Is your heart clinic ready for reimbursement cuts? Four ways to increase your income

Heart clinics are facing significant financial pressure as providers face reimbursement reductions and new payment models. Particularly for high-value cardiac device clinics and heart rhythm monitoring service lines, two key external threats create a perfect storm:

• economic pressure: Potential cuts to Medicaid and insurance deals are expected to put pressure on traditional revenues.
• flow transition: Cardiovascular surgery is increasingly moving out of hospitals and into private ambulatory surgery centers (ASCs), creating new competition for inpatient arrhythmia surgery and long-term monitoring.

Cardiac device services represent a significant market opportunity for health systems. The market size of cardiac monitoring and rhythm management is expected to grow to US$26.4 billion by 2029 due to the high prevalence of cardiovascular diseases and the increasing popularity of remote monitoring technology for cardiac devices.

However, to remain profitable, these hospital cardiac device clinics must fully understand new reimbursement challenges and work to streamline operations. Four strategies are gaining widespread market adoption: intelligent alert management, revenue integrity and expense capture, diverse services, and text-based patient communications. Here's expert insight on each question.

Strategy 1: Reduce alarm noise to simplify operations

Remote monitoring of cardiac implantable electronic devices (CIEDs) creates significant “noise” that takes up clinicians' time and leads to burnout.

The most effective clinics reduce noise by setting specific, technology-enabled alert rules based on equipment, patient clinical profiles, and clinic-approved protocols. This enables technicians to manage by exception, reducing the time required to assess and respond to inoperable equipment transmissions.

It is also important that leading clinics invest in technology that helps standardize and enforce these alert protocols. This investment sends a clear signal to staff that we are helping you focus on clinical work rather than chasing unactionable spread.

This effort can significantly reduce the number of inoperable remote monitoring transmissions requiring technician intervention, resulting in significant annual cost savings in recovered staff time.

Strategy 2: Automate your billing workflow to get full value

Proper billing is critical to running a cardiac clinic. A recent industry survey of electrophysiologists and interventional cardiologists found that a majority of respondents highlighted “the ability to provide appropriate billing to facility clinics” as a very important competency. The billing rules for these services are complex, and failure to properly bill for CIED monitoring can result in lost revenue.

In practice, staff must track payer-defined monitoring intervals (typically 30 or 90 days) across thousands of patients while coordinating frequent transmissions, office visits, and overlapping programs (e.g., heart failure monitoring at a 30-day cadence with concurrent 90-day device monitoring). Without automation, clinics often miss billing intervals and experience higher denial rates due to late, incomplete, or non-compliant charge postings.

The automatic interval billing method can solve this problem. The system monitors activity against payer requirements throughout the monitoring period and once conditions are met, it automatically generates accurate charges and sends them to the biller. The effect is twofold. First, nurses spend much less time on nonclinical administrative tasks. Second, clinics experience greater billing accuracy and fewer rejections and missed intervals.

This automated approach improves billing accuracy and increases billing intervals per patient while reducing unnecessary transfers.

Strategy 3: Establish a heart failure surveillance program to enhance care and generate revenue

Many clinics are primarily concerned with the underuse of arrhythmia monitoring and CIED heart failure (HF) monitoring. Structured heart failure programs can reduce preventable readmissions by providing early insight into signs of decompensation and promoting timely intervention, particularly during the critical 30 days after discharge. This clinical benefit also increases the economic value of the program at the clinical level.

CIEDs can collect physiological signals related to fluid status and cardiac function. When integrated into formal heart failure programs and workflows, this continuous data flow becomes a separate billable service that can be managed alongside arrhythmia monitoring.

Strategy 4: Close patient care gaps through proactive communication

Consistent patient engagement is critical to effective care. While some patients still need to manually initiate the transfer, even automatic transfer devices can fail. The monitor may go silent or become unplugged, the app may not configure correctly, or the patient may not even know data is being sent.

Simple, proactive communication tools can change the dynamic. Rather than passively waiting for patients to take action, automated text messages create an active partnership, guiding them to submit data on a schedule and increasing the number of fully compliant patients.

In addition to detecting adverse events more quickly, these interactions can verify that devices are functioning properly, an important aspect of safety and ongoing care.

Conclusion: A Proactive Profit Plan

The economic and competitive pressures facing hospital heart clinics have not gone away. Expected cuts to Medicaid (exchange-based insurance coverage) may reduce high-value cardiac clinic revenue in the coming year.

Successful core strategies aim to:

• Intelligently manage remote monitoring data to reduce noise and focus clinical efforts.
• Enable automated billing to reduce denials and get the full value of the care provided.
• Diversify services (e.g. high-frequency monitoring) to improve outcomes and support sustainability.
• Improve patient engagement with automated communications, making the entire journey clearer and less daunting.

Ultimately, these strategies prepare the clinic to refocus on its primary mission. The goal is to eliminate formulaic work through automation and logic, freeing clinicians to perform the high-value clinical work they have been trained to do. Heart clinics that adopt this vision will build a resilient future centered on financial stability and excellence in patient care.

Photo: BrianAJackson, Getty Images

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