What happens when you apply business discipline and patient-first service to the most expensive corner of healthcare? In this episode of The Granite List Live, host Lee sits down with Sean Kelley and Javier Lira, RN of Texas Medical Management to unpack how bundled surgery pricing changes the game for employers, brokers, and members. They discuss why hospitals fail at cost accountability, how TMM vets and selects surgeons, and why mid-market, self-funded employers are leading the charge toward transparent, predictable surgery costs.

Watch the full episode:

Highlights from the conversation

• The origin story: why Sean left hospital systems to build a transparent model inspired by Surgery Center of Oklahoma
• How TMM measures quality beyond “safety” metrics, using 7+ years of outcomes data and patient-reported results
• Why direct contracting creates value for employers, TPAs, and members—and why the mid-market is driving adoption
• Real-world examples of lowering surgical costs (a $100K facility bill reduced to under $30K) without compromising outcomes
• How single-case agreements work and how TMM is expanding collaboration outside Texas

What if surgery didn’t come with surprise bills, opaque quality, or wasted time? In this episode of the Best DPC Podcast, host Wayne Lowry interviews Sean Kelley (Co-Founder and Managing Partner) and Javier Lira, RN of Texas Medical Management about how transparent, all-inclusive bundles change the game for patients, surgeons, and self-funded plans. They cover how TMM vets surgeons, why facility selection matters, and how DPC clinics plug in to steer members toward better outcomes and predictable pricing.

Watch the conversation, then see how the model applies to your plan or practice.

Why this is worth your 20 minutes

• Real talk on price transparency and quality, straight from an OR leader and a founder who built around outcomes, not paperwork.
• Practical steps for DPCs and self-funded employers to activate steerage and incentives that members actually use.
• Concrete examples of cutting waste, from smarter implants to right-sited cases.

Learn more about TMM or see live bundle prices.