Ep. 46 Cardiology Procedures and Ambulatory Surgery Centers: Key Insights with Dr. Fadi Saab
BackTable CardiologyShow Notes
What are the real-world challenges and rewards of running an ambulatory surgery center (ASC)? On this episode of BackTable Cardiology, host Dr. Hady Lichaa interviews Dr. Fadi Saab about his transition from an outpatient-based lab (OBL) to an ASC, focusing on business, regulatory, and clinical considerations that go beyond procedural technique. They discuss how rising healthcare costs are driving ASC expansion, the benefits of improved patient experience, efficiency, convenience, and physician autonomy, as well as concerns about private equity influence and systemic pressures to shift cases out of hospitals.
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Timestamps00:00 - Introduction 03:10 - Why ASCs Are Expanding 05:36 - Autonomy, Efficiency, and Key Concerns10:43 - Ensuring Safety and Outcomes14:07 - OEIS Registry and Certification17:02 - Managing Complications and Transfers22:36 - EP Procedures in the Outpatient Setting 27:09 - OBLs Under Pressure34:43 - Reimbursement Challenges and Burnout39:22 - Business Skills and Consultants44:07 - Income Reality and Partnerships50:12 - Reflection on the Transition55:46 - Closing Thoughts and Advice
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More about this episodeDr. Saab outlines critical safety oversight measures including state regulations, registry reporting, transfer agreements, ACLS-trained teams, and peer review. He shares data showing that PCI outcomes in ASCs are comparable to those in outpatient hospitals, and reviews the expansion of electrophysiology procedures into ASCs enabled by CMS codes. The conversation highlights infrastructure needs, differences in OBL versus ASC reimbursement, and the importance of hiring experienced leaders and consultants. Dr. Saab provides practical advice on partnering with like-minded physicians, understanding Stark and anti-kickback rules, and setting realistic expectations for profitability, which may take 18 to 30 months. The episode closes with reflections on mentorship, operational excellence, and how ASCs are adapting to the changing landscape of cardiovascular care.
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ResourcesInterventional Cardiologists' Perspectives on Percutaneous Coronary Intervention at Ambulatory Surgical Centershttps://pubmed.ncbi.nlm.nih.gov/41088884/
Administrative Expenses In The US Health Care System https://jamanetwork.com/journals/jama/fullarticle/2785479#google_vignette
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