I have been in private practice for over two decades in the Pacific Northwest. I started Transform in 2019 to provide value based weight management programs. Ambulatory bariatric surgery will be the future of bariatric surgery. It offers patients and employers value based care. It offers surgeons autonomy and equity. In 2023 I founded Transform Health Partners, a bariatric management service organization, MSO to help surgeons thrive in this competitive and regulated healthcare environment against insurance companies and coporate medicine. We provide services for insurance contracting, revenue cycle management, marketing, practice management and help surgeons set up de novo ambulatory surgery programs. The future of metabolic bariatric surgery is in the ASC.