Cardiology’s migration to the outpatient setting is accelerating as CMS expands the procedures eligible for ASCs and cardiovascular groups invest in new facilities, technology and service lines.
Two cardiology leaders recently joined Becker’s to discuss how their systems are approaching new developments as cardiology continues to shift towards outpatient settings.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How are you and your organization thinking about expanding outpatient cardiology services in 2026?
Luis Hernandez, MD. Cardiologist at Memorial Health Heart and Vascular Institute (Rapid City, S.D.): In 2026, we’re expanding outpatient cardiology on several fronts. Most recently, we welcomed three new physicians to the Heart and Vascular Institute — Shazia Aziz, MD, Nebojsa Markovic, MD, and Rhythm Vasudeva, MD — continuing HVI’s long-running investment in bringing highly skilled cardiovascular care to western South Dakota and eastern Wyoming. Today, HVI is home to the largest group of cardiovascular specialists in western South Dakota, spanning cardiology, vascular medicine, cardiothoracic surgery, vascular and endovascular surgery, advanced cardiac imaging, interventional cardiology and electrophysiology, which allows our team to manage nearly any cardiovascular condition under one roof, from routine diagnostics to complex structural heart procedures.
Alongside growing our physician team, we’re building out disease-specific outpatient programs. One example is our Heart Failure and Advanced Heart Failure Program, which uses a multidisciplinary team to provide rapid initiation and titration of guideline-directed medical therapy, remote monitoring, CardioMEMS management, and outpatient IV diuretic therapy — care that helps prevent emergency department visits and hospitalizations. That model has contributed to strong outcomes: Rapid City Hospital ranked fifth nationally for the lowest 30-day heart failure readmission rate on CMS data from July 2020 through June 2023, and sixth nationally in the subsequent period with a 15.9% readmission rate versus the 19.7% national rate.
We’re taking a similar disease-specific approach elsewhere, developing dedicated outpatient programs for hypertrophic cardiomyopathy, cardiac amyloidosis and cardio-oncology. These will promote earlier diagnosis, standardized evaluation, access to specialized therapies, genetic testing and counseling when appropriate, and closer coordination among cardiology, oncology, hematology, imaging, pharmacy and regional referral centers.
Kevin Shah, MD. Advanced Heart Failure and Transplant Cardiology at MemorialCare Heart & Vascular Institute (Fountain Valley, Calif.): One of the biggest opportunities we see in outpatient cardiology is moving care further upstream, particularly for patients with heart failure and those at elevated cardiovascular risk. At MemorialCare, we are focused on improving access to specialty cardiovascular care while developing pathways that can keep appropriate patients out of the emergency department and hospital.
In heart failure specifically, that means exploring models such as outpatient IV diuresis, remote hemodynamic monitoring, and more streamlined access for patients who are beginning to decompensate. More broadly, I think outpatient cardiology will increasingly need to connect prevention, advanced diagnostics, remote monitoring and specialty care rather than treating each as a separate service.
The goal is to ideally identify risk earlier, intervene sooner and create an outpatient infrastructure that improves both the patient experience and clinical outcomes.
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