The Rise of Cardiovascular ASCs – Bridging Gaps

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With an increasing need for high-quality, cost-effective healthcare, Cardiovascular Ambulatory Surgery Centers (CV ASCs) are coming into their own. Payers and Centers for Medicare & Medicaid Services (CMS) see opportunity to achieve financial gain with CV procedures performed in ASC settings.

In this article, Atlas Healthcare Partner’s Regional Vice President of Cardiovascular Operations Kristen Richards examines the growing importance of Cardiovascular Ambulatory Surgery Centers (CV ASCs) in the healthcare industry. With the need for cardiologists increasing and the focus on cost-effective care delivery, Kristen explains why CV ASCs are more suitable than hospital inpatient or outpatient settings for low-risk cardiac procedures, and how a health system can implement an effective ASC strategy.

Why is it vital for health systems to develop CV ASC services?
They must find new ways to provide easier access for patients in lower cost settings. Many Americans struggle with healthcare debt: a 2022 investigation found that more than 100 million people — 41-percent of adults — are saddled with healthcare debt. But lower-cost settings are also important for hospitals and physicians, so all three groups are seeking more cost-effective care delivery settings that provide the same high-quality care.

With the rise of Accountable Care Organizations (ACOs) and value-based healthcare, there will be more focus on getting the right patient to the right facility for the right procedure—and at the right price. Any health system whose mission is about bringing such initiatives and services to the community and who want to be a strong community partner must examine how ASCs can fill gaps in access and lower cost.

Why is a CV ASC more suited than, say, hospital inpatient or outpatient settings?
CV ASCs are perfect for low-risk cardiac procedures, such as coronary interventions (PCI), catheterizations, or implants. They can provide greater patient access, convenience, and high patient satisfaction because it is easier for patients to get to an ASC, than, say, having to navigate a large hospital complex. The right ASC in the right location can help bring services to rural settings, where we are seeing an increase in the number of hospitals closing or are at risk of closing. CV ASCs can help fill a need of about 61 million people who live in rural settings.

So how can a health system implement an effective ASC strategy, CV or otherwise?
Since CV procedures are significant revenue generators for health systems, building the right CV ASC strategy in today’s competitive healthcare market is challenging. But it’s important to proactively map a strategy in light of changes happening now. The first step is starting with good partnerships—hospital systems and physicians that are aligned and share the same vision and values. We find systems that share our mission of “providing exceptional care and outstanding customer service to every patient, every physician, every time.”

So, how do you bring partners together?
We form joint ventures with health systems and physician-investors to develop and manage ASCs. This is a key part of physician alignment because when you build strong alignment, you build trust, and you create long-term relationships that are collaborative–everyone works together rather than against each other. Attracting physicians requires providing the right culture, equipment, staff, and return on investment that they seek.

How do you attract physicians?
We work hard to build strong teams and great cultures because happy employees make the patient experience better. It’s been studied; ask Virgin Group Founder Sir Richard Branson. He believes that his philosophy, “employees come first,” is the reason behind his success. And we agree.

We work hard to provide great service, the right staff and equipment, and the return on investment they expect. If the right decisions are made from both a professional and investment standpoint, cardiologists will stay for the long term. And that positive culture translates to patient care.

Do you have an example of this?
It’s exciting for me to see conversations that never happened before in healthcare. When we have governance board meetings, everyone is around the table – us, health system representatives, cardiologists, medical staff. Everyone has parity—more importantly, physicians have agency and decisions are being made together.

One center recently received accreditation by the Joint Commission, so we gathered the team to discuss what was needed to outfit the ASC. Physicians were part of the discussion around equipment – pacemakers or ICDs, for example. In a hospital, a doctor would say what they would want and that would be the end of it, and maybe the hospital would listen to them or not. But at the ASC, there was a lengthy and intelligent discussion about which pacemakers or stents to implement.

Cardiologists were part of the discussion about which ones were clinical efficacious as well as cost-effective. If the clinical data shows a device to be just as effective as another that is more costly, physicians were now considering the lower-cost solution. That is how patient-care delivery decisions ought to be made – looking at cost and clinical data, and letting physicians have a voice in the decision-making, so there is consensus and ownership.

Finally, can we discuss benchmarking? Won’t that be important for ASCs moving forward?
It will, and through our partnership with MedAxiom, we are working to develop low-cost and low- burden quality data tools for the CV ASC setting. It is vital to demonstrate outcomes that show we are upholding high-quality levels for lower costs, and we are lucky to be the exclusive partner with MedAxiom to attack this work. We want to show ASCs are just as—if not more than—efficient than hospitals. That is how you set a new standard of care delivery, and that’s what keeps me going.

Interested in learning more about CV ASCs? Contact Kristen here.


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