Becker’s Healthcare Podcast Brett Caplan, Director & Peter Winslow, Managing Consultant at Berkeley Research Group (BRG
4 snips
Dec 11, 2025 Brett Caplan, a Director at Berkeley Research Group, specializes in managed care and revenue analytics, while Peter Winslow, a Managing Consultant, focuses on payer-provider negotiations. They discuss the mounting pressures impacting payer-provider relationships and highlight the emergence of out-of-network strategies. The duo emphasizes the importance of finding win-win opportunities amidst ongoing tensions and offers insight into BRG's growth strategies. Lastly, they share valuable advice for emerging leaders on curiosity, initiative, and building professional relationships.
AI Snips
Chapters
Transcript
Episode notes
Perfect Storm Pressuring Negotiations
- Multiple pressures—economic, regulatory, and MA plan instability—are creating a perfect storm for strained payer-provider relations.
- Hospital margins are compressed, making managed care contract outcomes crucial for revenue protection.
Negotiations Now Extend Beyond Rates
- Negotiations are increasingly contentious and extend beyond rates to denials, prior authorization, and access issues.
- Providers must prepare comprehensive out-of-network strategies to protect finances and care continuity.
Pursue Wins But Prepare For Conflict
- Seek win-win opportunities with payers but prepare for contentious talks.
- Advise clients to be ready for tenuous negotiations while pursuing partnership where feasible.