A 2019 landmark CMS ruling, paired with the rapid development of technology for minimally invasive surgery, has fueled the rise of outpatient cardiovascular centers and ASCs in recent years.
Now, the specialty has become a major focal point of national management organizations, hospitals, health systems and independent physician groups looking to expand their outpatient service lines.
Here are five notes on the intertwined fates of cardiology and ASC growth:
1. Outpatient cardiology has been a driving force behind recent mergers and acquisitions in the ASC space. On June 17, St. Louis-based Ascension announced a definitive agreement to acquire Nashville-based AmSurg, one of the largest ASC chains with 250 centers and partnerships with over 2,000 physicians. In a news release, Ascension CEO Joe Impicciche framed the move as mission-aligned, expanding access to affordable, localized care and enhancing outpatient capacity as procedures in cardiology and orthopedics continue to shift out of hospitals.
2. Nashville, Tenn.-based ASC giant HCA Healthcare continues to invest capital into the cardiology sector, as it saw growth from both inpatient and outpatient cardiac surgeries during the first quarter of 2025. The company’s outpatient expansion, including in catheterization labs and ASCs, is ongoing but requires relatively smaller capital commitments, CEO Sam Hazen said in a recent earnings call.
3. “As we see site-of-service differential go away in diagnostic imaging between the HOPD rates and the outpatient world, and as Medicare continues to shift its focus on cardiovascular care being treated more in the outpatient arena than the inpatient arena, we’re going to see more and more hospitals looking for alternatives to how they’re going to deal with their cardiology programs,” David Konur, CEO of Houma, La.-based Cardiovascular Logistics, told Becker’s in April. “If site-of-service differential goes away, there is going to be a huge influx of cardiologists looking to join platforms like ours, and we’re already talking to almost a dozen groups that are very interested in what that would look like, because as they read the tea leaves, they see that coming as well.”
4. Becker’s has reported on at least six cardiovascular ASCs being planned, constructed or opened in 2025 so far. 5. A recent study even found that ASCs’ outpatient heart procedure outcomes may rival those of hospitals. Katerina Dangas, MD, of Boston-based Beth Israel Deaconess Medical Center, presented these findings at the Society for Cardiovascular Angiography and Interventions 2025 Scientific Sessions, as reported by the Cardiovascular Research Foundation’s TCTMD. Between 2018 and 2022, percutaneous coronary intervention procedures performed in ASCs rose sharply from 0.01 to 0.87 cases per 10,000 person-years, signaling a growing acceptance of the model.
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