What is Happening in the Ambulatory Space? Past Challenges and Future Directions.

Despite reimbursement pressures and scrutiny of procedural appropriateness, the demand for peripheral vascular ambulatory services remains strong. Improvements in minimally invasive technologies, coupled with a supportive regulatory environment and considerable preference for ambulatory services among purchasers, patients, and providers, have resulted in the rapid proliferation of ambulatory facilities in a number of markets. Emerging ecosystem dynamics, notably the rapid growth of Medicare Advantage and the growing presence of private equity and venture capital within healthcare, will likely have an impact on future growth trends but will not fundamentally alter the incentives driving the ambulatory shift. Indeed, it is likely that the dynamics currently at work within peripheral vascular services will become come to characterize a variety of other services, as more care shifts away from the hospital.