MedAxiom CV Business White Papers feature expert research, knowledge and insights on pressing issues in cardiology, arming CV organizations with solutions for success.
As procedures migrate from hospitals to outpatient settings, success requires more than opening the doors – it demands careful governance, operational discipline, financial sustainability and strategic foresight. It also demands appropriate patient selection, as well as a focus on patient satisfaction and outcomes. This CV business white paper outlines the operational and strategic considerations for ambulatory surgery center (ASC) leaders from opening through sustainability. This publication builds on content from a previous CV business white paper outlining major considerations for initial ASC development through opening day.
Recent updates from the Centers for Medicare & Medicaid Services have introduced significant changes in the reimbursement landscape for advanced cardiovascular imaging services, including coronary computed tomography angiography (CCTA), fractional flow reserve derived from computed tomography (FFRCT), and artificial intelligence (AI)-enabled coronary plaque analysis. This CV business white paper provides practical guidance on aligning revenue code assignments with cost centers to protect future reimbursement, optimizing chargemaster structures, and preparing for CPT and Ambulatory Payment Classification transitions. Use this paper to educate revenue cycle and coding staff to minimize denials and compliance risk.
This new CV business white paper explores a compelling case study of how Cedars-Sinai Medical Center closed a critical care gap by integrating an echocardiographic surveillance platform with a structured workflow into their electronic health record. Faced with delays in diagnosis and referral for structural heart disease patients, the team moved beyond isolated technology upgrades to create a complementary approach that transformed patient identification, monitoring and access to care. This proactive solution resulted in earlier intervention, improved outcomes, smarter resource utilization, and a lasting competitive advantage – proving that when technology is thoughtfully aligned with clinical workflows, it can truly save lives.
Despite advances in guideline-directed medical therapy (GDMT), many patients with heart failure with reduced ejection fraction remain symptomatic, struggle to tolerate or maintain therapy, and experience limited improvement in quality of life. This new therapy overview and operational checklist explores how baroreflex activation therapy, or Barostim, can help address this unmet need. The guide outlines how this novel therapy complements GDMT to improve heart failure symptoms and offers practical, step-by-step considerations for integrating Barostim into clinical practice.
In today’s healthcare landscape, cardiovascular service lines face increasing pressure to reduce hospital admissions while maintaining high-quality patient care. Syncope and atrial fibrillation hospitalizations remain a significant source of admissions and healthcare burden. Emergency department (ED) providers also face significant challenges with increased patient volumes, staffing and resource shortages, staff burnout, overcrowding, extended length of stay, patients leaving without being seen, and frequent ED visits. This CV business white paper aims to provide healthcare administrators with a comprehensive overview of the best practices when utilizing Philips Mobile Cardiac Telemetry – MCOT in the ED post-discharge setting. It also provides a detailed analysis of the operational, quality and financial factors that should be considered when evaluating the implementation of this technology.
Determining which hospitalized patients with severe aortic stenosis require urgent TAVR is challenging. While some patients are too unstable to delay, others can be stabilized, enabling safe discharge and return for elective procedures. Programs that use standardized triage, multidisciplinary decision-making, and strategies such as medical optimization or balloon aortic valvuloplasty can often defer less-urgent cases. This CV business white paper shares clinical and operational tactics from three leading programs to support timely intervention when needed and reduce non-elective procedures, enhancing care and sustainability across the cardiovascular service line.
Structural heart (SH) disease has emerged as one of the fastest-growing subspecialties in cardiovascular care. Since the Centers for Medicare & Medicaid Services approved TAVR for low-risk patients in 2019, the population eligible to receive TAVR has more than doubled, and similar expansions are underway in mitral and tricuspid interventions. To help programs understand this transformation, this CV business white paper gathers real-world insights from leading academic SH programs. The paper identifies critical lessons and forward-thinking strategies to prepare SH programs for growth, particularly in the ambulatory surgery center space.
There are several reasons to ensure atrial fibrillation (AF) is managed appropriately, including maintaining cost of care at a population level, guaranteeing appropriate care within a market, and growing market volumes and market share. This CV business white paper presents a proven population management framework to help healthcare organizations identify and treat atrial fibrillation (AF) patients eligible for left atrial appendage closure (LAAC). This approach leverages electronic health record data, decision support tools and targeted resources to find at-risk patients, streamline referrals, and ensure consistent, evidence-based care.
This CV business white paper serves as a practical guide for cardiovascular leaders to establish and expand a successful cardiac PET/CT program. Grounded in real-world experience, this guide highlights the clinical benefits, operational strategies, patient safety considerations and financial implications of cardiac PET/CT, equipping organizations to elevate their cardiovascular imaging services and patient care.
