•    Group purchasers and health plans should include incentives for the effective delivery of psychosocial care in payment reform programs—such as pay-for-performance and pay-for-reporting initiatives—in which they participate.

With respect to the above recommendation, “group purchasers” include purchasers in the public sector (e.g., Medicare and Medicaid) as well as group purchasers in the private sector (e.g., employer purchasers). Mental health care providers “with expertise in the treatment of mental health conditions in individuals undergoing complex medical regimens such as those used to treat cancer” include mental health providers who possess this expertise through formal education (such as specialists in psychosomatic medicine), as well as mental health care providers who have gained expertise though their clinical experiences, such as mental health clinicians collocated with and part of an interdisciplinary oncology practice.

Recommendation 6: Quality oversight. The National Cancer Institute, CMS, and AHRQ should fund research focused on the development of performance measures for psychosocial cancer care. Organizations setting standards for cancer care (e.g., National Comprehensive Cancer Network, American Society of Clinical Oncology, American College of Surgeons’ Commission on Cancer, Oncology Nursing Society, American Psychosocial Oncology Society) and other standards-setting organizations (e.g., National Quality Forum, National Committee for Quality Assurance, URAC, Joint Commission) should

•    Create oversight mechanisms that can be used to measure and report on the quality of ambulatory oncology care (including psychosocial health care).

•    Incorporate requirements for identifying and responding to psychosocial health care needs into their protocols, policies, and standards.

•    Develop and use performance measures for psychosocial health care in their quality oversight activities.

Ultimately, the delivery of cancer care that addresses psychosocial needs depends on having a health care workforce with the attitudes, knowledge, and skills needed to deliver such care. Thus, professional education and training should not be ignored as a factor influencing health practitioners’ practices. The committee further recommends



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