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The State of Cardiology | Oral GLP-1’s CV Potential
October 24, 2024
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Together with
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MedAxiom released its 12th annual Cardiovascular Provider Compensation and Production Report, providing an in-depth look at the current state of working in cardiology.
The massive 60-page report (n=5,663 providers, 202 programs, 2023 data) outlined four notable employment trends…
Rising PE Ownership – Nearly 50% of surveyed private practice groups were also part of a private equity portfolio, up from zero a few years ago.
- That’s a big difference from previous research in JAMA that found just 3.9% of cardiology practice locations in the U.S. are under PE ownership (including both private and hospital-integrated locations).
- Despite clearly different methodology, both this MedAxiom report and the previous JAMA study highlighted rapid PE expansions.
Cardiology Pay Increases – For the fourth year in a row, average pay for hospital-integrated cardiologists increased (from $645k to $688k), while private practice cardiologists saw compensation recover after a dip in 2022 (from $588k to $616k ).
- The increase was driven by electrophysiology, invasive, and interventional cardiologists all exceeding $700k in total compensation.
- Compensation for private APPs ($126k) also pulled ahead of integrated APPs ($122k).
Private Interventionalists, Integrated Generalists – Integrated practices employed more generalists and less interventionalists (43% & 29% of total employed physicians), while private practices staffed far more interventionalists than generalists (47% & 29% of physicians).
Advanced Imaging Takes Center Stage – The ratio of advanced imaging exams per cath lab procedure nearly doubled over five years, highlighting increased adoption of imaging before (or instead of) cath procedures.
- This trend was driven by the most imaging-focused groups, as the top 10% of programs performed 119 advanced imaging exams per 1,000 patients, while the bottom 25% performed just five per 1,000 patients.
The Takeaway
While MedAxiom’s annual report provides some assurance that cardiologist pay is rising steadily and advanced imaging adoption is increasing – many in cardiology are surely concerned about what private equity’s rapid expansion might mean for their careers.
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A Better Way to Coordinate Post-Stroke Care
Think your EHR messaging system might be holding back your post-stroke care? See how UC San Diego Medical Center streamlined its neuro and EP teams’ post-stroke workflow with Viz Connect, and the impact it had on cardiac monitor placements in inpatient and outpatient settings.
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Connecting the ECG Monitoring Ecosystem
There’s so much that goes into building the solutions that providers use each week, and that’s definitely true for ECG monitoring. In this Cardiac Wire Show interview with Flipside Media’s president Brad Ummer, we get an insider’s view of what it takes to develop an ECG monitoring solution, including Flipside’s partnership with Monebo Technologies.
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Structured Reporting, Redefined
Ready to realize the benefits of cardiovascular imaging structured reporting? See how Optum’s structured reporting could completely change how clinicians use data, while streamlining the imaging reimbursement process and making it easier to communicate.
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- Oral Semaglutide’s CV Potential: Results from the SOUL trial suggest that oral semaglutide prevents MACE similarly to its injectable sibling. The trial compared Novo Nordisk’s oral semaglutide (Rybelsus) to placebo in diabetic patients, revealing a 14% decrease in MACE risk, coming close to semaglutide injections’ 20%-26% MACE risk reductions. Oral semaglutide also appeared to be safe and well-tolerated. The results were enough to encourage Novo to begin planning Rybelsus’ U.S. and European regulatory filings for CVD risk reduction by early 2025.
- BSCI’s PFA Mapping Approvals: Boston Scientific added several new FDA approvals, allowing it to combine cardiac mapping and therapy delivery in a single catheter for its Farapulse pulsed field ablation system. The approvals eliminate the need for swapping its Farawave Nav probe with the Farapulse ablation platform during AFib PFA procedures by implementing magnetic navigation. The FDA also gave premarket approval for Farawave Nav as well as a 510(k) clearance for the paired Faraview mapping software, which visualizes catheter placement in real time.
- Lp(a)’s Unstable Middle: A study from the UK Biobank reveals that Lipoprotein(a) remains relatively stable for patients with low (<75 nmol/L) and very high (>189 nmol/L) baseline Lp(a) levels, but not for those in the intermediate range (75–189 nmol/L). A notable 31% of patients who initially had intermediate Lp(a) levels saw changes of 25 nmol/L or more during a median of 4.4 years.
- Viatris Licenses Sotagliflozin: Viatris obtained an exclusive license from Lexicon to commercialize its HF drug sotagliflozin outside of the U.S. and Europe. With the agreement, Viatris will pay $25M upfront with tiered royalties for the right to sell sotagliflozin, while Lexicon will provide its clinical and commercial supply at a transfer price. Viatris will also lead all regulatory and commercialization activities globally.
- Predicting MACE with Proteins: RIPK3 proteins could help predict MACE in MI patients receiving PCI, and might even be the cause of cardiac ischemia/reperfusion following acute heart attacks. An AHA study found patients with elevated RIPK3 levels after PCI had poorer short- and long-term outcomes, concluding that RIPK3 plays a role during cardiac I/R injury through the RAGE/CaMKII signaling pathway due to its function as a damage-associated molecule.
