“The registry has logged over 37,000 procedures and is a testament to the safety, quality outcomes and appropriateness of our procedures in this setting.”
“The hospital collects 18–20 times more than what’s being done in the OBL,” Dr. Niedzwiecki said. “You hear talk about overpayments and abuse in OBLs, and that’s why Medicare is running out of money. I don’t think that’s why.”
Private practice physicians, OBLs and ASCs aren’t the problem, Dr. Niedzwiecki said—they’re the solution.
Oversight and peer review OBL facilities are performing approximately 25% of the lower extremity arterial revascularization procedures in the United States, Bret Wiechmann, MD, FSIR, said. With this procedure growth exploding—and coming at the expense of hospital procedures volumes—there will undoubtedly be more scrutiny from CMS.
Until that happens, however, Dr. Wiechmann wonders how facilities will police themselves.
“The opportunities provided by the OBL model also create opportunities for risk,” he said, adding that there should be some kind of standardized accreditation, quality control and oversight in the space. But who does that?
In 2013, Dr. Wiechmann and a group of physicians formed the Outpatient Endovascular and Interventional Society (OEIS) specifically to advocate for the delivery of quality healthcare in a nonhospital environment. The society supports OBLs and ASCs and looks
38 IRQ | SUMMER 2023
to ensure patient safety, quality and success while creating resources for continuing education, peer review and fiscal responsibility.
In short, Dr. Wiechmann said, their goal is to “place the patient at the center of all decision making.”
To do this, OEIS members created a national registry with the intent of driving quality improvement by enabling the comparison of providers in the same and competing organizations, while improving efficiency and practice policies.
“The registry has logged over 37,000 procedures,” Dr. Wiechmann said, “and is a testament to the safety, quality outcomes and appropriateness of our procedures in this setting.”
OEIS has also considered a peer review program, which would be designed based on the hospital model and allow OBLs to report complications, commit to random site audits and engage in a network of quality and safety.
This program, along with the registry data, will be crucial in advocating for both IR and outpatient providers at the state and federal level.
“OBLs aren’t going anywhere,” Dr. Wiechmann said. “They’re only going to grow. When you want to get something done, you need a loud voice. And there are a lot of OBLs out there.”
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