As the novel coronavirus closed restaurants, schools, theme parks, salons and many other non-essential businesses, it also caused in vitro fertilization centers across the U.S. to "essentially shut down," said Hugh Taylor, chair of obstetrics, gynecology and reproductive sciences at Yale School of Medicine.
Now that states are reopening, patients are starting to return. "People still want to have their babies," said Taylor, who also serves as the chief of obstetrics and gynecology at Yale-New Haven Hospital. Taylor predicted fertility treatment usage will even out over time. But the global event nevertheless altered the landscape of his profession, one that is shaped by employer-provided benefits. Some changes he described as "heartbreaking." Others came as welcomed lessons or long-term boons.
A potential enhancement to health plans
Taylor said he had not heard of a single patient who lost a fertility benefit due to an employer adjusting healthcare offerings because of the pandemic, he told HR Dive in an interview. Rachael McCann, senior director of health benefits at Willis Towers Watson, confirmed his observation.
"Broadly, we’ve seen an enhancement of benefits," McCann said. Some, for example, have waived costs for COVID-19 testing and treatment. And many have lowered, if not erased, fees for virtual care. "That has a direct impact on going through the fertility process," McCann said, because it has allowed individuals to continue care with their providers.
Taylor agreed, noting that fertility professionals’ learning to use telemedicine well was "one good thing to come out of this crisis." "We didn’t do it before because it was difficult to get reimbursed," he said. Of course, some treatments necessitate an in-person visit, but many appointments consist of important conversations between physicians and patients, Taylor said.
In assessing the pandemic’s impact on health plans, it’s important to note that there are some roadblocks for employers inquiring about cuts at this point in the year — namely, tax and compliance considerations. McCann told HR Dive in an interview. She also noted that, overall, Willis Towers Watson is projecting healthcare spend in 2020 to be "the same or less as we would have projected six to 12 months ago."
But she does not foresee employers nixing fertility offerings going into next year. "Looking at [plan] design, thinking about 2021, I have not had one single conversation with clients that has been a reduction of benefits, particularly as it relates to family building," she said. Instead, employers have demonstrated a commitment to providing benefits that help diversity — a category fertility benefits certainly fall under. Such benefits help LGBTQ individuals and families have children, McCann said, as well as aid those with infertility issues.
Usage won’t go unaffected
Fertility benefit use, however, could see some changes. Mid-pandemic, some benefit users who had already begun fertility treatments will not resume treatment because they lost the benefits along with their jobs.
"It’s heartbreaking for us," Taylor said. "It’s very hard for your average person to afford these treatments without insurance coverage." Treatments can cost anywhere between $10,000 and $15,000, and some may need multiple before treatments result in a pregnancy.
Some employees may choose to forgo treatments as clinics reopen, too. "If someone has underlying health conditions or lives with someone with underlying health conditions, even now, as states are opening up slowly, there may be a hesitation for risk of exposure," McCann said. Additionally, prospective parents may be concerned about the risk a new disease could pose their newborns.
"Frankly there’s going to be a level of uncertainty in accessing healthcare for a length of time," McCann said. The pandemic and its consequences will keep some from using fertility benefits, while others won’t "put their lives on hold," she said.
As employers chart health benefits offerings for next year, they may want to consider how fertility benefits can boost talent acquisition and retention strategies. "Many young women or couples choose their employer based on having adequate benefits," Taylor said; "In trying to attract a workforce, it’s very important."
This advantage spills over into employment branding as well, McCann noted, something that firms have highlighted as important throughout the pandemic. Companies want to be the employer of choice and demonstrate that their benefits are useful and optimized for all people, McCann said