Clinical Oversight of Family-Building Benefits – Driving Cost-Efficient Outcome Improvements for Diverse Populations

With over 70 percent of employers projected to offer family-building benefits in 2023,  questions on the best approach to offer and manage these benefits are common. Employers could simply add coverage through their health plans or choose third party network programs that do little more than help patients find a provider and don’t offer meaningful education and guidance to patients to make the best decisions throughout their journey. Instead, a better option is a managed family-building benefit offered by WINFertility, which is backed by clinical oversight by fertility trained Nurses to help employees and their partners navigate a complicated journey and drive more successful outcomes, ensuring efficient use of their family-building benefit dollars.

Clinical Oversight

One of the predominant advantages of a managed family-building benefit is clinical oversight.  Nurse Care Managers serve as the employees’ personal advocates and guide them through their family-building journey.  These qualified, fertility-trained nurses help employees choose the most appropriate doctors, medications and treatments for their unique needs.  WIN’s protocols are also supported by our Medical Advisory Board of practicing Reproductive Endocrinologists, who actively contribute to clinical oversight and oversee credentialing criteria for network providers to ensure the highest quality of care. This approach is more efficient and effective because employees don’t waste valuable time and benefit dollars on ineffective treatments, but are instead supported by clinically-proven best practices.  For example, genetic testing of embryos may increase IVF success rates in certain instances by ensuring that only embryos without chromosomal abnormalities are used.  When used appropriately, genetic testing can significantly improve a patient’s chances of success. However, this testing is not necessary for everyone, and is often recommended only for older women or patients who have experienced multiple miscarriages.  An employee’s Nurse Care Manager will help them navigate nuances like these to determine the best course of treatment for their individual needs, helping them avoid unnecessary expenses and better succeed in building their family.

Cost Control and Safer Treatment

Offering benefits without management may seem less expensive at first, however the long-term costs of “unmanaged” benefits can be significant.  Employees without clinical guidance may choose to have IVF with multiple embryos transferred at once with the hopes of increasing their chances of success without having to pay for subsequent IVF cycles, yet many people don’t realize that a twin or triplet pregnancy can be a costly risk. More than 20 percent of twins and 80 percent of triplets require care in the neonatal intensive care unit (NICU), and an average NICU admission can last 20 days with costs ranging from $40,000 to $80,000.  Additionally, beyond the initial complications and expense of a high-risk birth, there can be increased medical costs over time as a result of treating lifelong conditions due to premature birth, such as asthma and cerebral palsy.  Not only does this place higher financial and emotional strain on employees, but these medical costs can add up for employers. Clinical oversight can prevent these costs from the start by guiding employees toward the safest, most effective treatment to result in a healthy singleton pregnancy.

Employee Wellbeing

Fertility treatment is an extremely stressful process, both emotionally and financially, but a managed family-building benefit can have a positive impact on employees’ overall wellbeing as a result of the one-on-one emotional support and clinical guidance from WIN’s dedicated Nurse Care Managers. Combining clinical and behavioral health expertise with individualized support, employees can feel empowered knowing they are not alone in making the best decisions for their specific journey to parenthood. Contact us to learn more about how WIN’s managed family-building benefits can reduce costs while improving outcomes for your employees.