Paul Slobodian, Board Member of the John Locke Foundation

Cardiology Business

Atria’s Independent Cardiology Play 

With 85% of cardiologists now employed by health systems, it may seem like the days of independent cardiology practice are long gone, but Atria Health is looking to reverse this trend with the help of a unique private equity model.

• The shift towards corporate and hospital-owned cardiology groups stems from a long list of factors like falling reimbursements, rising costs, and partners who want an exit.
• However, many cardiologists aren’t happy with their hospital employment and might be more likely to look for a partner to help their shift towards “independent” practice.

This is the niche Atria aims to fill, with their new business model seeking out cardiologists in hospital-owned groups (10-15 docs and up) who are looking to go independent.

• As part of the model, Atria uses PE to help carve out and fund the new cardiology practices while ensuring the docs keep at least 40% ownership, and keep getting paid until their practices get off the ground.
• Atria’s money also goes into the tech and infrastructure needed for high-ROI assets like cardiac imaging, cath labs, and EP labs.
• Because it builds these practices from scratch, Atria avoids tech debt and the hurdles of integrating different acquired practices.

That sounds like a pretty good deal for the docs, but it’s still a PE partnership, and Atria also makes it clear that the physicians can’t sell the practice once it’s established.

• Instead, Atria acts as a financial backstop to get physicians out from under their hospital employers and then takes about half of the profits.

But it’s not open season for Atria, as the company will have to compete with traditional PE and other practice growth-supporting companies like CardioOne.

• Atria differs from typical PE models by its focus on hospital-employed groups, and its shared ownership strategy .
• Perhaps most of all, Atria will have to overcome many physicians’ negative perceptions of PE. 

The Takeaway

Whether or not Atria will succeed depends on outcomes for both physicians and patients. If the docs are happier and the patients are healthier, then Atria’s alternative private equity model that invests in – but does not completely own – independent practices could be a viable way forward.

Vista.ai’s Cardiac MRI Case Studies

It’s easy to claim AI improves Cardiac MRI workflows, but it’s a lot harder to back those claims up. Tune in to these discussions with imaging experts to see how Vista Cardiac lives up to its promise of faster, more consistent, and reliable CMR scans.

Merge Still Best in KLAS

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Discover Innovation in Intervention

Explore how the AGENT™ Drug-Coated Balloon from Boston Scientific is advancing U.S.-based treatment options for patients with coronary artery disease. Rx Only. (Sponsored by Boston Scientific)

The Wire

• Genes for SCD/MVA Risk? One JAMA study suggests people carrying filamin C truncating gene variants (FLNCtv) could be at greater risk of sudden cardiac death and major ventricular arrhythmias. Among 308 individuals studied, those carrying FLNCtv had a higher risk of arrhythmia, leading researchers to develop a model for estimating SCD/MVA risk. The model achieved an AUC ranging between 0.76 at 12 months and 0.78 at 72 months of follow-up, and researchers now advise keeping an eye out for FLNCtv as a cardiac risk factor.

• Are The Biceps Worth It? It’s known that anabolic androgenic steroids can lead to increased CVD and mortality risks, but there aren’t many studies exploring the drugs’ true epidemiology. One study examined 1.2k steroid users and found that they led to an increased risk of acute MI (aHR: 3.00), PCI/CABG (2.95), VTE (2.42), arrhythmias (2.26), cardiomyopathy (8.90), and HF (3.63) over an 11-year average follow up. The kicker? Even though steroids help build muscle, the most important muscle (the heart) only gets weaker.

• Swell Results for WhiteSwell: ADHF treatment developer WhiteSwell announced positive data from its DELTA-HF trial evaluating its minimally invasive, catheter-based WhiteSwell eLym System for removing excess fluid. The device was deployed in 21 patients and led to a mean weight loss of -10.7 lbs, with every patient losing weight and experiencing a reduction of peripheral edema and orthopnea. At 90 days after discharge, 9.5% of patients were rehospitalized for HF and there were no deaths.

• The DanGers of mAFP: Microaxial flow pump (mAFP) treatment using the Impella CP may not be the best option for older STEMI and cardiogenic shock patients. A secondary analysis of the DanGer Shock trial uncovered that patients over 77 years experienced a much higher 180-day mortality risk than those under 77 when receiving mAFP therapy (OR: 1.52 vs. 0.45). Complications were also more frequent in the mAFP group, but there were no differences in incidence rates across all ages.

• Prenuvo Bolsters Series B: Whole-body MRI screening startup Prenuvo quietly raised $120M in Series B fundraising to add new modalities to its offering, including a notable expansion into cardiovascular health. The fresh funds will go to adding AI-powered whole-body composition analysis, a brain health scan, and a blood bio-marker assessment that provide insights into metabolic and cardiovascular health among other metrics.

• Acoramidis’ European Authorization: BridgeBio Pharma received marketing authorization in the E.U. for its ATTR-CM treatment, acoramidis (BEYONTTRA). The approval is based on positive results from the Phase 3 ATTRibute-CM study, in which acoramidis led to a 42% reduction in composite ACM and recurrent CVH events compared to placebo at month 30. Pharma giant Bayer will be responsible for launching acoramidis in Europe, while BridgeBio is handling acoramidis’ U.S. distribution (FDA approved as Attruby in November 2024).

