June 22, 2007
MINUTES
Kidney Care Quality Alliance Steering Committee
June 22, 2007
Conference Call
Attendees
| ANNA | Gail Wick |
| ASPN | Barbara Fivush |
| CMS | Barry Straube |
| DaVita | Kent Thiry |
| FMC | Ray Hakim |
| NKF | Dolph Chianchiano |
| NRAA | Maureen Michael |
| RPA | Allen Nissenson |
| KCP | Linda Keegan |
| Facilitator/Administrative Arm Patton Boggs | Kathy Lester, Julie Black |
Summary
NQF Steering Committee members reported that the ESRD measures are under review by the NQF Work Groups and that KCQA staff should anticipate answering questions raised by the panels. KCQA co-chairs will select experts from nominations submitted by the KCQA Steering Committee to harmonize measures with other developers.
Review and Approval of Minutes
The members approved the minutes from the April 26, 2007, meeting.
Update on Collaboration with the Consortium for Phase II
Kathy Lester reported that KCQA has shared the ground rules for collaboration with the AMA Consortium. She noted that due to participation in the NQF ESRD Steering Committee by both groups, formation of work groups for Phase II will be delayed until after the NQF process has concluded.
Report on NQF ESRD Steering Committee Meeting
The three Steering Committee members who also sit on the NQF Steering Committee described the initial NQF meeting that occurred on June 18. During that meeting, Work Groups were asked to identify similar measures, raise questions, and make recommendations to the measure developers. The Work Groups will continue measure evaluation on conference calls and at the July 9-10 Steering Committee meeting. The NQF will likely endorse only one measure per category.
NQF will ask developers to harmonize, modify, decline to modify, or withdraw their measures. Work Groups will recommend measures for endorsement to the Steering Committee at the July meeting. NQF ESRD Steering Committee members discussed their impressions that developers will harmonize measures. One member noted that the challenge is for CMS, RPA, and KCQA to agree on outcomes only measures and harmonize them. NQF gave clear instructions that the Steering Committee is not to develop measures, but only to make recommendations. NQF ESRD Steering Committee members noted that the critical issues are exclusions and outcomes versus process. Developers will also be asked to provide a written explanation as to how anemia management measures relate to the FDA black box warning. NQF has stated the possibility that anemia management measures would not be adopted until after the September meeting of the FDA.
The NQF has indicated that KCQA will need to answer an extensive array of questions and prepare to participate in a harmonization process. NQF will try to organize the harmonization effort among the measure developers and recommended that KCQA staff begin to draft answers to the anticipated questions. Staff noted that the KCQA Steering Committee should nominate experts from the kidney community to participate in the harmonization process. Nominations should be sent to Kathy Lester and Julie Black. Charlie McAllister and Mike Lazarus were nominated during the conference call.
Dr. Barry Straube noted that the NQF ESRD Steering Committee and its endorsement process do not necessarily keep policy considerations in mind. He stated that NQF has been encouraged to develop more measures more quickly. Dr. Straube cited two of CMS’ concerns: (1) combining physician and facility level measures; and (2) endorsing only one measure per category. He explained that measures may not be actionable if NQF moves forward in this way. Actionable measures are necessary to be able to link them to a payment system. He stated that every NQF member, including KCP and KCP organizations, should weigh in on these policy concerns. He reiterated that NQF should not endorse an arbitrary number of measures in each category.
Discussion of Next Steps
Members agreed that KCQA staff should begin to draft answers to the NQF questions pertaining to submitted measures. KCQA Steering Committee members will nominate experts to participate in the harmonization process. Staff announced that the meeting of the full Alliance is tentatively scheduled for August 1 at 12:00 p.m. EST. The meeting will be a teleconference given the number of people committed to the NQF process. If necessary, the Steering Committee will meet on July 20 at 11:00 a.m. EST. Otherwise, the committee will convene on August 23 at 11:00 a.m. EST.
