Cardiac procedures, as well as many other surgeries deemed elective during the pandemic, were postponed. This was a problem for many healthcare professionals.
Many outpatient facilities began performing cardiac procedures such as stent placements, catheterizations, and pacemaker implants. Now, almost 70% of cardiac procedures are taking place in hospital outpatient settings. Insurers are reimbursing outpatient facilities for these procedures.
Things to Consider if Planning to Add Cardiac Procedures to Your Surgical Facility:
Staffing:
- Cardiology care is specialized, your staff will need to have relevant experience and technical skills:
- Advanced cardiac life support.
- Catheterization labor.
- Critical Care Certification.
- Hire staff that’s specially trained in cardiology:
- cardiology nurses versus surgical nurses.
- Determine if you’ll have enough cases to warrant this specially trained staff.
- Hire seasoned physicians who are comfortable with handling common complications in cardiology procedures. Make sure they aren’t discouraged by the regulatory and reimbursement challenges that exist for this specialty.
Focus on these main categories of care:
Coronary:
- Both diagnostic and interventional work.
- Right and left heart catheterizations.
- Balloon angioplasty.
- Stent placements.
- Peripheral Vascular Interventions, or work performed on the vessels outside the heart.
- The placement of devices-implants such as pacemakers, defibrillators and loop recorders.
Patient Selection:
- The patient selection criteria you use will dictate the overall safety of your cardiology program.
- Establish your criteria and lab values.
- Cardiac patients are usually more vulnerable than standard ASC patients, they often have diabetes, high blood pressure, or other issues that can make procedures riskier to perform.
- Performing procedures on patients with kidney disease can increase the risk for complications, the contrast dye can overload the kidneys.
Complexity of Regulatory and Reimbursement:
- CMS approves cardiac procedures performed in ASCs, but the approval codes are constantly changing.
- Reimbursement can be difficult and challenging, negotiating contracts with payers can be difficult.
- Escalating start-up costs due to cost increases and supply shortages can be obstacles.
Conclusion:
Safe cardiovascular procedures will continue to be performed outside traditional hospital settings, and will increase in approved procedures in the future.
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