Unlike virtually every other form of medical treatment in America, IVF is largely not covered by insurance. To make matters worse, patients often require more than one attempt to have a reasonable chance for success, and the majority of people needing this treatment cannot afford enough attempts to shift the odds in their favor.

When it comes to selecting an IVF program, infertile couples often find themselves faced with two harsh realities. First, IVF affords them the only realistic chance of having a family and second, there is presently no reliable method by which to evaluate the competency of any IVF program on the basis of their performance. Granted, they may have access to success rates published the Society for Assisted Reproductive Technology (SART) and the Centers for Disease Control (CDC), but the accuracy of these statistics is not reliably verified. Simply stated, when it comes to choosing an IVF program in the U.S., it is still a case of “consumer beware.”

Against this background, many quality IVF programs are providing a creative approach to building consumer confidence by sharing financial risk with their patients. Such financial Risk Sharing Plans (RSP) link the cost of IVF services to a successful outcome (birth). In the process, the IVF program provides consumers with more than one IVF attempt for a single, much reduced fee. The RSP requires that the IVF program continue to treat until such time that a baby is born, or the promised services have been exhausted (whichever occurs first). In this manner, financial risk is shared between the provider and the patient.

Consumers instinctively recognize that only those IVF programs that are capable of achieving good results are able to offer (and benefit financially from) such an arrangement on an ongoing basis. Those that are not able to achieve consistent success would soon be forced to abandon the risk sharing arrangements.

While generally speaking, contingency pricing in medicine is ethically questionable, IVF is in my opinion a clear exception. Here, outcome is actuarially measurable, terms are clearly definable, and expectations are realistic. Thus, in the absence of insurance reimbursement, financial risk sharing in IVF gives the consumer another option, and helps shift the focus from the cost of treatment to the cost of having a baby.