What’s driving cardiology’s outpatient migration? 4 things to know

In 2021, about 25% of all ASCs in the U.S. had hospital shareholders, according to an article published July 7 in JACC. With the volume of ASCs in the U.S. expected to grow 21% by 2034, researchers were interested in analyzing the driving forces behind cardiology’s shift to outpatient care.

Here are four things to know from the article:

1. In 2022, 65% of outpatient peripheral vascular interventions in Medicare beneficiaries were performed in office-based laboratories. The volume of cardiovascular services performed in ASCs is projected to grow 15% between 2023 and 2028.
   
   Between 2018 to 2023, the number of single-specialty cardiology ASCs grew from 55 to 221, accounting for 4% of all Medicare-certified ASCs in the U.S.
   
   
2. The study authors identified six driving factors behind the increasing shift from cardiovascular procedures being performed in a hospital setting to outpatient facilities, such as ASCs and OBLs.
   
   The six factors are physician autonomy, technological advancement, same-day discharge, lower costs, patient experience and policy changes.
   
   
3. After the Medicare Modernization Act of 2003, CMS added 7,905 procedures to the ASC Covered Procedures List. The agency also made reimbursement modifications that favored performing some cardiovascular procedures in the outpatient setting.
   
   In 2020, CMS began reimbursing for coronary angioplasty and stenting in ASCs. The agency projected $20 million in cost savings if 5% of percutaneous coronary interventions migrated to ASCs.
   
   To alleviate hospital capacity during the pandemic, Medicare began reimbursing ASCs for performing ablation procedures. While the policy ended in 2023, some commercial payers continue to pay for ablation procedures performed in the outpatient setting.
   
   
4. “Advancing our understanding of non-hospital-based procedural care will require a concerted effort to advance the collection of registry data that may serve as the backbone for evaluating key measures of care quality, access, and outcomes,” the article authors wrote.

Read the full article here.