Commentary: Its time to increase your vascular revenue
Today, most hospitals and healthcare systems consider a cardiovascular program to be their heart program. A recent industry survey asked healthcare leaders, “In your opinion, which service line today has the greatest potential to produce strong revenue growth within the next three years?” Not surprisingly, cardiology (i.e., heart disease) topped the list at 15 percent, while vascular received only 2 percent of votes.1

The current economic crisis requires creative thinking and a deep examination of all costs, as well as opportunities to increase revenues. The fact is heart disease-related services will continue to increase a hospital’s overall revenue, but hospitals and healthcare systems that heavily pursue vascular and circulatory diseases will see revenues increase 50 to 80 percent over the next three to five years, as the vascular market is exposed to physicians, hospital administrations and the general public.   

In my meetings across the U.S. with hospital administrators and boards of directors, I have found that many people do not have a good working knowledge of vascular and circulatory diseases compared to heart disease. The term vascular is simply not understood by the general public, as well as many healthcare providers, and the connection of vascular disease to stroke, leg pain, abdominal aneurysms, diabetes-related wounds and amputations has not yet been made clear.  

A quick review of the 2009 National Center for Health Statistics reveals that approximately 80 million people are afflicted with cardiovascular (CV) disease. It should be noted that 25 million people suffer from ischemic coronary disease, heart failure, or electrical heart problems. By contrast, 55 million people suffer from non-coronary vascular disease, otherwise known as non-cardiac circulatory disease.  

Why is vascular disease a major focus today when it hasn’t been in the past? The answer lies in new technology that has been developed this decade, resulting in new forms of treatment and less complicated forms of treatment that are bringing about outstanding patient outcomes.  

Many of the new forms of treatment for all types of vascular disease are referred to as endovascular procedures, versus open surgery procedures. Endovascular procedures are easily compared to angioplasty and stents versus open heart surgery, but endovascular procedures have only been available to patients during this decade. Secondly, the vast majority of hospitals and physicians do not have a thorough understanding of the difference between the new procedures and the old procedures; therefore, they do not see the incredible opportunity that exists in each market as it relates to treating vascular disease.  

The population over the age of 45 in the U.S. in 2008 was approximately 1.6 million compared to the estimated total U.S. population of 304 million. In 2008, slightly more than 949,000 people in the U.S. died from CV-related diseases; in the over-45 population, deaths from CV disease were nearly 925,000.

Clearly, while the over-45 population only represented 38.3 percent of the total population in the U.S., the death rate from CV disease in this group was 97.4 percent. The number of baby boomers is expected to increase by more than 20 million in 2020. It is apparent that we will see a substantial growth in the number of CV disease-related deaths if we do not aggressively address it now. 

Finally, to differentiate the mortality impact that we have been discussing, it is noteworthy to point out that of the 949,000 deaths related to CV disease in 2008, 365,000 (or 40 percent) of them were attributable to non-coronary vascular disease. Stroke is the third leading cause of death and represents approximately 160,000 deaths of the 365,000 total non-coronary vascular disease deaths. 

In summary, vascular disease is one of the most rapidly growing conditions in the U.S. as a result of an aging population and a lack of treatment of the disease in previous years. On the other hand, those institutions and healthcare systems that aggressively pursue the treatment and management of vascular disease will see their gross revenues increase significantly and their net revenue increase 50 to 80 percent of the amount currently being generated from cardiac care.  

The time is now to address this new area of medicine. Additionally, a well-operated vascular program will feed your coronary program as it has been proven in several institutions throughout the country.  

1HealthLeaders, February 2009, page 21. 

Goodman is president of J O Goodman & Associates in Las Vegas, a strategic cardiovascular business consulting firm offering a range of services designed to improve the delivery of heart and vascular care. He can be reached at