As cardiology programs seek to expand patient access to left atrial appendage closure (LAAC), the efficient identification of patients who may benefit from this therapy remains challenging. This CV business white paper explores how cardiovascular organizations can leverage existing electronic health record (EHR) functionality to identify appropriate patients for LAAC and streamline the patient’s journey from evaluation to treatment and follow-up. Based on interviews and workflow assessments at two high-performing programs, this paper outlines practical strategies and implementation tips for using EHR data to improve patient access and experience and drive procedural growth.
The increasing adoption of LAAC procedures presents both opportunities and challenges for healthcare organizations. This CV business white paper combines insights from survey data and detailed interviews across diverse institutions to identify key barriers and best practices in LAAC lab capacity management. By integrating quantitative data with qualitative insights, this publication provides actionable recommendations for improving efficiency, addressing bottlenecks, and supporting program growth.
As a result of regulatory changes starting in 2020, more organizations are adding an ambulatory surgery center (ASC) to their cardiovascular care delivery portfolio, and private payers are engaging with the strategy as well. Early adopters have shown that care can be provided in these centers in a high-quality manner while providing great patient and team experience – all in a setting with a lower cost of care. While establishing a cardiovascular ASC has fewer regulatory hurdles and is less expensive than developing a hospital-based catheterization lab, it is still complicated. This document provides an inventory of the primary considerations for developing a new cardiovascular ASC.
This CV business white paper provides a comprehensive overview of the current state and future directions of cardiac CT and MRI, equipping healthcare professionals, administrators and policymakers with the insights needed to navigate this rapidly changing field and make informed decisions to improve patient care. The paper explores the shifting patterns in modality ownership and management and the increased involvement of cardiologists in image interpretation. It also addresses technological trends driving these changes, including the adoption of advanced post-processing software and cloud-based solutions.
Positron emission tomography (PET) and combined PET/computed tomography (PET/CT) imaging have fundamentally transformed diagnostic capabilities in radiology and cardiology. By implementing a shared PET/CT program, healthcare institutions can position themselves at the forefront of advanced cardiac imaging while optimizing resource utilization. This roadmap outlines best practices for successfully establishing and scaling such a collaborative initiative, ensuring that radiology and cardiology departments can harness the full potential of PET/CT technology for improved patient outcomes and operational excellence.
The concomitant performance of atrial fibrillation (AF) ablation and left atrial appendage closure (LAAC) procedures offers a compelling solution for patients with AF, simultaneously addressing symptom control and stroke prevention in a single procedure. This CV business white paper compiles best practices from seven experienced centers across the U.S., offering valuable insights into developing a successful concomitant AF ablation and LAAC program. By leveraging the expertise of these established programs, new centers can optimize their approach to this innovative and increasingly important treatment modality for patients with AF.
To succeed in an era of rising demands and financial pressures, structural heart programs must create efficient and effective patient management strategies. ValveTraq+ provides the tools to meet challenges head-on, enabling programs to survive and thrive in this dynamic healthcare environment. This CV business white paper explores how ValveTraq+ can help programs navigate modern cardiovascular care’s complexities, maximize resources, and enhance program capacity through more efficient patient care.
MedAxiom visited four cardiac electrophysiology (EP) labs of varying sizes in the Advocate Health system to better understand their early experience with FARAPULSE™ Pulsed Field Ablation. This new ablation system is rapidly being adopted, replacing thermal-based ablation techniques like radiofrequency ablation and cryoablation. The experience of procedural teams and over a dozen operators was gleaned through interviews, direct observation and a survey, the results of which show a a significant increase in AF ablation procedures since they adopted Farapulse.
As the healthcare landscape evolves, traditional models like hospital employment and private equity investments come with their own set of challenges—from loss of autonomy and bureaucratic constraints to profit-driven priorities and reduced control over practice decisions. In response to these limitations, a new paradigm is emerging, offering cardiologists the tools to reclaim their independence while enjoying comprehensive operational support. Access this CV business white paper and watch a recent on-demand webinar to learn about one program's successful transition from hospital employment to independence.
As TAVR volumes continue to rise, cardiovascular programs are seeking innovative ways to optimize resource utilization, improve efficiency and maintain safe, high-quality patient care. This CV business white paper provides a comprehensive framework for the nurse-led sedation (NLS) approach for TAVR and its impact on patients, providers and health systems. The paper discusses demonstrated safety, driving factors, benefits and important considerations for integrating this approach with insights from two programs that have successfully implemented NLS for TAVR.
In today’s complex healthcare landscape, cardiovascular care remains at the forefront of medical innovation and patient treatment. As healthcare administrators and medical directors strive to optimize their facilities’ performance, the choice of equipment vendors for cardiac procedural and imaging areas has become increasingly critical. This CV business white paper explores the operational, clinical and financial benefits of adopting a single-vendor strategy for cardiac equipment, providing valuable insights for decision-makers in healthcare management.
