Quality Priorities

November 30, 2005

MINUTES
Kidney Care Quality Initiative Pay for Performance Work Group
November 30, 2005
Conference Call

Attendees:
Alan Nissenson, Facilitator Leader
Jonathan Himmelfarb
LeAnne Zumwalt
Kathy Lester, Patton Boggs and Kidney Care Partners

Not in Attendance:
Ray Hakim
Brian Pereira
Don Wesson

Summary
The Kidney Care Quality Initiative (KCQI) Pay for Performance Work Group discussed the scope of recommendations and the payment incentive structure in crafting a pay for performance system, which resulted in changes to the Pay for Performance Policy Options chart.

The work group made a recommendation to the Steering Committee to include an explicit provision about cherry picking.

Discussion of Crafting the P4P Structure
The work group discussed the difference between the type of recommendations that should be made to CMS and to Congress. Members also discussed the issue of whether a pay for performance structure should reward improvement or performance. The group agreed that the program should do both. The conversation about the payment incentive structure centered on the payment amount for those meeting the benchmark versus those demonstrating improvement.

The group did not come to a consensus on this issue. However, the group agreed that a minimum threshold for improvement should be established. In addition, Members asked the staff to update the summary chart to exclude the specific reference to VISIONS and to add a more general reference about the adoption of an appropriate web-based information collection system.

Discussion of Steering Committee Guiding Principles
The group agreed that the Steering Committee should include an explicit provision about cherry picking in the principles.

Next Steps
The next work group call will take place on Friday, December 2 at 10am.