The Strategic Value of Fertility Care in Regional and Community Hospitals Amid Looming Medicaid Cuts
July 15, 2025
As regional and community hospitals brace for the financial headwinds of proposed Medicaid reimbursement cuts, hospital leaders are under pressure to find new, high-impact ways to diversify revenue, strengthen care delivery, and meet the evolving needs of their communities.
One timely and often overlooked strategy? Adding fertility care as a service line.
Fertility Care: A Revenue-Diverse, Mission-Aligned Growth Engine
Fertility care is no longer confined to boutique urban clinics or large academic systems. It’s evolving, becoming more standardized, technology-enabled, and scalable. That shift opens the door for regional hospitals to participate in a market that is poised to double in size by 2029, while advancing their mission to improve access and outcomes.
Here’s why this move makes strategic sense:
Rising Demand: The U.S. fertility market is projected to nearly double by 2029, fueled by cultural shifts, increased infertility rates, and growing employer-sponsored benefits.
Underserved Markets: Millions live in “fertility deserts”—especially in rural and lower-income areas. Community hospitals are uniquely positioned to close this gap and become trusted providers of local, family-building care.
Cash + Commercial Pay Mix: Fertility services are often paid out of pocket or through private insurance, offering insulation from Medicaid volatility and a more diversified revenue profile.
The Medicaid Crunch: A Call for Revenue Resilience
Medicaid accounts for nearly 1 in 3 hospital dollars. With cuts on the horizon, regional and rural hospitals, already stretched thin, face revenue losses exceeding $600,000 on average, and in some cases, the loss of more than half their net income.
To weather this storm, hospitals must hedge against public payer risk by adding service lines that draw from commercial and self-pay segments. Fertility care checks that box.
More Than Margin: Fertility as a Driver of Community Impact
✅ Equity in Access: Local fertility services can dramatically reduce travel, cost, and emotional burden, especially for cancer patients, LGBTQ+ families, single parents, and those with complex reproductive needs.
✅ Lifetime Patient Value: Fertility services often lead to OB care, pediatrics, and primary care keeping patients in-system and increasing long-term value.
✅ Public Health Alignment: Fertility care supports reproductive autonomy, addresses demographic challenges, and advances health equity which are core pillars of any community hospital’s mission.
Community Hospitals Have the Advantage
Here’s how regional and community hospitals are uniquely positioned to lead in fertility care:
Opportunity: Growing fertility care market
Advantage: Capture new patients and diversify revenue
Opportunity: Demand for local, equitable access
Advantage: Eliminate care deserts and reduce travel barriers
Opportunity: Payer mix diversification
Advantage: Reduce overexposure to Medicaid volatility
Opportunity: Deep community trust
Advantage: Deliver patient-centered, culturally competent care
Where to Start: Fertility Without the Lab
Contrary to popular belief, you don’t need to build an IVF lab to begin offering fertility services. Start with:
Diagnostic testing
Fertility consults and education
Ovulation induction and IUI
Partnership-based IVF referrals or on-site REI collaborations
With the right clinical training, workflow integration, and technology tools, fertility can be embedded within OB/GYN and women’s health departments quickly and efficiently.
Final Thought
In this era of fiscal pressure and policy shifts, the hospitals that survive won’t be the biggest, they’ll be the most adaptive.
Fertility care isn’t just a new service line, it’s a strategic response to a changing landscape. It’s a mission-aligned investment in community health, access, and sustainability.
Now is the time for regional and community hospitals to lead boldly.
