How payers can address racial disparities in fertility care

February 15, 2023
Matt Taylor
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With diversity, equity, and inclusion (DEI) becoming a top priority for groups and members alike, health plans have the opportunity to provide access to care and resources that begin to close long-standing gaps in care access and outcomes. 

For today’s groups, fertility benefits are a powerful way to demonstrate a commitment to DEI. And the right solution extends beyond an infertility diagnosis and includes an understanding of how fertility care impacts different populations, so support can also help address gaps in fertility healthcare. For example, BIPOC (Black, Indigenous, and people of color) communities are often negatively impacted by discrimination in care and are more likely to experience worse pregnancy and birth outcomes than white individuals. Let’s explore what disparities currently look like in fertility care and how partnering with the right fertility benefit can improve outcomes for members. 

What are current disparities in fertility care? 

As a health plan, it’s important to understand how incomplete care has disproportionately impacted marginalized groups. Studies have shown that Black and Latinx individuals are less likely to receive fertility care than their white counterparts. These disparities can result from various factors, including the cost of fertility treatments, lack of access to culturally competent healthcare, and cultural stigma. 

Despite encountering more obstacles to accessing care, people of color are also more likely to experience infertility and other fertility health issues. Black women have been shown to be twice as likely to have infertility issues compared to their white and Hispanic counterparts. Black and Latinx people are more likely to experience infertility due to underlying health conditions, such as diabetes, obesity, and hypertension. Additionally, Black women experience menopause symptoms earlier and more severely than non-Black women. These disparities can have a lasting impact on the health and well-being of individuals and communities. 

When it comes to maternal health, the statistics are especially startling in Black and Native American groups. Recent studies have shown that birthing people in these groups are 3.2 and 2.3 times more likely to die from pregnancy-related causes than their white counterparts. As Black women age, this risk dramatically increases. It is believed that two-thirds of pregnancy-related deaths could have been prevented. Black people already have a higher rate of adverse safety events in hospitals than other groups. The history of racism and bias in hospital settings still influences the experiences of people of color and helps explain the disparities we see today. 

How can the right benefit can help?

Partnering with the right fertility solution vendor allows health plans to offer a comprehensive approach to fertility care that can engage more plan members on their unique journeys through pregnancy, family-forming, and other fertility healthcare challenges. Most significantly, fertility benefits can help bridge some of the gaps in fertility care by promoting culturally competent care. Research has shown that when a patient and physician share the same race or cultural background, they have higher patient satisfaction scores, are more likely to take medication on time, and have overall better outcomes.

Doula support can also improve outcomes for birthing people, their babies, and their families by offering mental, emotional, and physical support. Having extra support from a doula during pregnancy and labor has shown increased favorable outcomes, especially in communities of color, which often battle chronic stress and other illnesses that stem from structural racism. Black doulas and Indigenous doulas, in particular, can add a cultural perspective to their support that helps providers unlearn their biases and helps clients feel empowered while improving health outcomes — but are rarely included in traditional insurance coverage. New York City recently introduced a community-based doula program for people who are income eligible for Medicaid. Dozens of states are in various stages of considering, planning, or implementing Medicaid doula reimbursements. 

Studies have shown that individuals participating in a community-based doula program are four times less likely to have low birth weight babies and two times less likely to have a birth complication. Other improvements include shorter labor times, reduced cesarean birth rates, and increased parental satisfaction after birth. As a result, health plans can lower downstream costs through inclusive fertility benefits that help mitigate high claims costs and support healthier outcomes. Fertility benefits like Carrot are also now including doula support as part of a comprehensive solution for improving birth and maternal health outcomes.

Why partner with Carrot? 

Health plans can work alongside Carrot to provide the most inclusive support to members. With Carrot, members have access to: 

  • BIPOC providers. Individuals should have the opportunity to work with the providers that they feel comfortable with. Carrot connects members with a network of BIPOC providers to give patients the option to select doctors and providers within their same race or ethnic group.
  • Telehealth and expert support. Members have access to Carrot Experts, personalized care navigation, and virtual small-group sessions led by medical experts.
  • Doula support. Carrot members can now use their Carrot funds to cover expenses for doulas. Members can use their Carrot funds to pay for eligible doula services. To ensure members receive high-quality support that promotes healthy birth outcomes, doulas must meet specific criteria — like obtaining accreditation from an approved organization, participating in an adequate training curriculum, and having an appropriate breadth of experience.

Diversity is more important than ever before. As organizations move to establish and maintain equity, it is becoming more essential to reflect those initiatives within their health plans — so those with inclusive plans will stand out. Through care navigation, expert support, and diverse fertility health options, Carrot connects members to equitable, high-quality fertility and family-forming support that considers each person’s unique background. 

Want to learn how Carrot can support your health plan — get in touch with us today.

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