility Coverage Increases Efficiency
Managing the fertility benefits allows patients to most efficiently use the benefit in a cost-effective way. WINFertility’s highly trained fertility team reviews medical history, benefit, eligibility, accumulator, and claims information prior to the initiation of treatment on any patient. WINFertility’s managed benefit plan offers a FertilityCoach® Nurse 24/7 to each patient. Historically, employees have been eager to participate and often reach out to WIN as soon as they were notified of the program (many times before the official start date).2. Authorization Ensures Fertility Medication Compliance
Pharmacy costs can easily make up a third of the overall fertility spend. WIN’s prior authorization program for outpatient and office fertility treatment services ensures that only appropriate medications and quantities are dispensed and that formulary compliance is maintained. Our FertilityCoach® Nurses spend time one-on-one educating patients on their pharmacy dosing usage, storage, and medication side effects and assisting patients in maximizing their fertility medication benefit.3. Managed Care Limits Costs and Increases Value of Fertility Benefit
The goal of WIN’s management is to enhance the likelihood of a successful singleton pregnancy for each patient, while limiting the costs of infertility care, thus saving the payer money and increasing the value of the employee’s benefit. WIN’s analytics are based on the broadest, most statistically significant sample in the fertility benefits management space, making our data and recommendations reliable.Recruitment and Retention are Added Fertility Benefits
In addition, offering fertility benefits helps with recruitment and retention of key female employees and supports diversity initiatives. As hiring more women has become a priority for many top companies, WINFertility knows that providing expertly managed fertility benefits is a tremendous draw particularly as it incentivizes women to focus on higher education and careers at a time when they may otherwise take leave to become the primary caregiver for newborns and young children. Also, WIN’s IVF treatments are accessible to members of the LGBT population and singles who want to have families. WIN’s managed care program includes adoption and surrogacy education and coordination. WIN has been successfully managing fertility benefits for two decades, covering millions of members and has compiled over 500,000,000 member months of data, the largest quality benchmark database in the entire industry.WINFertility provides more people with access to better fertility care at a fraction of the cost.
Our comprehensive fertility solutions give employer groups the ability to select from an employer-paid or voluntary program and the flexibility to customize their own individual plan. Contact us today for a free cost-saving analysis to see how much we can save your business. See what WINFertility can do for you. Yes, I want to learn more about WINFertility’s solutions!Fertility Solutions for All Businesses Sizes – National, Midsized and Small
[1] March of Dimes. Help reduce cost: The cost to business. Available at: http://www.marchofdimes.com/prematurity/21198_15349.asp. Accessed July 17, 2007. [2] March of Dimes. Help reduce cost: The cost to business. Available at: http://www.marchofdimes.com/prematurity/21198_15349.asp. Accessed July 17, 2007.
