Affordability and access are two of the biggest concerns among healthcare leaders in 2026, and cardiology falls directly into these priorities.
A 2024 study in the Journal of the American College of Cardiology found that almost half of all U.S. counties do not have a practicing cardiologist. Rural counties fare even worse, the survey found, as 86% do not have a practicing cardiologist. This rural population accounts for 22 million Americans.
The specialty is also poised for new waves of growth and expansion given CMS’ recent expansion of the Covered Procedures List for ASCs, which included four cardiovascular codes for electrophysiology studies and ablations and three codes for percutaneous coronary intervention, in addition to hundreds of other procedures.
“We’re seeing a move toward utilizing electrophysiology procedures, including ablation and insertion of some devices, in freestanding centers,” Richard Chazal, MD, medical director of heart health at the Fort Myers, Fla.-based Lee Heart Institute, told Becker’s. “Some of these procedures have matured to the point where many of these can, and perhaps should be, done in these lower-cost, efficient outpatient centers that can provide really good care.”
Between 2018 and 2023, the number of single-specialty cardiology ASCs grew from 55 to 221, accounting for about 4% of all Medicare-certified ASCs in the U.S., according to a July 2025 article published in JACC. Additionally, the volume of cardiovascular services performed in ASCs is projected to grow by 15% between 2023 and 2028.
This growth of cardiovascular ASCs is reflective of heightened interest from hospitals and health systems in expanding both cardiovascular services and ambulatory care as they hone in on access and affordability as key strategy drivers.
“I would say that [outpatient cardiology] is something that we’re actively pursuing,” Dennis Butts, executive vice president and chief strategy and network development officer for Detroit-based Henry Ford Health. “It’s a key part of our strategy. It is something that we are proactively moving towards as a part of our affordability initiative, not something that we’re waiting for legislation to cause us or force us to be in that space.”
Legislation surrounding outpatient cardiology is also something to watch as many states’ laws have not caught up to the advancements in the ASC industry.
“About 50% of states still have certificate-of-need laws that restrict PCIs or complex interventions, which creates barriers for outpatient migration,” Kristen Richards, the vice president of ambulatory care at Cardiovascular Logistics, told Becker’s. “The cost of setting up a cardiovascular ASC is also significant because of the complexity of the equipment. Outfitting a single room can cost well over $1.5 million.”
