Cardio Procedures Leaving Hospitals: Benefits & Risks
- Cardiovascular care in the United States is undergoing a meaningful transformation.
- In 2022, a considerable 65% of outpatient peripheral vascular interventions for medicare beneficiaries took place in OBLs.
- A recent analysis reveals that financial considerations are a major driving force.
The Changing Landscape of Heart Care: More Procedures Moving Out of Hospitals
Table of Contents
Published August 21, 2025
A Shift in Where We Receive Care
Cardiovascular care in the United States is undergoing a meaningful transformation. Increasingly, procedures once exclusively performed in hospitals are now being safely and effectively conducted in outpatient settings like ambulatory surgery centers (ASCs) and office-based laboratories (OBLs). This trend isn’t just a convenience factor; its driven by a complex interplay of financial incentives, technological advancements, and a growing focus on patient access.
In 2022, a considerable 65% of outpatient peripheral vascular interventions for medicare beneficiaries took place in OBLs. Projections from the Journal of the American College of Cardiology indicate that the volume of procedures performed in ASCs will rise by 21% by 2034.
The Economics of Outpatient Cardiovascular Care
The move towards outpatient care isn’t accidental. A recent analysis reveals that financial considerations are a major driving force. Starting in the mid-2000s, Medicare broadened the scope of procedures reimbursed in outpatient settings, including those involving device implantation and peripheral vascular interventions. This expansion continued in 2020 when the Centers for Medicare and Medicaid Services (CMS) began covering coronary stenting in ascs, anticipating $20 million in savings if even 5% of these cases shifted from hospitals.
This Medicare lead often prompts third-party payers to follow suit, creating a broader incentive to promote outpatient care. Furthermore, physicians are increasingly drawn to ASCs and OBLs, which often offer greater financial autonomy compared to traditional hospital employment.The rise of physician-owned facilities, coupled with investment from private equity groups and even hospitals themselves, highlights the growing revenue potential of these outpatient centers.
Benefits for Patients: Convenience and Equity
Beyond the financial aspects, the shift to outpatient settings offers tangible benefits for patients. As mustafa Husaini, MD, chair of the American college of cardiology Cardiovascular Management Council, notes, “Patients’ journey through healthcare has never been easy… They much prefer having procedures done at ASCs and OBLs, which are faster, more efficient, and frequently enough closer to home.”
Importantly, OBLs are proving to be particularly valuable in enhancing access to care for underserved communities. Data shows that individuals undergoing peripheral vascular intervention in OBLs are more likely to be Black and of lower socioeconomic status than those treated in hospitals. This suggests that these facilities are playing a crucial role in addressing healthcare disparities.
Addressing Concerns About Safety and Oversight
While technological advancements have made outpatient cardiovascular procedures safer, questions remain regarding consistent standards of care. Currently, there’s a lack of thorough data on complication rates and adverse events in ASCs and OBLs. Unlike the hospital setting, which benefits from robust quality registries, the outpatient sector lacks a similar system for tracking patient outcomes and identifying areas for improvement.
Robert Yeh, MD, a cardiologist at Harvard Medical School, emphasizes the need for better data collection: “In the ASC or OBL setting we don’t have that same rigorous data collection system to understand how patients are doing in these settings.” Developing clear guidelines and a standardized data collection system is crucial to ensure that the right patients receive care in the most appropriate setting.