Advocating for Cardiac Catheter Ablation Services in ASCs

In a recent letter to the Centers for Medicare & Medicaid Services (CMS), the Heart Rhythm Society (HRS) and the American College of Cardiology (ACC) have put forth a compelling case for the inclusion of cardiac catheter ablation services in the Ambulatory Surgical Center (ASC) Covered Procedures List (CPL) for the calendar year (CY) 2025. This advocacy stems from the belief that cardiac catheter ablation procedures, when performed on appropriately selected patients, can be safely and effectively managed in the ASC setting.

Why Cardiac Catheter Ablations Should Be Included in the ASC CPL

Cardiac catheter ablation procedures have increasingly demonstrated their safety and efficacy in the ASC environment, particularly during the COVID-19 pandemic. Many private payors already cover these procedures in ASCs, and the data collected during this period highlights the capability of ASCs to provide high-quality care for these patients. The HRS and ACC emphasize the importance of utilizing registries and quality measures to continuously track outcomes and ensure patient safety.

Data Supporting the Inclusion

A joint workgroup by HRS and ACC conducted a survey to assess the current clinical landscape of ablations in the ASC setting. Key findings include:

1. Increased Same-Day Discharges: A significant shift towards same-day discharge for cardiac catheter ablations.
2. Enhanced Patient Access: Performing these procedures in ASCs addresses patient access issues.
3. Lower Complication Rates: Preliminary analyses indicate lower complication rates for cardiac catheter ablations compared to other cardiac procedures already included in the ASC CPL.

The Economic and Clinical Benefits

Transitioning cardiac catheter ablation services to the ASC setting not only improves patient access but also offers financial benefits. Reduced hospital resource utilization and shortened lengths of stay contribute to cost savings for both patients and the healthcare system at large. These benefits, coupled with the lower complication rates, make a strong case for the inclusion of these procedures in the ASC CPL.

Commitment to Patient Safety

Patient safety remains the paramount concern for HRS and ACC. They advocate for the performance of cardiac catheter ablations in the ASC setting only under stringent safety protocols and with validated procedures for the timely management of any complications. The societies are also preparing to develop guidance documents to further ensure the safe execution of these procedures in ASCs.

A Call to CMS

HRS and ACC are urging CMS to consider adding cardiac catheter ablation codes to the ASC CPL in the CY 2025 Hospital Outpatient Prospective Payment System (OPPS) proposed rulemaking. This inclusion will enable public discourse and gather feedback from various stakeholders, paving the way for improved patient care standards.

The professional societies have also requested a meeting with CMS to discuss this proposal in detail. They are keen to provide further insights and address any questions or concerns CMS may have regarding the inclusion of cardiac catheter ablations in the ASC setting.

Conclusion

The collaborative efforts of HRS and ACC underscore the potential benefits of expanding cardiac catheter ablation services to ASCs. By doing so, CMS can enhance patient access, reduce healthcare costs, and maintain high standards of patient safety. The societies look forward to a positive response from CMS and are ready to engage in further discussions to ensure the successful implementation of this initiative.

You can read the original letter here.