Cardiology is growing in the ASC world. Here are five things to know about the industry's rise:
1) Most cardiovascular procedures are less expensive in ASCs than in the hospital outpatient department. Patients can use the Medicare.gov procedure price lookup tool to see the difference in price between procedures in the ASC and HOPD settings. For example, catheter placement in coronary artery for coronary angiography — one of the most common procedures — costs $382 at an ASC, versus $919 at an HOPD.
2) More high-acuity procedures are being performed for the outpatient cardiology setting. Some physicians expect that even more will be approved to be performed in the future.
"We are working diligently with our joint venture partners and our local cardiology community to build a solid program that will not just be able to perform the current array of ASC-authorized procedures with the same level of high quality and cost-effectiveness that drives all of our service lines," Alfonso del Granado, administrator and CEO of Covenant High Plains Surgery Center in Lubbock, Texas, told Becker's. "But be positioned to benefit from expected additions to the CMS covered procedures list whether these are authorized this year or next. The trend is inevitable, and we don’t want to miss the opportunity."
3) Cardiology is the fastest-growing ASC specialty. According to Avanza's 2022 "Key ASC Benchmarks and Industry Figures" report, cardiology procedures saw the highest estimated Medicare payment increases in 2021.
4) Cardiology is catching the attention of private equity firms. Since 2014, 342 cardiology clinics have been acquired by PE firms. There is also a number of active cardiology-specific PE firms.
5) The specialty faces clawbacks from private payers, who some physicians say aren't matching Medicare codes for cardiology procedures. "It feels incongruent for sure," Tracy Helmer, administrator of Mesa, Ariz.-based Tri-City Surgical Centers, told Becker's. "It's also frustrating to think that you've got all of your I's dotted and T's crossed, and then get hit with a denial after the fact when you felt like you were doing everything required to be compensated for the case."