necessary, oncology care that meets the standard of care set forth in recommendation 1.

  • In surveys conducted to assess the extent to which oncology care meets the standard of care, include questions to patients and caregivers about their knowledge of how oncology providers should address their psychosocial needs (the standard of care) and their actual experiences with receiving such care.

  • Use an annual patient-level process-of-care evaluation (such as CAHPS) to identify patient education experiences.

For recommendation 4 on dissemination and uptake of the standard of care, DHHS could report on the extent to which the National Cancer Institute/CMS/AHRQ had conducted demonstration projects and how they had disseminated the findings from those demonstrations.


For recommendation 5 on support from payers, DHHS/NCI and/or advocacy, provider, or other interest groups could

  • Survey national organizations (e.g., America’s Health Insurance Plans, the National Business Group on Health) about their awareness of and/or advocacy activities related to the recommendations in this report and the initiation of appropriate reimbursement strategies/activities.

  • Monitor and document the emergence of performance reward initiatives (e.g., RFP content on psychosocial care, pay for performance that specifically includes incentives for psychosocial care).

  • Evaluate health plan contracts and state insurance policies for coverage, copayments, and carve-outs for psychosocial services.

  • Assess coverage for psychosocial services for Medicare beneficiaries.

For recommendation 6 on quality oversight, DHHS could

  • Examine the funding portfolios of NIH, CMS, AHRQ, and other public and private sponsors of quality-of-care research to evaluate the funding of quality measurement for psychosocial health care as part of cancer care.

  • Query organizations that set standards for cancer care (e.g., the National Comprehensive Cancer Network, the American Society of Clinical Oncology [ASCO], the American College of Surgeons Commission on Cancer, the Oncology Nursing Society, the American Psychosocial Oncology Society) and other standards-setting organizations (e.g., the National Quality Forum, the National



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