Quality Priorities

January 16, 2007

MINUTES
Kidney Care Quality Alliance Steering Committee
January 16, 2007
Conference Call

Attendees

Gail Wick, ANNA
Don Wesson, ASN
Barry Straube, CMS
Kent Thiry, DaVita
Ray Hakim, FMC
Dolph Chianchiano, NFK
Deven McGraw, National Partnership for Women & Families
Allen Nissenson, RPA
Linda Keegan, KCP
Kathy Lester/Julie Black , Facilitator/Administrative Arm Patton Boggs

Summary
The KCQA Steering Committee reviewed the recommendation of the Adult Clinical Measures Task Group and agreed to move forward with submitting the measures for national endorsement through the National Quality Forum (NQF).  The Steering Committee also approved the report about the balloting of the Phase I measures.

Review and Approval of Minutes 
The members approved the minutes from the November 13, 2006, meeting.

Membership
Kathy Lester announced several changes in membership.  Ray Hakim has replaced Mike Lazarus as the FMC representative.  Dolph Chianchiano represents NKF on the Steering Committee.   Also, Allen Nissenson now serves as RPA’s representative.

Reports
Ms. Lester summarized the recommendations of the Adult Clinical Measures Task Group for the Steering Committee.  She reminded the members that the KCQA methodologist was involved in the development of the measures.  The Task Group made the recommendation to submit the measures for national endorsement from the NQF.   Ms. Lester explained that the Quality of Life measures remain an outstanding issue.  Due to questions regarding implementation, the Task Group will have until the end of January to resolve these issues.

Ms. Lester reported that several non-kidney care community Alliance members abstained from voting on certain measures based on a concern about their ability to evaluate the clinical measures from a technical point of view.  The staff re-balloted these organizations on the specific question about whether they believe it is appropriate to move forward with all of the Phase I Clinical Measure and Quality of Life Recommendations.  A majority of the non-kidney care community members agreed to move the measures forward.

Submission of Adult Clinical Measures for National Endorsement
Barry Straube reminded the Steering Committee that as a general policy, CMS recommends that groups submit measures to the NQF for national endorsement.  Ray Hakim asked whether the Alliance had talked to groups who are well-versed in the NQF process.  Ms. Lester noted that the process is cooperative and transparent; she recommended that the Alliance submit the measures and noted that staff and Task Group members can develop the submission and answer questions that may arise from NQF.

Allen Nissenson asked about the ongoing relationship with AMA as the Alliance and Consortium take steps to move measures through NQF separately.  Dr. Nissenson indicated his support for the Alliance submitting the measures itself, but also suggested maintaining a cooperative relationship with the AMA to minimize differences in the measures submitted.  With regard to the CMS Clinical Performance Measures Project, Dr. Straube noted that the measures should be aligned with KCQA recommendations.  He asked to be alerted if members found otherwise.

The Steering Committee approved submitting the clinical measures to NQF independently of the AMA or other organization.

Review Draft Report of Phase I Measure Balloting
The members approved this report without comment.

Review Phase II Plan
Ms. Lester explained that the Recommendations for Phase II is a broad outline.  Gail Wick asked for clarification on the Adult Clinical Measures Work Group charge to examine questions related to evaluating existing measures and harmonizing different measures.  Ms. Lester shared that a new generation of CPMs is being developed and by the time the work group meets, the measures may be available for review.  The work group will be tasked with harmonizing the new generation of CPMs with the starter set of clinical measures.  The members agreed to the broad ideas outlined and to have staff develop a full plan to be discussed during the February call.

Discussion of Next StepsThe Steering Committee concluded Phase I of the Quality Initiative and will begin Phase II on the call scheduled for February 8.  During the next meeting, the members will review the recommendations for Phase II.