In July, CMS proposed a significant expansion of the covered procedures list for ASCs, which included many cardiovascular procedures.
Here’s what five leaders have said about the expansion of cardiology into the ASC and outpatient setting since Jan. 1:
1. Bruce Feldman. Administrator of Eastern Orange Ambulatory Surgery Center in Cornwall, N.Y. I believe cardiovascular procedures will be amongst the most common procedures to migrate from the hospital to the ASC setting. These will include such procedures as ICD’s, pacemakers, peripheral vascular stenting, coronary ablations, PTCA & TAVR.
2. Ed Tolentino. Administrator of Outpatient Surgery Center of Central Florida (Wildwood): The proposed addition of electrophysiology procedures, particularly catheter ablations and device implants, will have the most significant impact on ASC growth over the next five years. These are high-acuity, high-reimbursement procedures that have traditionally been limited to the hospital setting. The movement of these cases into the ASC environment is a natural evolution driven by advancements in technology, improved patient selection criteria, and the overarching push toward cost-efficiency in healthcare.
If finalized, these additions will open new avenues for partnerships with cardiology groups, increase case volume, and expand the scope of services that ASCs can offer without compromising safety or outcomes. That said, ASCs must be thoughtful about their infrastructure, credentialing and readiness to handle these complex procedures. For centers that are willing to invest and align with experienced providers, this shift represents a major opportunity for strategic growth and long-term sustainability.
3. Saum Sutaria, MD. CEO of Dallas-based Tenet Healthcare: The opportunity in a wide variety of cardiovascular procedures is there. [But], I’ve always been clear that I think that that opportunity will proceed more slowly than people anticipate. The upfront investment for physician partners and other things is much higher, with potentially lower-margin assets. For economic and patient safety reasons, I think this market will evolve, but I think it will evolve slower than people like to think.
4. Amanda Ryan, DO. CEO and owner of Advanced ASC of Carlsbad, N.M.: The cardiovascular space for ASCs is really wide open. I think [there is] the chance for physician autonomy — and to me, it doesn’t mean staunch independence [or] ‘I answer to no one,’ because I think that’s a naive thought.’ We all are answering to one another and having accountability in our healthcare system. But I think finding people to partner with that maybe are more in line with our vision and mission is really what we’re looking for. As we look to expand our services, we look to partner with other physicians who are like minded in their approach.
5. Larry Sobal. CEO of Heart and Vascular Institute of Wisconsin (Appleton): My understanding is that the inpatient-only list will be phased out over a three-year period. This will open the door for a variety of procedures to be considered for an ASC setting. However, it will also place greater responsibility on ASCs to be focused on screening for patient appropriateness taking into account the patient’s medical condition and risk factors, the expertise of the physician, and the location of the ASC. What may be safe for an ASC located on a hospital campus (with an experienced physician) may not be appropriate for an ASC in a rural community with an early career physician.
