Texas Medical Management on The Granite List: Redefining Surgical Value for Employers

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