Cardiology is rapidly gaining momentum as an outpatient specialty. As CMS continues expanding its list of approved ASC procedures and technology makes more complex interventions possible in lower-acuity settings, more cardiovascular care is moving beyond the hospital.
The shift is already underway. Becker’s has reported over 80 new cardiology centers opening in 2024, including Dallas-based Medical City Heart Hospital’s $60 million expansion to grow its specialized cardiovascular service line.
Cardiology is now the fastest-growing specialty in ASCs, with 26 cardiology-focused centers opened or announced in 2024 alone. Recent CMS changes allowing procedures in the ASC setting, such as angioplasty, stenting and pacemaker placement, will further accelerated this trend.
But with opportunity comes friction. The migration is creating tension between hospitals and outpatient providers in many markets, according to Kristen Richards, vice president of ambulatory care at Cardiovascular Logistics, a national physician-led cardiovascular platform.
“Cardiovascular procedures are among the top revenue generators for hospitals, so this shift can be difficult for them,” Ms. Richard told Becker’s.
Hospitals, she said, risk losing margins as high-volume cardiovascular cases move to the outpatient space. However, she noted that hospitals can offset those losses by focusing on higher-acuity, complex procedures that remain inpatient-only.
“It’s critical that hospitals partner closely with their physicians, embracing this transition as ‘right patient, right procedure, right facility,'” she said.
“That’s why we focus on being good partners — aligning with hospitals to ensure we’re doing this for the community,” she said. “We’re moving lower-acuity cases outpatient, but hospitals will continue to care for higher-acuity patients. That partnership can also help relieve hospital capacity issues — many are stretched thin with bed shortages and staffing challenges. I like to say, ‘You’re either at the table or on the menu.'”
The shift, Ms. Richards emphasized, has systemwide benefits. Migrating lower-acuity procedures to ASCs reduces overall healthcare spending, which is critical “because our current spending isn’t sustainable,” she said.
It also benefits physicians.
“Physicians are frustrated by inefficiencies in hospitals — the red tape, the delays,” she said. “In ASCs, turnaround times are better, patients go home in hours instead of days, and physicians can complete their cases efficiently. They regain control over their schedules and get back time.”
Cardiology’s outpatient expansion is still in its early stages, which makes it unique among ASC specialties. The field remains less consolidated by large corporate entities, creating room for independent groups and smaller practices to lead growth. CVL, for instance, operates as a physician-led cardiovascular platform designed to align with hospitals while advancing outpatient cardiovascular care.
“Outpatient cardiovascular care is here to stay — it’s the right thing for patients,” she said.
