psychosocial health care consistent with the standard of care and its implementation as set forth in Chapters 4 and 5, respectively, the Department of Health and Human Services (DHHS) could

• Conduct an annual, patient-level, process-of-care evaluation using a national sample and validated, reliable instruments, such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS) instruments.

• Add measures of the quality of psychosocial health care for patients (and families as feasible) to existing surveys, such as the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS).

• Conduct annual practice surveys to determine compliance with the standard of care.

• Monitor and document the emergence of performance reward initiatives (e.g., content on psychosocial care in requests for proposals [RFPs] and pay-for-performance initiatives that specifically include incentives for psychosocial care).

For the committee’s recommendation on patient and family education (see Chapter 5), NCI could

• Routinely query patient education and advocacy organizations about their efforts to educate patients with cancer and their family caregivers that they should expect, and request when necessary, cancer care that meets the standard of care recommended in this report.

• Assess whether patients and caregivers show greater knowledge of how oncology providers should address their psychosocial needs (the standard of care) and whether they report more receipt of psychosocial health services as part of their cancer care. Surveys could be used to gather this information and would indicate the extent to which cancer care is meeting the standard of care.

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

For the committee’s recommendation on dissemination and uptake of the standard of care (see Chapter 5), DHHS could determine whether NCI, the Centers for Medicare & Medicaid Services (CMS), and AHRQ had conducted demonstration projects and how they had disseminated the findings from those demonstrations.

For the committee’s recommendation on support from payers (see Chapter 6), NCI and/or advocacy, provider, or other interest groups could



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