Cardiac interventional procedures are shifting from hospitals to ASCs

Editor's Note

At ACC.23 (the American College of Cardiology 2023 conference), Sunil Rao, MD, director of interventional cardiology at NYU Langone and president of the Society of Cardiovascular Angiography and Interventions (SCAI), spoke about the shift in interventional procedures from hospitals to ambulatory surgical centers (ASCs), Cardiovascular Business April 10 reports.

According to the article, ever since the Center for Medicare & Medicaid Services (CMS) began reimbursing for outpatient cath labs, more of these procedures in low-acuity patients are being done in the ASC setting—at about half the cost of a hospital-based cath lab. ASCs can now be “reimbursed for low-risk procedures such as diagnostic angiograms, peripheral artery disease revascularization, straightforward percutaneous coronary interventions (PCI), and electrophysiology procedures,” noted the article.

"SCAI wants to improve the quality in cath labs regardless of where patients are getting their interventions or diagnostic cath,” said Dr Rao in an interview with Cardiovascular Business. “We don't take a position if an ASC is the right or the wrong thing to do. We know this is happening, and we know there is a push on the part of CMS for more outpatient kinds of procedures largely because it is a cost-saving measure.”

An example of an SCAI standard is its position statement on the performance of PCI in ASCs, which has been approved for reimbursement by CMS since 2020 and is now allowed in 23 states. The position statement, Dr Rao explained, “offers a template for how to manage interventional quality standards in an ASC” in an effort to hold ASCs to the same standards as hospital cath labs in terms of patient safety and quality of care.

The American College of Cardiology is currently working on a “paired down version of its National Cardiovascular Data Registry for cath labs” to better include ASC data. Participation in such registries is one way to track quality and compare ASC vs hospital cath lab performance, the article concluded.