Four new revenue streams for cardiologists

Operating a financially successful practice requires a daily focus on operational concerns, but it also necessitates seeking new opportunities for revenue streams. Many cardiologists overlook opportunities to offer ancillary services that will boost practice income.

Here are four revenue streams that could increase efficiency, referrals, and patient volume, while improving patient care and satisfaction across the board. As the market moves toward value-based services, these are worth considering:

1. Cardiac rehabilitation clinic

After a cardiac event, many patients are hesitant, even fearful, of exercising. Consider establishing a cardiac rehabilitation clinic where patients can safely work out, raise their heart rates, and improve physical function all under the supervision of a trusted doctor.

To qualify as a rehabilitation clinic, Medicare requires the program to include a medical evaluation and a comprehensive program that helps modify cardiac risk factors. Exercise and nutrition counseling and overall lifestyle education are critical components. You might also offer blood pressure and stress management, lipid management, and a smoking cessation program. While CMS provides reimbursement for up to 36 sessions, a self-pay maintenance program that continues after reimbursed services end could be especially profitable.

There are some costs to consider, however. A physician must be on the premises, so it’s critical to find space within your building. You’ll also need to hire an exercise physiologist and a medical professional who can provide education. While it’s a great way to stay connected with your patient base, it’s also a place where patients will be comfortable and feel a sense of camaraderie with other patients while they improve their health and reduce risk factors.

2. Device services

With more than 180,000 new pacemakers and defibrillators implanted every year, adding a maintenance service might serve you well. Pacemakers should be tested every three months, and batteries only last between six and ten years. Based on the size of your practice, an in-house service might make financial sense and contribute to the caliber of your overall patient care. It would allow you to follow your patients as you check for battery depletion, pulse generator malfunction, lead malfunction, and pacemaker pocket erosion. Between in-home monitoring, interpretation, and office visits, the revenue can add up quickly. With a large patient population, an extension of your device services could include group education and support for patients and families.

3. Chronic care management

While not exactly new, recent changes in the Physician Fee Schedule make it much easier for physicians to provide CCM services to their Medicare patients. Easier enrollment into the CCM program, the elimination of face-to-face visits for existing patients, no longer requiring separate consent forms, and additional reimbursement for time beyond the standard 20 minutes makes it much more financially attractive. The creation of a care plan will also boost reimbursement as will the treatment of moderate and high complexity patients.

The goal is better care coordination, the results of which have been well documented. But, the challenge is how to execute and operationalize this method of patient management. Several third-party vendors provide automated CCM programs that can help physicians manage their chronic care patients in a way that easily and successfully captures the maximum reimbursement.

4. Medication adherence program

With approximately 50% of all prescriptions not taken as directed and 25% of which are never picked up from the pharmacy, medication adherence is a significant problem in our healthcare system. If physicians had the opportunity to dispense the initial pack of medication at the point-of-care, it would not only increase compliance, but it would also generate an additional revenue stream. The program does not add any cost to the practice, or the healthcare system, and can be easily integrated into your current office workflow. By leveraging the physician-patient relationship, patients would be better educated on the need for medication adherence, and it would simplify the prescription process.

A medical adherence solution could also be tied to more effective chronic care management. CCM patients take multiple pills at different times of the day, and in a different order, so smartly designed, calendarized, compliance packaging or a simple conversation with a familiar and trusted CCM professional could easily prevent a mix-up–or a potential catastrophe. In the end, a medication adherence program could allow you to provide complete care and better outcomes, both that contribute to the greater satisfaction of your patients.

Making a wise choice

While additional revenue streams are attractive, you should evaluate each opportunity carefully and with proper consideration. Look for services that will best serve the size of your practice and the needs of your patients. Determine the cost of implementation and the potential to differentiate your practice, increase your reach, and attract new patients. Making an informed and educated choice to add additional services could be one of the most important business decisions you make.


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