Health care access, costs, and treatment dynamics: Evidence from in vitro fertilization

Barton H. Hamilton, Emily Jungheim, Brian McManus, Juan Pantano

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


We study public policies designed to improve access and reduce costs for in vitro fertilization (IVF). High out-of-pocket prices can deter potential patients from IVF, while active patients have an incentive to risk costly high-order pregnancies to improve their odds of treatment success. We analyze IVF's rich choice structure by estimating a dynamic model of patients' choices within and across treatments. Policy simulations show that insurance mandates for treatment or hard limits on treatment aggressiveness can improve access or costs, but not both. Insurance plus price-based incentives against risky treatment, however, can together improve patient welfare and reduce medical costs.

Original languageEnglish (US)
Pages (from-to)3725-3777
Number of pages53
JournalAmerican Economic Review
Issue number12
StatePublished - Dec 2018
Externally publishedYes

ASJC Scopus subject areas

  • Economics and Econometrics


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