What if every patient received value-based care, regardless of their insurance plan? Shaun Romero returns to The Exam Room to unpack the cultural and operational shift needed to make this possible. From challenging the fee-for-service "chassis" to reducing clinician burnout, Shaun and Dr. Winsor explore how standardizing care workflows can improve quality, rebuild trust, and reduce friction for overburdened providers. They discuss the human cost of fragmented care, the importance of relational trust, and the vital role of ACOs in supporting health centers with social determinants of health.