"REFILL" | Dutch Rojas on Healthcare Economics, Direct Contracting, and Tax-Exempt Health Systems (Originally Aired: September 15, 2025)

This is a "REFILL" episode recorded in September 2025. At the time of recording, Dutch Rojas was a healthcare entrepreneur, founder of multiple direct contracting companies, and board member of Physician Led Healthcare for America, with a growing following on social media advocating for market-based healthcare solutions.

Joe Grogan sits down with Dutch Rojas, healthcare entrepreneur and social media advocate, to discuss his journey from accounting to building direct contracting companies that revolutionize employer healthcare. Rojas explains how direct contracting allows employers to negotiate directly with physicians, bypassing insurance middlemen. The conversation covers his experience building ambulatory surgery centers, certificate of need laws, self-funded employer plans, and his critique of not-for-profit health systems. Rojas argues that academic medical centers masquerade as not-for-profit organizations while receiving seventy-four subsidies annually from taxpayers, acquiring massive real estate holdings, and avoiding property and federal taxes. He advocates for policy changes on not-for-profit tax status and site-neutral payments, arguing these represent unfair advantages that harm independent physicians and patients.

Key Timestamps

0:18 Joe introduces Dutch Rojas and asks who is Dutch Rojas

1:32 Dutch's background, career path, and journey to social media

2:22 Physician-led Healthcare for America and PHA board

4:32 Starting in accounting, real estate investment trust, and ambulatory surgery centers

5:14 150 ambulatory surgery center deals and certificate of need experience

7:34 Building a practice in Scottsdale and expanding to 16 states

9:30 First direct contracting company in 2009 and how direct contracting works

12:45 Self-funded employer plans and 106 million Americans not covered by insurance

15:22 Deals with banks and large employers in New York City