Two independent trends, acting in combination, are currently resulting in increased Medicare fee-for-service (FFS) chemotherapy payments. The first trend is a shift in the site of care for cancer patients from physicians’ offices to hospital outpatient departments. Several factors contribute to this shift; this study evaluates the effects of one of those factors —the acquisition of physician-based oncology practices by 340B hospitals. The second trend is higher Medicare reimbursement rates for and greater utilization of chemotherapy administration in hospital outpatient departments compared to physicians’ offices. This trend is driven by Medicare rate setting policy and hospital utilization patterns and has been reported in studies performed over the last three years.