Tying, exclusive dealing, and non-compete agreements in contracts between healthcare entities directly contribute to market consolidation that decreases competition and patient access to affordable and quality healthcare.

Key points:

  • 61% of Texans reside in “highly” or “very highly” consolidated healthcare markets, wherein they have decreased access to affordable and quality care. Tying, exclusive dealing, and non-compete agreements support consolidation.
  • Tying, exclusive dealing, and non-compete contractual arrangements directly contribute to the construction of healthcare monopolies, monopsonies, and oligopolies at the expense of patient health and access to care.
  • Tying clauses between providers and insurers require that if one provider is covered, others must be, enabling providers to leverage market power, capture purchasers, manipulate prices, and foreclose rivals.
  • Exclusive dealing clauses between providers and insurers or other general contracting entities require that the entities not contract with the provider’s competitors, foreclosing other providers or insurers from the market.
  • Non-compete agreements constrain physician post-employment labor mobility by preventing physicians from working in certain areas for a specific time, severing physician-patient relationships and preventing the establishment of new practices.