Immense economic pressure is mounting on cardiac clinics as providers face shrinking reimbursements and new payment models. Particularly for high-value cardiac device clinics and rhythm monitoring service lines, two key external threats create a perfect storm:
- Economic Pressures: Potential Medicaid and insurance exchange cutbacks are predicted to strain traditional revenue.
- The Ambulatory Shift: Cardiovascular procedures are increasingly moving from hospitals to private ambulatory surgery centers (ASCs), creating new competition for inpatient-based cardiac arrhythmia procedures and long-term monitoring.
Cardiac device services represent a critical market opportunity for health systems. The sector for cardiac monitoring and cardiac rhythm management is projected to grow to $26.4 billion by 2029, driven by the high prevalence of cardiovascular diseases and the increasing adoption of cardiac device remote monitoring technologies.
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However, to remain profitable these hospital-based cardiac device clinics must stay well-informed of new reimbursement challenges and work to streamline their operations. Four strategies are gaining significant market adoption: intelligent alert management, revenue integrity and charge capture, diversified services, and text-based patient communications. Here are expert insights on each.
Strategy 1: Reduce alert noise to streamline operations
Remote monitoring of cardiac implantable electronic devices (CIEDs) can produce significant “noise,” which takes up clinician time and contributes to burnout.
The most effective clinics reduce that noise by setting up specific, tech-enabled alert rules based on the device, the patient’s clinical profile, and clinic-approved protocol. This allows technicians to manage by exception, which reduces the time needed to assess and respond to non-actionable device transmissions.
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Equally important, leading clinics invest in technology that helps standardize and enforce these alert protocols. This investment sends a clear signal to staff that we’re equipping you to focus on clinical work, not chasing non-actionable transmissions.
This effort can significantly reduce the number of non-actionable remote monitoring transmissions requiring technician intervention, resulting in substantial annualized cost savings from recovered staff time.
Strategy 2: Automate billing workflows to capture full value
Proper billing is critical for cardiac clinic operations. A recent industry survey of electrophysiologists and interventional cardiologists found that the majority of respondents highlighted the ‘ability to facilitate appropriate billing for the device clinic’ as a very important capability. The billing rules for these services are complex, and failure to properly bill for CIED monitoring leads to missed revenue.
In practice, staff must track payer-defined monitoring intervals — often 30 or 90 days — across thousands of patients while reconciling frequent transmissions, in-office visits, and overlapping programs (e.g., heart-failure monitoring on a 30-day cadence alongside 90-day device monitoring). Without automation, clinics routinely miss billable intervals and see higher denial rates because charges are posted late, incomplete, or out of compliance.
An automated interval‑billing approach resolves this. The system monitors activity against payer requirements and throughout the monitoring period, and once conditions are met, it automatically generates accurate charges and routes them to billing. The effect is twofold. First, nurses spend far less time on nonclinical administrative work. Second, clinics see higher billing accuracy with fewer denials and missed intervals.
This automated approach improves billing accuracy and increases billable intervals per patient, while reducing unnecessary transmissions.
Strategy 3: Build a heart-failure monitoring program to enhance care and realize revenue
Many clinics primarily focus on arrhythmia monitoring and underuse CIED-enabled heart failure (HF) monitoring. Structured HF programs decrease preventable readmissions, especially in the critical 30-day period after discharge, by providing earlier insights into signs of decompensation and facilitating timely intervention. This clinical benefit also enhances the program’s economic value at the clinic level.
CIEDs can gather physiologic signals related to fluid status and heart function. When integrated into a formal HF program and workflow, this continuous data stream becomes a separate, billable service that can be managed alongside arrhythmia monitoring.
Strategy 4: Close patient care gaps with proactive communication
Consistent patient engagement is essential for effective care. While some patients still need to manually initiate transmissions, even automatic transmitting devices can fail. Monitors might go silent or get unplugged, apps might not be configured properly, or patients might simply be unaware that data is being sent.
Simple, proactive communication tools can change the dynamic. Instead of a passive wait for patients to act, automated text messages create an active partnership that guides them to submit their data on schedule and increases the number of fully compliant patients.
In addition to catching adverse events sooner, these interactions also verify proper device function, a vital aspect of safe and ongoing care.
Conclusion: A proactive plan for profitability
Economic and competitive pressures on hospital-based cardiac clinics are not going away. Anticipated cuts to Medicaid, the exchange-based insurance coverage, threatens to diminish highly valued cardiac clinic revenues in the year ahead.
The core strategies for success are designed to:
- Manage remote-monitoring data intelligently to reduce noise and focus clinical effort.
- Enable automated billing to reduce denials and capture the full value of the care provided.
- Diversify services (e.g. HF monitoring) that improve outcomes and support sustainability.
- Improve patient engagement with automated communications that make the journey clearer and less daunting.
Ultimately, these strategies prepare clinics to refocus on their primary mission. The goal is to remove the formulaic work through automation and logic, freeing clinicians to perform the high-value clinical work they were trained to do. Cardiac clinics that adopt this vision will build a resilient future centered on both financial stability and exceptional patient care.
Photo: BrianAJackson, Getty Images
Todd Butka, the founder and CEO of Murj, has dedicated his career to the intersection of healthcare and technology. Todd began his career at Apple, where he worked in product management and learned how great design simplifies complexity. He then spent ten years as a Medtronic sales director in the cardiac rhythm space, where he regularly watched clinicians toggle between websites, paper charts, and EHRs. That experience convinced him the industry needed software with Apple-level usability. Todd founded Murj to modernize device-clinic operations by reducing administrative burden and sharpening clinical insight, so providers can spend more time on patient care and less on process.
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