title: The effects of insurance mandates on choices and outcomes in infertility treatment markets.
abstract: For the 10% to 15% of American married couples who experience reproductive problems, in vitro fertilization (IVF) is the leading technologically advanced treatment procedure. However, IVF's expense may prevent many couples from receiving treatment, and those who are treated may take an overly aggressive approach to reduce the probability of failure. Aggressive treatment, which occurs through an increase in the number of embryos transferred during IVF, can lead to medically dangerous multiple births. We evaluated the principle policy proposal-insurance mandates-for improving IVF access and outcomes. We used data from US markets during 1995-2003 to show that broad insurance mandates for IVF result in not only large increases in treatment access but also significantly less aggressive treatment. More limited insurance mandates, which may apply to a subset of insurers or provide weaker guidelines for insurer behavior, generally have little effect on IVF markets.
authors: Olin Business School, Washington University in Saint Louis, Saint Louis, USA. hamiltonb@wustl.edu
authors: Barton H
authors: BH
authors: Hamilton
authors: Brian
authors: B
authors: McManus
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D033161:Government Regulation; D006291:Health Policy; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D037141:Mandatory Programs; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013219:State Government; D014481:United States