News | Surging IVF Demand: How Clinic Chains Are Transforming Health Care
New research from the Haas School of Business at the University of California, Berkeley, indicates that fertility clinic chains have had a positive effect on in vitro fertilization (IVF) outcomes. From 2004 to 2018, IVF demand rose by nearly 140%, while the market share of for-profit clinic chains increased from 5% to 20%. These chains now account for more than 40% of IVF cycles nationwide.
Study author and assistant professor Ambar La Forgia said that although many people are uneasy about chains in health care and worry they may sacrifice patient outcomes for profit, the study offers a different perspective. Clinic chains served more patients and improved IVF success, increasing live birth rates by nearly 14%.
Significant improvements at clinic chains
IVF treatment usually involves five major stages, more than 100 individual steps, and four to six weeks of work. La Forgia and Julia Bodner of Copenhagen Business School used data from the U.S. Centers for Disease Control and Prevention and the National Center for Health Statistics to compare chain and independent fertility clinics from 2004 to 2018.
The results showed significant growth in IVF cycles at chain clinics and a 13.6% increase in live birth rates. La Forgia said, "This means these chains not only increased the number of IVF cycles, but also improved the proportion resulting in live births, representing a meaningful improvement in quality of care."
Encouragingly, chains did not improve success by transferring more embryos. Instead, they achieved more singleton births, suggesting better embryo selection.
Benefits of shared resources and knowledge
Despite concerns that chains may screen patients more strictly or selectively target certain markets, La Forgia and Bodner found no supporting evidence. Patient populations did not change significantly after chains acquired independent clinics. In fact, the largest gains in live birth rates occurred among patients age 38 and older, who generally have the lowest success rates.
The study also indicated that chains improve outcomes through greater resources and shared best practices. They tend to introduce new processes and procedures that raise birth rates. The lowest-performing clinics improved most after acquisition, while clinics acquired by high-performing chains saw the greatest gains.
La Forgia noted that affiliated clinics increased patient numbers and IVF cycles without improving live birth rates. This may be because chains readily share resources but are less willing to share specific knowledge with organizations they have not acquired.
Improving competition in health care markets
The findings suggest that some features of fertility clinics resemble retailers and restaurant chains, giving them a competitive advantage. Because patients often pay out of pocket and clinics are legally required to report data to the government, chains have stronger incentives to improve service quality.
La Forgia and Bodner proposed three policies to promote healthier health care markets:
Improve transparency in quality of care: Public fertility clinic data can help patients choose an appropriate provider.
Price transparency: Patients often do not know treatment costs in most health care settings; greater price transparency would support competition.
Preserve patient choice: Avoid excessive market concentration that could affect price and quality.
La Forgia concluded, "There is still very little research on how chains affect patients. We should begin examining which markets are suited to this business model."
News | Surging IVF Demand: How Clinic Chains Are Transforming Health Care
News | Surging IVF Demand: How Clinic Chains Are Transforming Health Care
New research from the Haas School of Business at the University of California, Berkeley, indicates that fertility clinic chains have had a positive effect on in vitro fertilization (IVF) outcomes. From 2004 to 2018, IVF demand rose by nearly 140%, while the market share of for-profit clinic chains increased from 5% to 20%. These chains now account for more than 40% of IVF cycles nationwide.
Study author and assistant professor Ambar La Forgia said that although many people are uneasy about chains in health care and worry they may sacrifice patient outcomes for profit, the study offers a different perspective. Clinic chains served more patients and improved IVF success, increasing live birth rates by nearly 14%.
Significant improvements at clinic chains
IVF treatment usually involves five major stages, more than 100 individual steps, and four to six weeks of work. La Forgia and Julia Bodner of Copenhagen Business School used data from the U.S. Centers for Disease Control and Prevention and the National Center for Health Statistics to compare chain and independent fertility clinics from 2004 to 2018.
The results showed significant growth in IVF cycles at chain clinics and a 13.6% increase in live birth rates. La Forgia said, "This means these chains not only increased the number of IVF cycles, but also improved the proportion resulting in live births, representing a meaningful improvement in quality of care."
Encouragingly, chains did not improve success by transferring more embryos. Instead, they achieved more singleton births, suggesting better embryo selection.
Benefits of shared resources and knowledge
Despite concerns that chains may screen patients more strictly or selectively target certain markets, La Forgia and Bodner found no supporting evidence. Patient populations did not change significantly after chains acquired independent clinics. In fact, the largest gains in live birth rates occurred among patients age 38 and older, who generally have the lowest success rates.
The study also indicated that chains improve outcomes through greater resources and shared best practices. They tend to introduce new processes and procedures that raise birth rates. The lowest-performing clinics improved most after acquisition, while clinics acquired by high-performing chains saw the greatest gains.
La Forgia noted that affiliated clinics increased patient numbers and IVF cycles without improving live birth rates. This may be because chains readily share resources but are less willing to share specific knowledge with organizations they have not acquired.
Improving competition in health care markets
The findings suggest that some features of fertility clinics resemble retailers and restaurant chains, giving them a competitive advantage. Because patients often pay out of pocket and clinics are legally required to report data to the government, chains have stronger incentives to improve service quality.
La Forgia and Bodner proposed three policies to promote healthier health care markets:
Improve transparency in quality of care: Public fertility clinic data can help patients choose an appropriate provider.
Price transparency: Patients often do not know treatment costs in most health care settings; greater price transparency would support competition.
Preserve patient choice: Avoid excessive market concentration that could affect price and quality.
La Forgia concluded, "There is still very little research on how chains affect patients. We should begin examining which markets are suited to this business model."
Story source:
Collected online