Patient First Healthcare

The healthcare industry doesn’t like competition. The medical-industrial complex has done its best to limit choice at the expense of patients. 

Worse, healthcare consolidation continues to rise, leaving consumers with fewer options.  

Once market dominance is achieved, large hospitals, health systems, and insurers use anti-competitive contracting terms to increase their bottom line, driving up the cost of care. 

Further, large providers often use non-compete provisions in healthcare employment contracts with physicians or other clinicians. They prevent providers from changing jobs and restrict new providers and insurers from entering the marketplace. Their refusal to accept competition in any form limits access and is, quite simply, a bad policy.   

While some may argue that non-compete agreements have a place in the board room, they are unquestionably bad for the emergency room. 

The following solutions would fix this misalignment. 

Removal of the following clauses: 

• Anti-steering clauses prevent insurers from encouraging patients to shop around for affordable, high-quality care.  
• Anti-tiering clauses restricting insurers, categorizing providers, and incentivizing patients to pick their providers from the highest-performing tiers.  
• Most-favored-nations clauses prohibiting a health system/provider from offering a lower reimbursement rate to a competitive insurer.  
• All-or-nothing clauses requiring insurers to include all of a provider’s members (physicians) in their network plan. 
• All-products clauses requiring providers to accept every insurance plan offered by a company, then existing or to exist in the future, even if they have different reimbursement rates or financial terms.  
• Non-compete provisions restricting physicians or other clinicians from going to competitive providers, limiting patient access should a physician/clinician want to leave his or her current employer.  

Prohibiting non-compete provisions will improve access and keep physicians and other clinicians from standing on the sidelines.