WIN Fertility

Create a vendor selection project & run comparison reports
Click to express your interest in this report
Indication of coverage against your requirements
A subscription is required to activate this feature. Contact us for more info.
Celent have reviewed this profile and believe it to be accurate.

Overview

Most Experienced Family Building Benefit Solution: Since our founding as an independent women's health management company in 1997, WIN has been exclusively dedicated to building families by providing access to top network doctors, technology and emotional support with the best outcomes and at the lowest cost. Today offering integrated, highly customizable, integrated programs supporting health plans and self-funded groups. With more than 20 years of experience and data driven protocols have allowed us to help over 100,000 patients achieve parenthood. Our targeted initiatives and purpose-built systems promote treatment options that yield better clinical outcomes, reduce direct treatment costs, lower the rates of high-order multiple gestations and related NICU utilization, and improve member satisfaction.

WIN has recently obtained a 98.3% customer satisfaction rating as evaluated by a third party. Our independently measured customer satisfaction has been in excess of 95% for over a decade.

Breadth of Services: Service offered typically include medical management, genetic testing, egg freezing and pharmaceutical management, in addition, adoption and surrogacy benefits are available all of which address the potential needs of an all-inclusive family building solution for health plans and employers.

Health Plan & PBM Integration (carve-in): WIN is the leader in providing integrated health plan solutions to employers with decades of demonstrated experience partnering with/Health plans and PBMs including being the exclusive embedded provider for several national health plans. WIN is fully integrated with ESI

and is currently partnered with Aetna and Highmark. WIN’s carrier integration allows for a seamless member experience, industry leading outcome improvement and lowest cycle cost. Through integrated fertility management, including medical treatment, pharmacy, genetics, surrogacy and adoption.

Carve-in or Carve-out:WIN maintain our own network and has for years offered a completely carved out option from the health plan(s).Many of our clients use our carve-out option to provide WIN’s services to groups of employees on staff model HMO programs.Mid-sized and smaller clients also make great use or WIN Premier solution and WIN Rx

Broadest Network Access: WIN’s integrated proposal will utilize Aetna’s and Highmark’s vast networks that include 95% - 98% of all reproductive endocrinologists in the addressable area. This integrated network access allows for convenient, quality access for employees, simple claim paying administration for the state and the lowest unit cost for care available.

Nurse Lead Patient Advocacy: WIN’s Fertility Support is delivered to a patient through an ongoing and dedicated relationship with one of our Nurse Care Managers. The nurse’s role is to provide education and support to the employee. WIN’s model provides the employee with 24/7 access to an educated, highly experienced, caring, and professional individual who will provide support (including emotional support) during what is often a very stressful time. Educational outreach is grounded in evidence-based medicine and highlights the most appropriate and effective care for the member. Before infertility treatment, the Nurse Care Manager completes an intake report on the employee to identify needs and develop a specific plan of care (e.g. education targeted to diagnostics for those who are going through an initial work-up) and assists the employee in selecting a high quality, in-network provider based on each employee’s individual needs.

During treatment, the Nurse Care Manager is available for emotional support and to reiterate strategies for avoidance of such complications as multiple gestations. Outreach during prescription processing helps to identify and continue engagement with the employee. Nurse Care Managers also have educational discussions with patients during this process for medication injection support and are available 24/7 for any assistance. If the treatment cycle is successful, the Nurse Care Manager explains the customary monitoring done to confirm a viable intrauterine pregnancy. The Nurse Care Manager also works to seamlessly integrate with the health plans maternity program for transition.

Highest Quality Providers: With the broadest access to network providers the WIN Nurse Care Managers will assist the patient to find the best providers in the area for their specific needs. WIN has evaluated every fertility facility and doctor in the country and provides steerage to facilities that best match the clinical profile of each patient. Our vast experience of 21 years in managing 25% of all IVF in the US allows us to have greater insight into doctor and facility success beyond publicly available information.

In collaboration with WIN’s medical advisory board consisting of practicing luminaries in the field of Reproductive Endocrinology, WIN has instituted a fair and objective method to profile providers across the country based on outcome measures that evaluate clinical quality. To do so, WIN has designed a scoring system that considers CDC data, the largest publicly available source of infertility practice information; specific attributes of the practice and its patient base (e.g., the provider’s patient population exhibits atypical clinical difficulty); and additional data obtained by WIN through network management activities (e.g., patient satisfaction, additional clinical measures).

Lowest Cycle Cost in the Industry: Managing treatment cost within a comprehensive solution provides the employer significant plan savings and enhances the overall value of the member’s lifetime maximum benefit limits, while concurrently coordinating best case practice treatment options to drive superior clinical

results and exceptional customer care. Health plans with large memberships typically have the broadest and lowest unit cost provider contracts. This is an advantage of WIN's model allowing client employees the greatest level of access, lowest cost, and along with WIN's management and steerage to the highest performing of those providers.

Process Governance: WIN’s trusted relationships with patients and doctors, cycle volume and treatment authorization allow our NCMs unsurpassed governance over the fertility treatment process. This assures a higher quality care delivery for the patient, improved outcomes, reduces unnecessary testing and procedures and lower costs for the employer and patient.

Independent and Unconflicted: WIN is an independently held, private Corporation, unlike other companies within the fertility management space. WIN is not beholden to a parent or affiliated health plan, fertility drug manufacturers, technology or testing facilities that conflict with the goals of our clients.

Aligned Incentives: WIN treats members as patients, not customers to be sold costly services that unnecessarily erode the member’s benefit. WIN’s member centric integrated health plan model promotes the most effective clinical protocols and procedures to optimize value and plan design by only promoting tests and procedures when medically necessary. In contrast, our competitors’ carve-out model profits on each additional test and service provided.

Largest Fertility Database in Country: Serving the broadest, most diverse set of clients allows us greater access to clinical data for benchmarking comparison and insight regardless of industry or locations. That data additionally allows us to continuously refine our process, protocols, education to patients and plan design suggestions to employers.

WIN's Product Roadmap: Our future mix of protocols, products and services is directly aligned with advances in reproductive science to help individuals more easily and less expensively overcome infertility. WIN works in conjunction with its Medical Advisory Board (MAB), comprised of practicing Reproductive Embryologists who are often involved in the cutting-edge research that advances treatment and improved results. WIN management meets regularly with the MAB, keeping WIN abreast of impending changes and advancements. Additionally, WIN continues to explore modes and approaches to enhance the member experience including their spouse or partner.

WIN now offers:

· Fertility advocacy services, adoption & surrogacy cost management on a global basis.

· Virtual video consultations with Nurse Care Managers via our proprietary app (1/1/20)

· Various app-based activity and milestone trackers (1/1/20)

WIN Rx: WIN is one of the largest suppliers of fertility related drugs in the country. We have a highly competitive Rx solution that saves employers money and greatly improves the benefit value to the employee.

Dedicated Public Sector Division: WIN is highly experienced in providing fertility benefit management to public sector clients.