1. Vance Chunn, CEO of Mobile, Ala.-based Cardiology Associates, told Becker’s that while cardiology’s shift to outpatient is inevitable, it still has a years-long trajectory.
Here’s the timeline Mr. Chunn anticipates for cardiology’s outpatient evolution:
- One to two years: Expect slow but steady growth, concentrated in large markets with forward-thinking providers. Expansion will largely be led by private equity-backed or physician-led ASC models.
- Three to five years: As payer pressure increases and infrastructure improves, a broader migration will take shape. Hospitals may look to joint ventures or begin shifting select low-risk procedures to outpatient settings.
- Beyond five years: A more substantial transition — similar to what’s already occurred in orthopedics and GI — will unfold. Widespread adoption will require a mature ASC ecosystem and continued momentum from payers and physicians.
2. As more cardiology and cardiovascular procedures shift toward the ASC setting, there could be a swing in consolidation in the industry, David Konur, CEO of Cardiovascular Logistics, told Becker’s.
Cardiovascular Logistics, a national cardiovascular platform, recently partnered with Cardiology Consultants of Philadelphia, the largest independent cardiology practice in the U.S. Of the 342 cardiology clinics that have been acquired in the past decade, more than 94% of acquisitions occurred during 2021 to 2023, according to a recent Medscape report. While private equity has a more established presence in other fields, such as orthopedics and ophthalmology, the newness of private equity’s presence in the field sparked discourse among cardiology experts.
3. Infrastructure and capital investment, regulatory barriers and resistance from hospitals and health systems are a few of the factors holding back cardiology’s outpatient growth. Certificate-of-need laws, in particular, are one regulatory challenge directly impacting cardiology’s ability to expand into outpatient settings. These regulations often reflect outdated views of outpatient care and are frequently used by hospitals to block competition.
Danielle Martin, administrator and director of physician services at Richmond-based Virginia Cardiovascular Specialists, experienced this firsthand. The group opened the state’s first freestanding, Medicare-approved outpatient cardiac catheterization lab in 2023 after a lengthy CON process.
“One of the biggest challenges that we experienced when we were doing the CON was the fact that the state manual for the CON for a cath lab was written, in the ’80s or ’90s, many years ago, when outpatient cath labs were just not a thing,” Danielle Martin, an administrator and director of physician services at VCS,” told Becker’s.
Though VCS ultimately secured approval in January 2024, Martin said the outdated framework was a “big hurdle.”
4. Diagnostic and interventional cardiology procedures are increasingly moving towards outpatient care. Becker’s has reported on the development of several cardiac catheterization labs in 2025, and according to a blog post by Ascendient, a healthcare consulting firm, cardiac catheterizations are used more than 1 million times per year in the diagnosis and treatment of cardiovascular disease. This represents a huge area for potential cardiac outpatient growth.
“Some aren’t approved yet, but the ones that are, and that will likely become the bread and butter of ASCs, include diagnostic caths and low-risk interventions,” Dr. Chunn said. “You’ve got to be careful with interventions — complex ones aren’t a fit without hospital backup. But diagnostic caths, percutaneous coronary interventions, and some low-risk EP procedures like pacemakers and ICDs, are being done. Transesophageal echocardiography is another. That’s pretty straightforward to do in an ASC.”
5. Some payers have begun to acknowledge cardiology’s outpatient migration. Aetna, for example, dropped its policy to not cover cardiac positron emission tomography/CT scans in July 2024.
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