Whether employed, aligned, or independent, many cardiology groups are having difficulty sustaining and/or improving performance in the evolving healthcare environment. Physicians and administrators are balancing mounting patient and provider demands against decreasing resources. Aligning with health systems and hospitals through employment or affiliation arrangements may be a lifeline for some practices, but it in no way ensures practice growth or optimal performance. The good news is you don’t have to stand idly by and hope your practice doesn’t sink. Instead, here are a number of tactics presented here that cardiology groups can take to improve performance and maintain a successful practice.