Affordable care puts cardiology, radiology in high demand

Demand for cardiology services will grow 20 percent by 2025, according to a projection published in the November issue of Health Affairs, and radiology will experience an 18 percent bump.

Timothy M. Dall, managing director for healthcare and pharma at IHS in Washington, D.C., and staff from the information and analytics company applied a workforce model that could assess the impact of getting medical insurance on demand. The model included a population database, equations to predict healthcare use and care delivery patterns.

The Congressional Budget Office estimates that under the Affordable Care Act, 25 million more Americans will obtain medical insurance by 2016 with an additional 28 million getting coverage by 2023. In the meantime, the proportion of Americans with a history of cardiovascular disease, MI or stroke is expected to increase by 27 percent between 2013 and 2025.

“In the absence of changes in care delivery patterns, one would anticipate that demand for specialist physicians would grow at approximately the same rate as the portion of the population with the chronic conditions treated by each specialty,” Dall et al wrote. “That is, demand for cardiologists would grow at approximately the same rate as the population with cardiovascular disease.”

Their analysis determined that the total number of office, outpatient and emergency department visits would increase 8 to 12 percent by 2025 and total inpatient hospital days would rise by 19 percent. Cardiology office visits would shoot up by 18 percent in the projection.

They calculated that demand for primary care physicians, which included geriatricians, would increase 14 percent by 2025. Vascular surgery would see the biggest gain, at 31 percent, with cardiology following at 20 percent. Radiology, neurological surgery, and general surgery each would post an 18 percent increase.

But demand varied by state. The increase in demand for cardiology services in West Virginia would reach only 5 percent compared with 51 percent in Nevada.  

“Our projections of the increase in demand for health care services and physicians reflect what will likely occur in the absence of paradigm shifts in use and delivery of care,” the HIS researchers noted. Technological advances might increase demand, for instance, or the use of allied health workers or cost-sharing in care delivery models might decrease demand for specialists.

They cautioned that the supply of physicians may not adequately meet patient needs. They cited current wait times as evidence, with one 2009 survey showing an average wait period of 15.5 days for a patient wanting to see a cardiologist for a heart checkup. Physicians now choosing to not take on Medicaid patients also signaled a supply-demand problem.

Patients in the future will need a large number of healthcare professionals who offer an array of skills and knowledge to treat complex conditions, they wrote. “Failure to train sufficient numbers of specialists could exacerbate already long wait times, reduce access to care for some of the nation’s most vulnerable patients, and reduce patients’ quality of life.”