When it comes to ambulatory surgery centers, Deb Yoder, RN, MHA, CNOR, CASC has been there, done that. We sat down with our Vice President of Facility Development to learn her strategies and tactics for planning, launching, and operating a successful cardiovascular ASC.

Want the highlights? Check out the video. Want to dig into some in-depth CV ASC development tips from Deb? Read on.

How can a cardiovascular ambulatory surgery center support our broader health system goals?

Patient demand for ASC care is growing. In data from 6.5 million patient encounters in 2023, ASCs snagged an 85.3 “likelihood to recommend” (LTR) score, according to Press Ganey. In contrast, hospital services scored 69.2.  

A high-performing CV ASC is a brand-building beachhead for your health system. It’s a point of entry for lasting patient relationships. By offering a superior patient experience — from easy access and parking to exceptional outcomes — you establish a powerful competitive advantage, attracting new patients and building loyalty that extends far beyond the ASC.

A CV ASC can also help you build and strengthen physician alignment. (More on that later.)

What unmet needs in our health system’s service areas could a CV ASC address?

Currently, about two-thirds of cardiovascular procedures can be performed in an ASC setting. But just because they can be performed in an ASC doesn’t mean they should be performed there.

Generally, about 50 percent of current hospital outpatient department (HOPD) CV patients are candidates for CV ASC procedures. This percentage varies depending on the overall health of patients in your service area.

By adding CV ASC service lines, you meet increasing provider, patient, and payer demand for ASC care and you free up near-capacity or at-capacity HOPD bandwidth for the 50% of CV cases that should not be performed in an ASC.

Adding an additional cardiac cath lab in your hospital is significantly more expensive than developing and operating a CV ASC, so why not add an ASC to meet demand and to ensure your health system is able to provide the most appropriate settings for your CV patients?

How can we demonstrate the value of a CV ASC to payers?

ASCs can do cardiovascular procedures at lower rates than HOPDs. However, as my colleague Stacy LaLonde emphasizes, launching an CV ASC doesn’t require you to ‘trade away’ your hospital cath lab revenue stream.

Instead, we recommend an ASC-focused payer strategy that forecasts what CV case migration will look like in your health system’s service area. Next, compare CV CPT® codes performed in your hospital currently to the codes that have recently moved or are expected to move to the ASC CPL. This data-driven approach equips you to demonstrate a strong value proposition to payers and negotiate competitive rates for the CV ASC you aspire to develop.

How do we engage and align physicians to optimize utilization?

Cardiovascular physicians are eager to explore ASCs — and not just for the ownership equity opportunity.  

In a climate of stagnant physician reimbursement, ASCs provide a compelling value proposition. The streamlined efficiency of ASC cath labs, with procedures averaging 23 minutes shorter than in hospitals [cite], allows physicians to maximize their time and potentially increase their overall earnings.

Bonus: In an ASC scheduled cases don’t get bumped for emergency cases. Predictable schedules boost patient satisfaction — a mood-booster for physicians as well.

Unlike their peers in surgical specialties, CV physicians are new to the ASC frontier. Especially if they are employed physicians, their ASC involvement plunges them into potentially unfamiliar topics like facility planning, myriad operations details, P&L accountability, and more. Truly collaborative partnerships, where CV physicians learn about ASC best practices and drive decisions, are essential.

Whether your health system plans to partner with independent physicians, employed physicians, or some combination of the two, it is crucial that your physician partners have governance and leadership opportunities because that’s precisely what makes the ASC model work so well.

What are some key facility planning and design considerations for a CV ASC?

Understanding the patient population the CV ASC will serve is crucial for planning equipment and storage needs. When I partner with physicians to plan a facility, we focus on conversion rates, that is, how often their diagnostic procedures become interventional procedures. I ask questions like, “How often when you do a diagnostic coronary do you find an occlusion that requires an intervention? And if you do an intervention, is it one vessel, two vessel, three vessel?”  

Patient flow is another facility planning consideration. Often, physicians assume the facility will need a large waiting area because that is what they see in their medical practice or in the hospital. But ASCs don’t need large waiting areas because the goal is to get patients checked in quickly and into the pre-op area. A small waiting area provides more space for other areas the ASC needs.  

Also crucial for facility planning: Understanding the CV ASC’s long-term growth strategy. You must ensure you factor in the potential for future growth without overbuilding. The option to expand service lines in the future requires careful foresight to ensure the necessary space and infrastructure are in place. Adding ablation procedures, for example, impacts room size, air exchange requirements and anesthesia needs. From room dimensions to ventilation standards and fixed equipment, careful planning at the onset ensures seamless integration of new procedures without the need for costly renovations.

Seeking ASC-focused insights and guidance for your health system? Deb Yoder and the Compass Surgical Partners team would love to help! Contact us to start the conversation.