These outpatient treatment centers offer higher rates of both provider and patient satisfaction, Biga said, in addition to delivering high-quality outcomes in a lower-cost setting. Medicare began reimbursing for ASC basic percutaneous coronary interventions (PCI) in 2020, which accelerated the growth of these centers. Regulations in some states favor OBLs or ASCs, so there has been a concentration of these centers in some states, mainly in the band from Florida across to country to the west to Arizona.

In some cases, larger hospital systems are even partnering with private companies that manage these labs to outsource their less complex cases and make room in the hospital cath labs for more involved (and more lucrative) procedures.

Biga said the Medicare fee schedule has changed in recent years to favor these outpatient centers for lower acuity patient care because they have much lower overhead costs than large hospital systems.The shift is being made for similar financial reasons asthe shift over the past decade from private cardiology practices to cardiologists increasingly being employed by the hospitals.

"There is a financial element to that you can't ignore, and the same is true here," Biga explained.

In many cases, OBLs and ASCs have the same equipment and often they have the same cardiologists at the area hospitals performing these procedures. She said the difference is just the location, which changes how much a procedure is reimbursed and how that translates into revenue when there are not a large number of additional costs that hospitals have to cover.

"Outcomes are probably just as good, if not better, and patient satisfaction tends to be much better because it is an easier in or out. If you go to a hospital and your are registering, it is a two-hour process. If you are in a smaller setting, it is a much better patient experience," Biga said.

Her biggest concern with these centers is that they meet the same patient safety and quality metrics as hospital facilities. Biga said this can be done if OBL and ASCs become a part of the ACC National Cardiovascular Data Registry (NCDR) like larger cath labs at hospitals. She said this would provide a benchmarking capability to measure the quality of the outpatient centers as compared to traditional care for similar types of patients and procedures. The ACC is presently working on a lighter version of the registry to support OBLs and ASCs.

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What the rise of outpatient cardiac OBLs and ASCs means for ... - Cardiovascular Business