Quality Priorities

July 16, 2007

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

Attendees

ANNA Gail Wick
ASPN Barbara Fivush
FMC Ray Hakim
NKF Dolph Chianchiano
NRAA Maureen Michael
RPA Allen Nissenson
Administrative Arm Patton Boggs Kathy Lester, Julie Black
KCP Linda Keegan

Summary
The Steering Committee reviewed the KCQA-submitted ESRD measures recommended by the NQF Steering Committee and discussed the harmonization efforts underway with the Consortium and CMS. Members will further evaluate ownership issues once staff provides NQF’s terms of ownership.

Report on NQF Timeline 
Responses to the NQF Steering Committee’s recommendations are due on Friday, July 20 at 6:00 p.m. EDT. KCQA Steering Committee Members noted that NQF’s aggressive timeline is possibly due to the fact that their contract with CMS expires in November.

Report on KCQA-Submitted ESRD Measures
The Steering Committee discussed the summary chart prepared by KCQA staff the outlined the Consortium, CMS, and KCQA measures, along with the recommendations from NQF.

Discussion on Harmonization and Ownership Issues
NQF Steering Committee members reported that NQF has scheduled a call for July 27 to review the responses from measure developers and to make final recommendations before the public comment period. Members noted that NQF could recommend time-limited endorsement for measures that have not been tested.

NQF did not discuss implementation of the measures. Physician measures will go through the rule-making process, including notice and comment, as part of the PQRI. However, CMS or Congress would have to implement a reporting process for facility measures.

Members discussed the responsibilities of ownership. Given the short timeframe, staff will negotiate joint ownership. Steering Committee members should register their objection after reviewing the NQF intellectual property agreement.

NQF stated that recommending how these measures should be used is beyond the scope of NQF and CMS. NQF also did not discuss target benchmarks. KCQA Steering Committee members agreed to register its philosophy that target benchmarks should be clear so that measures are not developed in a vacuum to NQF as part of the resubmission.

The KCQA harmonization team (LeAnne Zumwalt, Mike Lazarus, Kathy Lester, Linda Keegan, and Julie Black) will continue to meet with the Consortium to try to harmonize measures. The Steering Committee approved harmonization of CMS/KCQA measures for the Adequacy of Dialysis (hemodialysis) measures. Members recommended that KCQA and CMS specify the reporting period as four times a year for the Adequacy of Dialysis (peritoneal dialysis) measure, rather than monthly. Staff reported that the CMS measure was a combined outcome and process measure. KCQA asked CMS to eliminate the process component of the measure and a response is pending.

Staff asked that Steering Committee members email additional questions regarding NQF recommendations to Kathy Lester by noon on Tuesday, July 17.

Discussion of Next Steps
Staff will provide an outline of NQF’s conditions of ownership for the Committee’s review. The Steering Committee will meet on Thursday, July 19 at 9:00 a.m. EDT and on Friday, July 20 at 11:00 a.m. EDT. KCQA members agreed to accompany the revised measures with a statement on KCQA’s philosophy that measure developers should know the target benchmarks to avoid developing measures in a vacuum.