Venous thromboembolism (VTE) is still the most common preventable cause of hospital death, with cancer a known significant risk factor for its development. Prophylaxis to prevent VTE in hospitalized surgical and medical patients has been suboptimal, and efforts for improvement have been unsuccessful. Recent practice guidelines on VTE in oncology from the National Comprehensive Cancer Network and American Society of Clinical Oncologists have further highlighted this relationship and could bridge performance measures and outcomes that can affect the strategies for preventing deep venous thrombosis and pulmonary embolism in oncology patients. Hospitals and physicians with poor performance data will have problems with payment from the Centers for Medicare & Medicaid Services and contracting the best rates from other payors. Hospital accreditation from The Joint Commission could be an issue for poorly performing institutions, as could consumer acceptance. The authors believe that specific oncology VTE measures should be developed to help decrease the current poor rates of VTE prophylaxis and also improve hospital and physician compliance.