Dr. David Adamson, a leading expert with ARC Fertility, discusses the growing importance of family-forming benefits for employers and employees. In this interview, he highlights the significant rise in companies offering fertility benefits, the factors driving this trend, and the critical elements of a comprehensive benefits package. Discover how these inclusive benefits are shaping the future of workplace healthcare.
You can view the full video interview here
Key Takeaways
- Rising Demand for Fertility Benefits The number of employers offering fertility benefits has increased from 30% to 40% since 2020. This rise is driven by employees’ growing need for family-forming support.
- Comprehensive Coverage Matters Effective family-forming benefits should be inclusive and comprehensive, covering all necessary treatments and services. High-quality care from experienced providers is essential for better outcomes.
- Cost-Effective Solutions Fertility benefits are not as expensive as perceived, with many employers finding them to have minimal impact on overall healthcare costs. These benefits also help reduce the financial risk of high-risk pregnancies.
- Enhanced Employee Loyalty Offering fertility benefits increases employee loyalty and retention. Companies that provide these benefits see improved employee satisfaction and a more supportive workplace culture.
Exploring the Rise of Fertility Benefits in the Workplace
Host Mabel Jong – thINc360:
“Welcome back. I’m Mabel Jong, and I’m here now with Dr. David Adamson, who is with ARC Fertility. Thank you so much for your time, Dr. Adamson.”
Dr. David Adamson:
“Thank you for having me today. It’s great to see you again, Mabel.”
Host Mabel Jong – thINc360:
“So good to see you. I saw somewhere that 40 percent of employers are now offering some type of fertility benefit, up from 30 percent in 2020. That seems to be quite a dramatic jump. Why do you think that is?”
Dr. David Adamson:
“Well, it is great that so many more employers are offering family-forming benefits because for many years, coverage was very poor.
Now, not all those benefits that are offered are really inclusive and comprehensive, which is really important because you want to include everybody and cover everything that’s needed.
But there are a lot of reasons they’re looking at it. A lot of employers are asking for benefits now. They really, really want to have them.
With the younger generation, a significant proportion will leave their job if they need fertility benefits and want to go and get them somewhere else.
Over half would leave their job to get a benefit, and those who do have benefits are really, really grateful and more loyal to their employer. There are lots of other reasons as well.
HR professionals think that family-forming benefits are really going to be a necessity by 2025, or it’ll be discriminatory not to have them.
I think one of the important things is that more and more employers are covering them because they’re finding out they’re really not expensive.
There’s been this perspective that family-forming benefits cost a lot. Ninety-seven percent of employers in a survey that was done said that these benefits did not add a lot of cost to their health plan costs.
There are also big financial benefits because it really helps to mitigate the risk of high-risk pregnancy. So there’s actually real financial benefits as well.
We also know these days that employers are really paying attention to diversity, equity, and inclusion, and having family-forming benefits can be something that really helps everyone in the company, not just those that are affected, but creates a better culture in the company and helps address social determinants of health issues, which are really, really important.
Of course, it’s good for public relations as well. So there are many, many reasons that employers are saying yes, we should have a look at this and look at bringing in a really comprehensive and inclusive family-forming benefit.”
Understanding the Increasing Need for Fertility Benefits in the Workplace
Host Mabel Jong – thINc360:
“Can we get back to sort of the basics of why companies are having to look at this? What is happening, whether it be environmentally or for some other reason, that people are needing to seek out help in this area?”
Dr. David Adamson:
“Well, you know, it’s quite interesting that if you look at infertility by age across the population, it’s actually not really increased. There are a lot of things that have happened, though.
First of all, fortunately, because women are being educated for a longer period of time and in the workforce with more progress, they’re having babies when they’re older. This means that more people need to come for fertility care.
That, along with issues of gender equity with more women in the workforce and employers trying to be helpful to women, means that with these increased benefits, they’re finding that they can, in fact, go for fertility care, have a family, and still maintain a career.
This is increasing the number of women who want to do this. Very importantly, as you know, with the passage of legislation stating that LGBTQ+ individuals could not be discriminated against in the workforce, this means that a whole additional community of people, many of whom need help to have a family, can, in fact, access family-forming benefits.
The LGBTQ+ community and single women and men who want to have families are also coming more often. In addition to that, there have been some real technology advances such as sperm injection, which enables us to treat male fertility a lot better because men are involved in this, egg freezing, which allows us to help a lot of single women who want to preserve their fertility or any woman who might have to face cancer therapy.
Improvements in genetics testing and the application of genetics in the assisted reproductive technologies, or IVF, mean that we can help a lot more people.
There’s a huge combination of social factors, employers looking at it very differently, and technology changes, all of which together are bringing more people to seek fertility care.
I think really importantly, just like even breast cancer and HIV used to be unspoken topics and then emotional health was an unspoken topic, infertility has been like that. It’s a huge problem. It affects at least one in eight people.
A recent study from WHO says one in six people are affected by this in their lifetime. It is now a topic that people can talk about. I think maybe the pandemic, the new generation looking at a different work-life balance, the focus around talent retention and recruitment, and the importance of really making a workplace as conducive to people’s personal lives have all meant that there’s these many forces making family forming important for everyone, including those who have difficulty starting their family.”
Essential Features of Effective Family-Forming Benefits
Host Mabel Jong – thINc360:
“Fantastic. So what are the features that both employees and employers should keep in mind when they’re looking at family-forming benefits?”
