Number of cardiologists jumping to hospital practice doubles: Study

Between 2008 and 2019, the share of cardiologists practicing in a hospital, as opposed to an independent practice, increased from 26% to 63%, according to a study published Nov. 15 in the Journal of the American College of Cardiology.

Researchers from Washington-based George Washington University, University of Colorado in Aurora, Chicago-based Northwestern University and New York City-based Weill Cornell Medical College used Medicare data to assess the shift in cardiologists moving to hospital-based practices between 2008 and 2019, and how that shift affected patient outcomes and care quality.

Here are two things to know from the study:

1. During the study period, 186,052 acute myocardial infarction and 259,849 heart failure patients were cared for by cardiologists who shifted to a hospital-based practice, while 168,052 acute myocardial infarction and 245,769 heart failure patients were cared for by independent cardiologists.
   
   
2. The study found no significant difference in outcomes and only a small increase in the rate of 30-day follow-ups with heart failure patients among hospital cardiologists. 

Daniel Blumenthal, MD, and John Hsu, MD, explored these findings in an editorial published Nov. 15 in the Journal of the American College of Cardiology, "Understanding The Impact of Vertical Integration on Cardiovascular Care Quality: A Complex and Worthwhile Endeavor."

Dr. Blumenthal is a cardiologist at Boston-based Massachusetts General Hospital and the chief quality and research officer for Cardiovascular Associates of America. Dr. Hsu is director of the Program for Clinical Economics and Policy Analysis at Boston-based Harvard Medical School's Mongan Institute for Health Policy and associate professor of medicine at Massachusetts General Hospital.

Here are three takeaways from their commentary:

1. The shift of cardiologists from independent to hospital based practice is partly due to declining fee-for-service reimbursement, increasing administrative complexity, overhead costs and access to resources for new equipment and technologies.
   
   
2. Hiring cardiologists bolsters a hospital's market competitiveness and helps secure referral lines while improving the quality of care and the hospital's bargaining position with payers.
   
   
3. The authors suggest further investigation into how hospital-based versus independent practice care influences patient choice or benefits specific patient populations.