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The Cardio Service Line, Rebooted

Michael Zeis, for HealthLeaders Media, March 19, 2013

Contribution: Mostly positive

For most, the cardio service line remains a leading service line in terms of financial contribution. The mean positive contribution margin reported by respondents is 19%. Nearly half of respondents (45%) expect a minor increase in contribution margins from cardio in the next three years. On top of that, 21% expect a major increase. No wonder 74% of healthcare leaders expect to expand their cardio service lines in the next three years.

While only 1% of respondents expect a major decrease in cardio service line margins, a notable share (11%) expects a minor decrease.

Collaboration and alignment

More attention to collaborative care means more attention to physician alignment. Many provide collaborative care through comanagement programs (31%) or joint ventures (17%), but the fully employed model is used in 33% of cardio service lines. Robertson notes the benefits of the medical staff model for cardiology. "More than ever, we are aligning with medical staff. For the cardio service line, you need cardiologists who are committed to your facility to bring business, ensure quality and service, and manage costs." And today, interventional cardiologists are in demand, especially with more procedures done in an outpatient setting. Nearly one-third of respondents (31%) plan to hire interventional cardiologists to drive business to their cardiology service line. "Interventional cardio is the real driver of reimbursement," Robertson says. "They'll do the procedures like catheters and stents. A noninterventional cardiologist can do a diagnostic catheterization, but they can't do any interventions."

Carol Mascioli, vice president of clinical services at the 680-bed Baptist Hospital in Miami, explains how inclusion helps her organization earn buy-in from a 100% voluntary cardio physician team. Baptist Hospital is developing a protocol for patients arriving at the emergency department with atrial fibrillation. Baptist wants to identify which patients with the condition can be treated or observed in the ED and sent home, instead of being admitted as a matter of course. The effort started with a broad clinical team, including nursing leaders, the ED medical director, the clinical cardiology medical director, the electro physiology medical director, hospitalists, and the anesthesia medical director.

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