Brett Caplan, Director & Peter Winslow, Managing Consultant at Berkeley Research Group (BRG

Summary

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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.

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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.”

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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.”

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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.”

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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.”

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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.

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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.”

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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)

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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

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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.

Transcript

[A]

This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to be joined by two brilliant leaders. We're joined today by Brett Kaplan and Peter Winslow. Brett and Peter spent a ton of time in the managed care and payer space and they talk to us about what they do. They're with brg, Berkeley Research Group. Brett, Peter, can I ask you to take a second to introduce yourself and tell us a little bit about what you do and about brg?

[B]

Yeah, sure. Great. Thanks, Scott. And thanks for having us on the podcast. Really excited and really appreciate it. So, as you said, I'm Brett Kaplan. I'm a director here at brg. I have over a decade of experience in management consulting in the healthcare space. And 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 such as multi state, multi hospital systems, academic medical centers, et cetera, and comprehensive revenue analytics. So think benchmarking, macro, microeconomic review and things of that nature. And really all of that is to. In, in service of preparing for negotiations, which we'll, we'll touch on a little bit later, but I'll hand it over to Peter.

[C]

Thanks, Brett. Everybody, my name is Peter Winslow. I'm a managing consultant at Berkeley Research Group. I have about four years of experience in management consulting, all within the healthcare sector. And my primary areas of focus are payer provider contract negotiations, revenue reimbursement strategy development and market trend analysis. And I also serve as the strategic communications and external affairs subject matter expert within our managed care practice. So great to be here, Scott.

[A]

No, thank you so much. And tell us, maybe let's start with a second on payer provider relationships. We're also watching so much fallout and changes in Medicare Advantage right now. Brett or Peter can why don't you take the lead in telling us what trends are you watching in payer provider relationships currently? What are you seeing?

[B]

Yeah, so thanks Scott. I think it's really a perfect storm right now of pressures from an economic perspective, a regulatory perspective, thinking, you know, the uncertainty around MED, Medicaid, 340B, site neutrality and site neutrality, any regulatory shifts stemming from the one big beautiful bill and price transparency that's coming through and as you mentioned, the Medicare Advantage across that line of business, both from a provider and a payer side, there's rampant, you know, downgrades, denials, delays in payment, prior authorization issues really. So everything is a flexion point from an economic perspective. And really.

That leads to tenuous relationships between the Payer and provider, because it comes down to margin. Right. It's really what we're watching most closely is 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 to strengthen their source of the negotiated revenue that they have and try to protect that revenue through securing more favorable contract language.

[C]

Yeah, and what I'll add is, Scott, that we're really seeing, we're continuing to see an increasingly contentious negotiation landscape between providers and payers. And I mean, it's not centered exclusively around reimbursement rates, even though both sides are under tremendous financial pressure. I mean, on the provider side, hospitals, health systems alike continue to shoulder challenges associated with labor supply chain capital constraints. You know, these, these are by no means new issues. Right. All while trying to maintain, you know, quality and access for their patients. But on the payer side, there's a growing scrutiny from regulators and employers demanding cost containment, media and public skepticism which has been skyrocketing over the last couple of years. And, you know, while inflationary pressures, aging population and rising utilization compress their margins. So, I mean, what makes this moment particularly volatile? I'd say that American healthcare is a hot button, divisive topic at the center of discussions touching really are our broader economic and political climate. These, these disputes within the health care sector are no longer isolated events. I mean, they're really proliferating at a rapid speed with increasingly significant implications. Providers can't afford to adopt a passive stance or rely on the prospect of resolution through a payer negotiation, you know, on its own. You know, what we, what we think about with clients is establishing a comprehensive, you know, out of network strategy. You know, that's become imperative and to serve as a means to ensure equitable positioning of that organization, safeguarding their financial stability and really preserving the continuity of care when contract discussions reach an impasse. So that's kind of what we're seeing. And we see these tenuous negotiations across the country. I mean, UMass Memorial Hospital, Blue Cross Blue Shield of Massachusetts recently resolved one in North Carolina. CIGNA and UNC Health were, were at bat with one another. And UHC was, was also kind of duking it out with WakeMed and Lehigh Valley Health Network. So there are many, many others across the country, but those are just a couple that, that pop in top of mind.

[A]

Is there going to be more tension in these payer provider negotiations? Seems to go through cycles of the last 10, 20 years.

[B]

What.

[A]

Where some years things seem pretty copacetic. Other years, a lot of tension. What's the temperature currently?

[B]

I think to the points we were raising earlier on, just the economic realities, I think there is some tension that's going to continue. But at what point will it ultimately lead to more.

Partnership related is what I'm hoping for. And what we try to advise our clients is 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 tenuous negotiations moving forward.

[A]

Thank you. And talk about as you head into next year, BRG has had this great growing practice, brilliant management consulting and leadership. When you look at this next year, what are you most focused on and excited about heading into 2026?

