Independent vs. Hospital-Owned Cardiologists: 8 Reasons Your Choice Matters

Independent vs. Hospital-Owned Cardiologists: 8 Reasons Your Choice Matters

When you choose a cardiologist, you probably think about experience, reputation and location. But there’s another question few patients ask: is your cardiologist independent, or employed by a hospital system? An independent cardiologist owns and runs their own practice. A hospital-owned cardiologist is an employee of a hospital or health system, even if the office looks like a regular doctor’s office.

That difference can affect what you pay, how your care is coordinated, and how much choice you have. Here are seven reasons it matters.

The Shift Toward Hospital-Owned Cardiology

Cardiology has changed dramatically in the past two decades. The share of U.S. cardiologists employed by hospitals rose from 26% in 2008 to 61% in 2018, according to a 2024 study in the Journal of the American College of Cardiology. For many patients, the practice name on the door stayed the same while the ownership changed. Today, independent cardiology practices are less common, but they remain an important choice.

1. You May Avoid Hospital Facility Fees

When a hospital owns a physician practice, it can often bill that office as a hospital outpatient department. That allows it to charge a facility fee in addition to the doctor’s fee, even for a routine office visit or test.

Patients are frequently surprised by these fees. They often arrive as a separate bill, and with a high-deductible plan you may pay much of it yourself. Read how facility fees affect patients from KFF Health News.

Independent cardiology practices aren’t hospital departments, so they don’t charge exorbitant hospital facility fees.

Heart Tests Often Cost Less in an Independent Office

The same test can cost far more depending on where it’s done. A 2025 Health Care Cost Institute analysis of 57 services found that prices were higher in hospital outpatient departments than in physician offices for every service, every year studied. For nuclear medicine, which includes nuclear stress tests, the average price in 2018 was $2,159 in hospital outpatient departments versus $654 in physician offices.

Medicare also pays about two to four times more for identical procedures in hospital outpatient departments, according to the American Society of Echocardiography. Higher payments generally mean higher coinsurance for patients.

What this means for you: Echocardiograms, stress tests, heart monitors, and other routine tests done in an independent cardiologist’s office can cost you less out of pocket, especially if you have a deductible or coinsurance.

3. Quality Is Comparable, So You Get More Value

It’s natural to assume higher cost means better care. However, the 2024 JACC study of hundreds of thousands of Medicare patients with heart attacks and heart failure found no meaningful differences in death rates, readmissions or most quality measures between hospital-integrated and independent cardiologists. Integration was associated with higher Medicare costs.

In other words, an independent cardiologist can deliver the same quality of care, often at a lower cost to you and the health care system.

4. Your Independent Cardiologist Can Work With Any Hospital

Hospital-employed physicians typically practice and refer within their own system. An independent cardiologist can hold privileges at more than one hospital and recommend the one that best fits your needs, your insurance and your location.

For example, our cardiologist holds privileges at both Tampa General Hospital and St. Joseph’s Hospital. If you need a procedure, hospital care, or a surgeon, we can help you choose based on what’s best for you, not on which system owns the practice. Independent practices can also refer you to any specialist, imaging center, or lab in your network.

5. Treatment Decisions Stay Between You and Your Doctor

In an independent practice, the physician who treats you also leads the practice. Decisions about scheduling, testing, staffing, and how much time to spend with patients are made by doctors who see patients every day.

Large health systems bring economic strengths, but decisions about practice operations are often made at a system level. An independent cardiologist has the flexibility to tailor care, from how long a visit lasts to which tests and treatments make sense for you.

Independent Medical Practice Challenges: Why Remaining Independent is So Hard

6. You're More Likely to See the Same Cardiologist

Heart disease is often a lifelong condition, and continuity matters. A cardiologist who knows your history, your test results, and your goals can spot changes sooner and make better decisions.

Independent practices tend to be smaller, so you’re more likely to see the same physician at every visit and to reach a team that knows you by name. That relationship is especially valuable if you have a complex condition, multiple medications, or several specialists involved in your care.

