Negotiating Beyond the Rate — A Conversation with Kevin Barron on Payer Strategy, AI, and Playing the Long Game

Negotiating Beyond the Rate — A Conversation with Kevin Barron on Payer Strategy, AI, and Playing the Long Game

On this episode of the MGMA Insights Podcast Network, host and senior editor Daniel Williams sits down with Kevin Barron, vice president of payer relations at University Health in San Antonio. The conversation explores the realities of payer contracting, from aligning internal priorities to navigating underpayments and denials, along with how integrated contracting and revenue cycle strategies can drive better outcomes.

Barron also shares how AI is reshaping contract review workflows and why relationships — not just numbers — define success at the negotiating table ... with a few fun detours into Spurs basketball and Disney along the way.

Key Takeaways:

  • Rates aren’t the whole story — While reimbursement rates matter, contract language, policies, and operational requirements often have a greater long-term financial impact.
  • Consistency across stakeholders is critical — Successful negotiations begin with internal alignment across finance, physicians, and operations on what truly matters.
  • Live the contract after signing — Negotiations may take months, but organizations must manage and monitor performance for years afterward.
  • An integrated approach strengthens results — Combining contracting, auditing, and contract management under revenue cycle enables better accountability and performance tracking.
  • Underpayments often stem from outdated data — Frequent payer fee schedule updates require constant monitoring and system alignment to prevent payment discrepancies.
  • Denials management requires proactive strategy — Grouping, trending, and assigning accountability for denials can help identify root causes and drive improvement.
  • Relationships drive negotiation success — Understanding payer constraints and communication styles leads to more productive, balanced agreements.
  • AI is a force multiplier — Tools are dramatically reducing contract redlining time and increasing consistency, freeing teams to focus on strategy and relationships.

Resources



This episode is sponsored by ModMed.
Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.

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