Dutch Rojas - Healthcare

Dutch Rojas - Healthcare American healthcare isn’t broken. It’s built this way. I show you the receipts, daily. Founder ·· 🇳🇱→🇺🇸 [email protected].

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Three years ago, a venture capitalist named Bill Gurley stood on a stage at Royce Hall in Los Angeles and gave a talk ca...
09/02/2026

Three years ago, a venture capitalist named Bill Gurley stood on a stage at Royce Hall in Los Angeles and gave a talk called “2,851 Miles.”

My brother, Dutch, and I were both in attendance.

I have watched it several times since.

Not because it upset me.
But because a man I have never met stood in front of a thousand investors and described, with precision and considerable warmth, the thing I do for a living.

He got a standing ovation. Somebody in the crowd yelled that he should run for president That was the best day of my professional life.

Nobody in that room understood why.

NATIONAL. Becker’s now counts 29 hospitals and health systems that have added inaugural C-suite roles in 2026.One hospit...
09/01/2026

NATIONAL. Becker’s now counts 29 hospitals and health systems that have added inaugural C-suite roles in 2026.

One hospital immediately unveiled its boldest reorganization yet: a newly appointed Chief Transformation Officer whose sole mandate is to transform the office of the Chief Transformation Officer who came before.

“The previous officer transformed everything except the transformation itself,” explained the Chief Growth Officer, speaking from an administrative floor that now holds more vice presidents than the emergency department holds nurses.

The system also added a Chief AI Officer, a Chief Customer Experience Officer, and a Chief Strategy Officer. Patients seeking additional information were directed to the main patient line, which was still busy.

Leadership confirmed the new executives would begin delivering value to patients “at a date to be determined by a future Chief Value Officer.”

The independent physician pays income tax on what he earns. His building carries property tax. He borrows in the taxable...
09/01/2026

The independent physician pays income tax on what he earns.
His building carries property tax.

He borrows in the taxable commercial market, personally guaranteed. He buys drugs without a health system’s scale.

When he performs a procedure in his office rather than in a hospital-owned department, the insurers can pay him less for identical work.

The Health Care Cost Institute measured a primary care visit at $217 in the outpatient setting against $116 in the office.

The difference is the facility fee.

And if he and his partners want to build a hospital, Section 6001 of the Affordable Care Act closed that door in 2010. Physician ownership is still perfectly legal. His hospital cannot bill Medicare for the patients he sends it.

He competes against an institution his own taxes helped capitalize.
Article drops tomorrow....

09/01/2026

THE PREAMBLE TEST: We the People.

The healthcare industry spent about $757 million lobbying Washington in 2024.

The lobbyist arrives with research, projections, former congressional staff, and legislative language.

The physician arrives after passage and asks what happened.

The Constitution gives everyone the right to petition government.

K Street understands the deadline.

-Rojas out.

And here is my favorite part, the part I think about on Sunday.We never take anyone’s practice. I want to be precise abo...
09/01/2026

And here is my favorite part, the part I think about on Sunday.

We never take anyone’s practice. I want to be precise about this, because it is where people misunderstand us most badly.
There is no seizure.

No man arrives from the state with paperwork.

Nothing is confiscated from anybody, ever.

We wait, and eventually the physician across the street comes to us, and hands over the keys, and feels relief, and quite often sends a note afterward thanking us for the conversation.

I have a drawer of those notes.
I have read them more than once.

08/31/2026

WASHINGTON — Hospital Lobby Denounces Cruel New Proposal To Pay Hospitals What They Actually Paid

The American Hospital Association filed comments opposing a federal proposal to reimburse hospitals for discounted drugs at roughly the amount hospitals paid for them.

The group warned that paying hospitals based on acquisition cost would devastate the vulnerable communities hospitals serve.

“This rests on a flawed survey,” said a spokesman, referring to the survey in which hospitals reported their acquisition costs. “Our members cannot absorb a payment rate based on arithmetic.”

The AHA urged CMS to preserve the current system, under which hospitals buy drugs at a discount, bill insurers at full price, keep the spread and call the difference charity.

08/31/2026

WASHINGTON — Hospitals Explain They Cannot Return Billions In Overpayments Because They Already Turned The Money Into Buildings

The nation’s largest hospital lobby urged regulators to abandon plans to recover money the Supreme Court determined hospitals were overpaid.

“The money is gone,” a spokesman explained. “It is a cancer center now.”

Regulators offered hospitals additional time to return the money.

Hospitals rejected the offer, explaining that they oppose both immediate repayment and the dangerous precedent of eventually repaying anything.

The hospitals will keep the buildings.
Taxpayers may keep the Supreme Court decision.

08/31/2026

WASHINGTON — CMS Asks Hospitals To Voluntarily Explain Where The 340B Money Went, Hospitals Voluntarily Decline

Federal officials announced a new repository where hospitals may report what happened to billions of dollars in federal drug discounts.

Participation is voluntary.

“We strongly support transparency,” said a hospital spokesman. “We just do not personally participate in it.”

CMS may make reporting mandatory in 2027 after officials complete a two-year study confirming that hospitals prefer receiving public subsidies without publicly accounting for them.

The repository goes live October 1. It will contain everything hospitals want patients to know.

08/30/2026

MILWAUKEE — Non-Profit Hospital And CVS Enter Bitter Custody Battle Over Drug Discount Neither Wants To Give The Patient

A Milwaukee health system has sued CVS, alleging the pharmacy chain kept millions of dollars generated through the federal 340B drug-discount program.

“Those savings were intended for our most vulnerable patients,” said a fictional hospital spokesman from the lobby of a newly acquired physician practice. “We were going to get to them eventually.”

CVS denied wrongdoing and confirmed that it also had important plans for the money.

The two sides will now spend millions establishing which multibillion-dollar organization gets to keep a drug discount created for low-income patients…

Congress forced the manufacturer to sell me the drug at a discount.I gave it to your commercially insured employee. I bi...
08/30/2026

Congress forced the manufacturer to sell me the drug at a discount.

I gave it to your commercially insured employee. I billed your health plan the full price.

The patient kept the deductible.
I kept the discount.

We call that stretching scarce resources.

-Rojas out.

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