7. Simpler, More Transparent Billing

Visits and tests at an independent practice typically generate one bill from one practice. Hospital-based care can involve separate bills for the physician, the facility, and sometimes the reading of a test. That can make it hard to know what you’ll owe until the bills arrive.

Independent practices can usually give you a clearer estimate up front, which helps if you have a high-deductible plan or are paying out of pocket.

8. You Can Actually Reach Your Cardiologist

Few things are more frustrating than having a question about your heart and not being able to reach the doctor who treats you. In large health systems, calls are often routed through centralized call centers that schedule for dozens of physicians across many locations. Portal messages may go to a shared inbox or nurse pool before they reach your doctor, if they reach your doctor at all. It can take several handoffs, and several days, to get an answer.

An independent cardiologist’s office works differently. The staff who answer the phone work alongside your cardiologist every day, often in the same office. They know you, they know your history, and they can walk down the hall to ask your doctor a question. That close communication between staff and physician means:

  • Faster answers to questions about symptoms, test results and medications
  • Fewer miscommunications, because messages pass through fewer hands
  • Quicker scheduling when you need to be seen sooner
  • Direct follow-up from the physician who ordered your test, not a system you’ve never met

When you’re worried about chest pain, a new medication, or an abnormal result, getting a clear answer from your own doctor quickly isn’t a luxury. It’s good heart care.

When a Hospital-Owned Cardiologist May Be the Right Fit

To be fair, hospital-employed cardiologists offer real advantages in some situations. Large systems can provide one shared medical record across many specialists, on-site access to rare subspecialty programs, and coordinated care for very complex conditions. If most of your doctors are already in one system, staying within it can simplify coordination.

The best choice depends on your needs. What matters most is that you know which kind of practice you’re choosing and what it means for your costs and care.

How to Tell If Your Cardiologist Is Independent

It isn’t always obvious. Ask these questions:

  • Is this practice owned by a hospital or health system? The front desk can tell you.
  • Will I receive a facility fee for visits or tests? Ask before scheduling an echocardiogram or stress test.
  • Where will my test be billed, as an office or as a hospital outpatient department? Your insurer can also help.
  • Which hospitals is the cardiologist affiliated with?

You can also check your past bills. A line for a “facility fee” or charges listed under a hospital’s name for an office visit usually means the practice is hospital-owned.

Whatever type of practice you choose, don’t wait to get care if you have symptoms. Review the 10 warning signs you should see a cardiologist.

Frequently Asked Questions

Can an independent cardiologist still treat me in the hospital? Yes. Independent cardiologists hold hospital privileges and can admit patients, perform procedures and see you in the hospital. Our cardiologist performs procedures at Tampa General Hospital and St. Joseph’s Hospital.

Do independent cardiologists accept insurance and Medicare? Yes, most do. Independent practices contract directly with insurance plans, including Medicare. Check with the practice and your plan to confirm they’re in network.

What is a hospital facility fee? A facility fee is a charge a hospital adds for using its facility, separate from the doctor’s fee. It can apply to office visits and tests at hospital-owned clinics, even if the clinic is located off the hospital campus.

Is care from an independent cardiologist as good as care from a hospital system? Yes. A large 2024 study published in the Journal of the American College of Cardiology (JACC) found no meaningful differences in death rates, readmissions or most quality measures between hospital-employed and independent cardiologists.

Can I switch from a hospital-owned cardiologist to an independent one? Yes. You can choose any cardiologist in your insurance network. Ask your new practice to request your records, including recent test results, so your care continues smoothly.

Choose Independent Cardiology Care in Tampa

Ascent Cardiology is an independent, physician-owned practice in South Tampa. Our board-certified interventional cardiologist provides comprehensive heart care, from in-office and hospital consultations, in-office testing such as echocardiography, stress testing, and venous diagnostic testing to advanced procedures at Tampa General Hospital and St. Joseph’s Hospital. You’ll see the same physician, get clear answers, and avoid hospital facility fees for care in our office.

Learn more about the advances in heart disease treatment we offer, and the benefits of minimally invasive heart treatment.

Request an appointment or call (813) 540-4322.

602 S Audubon Ave, Suite A, Tampa, FL 33609

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