As CMS expands its coverage of cardiovascular procedures performed at ASCs, more eyes are shifting toward outpatient settings as the demand for cardiovascular services rises and health systems look to increase inpatient capacities.
Anish Amin, MD, an electrophysiologist with Columbus-based OhioHealth Heart & Vascular Physicians and co-founder and chief medical officer of Carlsbad, N.M.-based Current Clinic, recently joined Becker’s to share how he foresees cardiology, and especially EP procedures, developing in the ASC space.
Editor’s note: This response has been lightly edited for clarity and length.
Question: A lot of people are excited about what this means for both access and ASC development. What do you see missing in the conversation around how outpatient cardiology is developing?
Dr. Amish Amin: First, I don’t think that there’s going to be, like, a wholesale movement of electrophysiology into the ambulatory space. Many of the state and local regulatory structures are there to help preserve quality and patient safety — and rightfully so. Many are there to condense care in legacy hospital systems, so there’s not going to be this wholesale shift. I think that one of the assumptions is that every electrophysiologist is going to wind up working in an ASC. I don’t think that’s necessarily the case.
The second thing is that we also need to remember that working in an ambulatory space, yes, can broaden access for patients. It also requires an understanding of the economics of working in that space, recognizing a lower total reimbursement compared to the hospital setting, and recognizing that while we may be able to care for more patients, we need to be able to do it more efficiently — and that doesn’t mean fast. That means building a structure of care that’s more than just the procedure. I think we need to remind clinicians that, yes, this is a great opportunity to potentially be an owner of a facility or a partner in a facility, but the care of the patient is more than just the procedure. I think that’s often overlooked. And then I don’t think that many folks recognize the grit that’s required to run a facility, especially, for those of us who have been in employed models. We’re not managing the day-to-day operations component of it. We may bemoan the administrative teams that we work with, but they are lifting the load for us in many ways so that we can just be clinicians. And so taking on a facility partnership means that you’re going to have to take on some of that operational path, if you will, and be on top of the requisite regulatory and operational needs of the facility.
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.