In Episode 45, Dr Roussel interviews Mr Dutch Rojas, CEO & founder of Sano Surgery and a disruptive broker of ambulatory surgical services about his work negotiating bundled payment deals for employers and health plans. In the interview they talk about how bundling payment for surgery can lower cost to employers, why surgery centers and hospitals are eager to accept a bundled payment, why major carriers are reluctant to negotiate bundled payments and how bundled payment can work with direct primary care to lower cost for a wrap-around plan.