- Baroreflex CPT Code: CVRx announced that the AMA accepted a new CPT Category I code (D0266T) for Barostim’s baroreflex activation therapy for heart failure. This follows the increasing prevalence of baroreflex treatment and growing evidence supporting its clinical outcomes. The new code is expected to start January 1, 2026 and will help facilitate reimbursement for healthcare providers while broadening patient access.
- Plaque AI CPT Code: In similar news, HeartFlow announced that the AMA accepted a new Category I CPT code for AI-enabled plaque quantification (75XX6). The new code comes as an extension of a Category III code previously granted in 2021. In parallel, CMS will establish RVUs for Plaque Analysis. The new CPT codes come as expected, noting that four Medicare Administrative Contractors supported coverage for plaque AI just a few weeks ago.
- Predictive PREVENT Equations: A validation study of the PREVENT equations, developed by the AHA late last year, demonstrated their ability to accurately predict 10-year CVD mortality risks. Among 173M participants from the NHANES survey, a 1% increase in PREVENT estimates was closely associated with increased CVD mortality risk (HR: 1.09). The PREVENT scores also performed better than the AHA’s Pooled Cohort Equations from 2013.
- Generic Entresto Coming Soon? In a win for affordable HF drugs and a setback for Novartis, the Swiss pharma giant lost its bid to keep a generic version of Entresto out of the U.S. A federal district judge ruled that the FDA did not overstep by approving MSN’s generic of Entresto, despite slight differences between the drugs. However, MSN remains barred from launching its generic while Novartis appeals an earlier patent infringement case.
- PFO Closure Cutoffs: It might be time to rethink the age cutoffs for PFO closure. A study of more than 700 patients found no differences in the risk of recurrent stroke or complications in patients under-60 and between 60 and 84 years old. This remained true even when considering that the 60-plus patients were also more likely to have hypertension, diabetes, and be smokers.
- How is the FDA Regulating AI? If that question is keeping you up at night, a JAMA article co-authored by FDA Commissioner Dr. Robert Califf has you covered. The piece outlines the agency’s approach to monitoring the skyrocketing number of FDA-approved AI medical devices, noting that the “scale of effort” needed to evaluate these models “could be beyond any current regulatory scheme.” The FDA plans to play a key role in overseeing the technology, but called on the industry to “ramp up assessment and quality management of AI.”
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TeraRecon’s Mitral Valve Workflow
Are your mitral valve planning workflows ready for higher procedure volumes? Take this step-by-step tour of TeraRecon’s Mitral Valve Workflow to see how it gives imagers the tools to evaluate the mitral valve and support TMVR treatment planning.
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Experience the Future of Learning: Medtronic Academy 2.0 is Here!
Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!
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The First Step to Coronary Artery Disease Diagnosis
HeartFlow’s new RoadMap Analysis solution allows CT readers to accurately, efficiently, and consistently identify stenoses in the coronary arteries. See how RoadMap Analysis’ visual and quantitative insights into the narrowing of all major coronary arteries helps readers evaluate coronary CT angiograms before determining the need for an FFRCT.
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- Identify and Treat Cardiovascular Disease: Complex care pathways make getting patients to the next step a challenge. See how Tempus Next, an AI enabled care pathway platform, helps providers identify and reduce under treatment in cardiovascular disease by adding an intelligent layer onto their routinely generated EHR data.
- PIA’s Post-Processing Solution: Advanced cardiac imaging often calls for a time-consuming post-processing step, requiring costly software, hardware, and training. See how PIA provides this post-processing at lower cost, improved consistency, and greater efficiency.
- AI-Driven Novice Heart Failure Screening: We hear a lot about AI’s potential to expand echocardiography to far more users and clinical settings, and a study using Us2.ai’s AI-automated echo analysis and reporting solution showed that echo AI might make novice-led heart failure screening possible.
- Merge and Duly Health Streamline Cardiology Reporting: Over the last 10 years, Dr. Sujith Kalathiveetil of Duly Health and Care has seen a significant evolution in cardiovascular imaging and experienced a similar evolution with Merge’s cardiology solutions. See how Merge Cardio has helped make cardiology reporting more consistent, accurate, and easier to obtain for Dr. Kalathiveetil and his colleagues.
- Redefining Percutaneous Coronary Intervention: Learn about the AGENT™ Drug-Coated Balloon from Boston Scientific and how this technology is expanding the treatment options for patients with in-stent restenosis in the U.S. Rx only. (Sponsored by Boston Scientific)
- A Single Cardiac Service Line Platform: Transitioning across multiple imaging platforms is a daily reality for many cardiologists, but it doesn’t have to be. See how three leading cardiac imagers are leveraging Circle CVI’s unified multi-modal software across their diverse caseloads, without switching to other platforms.
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