THE SOURCE BLOG

Editor's Note

Introducing the Source New Interactive Key Issue Page: Provider Contracts

We did it again! The Source on Healthcare Price & Competition is proud to announce that, in partnership with UC Berkeley's Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, we have launched another brand new interactive key issue page, "Provider Contracts", which looks at the most effective strategies for states to understand and address the ability of providers with dominant market power to utilize contracting strategies to negotiate high rates.

With support from Arnold Ventures, this new installment is part of a collaborative research series that leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider and insurer markets in the United States in the last ten years and presents evidence-based information and analyses on the most effective strategies for states to address rapidly consolidating healthcare markets. The "Market Consolidation" key issue page, which examines state merger review authority, was launched last December.

We present our findings in a series of user-friendly interactive features including maps and resource tables, as well as summaries of major lawsuits. The newly unveiled interactive features show, among other findings, that 19 states prohibit most favored nations clauses in contracts between insurers and providers. Furthermore, 8 states prohibit the enforcement of non-compete clauses in most physician contracts, and 12 more limit the duration of non-competes through statutes. Additionally, while Massachusetts is the only state to restrict anti-tiering/anti-steering and some all-or-nothing contract provisions, 3 states have introduced legislation in the current session to restrict the use of these terms in provider contracts. We round off our new interactive with coverage of the three major lawsuits filed by state and federal antitrust enforcers alleging the anticompetitive use of these contract terms by dominant providers.

Find out more on the new page and stay tuned as we continue to roll out additional features and analyses in multiple phases throughout the next few months. We look forward to your comments and feedback here!

Download PDF

Download PDF
avatar
  Subscribe  
Notify of