Despite its breakthrough approach and clinical success, TAVR is often perceived as economically unsustainable due to limited reimbursement in relation to its resource intensive, high-acuity patient population. This CV business white paper highlights key insights from Baylor Scott & White Health’s analysis of the far-reaching impact and patient loyalty effects of their TAVR program beyond the procedure itself. Often referred to as the “halo effect,” quantifying adjunct revenues is critical for organizations seeking a holistic understanding of their structural heart service line to foster adoption of new and innovative therapies.
With the transition from traditional care delivered in the medical center to contemporary approaches based in the community, it has become paramount for health systems to ensure appropriate care is provided in the appropriate setting. Developed by ACC and MedAxiom as part of a major care transformation initiative, this document introduces a series of chapters designed to provide a comprehensive framework for health systems to effectively integrate community-based care into their delivery models. Drawing upon extensive clinical knowledge, guidelines and resources, this framework emphasizes a holistic approach to optimize care delivery.
The standard of care has evolved to recognize that functional – not just anatomical – information is crucial in determining the appropriate prognosis and treatment for patients presenting with angina or anginal equivalents. Treating physicians frequently face a tough choice between efficient versus effective diagnostic modalities for pursuing functional interrogation. Unique in how efficient and thoroughly noninvasive it is, magnetocardiography is a tool with unmatched resolution to understand cardiac function without the burdens associated with more traditional forms of functional testing. Learn more about this new imaging modality and a novel approach to the diagnosis and treatment of ischemia in this CV business white paper.
The rising demand for cardiovascular services, coupled with a shortage of cardiologists, is placing immense pressure on healthcare systems. Moonlighting Solutions is leading the way in addressing this challenge with their innovative Cardiology Call Relief Program. This program offers access to highly skilled, board-certified cardiologists to cover night and weekend call to minimize burnout and create a more sustainable staffing model. A new CV business white paper explores how Moonlighting Solutions helps reduce the call burden on in-house physicians, minimizing burnout and post call days, while improving recruitment and retention of your valuable cardiologist resource.
Nuclear cardiology is rapidly evolving with technological advancements driving significant improvements in image quality, radiation exposure and diagnostic accuracy. This CV business white paper reviews the latest research and expert insights to explore how modern SPECT imaging can potentially impact cardiovascular disease diagnosis, risk stratification and management. This may allow a cardiology program the ability to build a foundation for more efficient use of resources and enhanced patient care.
Due to increasing costs to healthcare, longer access times, and pressure from payors, healthcare organizations are exploring their options for opening cardiovascular ambulatory surgery centers (ASCs). An ASC’s regulatory environment, specialized construction needs, sophisticated equipment requirements, and operational considerations all pose unique challenges. This CV business white paper provides an inventory of the major considerations when developing a new cardiovascular ASC.
This CV Business White Paper explores the rationale and best practices for improving lipid management post-ACS as framed by the ACC’s TRANSFORM-ACS initiative. This document provides a solution-focused resource to support the clinical team in achieving early lipid measurement and initiation of guideline-directed lipid-lowering therapies during ACS hospitalization, ensuring follow-up lipid testing in the ambulatory setting to facilitate rapid achievement of LDL-C targets in the secondary prevention of atherosclerotic cardiovascular disease.
Volume derangement in both total blood and red blood cell volume has driven hospitalizations, mortality and poor quality of life for heart failure (HF) patients. Significant opportunity and value exist for integrating blood volume analysis (BVA) into outpatient heart failure (HF) management strategies for volume management. MedAxiom interviewed programs to create this CV business white paper, which provides key information and best practices to facilitate the successful implementation of BVA for HF patients in the ambulatory setting.
With the expansion and evolution of structural heart (SH) procedural programs, the cardiovascular industry has seen a significant increase in the volume of SH procedures to treat complex patients. Expanding caseloads require a higher degree of care coordination, making it challenging for many SH programs to achieve effective access, efficient patient throughput, appropriate staffing, and clinical efficacy. In this CV business white paper, learn from two programs that have successfully redesigned their procedural staffing model to increase access and provide optimal care for patients with aortic valve disease.
Transcatheter left atrial appendage occlusion (LAAO) procedures have become the standard of care in response to the challenges related to the increased prevalence of atrial fibrillation (AFib). As programs continue to grow and expand their use of LAAO, many have identified areas of opportunity for improvement to ensure appropriate care coordination. In this CV business white paper, learn how four LAAO programs with similar challenges implemented innovative solutions to create efficiencies and nurture growth.
