Episode Overview

Podcast: Becker’s Healthcare Podcast
Date: December 11, 2025
Guests: Brett Kaplan (Director) & Peter Winslow (Managing Consultant), Berkeley Research Group (BRG)
Host: Scott Becker

In this episode, Scott Becker speaks with Brett Kaplan and Peter Winslow of BRG about trends and challenges shaping payer-provider relationships, the current state of managed care contracting, and key strategies for emerging healthcare leaders. The conversation offers insights into economic and regulatory pressures, negotiation dynamics, and the evolving consulting landscape in U.S. healthcare.

Key Discussion Points & Insights

1. Introductions and BRG Focus

• Brett Kaplan highlights his expertise in managed care contracting, strategic pricing, and revenue analytics, serving large, complex health systems.
• Peter Winslow specializes in payer-provider contract negotiations, reimbursement strategy, and market analysis, also serving as the practice’s strategic communications lead.
• Quote (Kaplan, 00:40):
  “I primarily spend my time in the managed care space or really revenue strategy, reimbursement strategy around managed care contracting, strategic pricing, and complex enterprises… all in service of preparing for negotiations.”

2. State of Payer-Provider Relationships

• Market Volatility and Uncertainty:
  Pressure comes from economic and regulatory shifts — including Medicaid, 340B, site neutrality, and ongoing price transparency measures.
• Increasing Negotiation Tension:
  • Both hospitals and payers are facing margin squeezes due to inflation, labor costs, supply chain issues, and rising utilization.
  • Regulatory scrutiny, public skepticism, and employer demands for cost containment fuel animosity.
• Key Examples:
  • Recent high-profile contract disputes (e.g., UMass Memorial vs. Blue Cross MA; Cigna vs. UNC Health; UHC vs. WakeMed).
• Quote (Kaplan, 02:55):
  “That leads to tenuous relationships between the payer and provider, because it comes down to margin. It’s really what we’re watching most closely — hospital margins being very uncertain today, being compressed today.”
• Quote (Winslow, 04:10):
  “These disputes within the health care sector are no longer isolated events. They’re really proliferating at a rapid speed with increasingly significant implications.”

3. Negotiation Dynamics & Strategies

• Trend Toward Contentious Negotiations:
  • The negotiation landscape is more combative — not solely over rates but also contract terms, continuity of care, and payment integrity.
• Active Stances Needed:
  • Providers can’t afford a passive stance; establishing comprehensive “out-of-network” strategies is increasingly vital for leverage and continuity.
• Quote (Winslow, 04:58):
  “Providers can’t afford to adopt a passive stance or rely on the prospect of resolution through a payer negotiation on its own.”
• Looking for Collaboration:
  • There’s hope for more partnership but preparation for conflict is essential.
• Quote (Kaplan, 06:14):
  “Let’s try to find some common ground, let’s find some win-win scenarios when possible, but ultimately be ready for those tenuous kind of conversations and negotiations moving forward.”

4. BRG’s Vision & Growth (2026 Outlook)

• Expansion and Investment:
  • BRG is actively expanding its healthcare practice with expertise spanning enterprise strategy, managed care, operational diligence, and bringing on new leadership.
• Client & Patient Impact:
  • The core goal is to drive impact for clients and ultimately the patients they serve through integrated consulting solutions.
• Quote (Kaplan, 07:01):
  “We’re making some big investments bringing expertise… clinical and operational diligence and bringing all the pieces of the healthcare industry together in an integrated way.”
• Quote (Winslow, 07:39):
  “There are people at this firm that are incredibly impressive and contribute so much to developing healthcare solutions that benefit not only our clients, but the patients that they serve.”

5. Personal Paths and Reflections

• Brett’s Diverse Background:
  • Kaplan reflects on blending his family legacy in medicine, law, and sports, bringing empathy and negotiation to consulting.
• Quote (Kaplan, 08:37):
  “My job is hopefully to make the clinician’s job easier. So I’m trying to fuse the two of them. And, you know, if you think about it, everything’s a little bit of a sport.”
• Memorable Moment (09:34):
  • A lighthearted family question about who’s the better athlete, with Brett diplomatically acknowledging family members and mentioning his uncle played Michael Jordan in high school.

6. Advice for Emerging Leaders

Brett Kaplan:

• Be Curious:
  • Emphasizes continual learning and curiosity as fundamental consulting traits.
• Be a Self-Starter:
  • Focus on making others’ lives easier — colleagues, managers, or clients.
• Quote (Kaplan, 10:18):
  “Being a lifelong learner… driving personal growth through learning a new skill, deeper understanding… Trying to keep pace with all the change that’s happening in not just the healthcare industry, but industries writ large around AI, et cetera.”
• Quote (Kaplan, 11:05):
  “If you just think about how can I make that person’s life a little bit better, a little bit easier, a little bit more manageable.”

Peter Winslow:

• Network Authentically:
  • Draws from experience as an investigative reporter; meaningful connections are key, not just collecting contacts.
• Relationships Over Transactions:
  • Networking is about cultivating trust and collaboration for long-term organizational and personal success.
• Quote (Winslow, 12:05):
  “Effective leaders recognize that networking isn’t just about collecting contacts or filling the Rolodex… It’s about cultivating meaningful relationships… these connections benefit both their personal growth and their organization’s success.”

Notable Quotes & Timestamps

• Brett Kaplan, on negotiations:
  “Hospital margins being very uncertain today, being compressed today. And now more than ever is why our clients are dependent on the outcomes of these managed care contract negotiations…” (02:55)

• Peter Winslow, on industry volatility:
  “What makes this moment particularly volatile? I’d say that American healthcare is a hot button, divisive topic at the center of discussions touching our broader economic and political climate.” (04:05)

• Brett Kaplan, on advice:
  “Never stop learning… being a lifelong learner… That’s why I chose consulting.” (10:22)

• Peter Winslow, on networking:
  “Networking isn’t just about collecting contacts… It’s about cultivating meaningful relationships.” (12:05)

Segment Timestamps

• Guest Introductions & BRG Overview: 00:34–01:50
• Current Trends in Payer-Provider Relationships: 01:50–05:47
• Future of Negotiations: 05:47–06:31
• BRG Practice Growth & Vision: 06:31–08:15
• Personal Reflections & Lighthearted Moments: 08:15–09:48
• Advice to Emerging Leaders: 10:18–13:24

Conclusion

This episode offers a succinct yet wide-ranging look at the instability and complexity shaping U.S. healthcare payer-provider relations, strategies for effective negotiation and consulting, and personal perspectives on leadership. Brett Kaplan and Peter Winslow emphasize the importance of creativity, proactive strategy, lifelong learning, and relationship-building in navigating today’s healthcare landscape.