This month, Vascular Specialist launches its newest column, The Outpatient, which seeks to cover issues near and dear to the hearts of vascular surgeons practicing in outpatient settings such as office-based labs (OBLs) and ambulatory surgery centers (ASCs). Here, in the inaugural edition, Robert Molnar, MD, and Anil Hingorani, MD— two key figures behind the creation of the newly launched Society for Vascular Surgery (SVS) Section on Ambulatory Vascular Care (SAVC)— detail the column’s aims and objectives.
Welcome to the first article in a series intended to help you and your practice achieve enhanced success in delivering high quality outpatient vascular care. This is also an introduction to SAVC, formed by combining the SVS Community Practice Section (CPS) and the Section on Outpatient and Office Vascular Care (SOOVC). SAVC will leverage the collective knowledge, resources and expertise of vascular surgeons providing outpatient care to foster innovation, education, research and high quality care. Unifying the CPS and SOOVC will strengthen those vascular surgeons performing outpatient procedures in their ability to network, mentor upcoming vascular surgeons, and advocate for their practice, their patients and their communities—and, very significantly, for themselves.
It is clear that the majority of invasive vascular procedures has shifted to the outpatient arena. There are more than 1,300 OBLs and nearly 5,000 ASCs in the U.S. Nearly 80% of peripheral vascular intervention (PVI) cases are appropriately provided—and nearly 60% of these cases are currently being performed—in these sites of service. As compared to the hospital outpatient setting, OBLs and ASCs provide significant value to the payer system, as the reimbursement rates are much less than the Hospital Outpatient Prospective Payment System (HOPPS). In addition, patient satisfaction outside of the hospital setting is extremely high. Regardless of the site of service, all vascular surgeons—whether private practice, community practice, academic affiliated/employed—are being significantly harmed by the inadequate reimbursements for providing these needed services. As we have recognized the significant cuts to our reimbursements and the inefficiencies we are forced to accept in the hospital outpatient space, we need to advocate for ourselves, our patients and our communities. As the leaders in the delivery of expert, quality and high value vascular care, we need to leverage our collective strength in advocating for our patients and our communities.
The headwinds have been—and will continue to be—significant for the foreseeable future. However, the pendulum will begin to swing in our favor once the ill-intended consequences of payor and regulator decisions lead to limited access to care, increased costs due to hospital inefficiencies, and patient dissatisfaction. To combat these headwinds, we need to engage with each other, continue to advocate on our behalf, and share common problems and lessons learned with each other.
By bringing the CPS and SOOVC under SAVC, we will continue to promote the community practice surgeon and outpatient vascular care in the OBL and ASC settings. Specifically, we will continue to hold educational sessions at the Vascular Annual Meeting (VAM), webinars, and offer guidance in print within Vascular Specialist. We are striving to enhance all of these offerings, but we need your engagement to move the needle.
One of the projects that we continue to work on is the OBL Handbook, which is meant to help our community to open and maintain their practices by establishing and excelling in providing quality, cost-effective and needed vascular care. We certainly recognize the fluctuating reimbursements in the outpatient site of service and want to capitalize on opportunities to appropriately enhance your revenue streams by networking with those who have led the way in developing effective and highly productive practice developments.
In addition, we continue to recognize leaders in community practice with the SVS Excellence in Community Practice Award, the SAVC Presentation Award and the SAVC Research Seed Grant awards. We continue to promote the goals of the members of our section with representation from the SVS Coding Committee, the SVS/American College of Surgeons (ACS) Vascular Verification Program (Vascular-VP) and the Postgraduate Education Committee. These are just some of the projects that we have and continue to work on to help vascular surgeons across the spectrum of our various vascular surgery practice types. We are currently engaged in ways to enhance practice revenue, given the significant cuts we have experienced for the care we provide. By engaging each and every vascular surgeon, we can promote the advocacy we deserve and share successful practice development tools and opportunities. We aim to appropriately enhance the reimbursements that each of you so significantly deserve to protect your practice and to continue to secure the finances needed to enable your continued success. We hope to enable you to compete on a level playing field through the newly launched vascular branding campaign and provide you with the marketing opportunities and SVS outreach that has been established to boost your recognition.
Therefore, if you are not currently a member, please join your colleagues in SAVC at [email protected] to leverage our strength in protecting all of our futures. We need engagement, ideas and a forum to share opportunities in order to strengthen your practice.
ANIL HINGORANI is chair of SAVC, having previously held the role of chair of the SOOVC Steering Committee. ROBERT MOLNAR chaired the CPS Steering Committee.
