Skip to content


Clinical Innovation

CABG surgery volumes continue to show year to year declines; if your program is experiencing low or declining volumes, what are your options?

CFA uses an analytics generated profile that helps senior leaders make more informed decisions regarding a strategy that best fits your facility goals and community needs.



Service Delivery

Revenue Growth

The Continuing Challenges To The Cardiovascular Service Line

Hospitals and physicians responsible for the ongoing success of the Cardiovascular Service Line will need to address a set of critical issues and overarching strategic choices driven by major trends.  These include:

  • As technology advances, the continuing rapid conversion of inpatient/invasive procedures with outpatient/non-invasive and outpatient interventional procedures.
  • The rise of competing facilities within a market region, specifically the multispecialty and/or cardiovascular-specific ambulatory surgery center, with the potential for a given hospital to suddenly lose a significant portion of its elective/outpatient and “free-market” cardiovascular business.
  • The continuing decline of cardiac surgery volume, raising the need to consider alternative scenarios of growth, divestiture or consolidation.
  • The ongoing conversion of a growing proportion of cardiac valve repair/replacement surgeries with catheter-based interventional approaches and, over time, the shift of transcatheter valve procedures to higher volume, more specialized regional providers given regulatory minimum volumes and quality standards.
  • A gradual but inescapable increase in the percentage of patients who are clinically complex, requiring additional resources, increased staff training and skill levels, facilities and equipment, thus challenging operational efficiency, clinical outcomes and costs-per-case.
  • The increasing clinical complexity of cardiovascular patients also drives the need for cardiovascular programs to continuously strive for achieving excellence in the provision of clinical services.  This is an increasingly important differentiation strategy and may be a key to long term survival of one’s program.
  • Continuing need to invest in new technology, equipment, facilities and staff training driven by both advances in clinical medicine, addition of new programs and services, and the need for competitive positioning.
  • Increasing competition for physician and supportive clinical staff and the economic and operational consequences thereof. 
  • The overall question of hospital and physician alignment, and an increase in both interdependence and competition among cardiovascular physicians in and between sub-specialty areas – both employed and non-employed – for both patients and resources.

Underlying all of the above strategic issues lies the continuing need for the CV Service Line to continue to develop and refine its program and service offerings in an increasingly value-drive marketplace.  A marketplace where operational efficiency, staffing challenges, cost-per-case reduction, bundled pricing, adaptation of best practices, achieving and maintaining technological parity, and attaining high quality outcomes, remains paramount for continuing success.

For more than 25-years, CFA has exclusively provided innovative, value-based cardiovascular consulting and management services for its clients – hospitals, health systems, physicians, medical groups, vendors and industry – nationally and internationally.

CFA has broad and deep experience in all aspects of cardiovascular consulting, from identifying and clarifying strategic alternatives (“What can and should we do?”), to identifying and successfully addressing marketplace opportunities/threats, and achieving operational efficiency and effectiveness (“How do we make it happen?”).

Low Volume Cardiovascular service line whitepaper download