; Sense of Congress (a) Findings Congress finds the following: (1) In January 2019, there were an estimated 16.9 million people in the United States with a history of cancer and that number is expected to increase to 22.2 million in 2030. (2) In 2018, national expenditures for cancer care were an estimated $150.8 billion. (3) The United States is recognized as a leader in developing new cancer treatments and providing high-quality care for patients receiving cancer care. (4) Cancer survival rates for all rare cancers is 17 percent higher in the United States than in Europe. (5) More than half of the people in the United States with cancer receive treatment in the community cancer setting. (6) Over the past 10 years, there has been a shift in outpatient cancer care from the physician’s office to hospital outpatient departments. (7) In June 2022, a MedPAC report found that the hospital outpatient department (HOPD) share of office visits provided to fee for service beneficiaries grew from 9.6 percent in 2012 to 13.1 percent in 2019, and the HOPD share of chemotherapy administration services rose from 35.2 percent to 50.9 percent. (8) This shift in care was partially the result of the increase in consolidation among healthcare providers. (9) 48,400 additional physicians left independent practice and became employees of hospitals or other corporate entities, and 22,700 of that growth occurred after the onset of COVID–19, resulting in a 12 percent increase in employment. (10) The consolidation of healthcare practices and the resulting shift in care to hospital settings has increased costs for Medicare beneficiaries by $150 million and the Medicare program by $615 million between 2015 and 2019. (11) This shift in care has increased costs for patients but has not been accompanied by improved quality of care. (12) A 2019 study found that average price for a level 5 drug administration visit increased 57 percent in outpatient settings from 2009 to 2017 but only 15 percent in office settings. (13) If payment rates between