NEW YORK, Jul 16 (Reuters) -- HMO expenditures for infertility treatments increased at rates less than the rate of inflation in Massachusetts in the years 1988-1992, and represented less than 1% of total healthcare costs, experts report. They believe their findings support the continued health plan coverage of infertility treatments.
Any consumer savings stemming from restrictions on access to infertility treatments "would be small relative to total premiums," conclude researchers Martha Griffin, a graduate student at the University of Rhode Island in Kingston, Rhode Island, and Dr. William Panak of the University of Northern Iowa in Cedar Falls, Iowa.
Their report appears in the July issue of the journal Fertility and Sterility.
Rapidly-expanding healthcare costs have led to calls for cutbacks in patient access to certain types of care, including infertility-related services. At the same time, some state lawmakers have regulated that health maintenance organizations (HMOs) guarantee that reproductive technologies be made available to infertile couples.
Massachusetts legislators passed just such a bill in 1987. In their study, Griffin and Panak sought to discover if the percentage of expenditures earmarked by health plans for infertility treatments rose or fell after this legislation. To do so, they evaluated the 1988-1992 financial records of eight Massachusetts HMOs as well as those of the state's fee-for-service Blue Cross/Blue Shield plan.
They discovered that "expenditures for infertility services increased at a rate similar to or slower than inflation" during those years. In fact, they found that per capita costs for infertility services actually fell by 4.1% annually among the eight HMOs. And by 1993, "the expenditure for the infertility-related (treatments) was approximately 0.41% of the total expenditure within the Blue Cross/Blue Shield of Massachusetts plan," according to the study authors. They estimate that this small percentage would work out to about $1.71 per month for a policy holder whose premiums averaged $5,000 per year.
Furthermore, the 1987 legislation did not seem to produce a sudden "boom" in the use of infertility treatments among Massachusetts couples. Griffin and Panak uncovered "no evidence of overutilization by patients with a low chance of (fertilization) success."
The authors warn that future attempts at restricting access to reproductive technologies could well backfire. In the absence of regular reproductive screenings, the diagnosis of many cases of endometriosis could be postponed, raising healthcare costs further down the road. Griffin and Panak also speculate that "limiting the number of assisted reproductive technology attempts could motivate clinics to... (implant) numerous embryos as a way of increasing success rates for couples." These changes could result in a sudden surge in the number of multiple births, with all their attendant expenses.
SOURCE: Fertility and Sterility 1998;70:22-29.
