National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

David Seifer, Ethan Wantman, Amy E. Sparks, Barbara Luke, Kevin J. Doody, James P. Toner, Bradley J. van Voorhis, Paul C. Lin, Richard H. Reindollar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To assess the attitudes of Society for Assisted Reproductive Technology (SART) members regarding expanding insurance coverage for patients seeking assisted reproductive technologies (ART) and identify some of the factors that may influence such attitudes. Design: An anonymous online 14-question survey of SART membership; 1,556 surveys were sent through the SART Research Portal from June to December 2017. Questions were incremental in scope, beginning with expanding insurance coverage for ART for vulnerable populations (e.g., fertility preservation for cancer, couples with same recessive gene, fertility preservation for transgender individuals) to extending coverage to include patients who were uninsured for ART. Additional questions assessed attitudes about assuming some fiscal responsibility if mandated insurance were contingent on elective single-embryo transfer (eSET) and lower charges in anticipation of increased number of cases. Setting: Not applicable. Patient(s): Not applicable. Intervention(s): Not applicable. Main Outcome Measure(s): Specific response to 14 survey questions. Result(s): The overall response rate was 43.4% (675/1,556). A large majority (>95%) favored insurance for fertility preservation for cancer patients and for avoidance of genetic disorders; 62.3% were supportive of infertility insurance coverage for transgender patients; 78% supported expanding insurance for the broadest segment of the general uninsured population; 76.7% supported expanding insurance contingent on eSET; and 51.3% would consider expanding insurance contingent on lowering charge per cycle in general, but only 23% responded as to what lower charge would be acceptable. Three of four factors were shown by multivariable logistic regression to be predictive of attitudes willing to expand insurance: practice setting (academic > hybrid > private), practicing in a mandated state, and higher annual volume of cases (>500 cycles); these had significant increased adjusted odds ratios ranging from 1.7 to 2.9. A fourth factor, the professional role one had in the practice, was not found to be of significant predictive value. Conclusion(s): The great majority of respondents were supportive of expanding insurance for specific segments of vulnerable populations with special needs and for the population who are presently uninsured. Furthermore, the majority of respondents would consider expanding insurance coverage contingent on age-appropriate eSET but have concerns about reduced reimbursement. Those most likely to be willing to expand insurance are those who practice in an academic setting or a mandated state and/or have a high annual volume of cases.

Original languageEnglish (US)
Pages (from-to)1081-1088.e1
JournalFertility and Sterility
Volume110
Issue number6
DOIs
StatePublished - Nov 1 2018
Externally publishedYes

Fingerprint

Assisted Reproductive Techniques
Insurance Coverage
Insurance
Single Embryo Transfer
Fertility Preservation
Transgender Persons
Vulnerable Populations
Recessive Genes
Professional Role
Inborn Genetic Diseases
Surveys and Questionnaires
Infertility
Population
Neoplasms
Logistic Models
Odds Ratio
Outcome Assessment (Health Care)

Keywords

  • access to care
  • SART
  • Survey

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies. / Seifer, David; Wantman, Ethan; Sparks, Amy E.; Luke, Barbara; Doody, Kevin J.; Toner, James P.; van Voorhis, Bradley J.; Lin, Paul C.; Reindollar, Richard H.

In: Fertility and Sterility, Vol. 110, No. 6, 01.11.2018, p. 1081-1088.e1.

