Why Fertility Benefits Must Be Paired with Maternity and NICU Care Management

Since the first successful IVF birth in 1978, artificial reproductive technology (ART) has transformed the way families are built—offering hope to individuals and couples who might otherwise be unable to conceive. It’s also become an increasingly popular benefit for employers looking to hire in competitive markets. No longer a niche offering, recent data shows that nearly 45% of large employers now offer some form of ART benefit.

But while ART opens doors, it also introduces complexity. Pregnancies resulting from ART are statistically more likely to involve complications such as prematurity, low birth weight, and NICU admissions. A 10-year cohort study found that infants conceived via IVF had significantly higher rates of NICU admission and were more likely to require respiratory support.

Despite these risks, most ART pregnancies are handed off to standard OB care after a fetal heartbeat is confirmed—without additional support. This gap in care can lead to missed interventions, fragmented coordination, and escalating costs. Luckily for health plans with employer clients, ProgenyHealth possess over 20 years of experience in solving for these very issues.

Why Maternity and NICU Care Management Matters

Traditional maternity programs focus on prenatal visits, delivery, and postpartum care. But without integrated NICU care management, they fall short in addressing the full spectrum of risks and costs associated with ART pregnancies. Here’s what’s often missing:

• Fragmented Care: Without NICU coordination, transitions between obstetrics, neonatology, and post-discharge, care can break down.
• Missed Interventions: Early warning signs may go unnoticed, reducing opportunities to improve outcomes.
• Escalating Costs: NICU care is one of the most expensive costs associated with childbirth. Without active management, costs can spiral due to longer stays, inaccurate leveling of care, readmissions, and complications.
• Limited Family Support: Families navigating NICU care need emotional, educational, and logistical support—often absent in standard maternity programs.

What ProgenyHealth Offers

ProgenyHealth delivers a comprehensive, end-to-end solution that integrates maternity case management, NICU utilization and case management, and NICU payment integrity—all under one roof.

• Maternity Case Management: ProgenyHealth’s team works with families from pregnancy through 12 months postpartum, tailoring interventions based on medical conditions, behavioral health needs, and social determinants of health (SDoH). This proactive approach helps reduce the frequency and severity of preterm births [3].
• NICU Care Management: If a NICU admission occurs, ProgenyHealth assigns a dedicated team—including a NICU-experienced case manager and medical director—to ensure adherence to best practices, optimize length of stay, and support families through discharge and beyond.
• NICU Payment Validation & Assurance: ProgenyHealth’s proprietary Baby Trax® platform uses predictive analytics to validate claims, flag inconsistencies, and ensure accurate billing. This results in 12–16% average savings for health plans and employers.
• Real Results: ProgenyHealth’s integrated model has led to:

The Bottom Line for Employers

For health plans and their employer clients, offering ART benefits is a powerful way to support employees—but it’s only part of the equation. Without maternity and NICU care management, employers’ risk higher costs and poorer outcomes. By partnering with ProgenyHealth, health plans can ensure that employer clients and their families receive the right care at the right time—while preserving their bottom line.