Cardiology has been recognized as a prime growth specialty for ASCs, so why aren't there more cardiovascular-focused surgery centers?
Cardiology is the fastest-growing ASC specialty, according to Avanza's "2022 Key ASC Benchmarks and Industry Figures" report. Though the speciality has gained popularity in the surgery center space, it has yet to become commonplace.
Prashanth Bala, vice president of ASC operations at Shields Health in Quincy, Mass., spoke with Becker's to discuss why this is the case.
Editor's note: Responses have been lightly edited for length and clarity.
Question: Though outpatient cardiology is becoming more common, why aren't cardiovascular-focused ASCs an industry standard at this point in time?
Prashanth Bala: I think we're gonna see that happen over time. But I think one of the number one reasons, at least what we're seeing here in the Massachusetts and New England market, is that most of those cardiologists or cardiovascular surgeons are employed by hospitals. So it makes it harder for them to break free and do something separately. If they're employed by the hospitals, and or since they're employed by hospitals, unless the hospital or the health system wants to do freestanding facilities such as an ASC focusing on cardiovascular, it typically isn't done or isn't seen. So though it is sort of becoming a national trend, you're seeing that happen more amongst the private groups. They're doing remarkably well and they're showing that the quality of care that can be performed in the outpatient setting is as good as, if not better than, some of the hospitals. It's the same providers doing great high-quality care, just in a different location.
Q: What is pushing cardiovascular procedures to ASCs?
PB: I think it starts with the payers. Medicare, for example, has included those CPT codes now on the outpatient ASC fee schedule, allowing for those procedures to be reimbursed. If they're being reimbursed, you're finding providers now taking advantage of that, and moving those cases into a location that they can better control or to gain efficiencies from.
First and foremost is that Medicare now reimburses several cardiology related CPT codes. But secondly, something that you have to keep an eye on is our state regulations. State regulations either allow you to move [cardiovascular procedures] into an outpatient setting or restrict the types of procedures that can be performed in the outpatient setting. That may be another reason why you're not seeing too many of those cardiovascular ACS popping up just yet.
I think there's still room for growth and opportunity, but I think it's going to be a state-by-state determination of whether these are prevalent or are really great opportunities. You are seeing a small subset of providers in the vascular space, taking advantage of the office based labs, and I think you'll see that continue to be prominent in the workplace as long as reimbursement is there. So to your question about what's pushing it, it's really the opportunity to be reimbursed.