Changes in Fertility Care Use After Benefit Implementation

Infertility is recognized as a disease with significant emotional and financial burdens. To improve access and reduce disparities in fertility treatment, some states and employers have expanded insurance coverage. A retrospective study was conducted at a reproductive clinic within a large urban academic hospital to evaluate the impact of expanded fertility benefits on patient demographics and treatment utilization between 2017 and 2021.

Impact of Fertility Insurance Coverage: Study Overview

The study compared two periods: the pre-implementation phase (2017–2018) and the post-implementation phase (2019–2021). Medical chart reviews were conducted, and descriptive statistics, including means and proportions, were calculated. Comparisons were made using chi-square tests, Fisher's exact tests, and Mann-Whitney U tests.

Fertility Care Trends After Expanded Insurance Coverage

The expansion of fertility benefits was associated with a marked increase in access to care. Over the study period, 1,586 new individuals sought fertility services, with 378 patients before the benefit expansion and 1,208 patients after. This represents a 162.9% increase in utilization following the implementation of expanded coverage.

Age distribution shifted after coverage expansion. The proportion of individuals aged 38–40 years increased, while those aged 41–42 years and those over 42 years decreased. Younger patients under 38 years showed no significant change.

Racial and ethnic representation remained stable despite the increase in patient volume. Non-Hispanic White and non-Hispanic Black individuals remained the most represented groups, with no significant shifts in overall diversity.

In addition to infertility treatment, more patients began seeking proactive reproductive services, including oocyte cryopreservation and preconception counseling.

Specific Changes in Age, Treatment, and Patient Demographics

• Age Distribution (P = 0.01)
  • Ages 38–40 years increased from 12.4% to 17.8%
  • Ages 41–42 years decreased from 9.3% to 5.1%
  • Ages >42 years decreased from 7.4% to 6.7%
  • No change for patients under 38 years
• Racial and Ethnic Distribution (P = 0.89)
  • Non-Hispanic White: 41.5% before vs 40.0% after
  • Non-Hispanic Black: 38.6% before vs 39.7% after
  • Overall racial diversity remained unchanged
• Care Beyond Infertility
  • Individuals without infertility seeking care increased from 17.5% to 23.1% (P = 0.03)
  • Demand for oocyte cryopreservation rose from 12.2% to 16.7%
  • Preconception counseling increased from 3.4% to 5.6% (P = 0.02)
• Highest Level of Treatment
  • Oocyte cryopreservation, as the highest treatment, increased from 5.8% to 15.4%
  • Reported infertility before the first appointment declined significantly (P < 0.001)

Supporting OB/GYN's Practices with BillingFreedom

With the growing demand for fertility and reproductive care services, OB-GYN practices are seeing increased patient volumes and more complex insurance requirements. Managing accurate billing for a wide range of treatments, from infertility care to proactive reproductive planning, can become time-consuming and resource-intensive.

BillingFreedom's OBGYN medical billing services are designed to support practices by streamlining insurance claims, minimizing errors, and optimizing reimbursements. By handling the administrative complexities of fertility-related billing, BillingFreedom allows providers to focus on delivering high-quality patient care while maintaining financial stability and compliance.