A Dec. 11 report by the Center for American Progress outlined recent controversy surrounding the FTC's attempt to ban noncompete agreements earlier in 2024, as well as several common types of clauses found in healthcare contracts between providers, payers and health systems that it identifies as "anticompetitive."
Here are seven types of "anticompetitive" clauses frequently seen in healthcare contracts:
1. All-or-nothing clauses: These require that if a payer wants to contract with a particular provider in a health system, the payer must contract with all providers in that health system.
2. Anti-tiering clauses: These restrict a payer from creating or altering a tiered network, block them from putting a provider in a nonpreferred network tier or require the payer to put all providers within a health system in the same tier.
3. Anti-steering clauses: These prevent a payer from using incentives and tools that encourage patients to use competing providers, even if those providers are more efficient or cost effective.
4. Exclusive contracting clauses: These bar a payer from including competing providers in their network, ensuring that the contracted provider is the only in-network option.
5. Most-favored nation clauses: These require a provider to give a payer the lowest rates of all payers they have contracted.
6. Gag clauses: These restrict the ability of a payer, plan administrator or provider to disclose price and quality information in contracts with government entities, patients or other parties.
7. Noncompete clauses: These prevent an employee from taking a job with a competing provider or starting a new practice within a given distance for a stated amount of time.