AMGA recently sent a letter to the Federal Trade Commission (FTC) regarding the agency’s proposed Non-Compete Clause Rule, recommending that the agency withdraw the proposal. Under the proposed rule, a national framework would be created for contractual provisions that are historically regulated by individual states. Included in that framework would be prohibitions regarding an employer’s use of non-compete clauses, making it illegal for an employer to enter into or attempt to enter into a non-compete with a worker; maintain a noncompete with a worker; or represent to a worker, under certain circumstances, that the worker is subject to a non-compete. The proposed rule would apply to employees, paid and unpaid, and to independent contractors. It would also require employers to rescind existing non-competes and actively inform workers that they are no longer in effect.
The FTC believes that such a framework would help to both promote competition, protect and educate consumers, and protect healthcare workers.
In the letter, AMGA notes that while it can “appreciate” the intent of the FTC to “promote healthy competition and innovation in the marketplace,” given the “unprecedented healthcare workforce crisis,” the proposed rule would “further destabiliz[e] local healthcare labor markets.” AMGA specifically points to its belief that such a national framework would “hinder the coordination of patient care and undermine competition by increasing costs for multispecialty medical groups and integrated delivery systems.
AMGA provided comments on three points regarding the proposed rule: (1) individual states are the most appropriate arbiters of non-compete agreements; (2) non-compete agreements protect medical group investments, ensuring continued care access for patient communities; and (3) the proposed rule would undermine care coordination.
AMGA believes that states are best left to manage non-compete agreements because they “are most familiar with local market conditions,” and that they are “unaware of evidence indicating that states cannot effectively evaluate the reasonableness of these contractual arrangements in the healthcare setting.” AMGA points to several states that have already worked to address the problems the proposed rule seeks to address, such as Rhode Island and Illinois have regulated non-compete agreements for low-wage workers while Tennessee and the District of Columbia have excluded physicians from many of the restrictions on non-compete agreements.
While the FTC believes that eliminating non-compete agreements would reduce healthcare costs, AMGA believes it would actually increase the cost of healthcare. AMGA believes that if a new physician were able to leave one practice for another with no consequences, the old practice would have to find another physician to replace him or her, costing anywhere from an estimated $300,000 to $500,000 on average in recruiting costs. That investment does not account for the two to three years a new physician often takes to build their practice. Not only will the practice have to expend additional money, but patient care is often disrupted and delayed when doctors leave medical practices. Non-compete agreements allow multispecialty medical groups and integrated delivery systems to protect the investments they make in recruiting physicians to help meet the healthcare needs in their communities.
“Patients benefit the most from a model that is built around care coordination and a carefully designed team-based environment,” said AMGA President and CEO Jerry Penso, MD, MBA. “Patient access to their team of providers is important for care continuity, especially for those patients with chronic diseases. The FTC should prioritize the stability of doctor-patient relationships and not move forward with a plan that could disrupt patients’ care.”