Service Line Focus: Cardiovascular Care

Increasing demand is making it difficult for provider systems’ cardiovascular service lines to maintain access for patients across the care continuum. Growth is fueled not only by the aging of the population but also a concerning rise in disease onset and acute events in patients younger than 45. Here at the start of 2025, a couple of areas have bubbled to the top of systems’ CV priority lists.

Valve Procedures

Capacity is emerging as the defining challenge of the next decade for heart valve disease management. Access to transcatheter aortic valve replacement (TAVR) in particular is strained due to novel interventions for mitral, pulmonic and tricuspid disease. And demand for valve procedures is projected to increase significantly over the next several years, with transcatheter interventions like TAVR making up the vast majority of total volumes.

TAVR has emerged as the preferred choice for many patients over traditional open-heart surgery. It requires specialized teams, hybrid operating rooms and cath labs, and careful post-procedural monitoring. Systems cite numerous issues driving capacity constraints for this intervention: organizational barriers in physician hiring, difficulty retaining structural heart teams, space constraints, inconsistent access to pre-procedure workup, and complexity coordinating the required skills and clinicians across specialties (eg, radiology, anesthesiology).

To counter that, some service line leaders underscore the need for health systems to rethink how they deploy their cardiovascular resources. It’s not just about performing more TAVR procedures, but about optimizing the entire care pathway, from pre-op planning to post-op care. Expansion of physical infrastructure, staffing models and enhanced scheduling systems will be crucial for success.

Strategic Imperative: Competition will be fierce among CV service lines for transcatheter valve procedures. To meet demand without sacrificing quality, systems must begin now to assess current capacity and prepare to scale both their clinical and operational infrastructure.

For more strategic insight on this topic, Sg2 members can access our heart valve disease subspecialty guide.

Congestive Heart Failure

Already the top cause of hospitalization among Americans aged 65+, congestive heart failure (CHF) will see strong growth in demand over the next decade, according to Sg2’s 2024 Impact of Change Forecast.

Those rising volumes and increased patient complexity have driven numerous Sg2 members to adopt a more proactive, systemwide approach to how they manage this condition. That includes several notable shifts:

• Emergency Department Triage: Early discharge pathways is enabling successful outpatient management for CHF patients who traditionally would have been admitted.
• Virtual Care Models: Guideline-directed medical therapy is now incorporated into virtual consultations. That enables systems to deploy personalized, tech-enabled care at scale.

Eschewing reactive, inpatient-heavy care requires a fundamental shift in mindset and scalable outpatient care pathways. Success will not only curtail potentially avoidable admissions but ensure patients receive the most cost-effective, convenient care possible.

Sg2 members can access our CHF subspecialty guide for in-depth strategies to transform their CHF care delivery model.

Smart Growth requires service lines optimally configured to compete effectively for clinical demand. Sg2 offers members in-depth strategic guidance in numerous service lines: Behavioral Health, Cancer, CV, Medicine, Neurosciences, Orthopedics, Surgery and Women’s Health. Not a member, reach out to us at learnmore@sg2.com for information on the expert intelligence, data-driven insights and strategic perspective Sg2 offers to health systems nationwide.