As more organizations realize the value of advanced practice providers (APPs), many continue to be challenged with effective utilization of this care team member. This white paper developed by the MedAxiom Consulting Team based on their first-hand experience working with cardiovascular programs across the country underscores the value of the team-based care model when implemented appropriately. “We have seen the impact on programs where APPs are operating to their fullest capabilities and have outlined recommended implementation steps and a checklist of do’s and don’ts to take into consideration to advance APP utilization.” says Ginger Biesbrock, PA-C, MPH, MPAS, FACC, MedAxiom’s EVP of Care Transformation.
Healthcare leaders can no longer look at access the way they have in the past, especially in a post-COVID-19 environment. Solving the patient access problem for the long term requires more than operational change. Leadership and governance structures that support a culture of access are necessary for success.
Fractional flow reserve derived from CT (FFRCT) is growing in both utilization and importance in the diagnostic pathway for patients with heart disease. As adoption of this technology expands, it is crucial to build a strong collaborative relationship between payers and programs to ensure patient access to new and novel healthcare services. MedAxiom, with support from HeartFlow, outlines how to be your own best advocate for new technology payment.
Heart failure (HF) is not only the leading cause of morbitity and mortality in the U.S., but is also one of the most expensive health conditions to manage. Misdirection of care can cause extended hospital stays and unnecessary treatments. Blood volume analysis (BVA) provides results that can accurately guide total fluid management as clinicians seek to optimize a patient’s total volume status. In this CV business white paper you will find implementation steps and best practices for adding BVA demonstrating notable improvements in patient outcomes.
With rising TAVR volumes, post-TAVR monitoring is receiving heightened attention within the first 30 days after discharge. To better understand the benefits of post-TAVR monitoring, MedAxiom collected feedback from cardiovascular organizations that implemented programs using Philips BioTel Heart Mobile Cardiac Outpatient Telemetry (MCOT®) to improve outcomes. This white paper details reasons for using near-real-time MCOT, best practices for program implementation, and how programs can elevate the standard of care post-TAVR.
Technology plays a major role as cardiovascular programs strive to achieve the Quadruple Aim for better outcomes, lower costs, and improved patient and clinician experience. In part one of a three part CV business white paper series the Heart and Vascular Institute of Wisconsin (HVIW) share their experience with ScImage’s PICOM365 cardiology suite to create an integrated imaging and data platform for their cardiovascular enterprise. Hear how the uniquely designed workflows, vendor-agnostic adaptability, and cost-effective native cloud design allow them to manage advancing imaging modalities, growth and geographic expansion. “To provide the most advanced care possible we have to address every opportunity to improve efficiency in clinical workflows for our providers,” says Larry Sobal, CEO of HVIW.
Careful thought and strategic planning are needed to manage the accelerated shift to ambulatory interventional labs and avoid additional strain on the industry’s efforts to assure intentional, well managed care transitions. In an effort to meet the needs of the growing ambulatory surgical center/office-based lab (ASC/OBL) market, ScImage now offers a game-changing solution: a fully integrated hemodynamic system within the PICOM365 CVIS/CPACS through a partnership with Fysicon (a Canon company). In part two of a three part CV business white paper series three programs share outcomes of using ScImage’s PICOM365 cardiology suite integrated with Fysicon’s QMAPP in their ASC/OBL settings.
Without intentional transitions care is often fragmented, redundant and costly. Patients may experience less than excellent outcomes with delayed decision-making, or be lost to care altogether. Securely connecting health data, images and care planning across broad geographies and care settings is a core need for organizations to achieve a level of integration necessary for these types of intentional care transitions. In part three of this CV business white paper series, Boone Health and Missouri Heart Center share how ScImage’s cloud-based technology provided the foundation to shift to an enterprise approach for truly integrated patient care.
As cardiovascular leaders we strive for a patient-centric model of care that improves access and health. To achieve that we need solutions to bridge the gaps between the data and images used to plan and deliver care across all settings in a diverse continuum of care. This white paper overviews how ScImage’s PICOM365 offers a secure, turnkey, end-to-end cloud-based cardiovascular data and image integration solution where disparate technologies are no longer a barrier to clinical workflows.
Coronary computed tomography angiography (CCTA) techniques have been proven to accurately diagnose the presence or absence of atherosclerotic heart disease. More recently, CCTA derived fractional flow reserve (FFRCT) has been shown to accurately define the physiologic significance of lesions identified on CCTA images. Accordingly, we now have a single non-invasive test that is rapid, accurate, low cost, requires low radiation exposure and answers the key questions needed to effectively manage patients with stable chest pain. This MedAxiom white paper explores opportunities using CCTA and FFRCT and how cardiovascular programs can leverage these technologies to achieve the Quadruple Aim.
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