Episode 2

The development of Medicare, Medicaid and payment reform measures in the United States Part 1

by OBGYN Business Institute | November 10, 2022

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In this show, Dr. Mikio Nihira & Naren Arulrajah discuss how the current payment reforms have evolved and, as an OBGYN, why it’s so important to talk about payment reforms. Tune into this episode & find out some critical points in the current US healthcare system.


  • Introduction to OBGYN Business Institute
  • 00:00:53 Introduction to Dr. Mikio Nihira 
  • 00:03:59 Introduction to the episode
  • 00:04:43 As an OBGYN why payment reforms are important to you
  • 00:06:06 Medicaid coverage of childbirths 
  • 00:06:53 How are doctors getting paid?
  • 00:08:30 Medicaid & Medicare: Past as Prologue
  • 00:15:05 Overview of the affordable care act & the expansion of Medicaid
  • 00:17:55 Payment reforms in the private sector
  • 00:18:30 Is our healthcare system broken?
  • 00:20:00 Addressing the real problem
  • 00:22:12 Design and development of the Diagnosis Related Groups (DRG)


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