Dr. David Adamson:
“You know, that’s a great question because there are a lot of benefits that have been out there historically. Fertility benefits sort of stopped at the time of diagnosis, which didn’t help much because most of the cost would come with treatment.
Then treatments did come in with a lot of the conventional plans, but they were very limited. It had to be a heterosexual couple, had to meet certain criteria, or what have you. So there are a number of features that are really important.
The first one is to have high-quality care. As we’re hearing here, high-value care is critical, and to get high-value care, you need high quality. That requires really good doctors who know what they’re doing. You can’t get around the fact that you have to have an experienced, qualified provider, or you’re not going to get good care.
The second aspect of it is that you need to provide evidence-based medicine. We’ve just heard today, and it’s nobody’s surprise, that 25 percent of the healthcare dollars in this country are wasted—one trillion dollars. A lot of waste goes into the fact that some services are provided that are not needed or even needed services are provided too often or services that are provided are not provided with high quality or in the appropriate way by the provider or whoever it’s done. We need to get rid of this waste by having evidence-based care by top-quality doctors.
On top of that, we really need to provide a good employee-patient experience. Our healthcare system is so complicated, so everyone needs to be met where they’re at.
Seventy percent of incoming information today is on a cell phone, so it’s really important for the quality to have a very sophisticated digital program with apps that are interactive, that engage people, and are personalized for that individual.
Again, because of the complexity, especially in fertility care, you need that personal navigation one-on-one to help people get guided through it.
You can get very high engagement scores with both digital and one-on-one. So the quality is top-quality doctors, evidence-based care, and having both a hybrid digital and one-on-one concierge experience.
The second major feature of value, of course, is cost. You need high quality, but to have high value, you have to have good costs. There are ways to manage the cost.
The first one, of course, is to have individualized care, so you’re not just putting everybody into the same basket. When you can do that with packages of care that are evidence-based, you do what’s right for that person and avoid the waste, which is so common. This cuts the cost down significantly.
You can get some discounts from doctors, but we know that with all the challenges and personnel in the healthcare space, we have to pay providers fairly, or else they’re not going to be there to do the work.
You want to get discounts, but there has to be fair compensation, and it has to be value-based. The doctors have to have some skin in the game and the providers. It’s important to have that kind of cost structure, a benefit design that really matters.
It’s very important to get everybody in the top of the funnel, so you want very low access fees to get people involved. A lot of employers these days are saying they don’t want to pay for care that they don’t receive.
If you can have a program that only pays when care is received, it really helps a lot. So not necessarily a PEPM model but one where when the care is received, we’re going to pay for it.
The third aspect besides quality and cost, which is the high-value aspect, is that every company is different. We have a very diverse country with diverse companies, diverse patients, and population, so flexibility really matters.
As I mentioned earlier, you need something that’s inclusive and comprehensive. The healthcare system today under the ACA doesn’t allow certain kinds of care to include everyone, for example, surrogacy or some aspects of donor egg or adoption, because that’s not a medical service.
You really need a type of program that can be flexible, include everyone, have equity for everybody—everybody gets the same in the company—and then it has to be comprehensive.
You want to cover preventive care, general good health, help people get pregnant on their own, help them if they have a challenging fertility journey with any type of thing they need: male treatment, genetics, surrogacy, adoption, donors.
It needs to be comprehensive. On top of that, you want to have options. Employers need options. Do they want to have a pharmacy plan that’s in their program with their own PBM or something that’s standalone? Do you want to have something that can really cover all aspects of adult reproduction, like pregnancy counseling and genetics counseling, return to work programs, lactation programs? You want to have a program that can provide everything that that particular company needs.
You really like to have programs where, from a budget point of view, each employer can decide how much they can afford to put into this and maybe have some cost sharing with the employee.
But a reasonable cost sharing that makes it more affordable for the employer because they can choose how much they can pay and more affordable for the employee because they know the employer is putting some funds in.
This is a conversation around flexibility—what’s going to work best for that employer and employee in that situation, bringing financial solutions to the table.
I really believe that high value, which means high quality at a lower cost and flexibility to meet everyone’s needs, are the keys to bringing in successful not only family-forming benefits but all the types of healthcare benefits that we know our population needs.”
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The Importance of Sharing the Message at thINc360
Host Mabel Jong – thINc360:
“This message seems very important to a wide number of people. Why bring it to thINc360 to spread the message? Who are you meeting here or speaking with that is especially advantageous to the message?”
Dr. David Adamson:
“This is a wonderful meeting at thINc360 because you really do have innovative thinkers. There are a lot of people who are trying to change our four trillion dollar healthcare system, which is way above the most expensive in the world, and yet we do not have the best health outcomes.
I think many people here believe that we have to change the model. The model does need to be changed towards high value. It needs to be changed towards everyone in the system having a motivation to do the right thing, having a reward to good providers for doing the right thing, having incentives to have predictable costs, know that you’re providing the best care, and being flexible for different situations.
These are features that are being discussed here by people and not only just discussed, but the presenters are people who have actually implemented these in hospitals and health systems.
They’re dealing with the real challenges and bringing real solutions. I find it very stimulating to talk with those people because certainly, our vision, mission, and goals are to bring increased access of really high-quality care to people.
That’s going to require higher quality, lower cost, and flexibility and innovation. That’s what thINc360 is all about.”
Host Mabel Jong – thINc360:
“Terrific. Thank you so much for your time today.”
Dr. David Adamson:
“Thank you so much, Mabel. Great to see you.”
Host Mabel Jong – thINc360:
“Great to see you.”
