By Kristen Richards, vice president of ambulatory care, Cardiovascular Logistics
Anyone working inside or alongside a hospital today can feel that the way we deliver care is reaching a breaking point.
Capacity is tight in many regions. Staffing has been a challenge for years. And the volume and complexity of patients continue to increase.
While this pressure has been building, something has shifted recently.
There is now a growing range of procedures that can be performed safely and reliably outside the hospital, changing how the entire system thinks about where care should happen.
One of the most evident instances of this change is in cardiovascular medicine.
Over the next 10 years, outpatient cardiovascular procedures are expected to increase by 25 per cent, compared to just 8 per cent growth for inpatient care.
2026 will be a significant turning point for cardiology and the entire healthcare industry when paired with payer expectations, technological advancements, and regulatory pressure.
Reinforcing this momentum is the newly released Centers for Medicare & Medicaid Services (CMS) 2026 Final Payment Rule, which expands the ASC Covered Procedure List by nearly 300 procedures.
An encouraging step forward for access, this also brings a new level of responsibility to ensure every outpatient setting is equipped to deliver these services safely and consistently.
Why Outpatient Care is Gaining Momentum
Several factors are accelerating the growth of outpatient care in cardiology.
Payers and regulators are aligned.
Payers have been encouraging appropriate site-of-service shifts for years, but the regulatory environment is now reinforcing it.
The 2025 CMS outpatient rules clearly favour ambulatory surgery centres (ASCs), which have stronger quality controls and facility requirements.
This creates a natural pull toward ASCs and makes it important for practices to design facilities that can either function as an ASC today or convert easily in the future.
Technology is ready
With advancements in imaging, monitoring, anesthesia, and procedural tools, more cardiovascular procedures are being safely performed outside of hospitals.
Cases like diagnostic cath, some PCI procedures, device upgrades, and loop recorder placements are already routine in outpatient settings.
As these tools continue to improve, the range of procedures that can safely shift will grow.
Operational reality is unavoidable
Hospitals are facing capacity constraints, staffing variability, and competing demands in their procedural areas.
Outpatient centres help absorb the predictable cases that don’t require hospital-level resources, which gives hospitals room to manage the high-acuity and emergent care they are built for.
This division of work supports the whole system rather than pulling it apart.
Patient expectations have changed
Patients’ expectations have also evolved. They want reliability, simplicity, and a recovery they can reasonably plan for.
Outpatient settings make that possible because they are designed with those needs at the centre.
As patients become more familiar with how these environments operate, their preference for them naturally grows.
The State of Cardiovascular Outpatient Care Today
Kristen Richards
Due to the higher cost of the equipment, more specialized staffing model, and variations in state regulations through certificate-of-need programmes, cardiovascular ASCs have not expanded as quickly as those in other specialties.
However, the model is very effective once the proper infrastructure is in place.
Outpatient cardiovascular programs benefit from:
- Predictable scheduling
- Fewer delays and cancellations
- Tighter, more consistent protocols
- Streamlined workflow for both physicians and staff
- Environments tailored to a narrow set of procedures
This does not diminish the role of the hospital.
When hospitals and outpatient centres operate in partnership, the entire system becomes stronger and more balanced.
The Importance of Physician-Led Structures
Across outpatient cardiovascular care, the dynamic changes when physicians are involved in shaping the operational approach.
Physician-led structures offer better stability and higher-quality care. When physicians help design the workflow, scheduling, protocols, and team structure, the operations line up with real-world clinical needs.
The daily pressure points become easier to solve because the people closest to the work are informing how it runs.
This also matters for workforce stability. For many years, burnout has been a defining problem in cardiovascular care.
Patients gain from this stability, and retention increases when doctors feel more empowered and supported.
Why 2026 Represents a Turning Point for Outpatient Care
Though the transition to outpatient care has been developing for years, 2026 will mark a significant turning point.
Payers are more assertive about site-of-service expectations. Patients are asking for convenience and faster access.
Technology, including AI, is becoming more central to procedural planning and recovery. CMS policies continue to evolve to support outpatient care. And hospitals are more constrained than ever.
Simultaneously, a new wave of cardiovascular procedures is approaching.
Ablations are already moving to the outpatient setting in some areas, and CMS’s 2026 Final Payment Rule adds cardiac ablations, more complex percutaneous coronary interventions (PCIs), chronic total occlusions, and other advanced interventions to the covered procedures list.
Practices with ASC-ready infrastructure will be first in line when these changes take effect next year.
At the same time, the American College of Cardiology launched an ASC registry in 2024 and is beginning to generate early data on outcomes and quality.
Those results are helping validate the model with payers and regulators.
Looking Ahead
We are entering a period where outpatient care will influence not only where procedures are performed, but also how the entire cardiovascular system operates.
Hospitals will continue to lead on complex and emergent care. Outpatient centres will expand the range of predictable procedures. Physician-led governance will tie it together by keeping decisions aligned with patient needs.
Outpatient cardiovascular care isn’t just about moving a procedure from one setting to another. It reflects a much bigger shift in how we think about effective, high-quality care and delivering it in the place that makes the most sense for each patient.
About the author
Kristen Richards is the vice president of ambulatory care at Cardiovascular Logistics, supporting the organisation’s cath labs, ASCs, and office-based labs.
She brings decades of cardiovascular operational experience, including leadership roles at Atlas Healthcare Partners, Philips Healthcare, and Banner Heart Hospital. Kristen holds a BS in respiratory therapy and an MBA in healthcare administration.