Research output: Contribution to journalArticle

Seifer, D, Wantman, E, Sparks, AE, Luke, B, Doody, KJ, Toner, JP, van Voorhis, BJ, Lin, PC & Reindollar, RH 2018, 'National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies', Fertility and Sterility, vol. 110, no. 6, pp. 1081-1088.e1. https://doi.org/10.1016/j.fertnstert.2018.07.016
Seifer, David ; Wantman, Ethan ; Sparks, Amy E. ; Luke, Barbara ; Doody, Kevin J. ; Toner, James P. ; van Voorhis, Bradley J. ; Lin, Paul C. ; Reindollar, Richard H. / National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies. In: Fertility and Sterility. 2018 ; Vol. 110, No. 6. pp. 1081-1088.e1.
@article{469a49671e5d4764a452cd70f4b4cf9c,
title = "National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies",
abstract = "Objective: To assess the attitudes of Society for Assisted Reproductive Technology (SART) members regarding expanding insurance coverage for patients seeking assisted reproductive technologies (ART) and identify some of the factors that may influence such attitudes. Design: An anonymous online 14-question survey of SART membership; 1,556 surveys were sent through the SART Research Portal from June to December 2017. Questions were incremental in scope, beginning with expanding insurance coverage for ART for vulnerable populations (e.g., fertility preservation for cancer, couples with same recessive gene, fertility preservation for transgender individuals) to extending coverage to include patients who were uninsured for ART. Additional questions assessed attitudes about assuming some fiscal responsibility if mandated insurance were contingent on elective single-embryo transfer (eSET) and lower charges in anticipation of increased number of cases. Setting: Not applicable. Patient(s): Not applicable. Intervention(s): Not applicable. Main Outcome Measure(s): Specific response to 14 survey questions. Result(s): The overall response rate was 43.4{\%} (675/1,556). A large majority (>95{\%}) favored insurance for fertility preservation for cancer patients and for avoidance of genetic disorders; 62.3{\%} were supportive of infertility insurance coverage for transgender patients; 78{\%} supported expanding insurance for the broadest segment of the general uninsured population; 76.7{\%} supported expanding insurance contingent on eSET; and 51.3{\%} would consider expanding insurance contingent on lowering charge per cycle in general, but only 23{\%} responded as to what lower charge would be acceptable. Three of four factors were shown by multivariable logistic regression to be predictive of attitudes willing to expand insurance: practice setting (academic > hybrid > private), practicing in a mandated state, and higher annual volume of cases (>500 cycles); these had significant increased adjusted odds ratios ranging from 1.7 to 2.9. A fourth factor, the professional role one had in the practice, was not found to be of significant predictive value. Conclusion(s): The great majority of respondents were supportive of expanding insurance for specific segments of vulnerable populations with special needs and for the population who are presently uninsured. Furthermore, the majority of respondents would consider expanding insurance coverage contingent on age-appropriate eSET but have concerns about reduced reimbursement. Those most likely to be willing to expand insurance are those who practice in an academic setting or a mandated state and/or have a high annual volume of cases.",
keywords = "access to care, SART, Survey",
author = "David Seifer and Ethan Wantman and Sparks, {Amy E.} and Barbara Luke and Doody, {Kevin J.} and Toner, {James P.} and {van Voorhis}, {Bradley J.} and Lin, {Paul C.} and Reindollar, {Richard H.}",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.fertnstert.2018.07.016",
language = "English (US)",
volume = "110",
pages = "1081--1088.e1",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

AU - Seifer, David

AU - Wantman, Ethan

AU - Sparks, Amy E.

AU - Luke, Barbara

AU - Doody, Kevin J.

AU - Toner, James P.

AU - van Voorhis, Bradley J.

AU - Lin, Paul C.

