Which Shared Risk Option is Best? -- Ask The Experts

Posted on August 15, 2007 by Inception Fertility

Question:**Answer:** It is estimated that there are approximately 2 million infertile patients in the US. Approximately 1.5 million will seek treatment. Of these, about 750 K conceive with standard treatment and 750 K remain infertile. Of the 750 K who remain infertile, 50 K adopt, 50 K undergo IVF, and 650 K drop out of treatment. Only about ¼ to ¹/3 of infertile patients see a Reproductive Endocrinologist; most patients are only treated by gynecologists. The remaining ¹/3 don’t seek treatment because they believe that they can’t afford it, and ¹/3 don’t proceed to adequate treatment secondarily to financial barriers. Given these daunting statistics, we understand that it is important for IVF clinics to help maximize access to all levels of fertility care, by sharing the financial burden and the risk of an IVF cycle. With these goals in mind, PFC offers two “shared risk” financial plans to our patients. We call our two plans: the Refund Plan and the Option 2 Plan. When engaged with you in a shared risk plan, we are indicating that if you meet the appropriate medical criteria, we feel confident that we have a reasonable chance to help you achieve your goal of parenthood, and we are therefore willing to share in the financial risk associated with IVF. Sharing in the financial risk of treatment is a statement of confidence in our ability to help you overcome infertility. As physicians, we are often asked by our patients to recommend a financial plan. Each patient’s case is different, and choosing the best plan for you has to do with your own comfort level in taking financial risk, dovetailed with your emotional comfort and commitment to treatment. These levels of comfort can only be addressed on a personal and individual level. Some general questions to consider in analyzing the plans are the following:

  • • What are your estimated chances of success with your fresh embryo transfer?
  • • What are the chances of having any frozen embryos?
  • • What are your estimated chances of success with your frozen embryos?
  • • If you are not pregnant with this IVF cycle, would you want to proceed to another IVF cycle?
  • • If you do not become pregnant after a treatment cycle, would you rather receive a refund and then decide on the next steps for treatment?

Depending on the answers to these questions, you can begin to define which financial plan may make the most sense. For patients who want some financial buffer if their cycle is not successful, the Refund Plan may be the best choice. It allows you to receive a refund and then decide if the next steps will be to do nothing more, to continue treatment, or to use the refund for other options such as adoption. For those who are ready to commit to a second IVF cycle attempt if the first cycle is not successful, the Option 2 Plan may be the preferred choice. This plan provides the option of 2 cycles for only a little more cost than a single cycle. In general, the Option 2 Plan is for those whose chances of having frozen embryos is less—making the probability of needing a second fresh IVF cycle greater. At PFC, we have two financial coordinators dedicated to providing all the information about costs which can then help you to make these important decisions. As in any financial decision, there is no right or wrong answer, but only an answer which best fits your particular situation. This decision is then matched with your personal comfort level in sharing risk. For some patients, neither of these plans may seem appealing, and the Single Cycle Plan (pay for services as provided) will be most appropriate. For patients with insurance coverage for IVF, the Single Cycle plan is the only option. While Pacific Fertility Center can not choose a financial plan for you, if you need more information about your specific fertility situation before deciding on a “shared risk” plan, please do not hesitate to discuss this with your physician or your financial coordinator. -- Dr. Isabelle Ryan

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