By [Byline]
For the better part of two decades, cardiology has moved steadily inside hospital walls.
Hospital employment of cardiologists climbed from roughly 26% in 2008 to 63% in 2019, and by 2022 only 10% to 12% of cardiology practices remained independent, according to an American Journal of Managed Care analysis. A growing group of physician-led companies is betting that model has peaked.
Denver-based CardioOne, a technology-enabled management services organization that supports physician-owned cardiology practices, joined forces Oct. 8 with Warrenville, Ill.-based CardioSphere, a cardiovascular-focused MSO. As part of the deal, CardioOne added Midwest Cardiovascular Institute, an independent practice in Chicago’s western suburbs, bringing its network to more than 110 providers nationwide.
MCI President Mark Goodwin, MD, and former CEO Jacob Corbell, who co-founded CardioSphere in 2024, are joining CardioOne, along with Cathleen Biga, MSN, past president of the American College of Cardiology, as chief strategy officer.
The combined company helps employed cardiologists establish independent practices, then builds new arrangements with health systems, including service line co-management, professional services agreements, joint venture ASCs and group practice enterprises. Both companies were built as alternatives to private equity ownership.
“We knew that the management company couldn’t buy the physician practices; it had to let the doctors own all of it, but they needed professional management,” Mr. Corbell told Becker’s.
“We felt like what we had done at Midwest Cardiovascular Institute was really a blueprint for the future of cardiology, where the hospitals did not have to foot the bill for everything,” he continued. “The doctors could start sharing in some of that risk, and in exchange for that, be more incentivized to grow the program.”
The model is built around a long-term forecast that cardiology services will continue to be one of the most in-demand and expensive specialty service lines for hospitals — which means alignment between physicians and the organizations is essential.
“I think the future is really focused on the fact that cardiologists need hospitals and hospitals need cardiologists,” said Alex Struck, co-founder and chief growth officer of CardioOne. “So how do you create a new model that aligns incentives and creates a win-win for both of them?”
For the cardiologists weighing that move, though, the frustrations tend to begin with the day-to-day mechanics of the practice.
“It starts by answering the phone,” Mr. Corbell said, noting the challenges of connecting directly with providers at large health systems and the notable wait times that persist in the specialty. According to one 2025 report from AMN Healthcare, the average patient wait time to see a cardiologist in the U.S. is 32.7 days.
“Patients simply can’t get into the hospital, and it’s because they have put cardiologists into a multispecialty medical group, where they have centralized functions like call centers, prescription refills, and it has created this bogging down of people. Centralization does not always mean success,” Mr. Corbell said.
Shared EHR builds compound the problem.
“They can’t custom make templates for scheduling. So a physician who used to see 25 patients in a day, which kept him from being backed up three months, can now see 12,” Mr. Corbell added. “What about the other 13 that can’t come in now? Are they just dying of myocardial infarctions in the grocery store or in their kitchen at home?”
Independent practices, by contrast, set their own scheduling templates, staffing and phone operations.
“Answer the phone with no hold time. Double book my schedule if you need me to. Never make a patient wait,” Mr. Corbell said.
Employed physician compensation is typically tied to work relative value units, a productivity measure, rather than to the performance of the practice as a whole.
“We have employed doctors saying they have never even seen an income statement,” Mr. Corbell said. “They have no idea the cost of the practice. They have no idea the revenue of a practice. It’s become very transactional.”
“When we do this, you see employed physicians who have only ever thought about their own number of RVUs going from an employee mindset to an owner mindset, and when you start showing them the data, they start thinking about how do we provide better care to our patients, how do we provide better access, and how do we run something that’s efficient,” Mr. Struck added.
The executives point to MCI’s relationship with its former employer as evidence that independence does not have to mean a break with the hospital. MCI’s cardiologists were previously employed by a hospital now part of Evanston, Ill.-based Endeavor Health, according to Mr. Struck, and the practice now works with the system through co-management, professional services and group practice enterprise arrangements.
“We saw in Chicago when the physicians that went independent and took over management of the cath lab in partnership with the management company, the inpatient cath lab volume actually grew across multiple hospitals, nearly 60% across the board,” Mr. Struck said. “So the group itself, the practice, got a lot more productive. We saw [an] almost 100% increase in visit volume. Almost 100% increase in new patient volume speaks volumes to access.”
For Mr. Corbell, access is the metric hospital leaders should be watching.
“If I am challenging every hospital CEO in America, I’m asking: how quickly can a cardiac patient get into your clinic?,” he said. “And if it’s more than a month, you have a problem, because guess where they’re going — the ER.”
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