ABOUT THE ROJAS REPORT

Rojas Actual.

In 2021, the president of the Federation of American Hospitals sat for an interview and said the provision that froze physician ownership of hospitals would not exist without his organization. He mentioned the talking points he sent to senators.

He said it into a microphone. It sat there for years.

That is the job. The record is public. Somebody has to read it.

WHO IS WRITING THIS

Dutch Rojas. Twenty-seven years on the supply and demand side of healthcare.

I built ambulatory surgery centers and independent practices. I founded direct contracting companies. I speak around the world on behalf of patients. Most recently, I deployed capital toward a medical malpractice carrier and a health plan built for independent physicians. I serve on the board of Physician-Led Healthcare for America, uncompensated.

I have negotiated the payer contract. I have signed the lease. I have made payroll in a practice that competes with a tax-exempt system down the street.

THE POSITION

Twelve percent of physicians across five major specialties still practice unaffiliated. Hospital affiliation adds $1,327 per patient per year. Corporate affiliation adds $1,140.

Those numbers come from Avalere Health, September 2024. They are the argument.

This publication takes the side of the independent physician and the patient paying the bill. Every time. When a policy helps independent practice, it gets defended here. When it hurts, it gets prosecuted here, and the party name attached to it changes nothing.

WHAT RUNS HERE

Monday through Friday. The prosecution. Named actors, dated receipts, primary documents. Form 990 walk-throughs, PAC trails, statutory text, comment dockets.

Saturday. The operator’s manual. Captives. Direct contracting. What your practice actually keeps. The cancellation provision buried in your fully insured contract that most physicians never find.

Sunday. The long view. No headers, no pitch.

Every article opens free. Paid subscribers get the full archive and the material that takes weeks to build.

HOW THE WORK GETS MADE

Every factual claim traces to a primary source, or it gets labeled as inference in the body.

Sponsor-funded research gets identified as sponsor-funded, including research that supports the argument.

Modeled figures get labeled modeled. Observed figures get labeled observed. Estimates built on different constructions never get added together.

When something here turns out wrong, the correction runs.

THE TERMS

$300 a year. $49.95 a month.

100,000 readers a month. Physicians, healthcare executives, and lawmakers.

No sponsors. No advertisers. No health system pays for placement here, which is why the health systems get named.

Subscribe if you are building something.

Subscribe if you are tired of finding out at contract renewal.

Subscribe if you would rather read the statute than the press release about the statute.

New here? Start with how the machine actually works.

-Rojas out.