AU - Reindollar, Richard H.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objective: To assess the attitudes of Society for Assisted Reproductive Technology (SART) members regarding expanding insurance coverage for patients seeking assisted reproductive technologies (ART) and identify some of the factors that may influence such attitudes. Design: An anonymous online 14-question survey of SART membership; 1,556 surveys were sent through the SART Research Portal from June to December 2017. Questions were incremental in scope, beginning with expanding insurance coverage for ART for vulnerable populations (e.g., fertility preservation for cancer, couples with same recessive gene, fertility preservation for transgender individuals) to extending coverage to include patients who were uninsured for ART. Additional questions assessed attitudes about assuming some fiscal responsibility if mandated insurance were contingent on elective single-embryo transfer (eSET) and lower charges in anticipation of increased number of cases. Setting: Not applicable. Patient(s): Not applicable. Intervention(s): Not applicable. Main Outcome Measure(s): Specific response to 14 survey questions. Result(s): The overall response rate was 43.4% (675/1,556). A large majority (>95%) favored insurance for fertility preservation for cancer patients and for avoidance of genetic disorders; 62.3% were supportive of infertility insurance coverage for transgender patients; 78% supported expanding insurance for the broadest segment of the general uninsured population; 76.7% supported expanding insurance contingent on eSET; and 51.3% would consider expanding insurance contingent on lowering charge per cycle in general, but only 23% responded as to what lower charge would be acceptable. Three of four factors were shown by multivariable logistic regression to be predictive of attitudes willing to expand insurance: practice setting (academic > hybrid > private), practicing in a mandated state, and higher annual volume of cases (>500 cycles); these had significant increased adjusted odds ratios ranging from 1.7 to 2.9. A fourth factor, the professional role one had in the practice, was not found to be of significant predictive value. Conclusion(s): The great majority of respondents were supportive of expanding insurance for specific segments of vulnerable populations with special needs and for the population who are presently uninsured. Furthermore, the majority of respondents would consider expanding insurance coverage contingent on age-appropriate eSET but have concerns about reduced reimbursement. Those most likely to be willing to expand insurance are those who practice in an academic setting or a mandated state and/or have a high annual volume of cases.

AB - Objective: To assess the attitudes of Society for Assisted Reproductive Technology (SART) members regarding expanding insurance coverage for patients seeking assisted reproductive technologies (ART) and identify some of the factors that may influence such attitudes. Design: An anonymous online 14-question survey of SART membership; 1,556 surveys were sent through the SART Research Portal from June to December 2017. Questions were incremental in scope, beginning with expanding insurance coverage for ART for vulnerable populations (e.g., fertility preservation for cancer, couples with same recessive gene, fertility preservation for transgender individuals) to extending coverage to include patients who were uninsured for ART. Additional questions assessed attitudes about assuming some fiscal responsibility if mandated insurance were contingent on elective single-embryo transfer (eSET) and lower charges in anticipation of increased number of cases. Setting: Not applicable. Patient(s): Not applicable. Intervention(s): Not applicable. Main Outcome Measure(s): Specific response to 14 survey questions. Result(s): The overall response rate was 43.4% (675/1,556). A large majority (>95%) favored insurance for fertility preservation for cancer patients and for avoidance of genetic disorders; 62.3% were supportive of infertility insurance coverage for transgender patients; 78% supported expanding insurance for the broadest segment of the general uninsured population; 76.7% supported expanding insurance contingent on eSET; and 51.3% would consider expanding insurance contingent on lowering charge per cycle in general, but only 23% responded as to what lower charge would be acceptable. Three of four factors were shown by multivariable logistic regression to be predictive of attitudes willing to expand insurance: practice setting (academic > hybrid > private), practicing in a mandated state, and higher annual volume of cases (>500 cycles); these had significant increased adjusted odds ratios ranging from 1.7 to 2.9. A fourth factor, the professional role one had in the practice, was not found to be of significant predictive value. Conclusion(s): The great majority of respondents were supportive of expanding insurance for specific segments of vulnerable populations with special needs and for the population who are presently uninsured. Furthermore, the majority of respondents would consider expanding insurance coverage contingent on age-appropriate eSET but have concerns about reduced reimbursement. Those most likely to be willing to expand insurance are those who practice in an academic setting or a mandated state and/or have a high annual volume of cases.

KW - access to care

KW - SART

KW - Survey

UR - http://www.scopus.com/inward/record.url?scp=85055876086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055876086&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2018.07.016

DO - 10.1016/j.fertnstert.2018.07.016

M3 - Article

C2 - 30396552

AN - SCOPUS:85055876086

VL - 110

SP - 1081-1088.e1

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 6

ER -