[B]

Yeah, thanks, Scott. And I think you hit it right on the head with that one. Really. It's we're in a growth mode from a firm perspective primarily or a lot in our healthcare space. We're making some big investments which I'm really excited about, bringing expertise from enterprise strategy, managed care, contracting and financial management, clinical and operational diligence and bringing all the pieces of the healthcare industry together in an integrated way. And we just announced our leader of Rich Boehner coming to the firm. So really excited about the investments and strategic investments from our first firm that we're making and what it's going to do from a professional standpoint, but more importantly from our clients and how we're going to be driving really great impact from a client perspective in the marketplace. So more to come from a BRG in the market. And I'm excited to be a part of it.

[C]

Absolutely. And just, and just to reiterate Brett's points, I mean, we were able to join a group of really intelligent and passionate leaders. I mean, 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. And it's just such a great opportunity to be at BRG and to see what we're actively building out. And like Brett said, much more to come and we're very excited for what's coming down the road.

[A]

And Brett, I'll ask you this question. You come from a brilliant family of physicians and lawyers and actually athletes as well. Do you ever feel like that you're on the right side of history by moving into consulting and healthcare versus law or medicine or sports? How do you look at that?

[B]

Thanks, Scott. So I like to think I take the good of both my paths that I've seen ahead of me. I really appreciate in the healthcare world of really having the altruistic helping people aspect. But at the end of the day, the lawyer in me and brokering conversations, working with people and the administrative side of the healthcare industry to kind of move it forward. 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. So that's, I think part of the negotiation in me too. So I do my best to try to, to blend all of my background together and, and take what I think is, is the good and move it forward. So.

[A]

You are a remarkable leader. And by chance I happen to know some of Brett's family. I'm going to ask you one more question. You do not have to answer this.

[C]

Okay.

[A]

Who is a better athlete, Mickey or Gary?

[B]

Oh, that's, that's a tough one. I think it depends on the sport. But I'd be remiss to say that my uncle did play Michael Jordan back in high school days. So that'd be a tough one. That'd be a tough one.

[A]

That's a very, well, well way of stating it without offending your father. I think that was really well put. I have to tell you, it's a pleasure to visit with the two of you. Aside from knowing a little bit of Brett's family, brilliant, brilliant people. Peter and Brett are brilliant leaders and management consultants at brg. Brett or Peter, take the lead on the next question. Advice to emerging leaders, emerging careerists. What advice would you give to emerging leaders, emerging professionals?

[B]

Yeah, I think really there's two that I would like to voice. First is be curious. Right. We're in such a complex world that's ever changing. So being a lifelong learner and I think that's why I chose consulting. It's all about lifelong learning and just driving personal growth through learning a new skill, deeper understanding of anything in your area of expertise or not in your area of expertise too. 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. So I think just being curious is something that never stop learning is something I definitely continue to tell people as whoever listens to me. And Peter probably is rolling his eyes as I say that because I've definitely told them to him too. But the other one I think is about being kind of a self starter and looking for ways to make somebody else's life a little easier again. Whether that's your boss or your manager, a client, a colleague, or even a friend. By lending a hand or stretching your role, you will advance to wherever that next step may be, professionally and personally. If you just think about how can I make that, that person's life a little bit better, a little bit easier, a little bit more manageable.

[A]

But I think that that last point is so well taken and so well stated. People often don't realize in a professional organization or any business, whatever you're doing, so much of what you do is about trying to help whoever you're working with make things a little bit easier, a little more concise, a little bit better.

And to solve problems rather than to create more problems. I just, I just love that actually. Peter, let me turn it to you. Any piece of advice that you'd give to emerging leaders?

[C]

Yeah, absolutely. And I really kind of draw on some of my past experiences before I put the consulting hat on. I was an investigative reporter based in Chicago. And one of the things that has done me personally very well and that I see really effective leaders doing is networking and just being open to connections. I mean, Scott, you're one of the best to do it yourself. I mean, you know, the way that we are able to, to get connected and just build these bridges and start forming a relationship has, you know, been invaluable. And it's something that, you know, I'm looking forward to going into the future. But I mean, effective leaders really recognize that networking isn't just about, you know, collecting contacts or filling the Rolodex, right? It's about cultivating meaningful relationships. So they invest time in the individuals, they listen, they, and they build this trust and curate a broad and diverse contact list. So, you know, these connections benefit both their personal growth and their organization's success. I mean, they open doors to collaboration, innovation, problem solving. And it makes networking a strategic leadership skill rather than seeming like a transactional activity.

[A]

And I think that point of developing real relationships versus a transactional activity is right on. I mean, the more that long term people are available to each other, it's not so much you do this, I get that, or vice versa. It's more over time you figure out where there's synergistic opportunities for people and that work for everybody. And I think that's right on. I think that's just a very, I think that's a great perspective on networking and relationship building versus the alternative, which is everything's quid pro quo and transactional, which is very short lived and leads to very flawed relationships, quite frankly.

[C]

Right.

[A]

Brett and Peter, I want to thank you both for taking the time to join us today on the Becker's Healthcare podcast. For me, this is a tremendous pleasure to visit with the both of you. Thank you so much for taking the time and joining us. Thank you.

[B]

Thank you, Scott. The pleasure is ours.

[C]

Thanks, Scott.