• Lung CT Scans Find Heart Disease: Patients getting CT scans for lung cancer also have detectable signs of cardiovascular disease. In 276 lung cancer patients getting staging CT scans, researchers found 78% had detectable atherosclerosis, as well as elevated rates of systolic and diastolic blood pressure. Patients in the study group had high risk factors for heart disease, including obesity (27%) and smoking status (89%). The study suggests that cardiovascular tests like coronary artery calcium scoring could be added to CT lung screening exams.

• Cellphones & Bad Blood: A new Frontiers in Cardiovascular Medicine study raises fresh concerns about the impact of cell phones on blood circulation. Researchers from the Environmental Health Trust found that holding a cell phone next to the body for just five minutes can cause red blood cells to stick to one another (rouleaux formation) which could potentially impact blood circulation. While that sounds frightening, it’s worth mentioning the researchers studied only one 62-year-old woman and still have a long way to go statistically before they can prove causality. 

• Viz.ai Improves PFO Referrals: Data analysis suggests that Viz.ai’s PFO module could help improve referral rates for patients with patent foramen ovale. Researchers compared data from before the Viz.ai PFO module (Dec. 2022–Nov. 2023) to after its implementation (Nov. 2023–Jun. 2024) and found that it led to a 492% PFO referral increase (11 vs. 38.65 per year). This referral increase led to 186% more PFO closures (6 vs. 10.17 per year), but that increase wasn’t statistically significant because the study was too small.

• SMCs for Neovascularization: Although cell therapy has the potential to promote neovascularization, it’s mostly limited to capillaries, yet new research suggests layering smooth muscle cells (SMCs) could be the answer. By combining myocardin and all-trans retinoic acid, researchers were able to reprogram human fibroblasts into contractile and functional SMCs. These new SMCs proved effective at vascular repair and contributed to neovascularization, representing a new source of cell-based therapy and research.

• AI Screening for Trials: Clinical trial enrollment could get easier thanks to AI’s ability to rapidly screen patients for their fit in potential studies. A recent JAMA study randomized 4.5k patients to be either screened manually or using AI for the COPILOT-HF trial and found that the AI-assisted screening process was far more efficient, screening 458 eligible patients compared to the 284 patients screened by study staff. This screening difference resulted in 35 patients enrolling from the AI group compared to 19 in the manual group.

Making Cardiovascular Data Work for You

Today, cloud-native analytics can automate data acquisition and synthesize complex data. Discover what Optum’s technology can do to facilitate future advancements in cardiovascular data and analytics.

Partnerships That Produce Results

Find out how Monebo can help you develop algorithms that meet your specific ECG analysis needs using its Kinetic Family of ECG Algorithms that scale for use in devices utilizing small microcontrollers or DSP’s, all the way up to PC or server-based platforms.

Cardiology AI: From Research to Clinical Practice

Explore how AI algorithms are reshaping cardiology with insights from Tempus’ recent webinar, featuring Dr. David Ouyang of UCLA and Cedars-Sinai, alongside Tempus’ Dr. John Pfeifer and Dr. Brandon Fornwalt. This expert panel dives into how AI can bridge diagnostic gaps, enhance patient outcomes, and streamline workflows for conditions like AFib and pulmonary hypertension. Read the full recap to glimpse the future of AI-driven cardiology.

The Resource Wire

• PIA Medical Processes It All: Need an analysis like calcium scoring, strain or even FFR? PIA Medical began as a Core Lab and can handle creative cardiac research and clinical trials along with the full breadth of clinical analyses available today.

• A New Era of Precision and Efficiency: Ready to enhance your cardiovascular imaging precision and efficiency? See how Circle Cardiovascular Imaging’s new cvi42 6.1 platform is bringing CT and MR imaging under a single platform.

• Configure Your PCI Study: See for yourself how cardiac imagers use GE HealthCare’s Centricity Cardio Enterprise Universal Viewer to do their PCI studies, including configurable viewport setup and side-by-side comparisons.

• AI Analysis of ATTR-CM: ATTR-CM is a progressive and fatal cardiomyopathy with a rising number of diagnoses and a highly variable clinical course. See how Us2.ai’s fully automated machine learning algorithm analyzes echocardiographic DICOM images without human interaction to improve tracking ATTR-CM progression and treatment responses.

• Plaque Analysis Now Covered by Medicare: HeartFlow’s Plaque Analysis is now reimbursable thanks to Medicare’s new coverage for AI-enabled plaque analysis of eligible patients with coronary artery disease.

• Explore Vitrea Advanced Visualization: Discover Canon Medical Healthcare IT’s suite of advanced imaging workflows designed to increase efficiency in cardiovascular imaging, and facilitate the assessment, diagnosis, and treatment of cardiovascular diseases. These cutting-edge tools support the delivery of faster, more accurate care while integrating seamlessly into clinical workflow

• 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.

• 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!

• Predicting Coronary Events With Plaque Analysis: How can measuring non-calcified plaque burden change how we detect heart disease? Tune-in to Cleerly’s on-demand webinar featuring Sarah Bär, MD, PhD to discover how Cleerly’s AI-powered coronary CTA plaque analysis is reshaping CAD risk prediction, beyond standard tests.

The Industry Wire

1. RFK Jr. confirmed as HHS secretary.
2. HHS to dismiss 5.2k probationary workers. 
3. Texas measles outbreak doubles to 48 cases.
4. Colorado removes 500k people from Medicaid. 
5. States mull Medicaid work requirements.
6. Eating yogurt may reduce colon cancer risk. 
7. Federal layoffs target Indian Health Service.
8. Aetna costs weigh down CVS profit. 
9. Ambulatory focus helps Tenet in 2024.
10. Healthcare firms sending profits to shareholders.