Becker’s Healthcare Podcast Payment Reform, Physician Independence, and Rebuilding Healthcare’s Architecture with Dutch Rojas
Mar 5, 2026
Dutch Rojas, founder of Bliksem Health and healthcare investor focused on architecture and payment reform, shares candid views on structural misalignment. He discusses how payment models shape care. He highlights physician independence, site neutral policies, and policy fixes to revive rural care. He outlines leadership traits and teaching balance-sheet skills to empower clinicians.
AI Snips
Chapters
Transcript
Episode notes
Payments Reward Location Not Quality
- U.S. healthcare is structurally misaligned because payment rewards site of care instead of quality.
- Dutch Rojas highlights knee replacements getting higher CMS reimbursement at HOPDs than ASCs as a clear pricing distortion.
Advocate For Site Neutral Reimbursement
- Push for site neutral payments so identical procedures get identical reimbursement regardless of location.
- Rojas warns strong lobbies resist this change and notes multiple past attempts to block site neutrality.
Physician Independence Is Rebounding
- Independent physician practice is resurging with physicians leaving employed roles as non-competes expire.
- Rojas cites Avalere data and his conversations across cities predicting >20% independents by 2027 and growth in DPC and concierge models.