Cardiology is expanding increasingly into ASCs as CMS policy updates, advancements in cardiovascular innovation and population health concerns necessitate more access to outpatient cardiology procedures.
Mitesh Amin, MD, CEO of AlignedCardio, a Richmond, Va.-based cardiovascular group formed through a partnership between James River Cardiology and RC Capital, and president of South Park Heart and Rhythm Center of Colonial Heights, Va., has experienced this shift firsthand. He recently joined Becker’s to discuss his experience at the forefront of cardiology’s outpatient expansion and to share what he’s learned so far with groups considering the same path.
1. Start with your case mix, not your ambition.
Before anything else, Dr. Amin said, a group needs to take an honest look at whether its patients actually fit the ASC model.
“It comes down to looking at their patients, their providers and their case mix to determine if they have enough volume to move forward with it right now or down the road,” Dr. Amin said. “Practices that have very sick or high-risk patients wouldn’t benefit if they don’t have patients at the earlier stage of disease that can be easily navigated in an ASC.”
2. Employed physicians aren’t shut out — a joint venture can work.
Dr. Amin said ASC expansion isn’t just an option for independent groups. He’s seen it work for hospital-employed physicians, too, through a different structure.
“For all private groups right now, it should be something that they should be exploring,” he said. “Even if they’re hospital employed, we’re working with some groups that are hospital employed that have an opportunity to still do a joint venture with the hospital and a private partnership and build an ASC. We think it’s a good opportunity.”
3. ASCs free up hospital capacity too.
Moving lower-acuity cases out of the hospital isn’t only a win for the ASC, Dr. Amin said. It can also help hospitals make room for the patients who most need an inpatient bed.
“It does impact the hospital — it pulls away some of their cases — but it gives them capacity to bring in the higher-risk patients that they oftentimes do not have the capacity to handle right now,” he said. “There can be a four- to six-week wait to get patients in. This gives them capacity to get these sicker patients in the door and allows them to free up some of these lower-acuity patients into an ASC.”
4. Size the center to your actual volume.
The most common mistake Dr. Amin has watched other groups make isn’t underbuilding — it’s overbuilding.
“I’ve seen others make mistakes where they’ve built too big, and then they have a larger space that they can’t really fill,” he said. “There’s a big buildout cost, construction costs, lease payment, a lot of equipment costs that go into filling up a larger space. I would encourage them to size it correctly and not to oversize it, because that is really what we see often, where people get into trouble because they’ve overspent, and then the ASC closes down and gets repurposed for something else.”
5. An ASC should be on every cardiology group’s radar.
Even for groups that aren’t ready to break ground, Dr. Amin said ASC strategy belongs on the radar now.
“I tell people all the time that it’s kind of the next generation for cardiology. I think it’s a great opportunity,” he said. “This may not be the right time. Maybe a few years down the road. But they should have it on their radar to determine this and figure out when it makes sense.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
