CMS published a proposed 2027 outpatient payment rule that includes a 2.4% base rate increase while imposing steep cuts to 340B drug payments and expanding site-neutral payment to off-campus imaging services. Provider groups warned the combined changes could push hospital payments into negative territory for some settings. Separately, the broader reimbursement backdrop includes planned reductions that could affect how hospitals structure formularies and care delivery under federal pricing programs. For biotech stakeholders, 340B is a key channel shaping demand for infused and high-cost therapies. The proposal also underscores how outpatient payment design choices can translate into near-term payer behavior, influencing inventory planning, contracting strategy, and utilization patterns for high-cost drug categories.