February 3, 2006
MINUTES
Kidney Care Quality Initiative Steering Committee
February 3, 2006
Conference Call
Attendees
Mike Lazarus, Fresenius Medical Care North America (FMC)
Marueen Michel, National Renal Administrators Association (NRAA)
Gail Wick, American Nephrology Nurses Association (ANNA)
Sandy Watkins, American Society of Pediatric Nephrology ASPN)
Alan Kliger, Renal Physicians Association (RPA)
LeAnne Zumwalt, DaVita (on behalf of Kent Thiry)
Linda Keegan, Kidney Care Partners (KCP)
Kathy Lester, Patton Boggs
Amy Yenyo, Patton Boggs
By Proxy: David Warnock, National Kidney Foundation
Bill Henrich, American Society of Nephrology (ASN)
Summary
The Committee briefly discussed the current political environment and the need to move the Phase I proposals forward. In addition to discussing the recommendations from each Work Group, Committee also discussed Phase II objectives, deliverables, structure, resources and time-line.
Discussion of Political Environment
Ms. Lester explained that the Budget Reconciliation Conference Agreement passed on Wednesday. She noted that it did not include the pay for performance provisions in the Senate version. Nonetheless, the Senate Committee on Finance and the House Ways and Means Committee are poised to discuss quality and pay for performance early this year, with legislation likely to be introduced in the Spring. Senators Max Baucus (D-MT ) and Charles Grassley (R-IA) have expressed interest in moving pay for performance legislation this year. Ms. Lester reminded the Steering Committee of the need to finalize the recommendation because Congress will move quickly given that it is a short legislative year because of mid-term elections. Furthermore, it will be critical to stress to Congress why the recommendations are more appropriate than the withhold provisions in the Baucus/Grassley Bill.
Discussion of Work Group Recommendation Documents
After a lengthy discussion of the documents, the Committee approved each of the Work Group recommendations, with slight revisions. Members considered whether the recommendations from the Clinical Measures and Pediatric Work Groups should include a chart with data elements required for submitting new measures to the National Quality Foundation (NQF).
The Committee agreed to forward the recommendations as drafted to the KCP Board for approval. They requested the Work Groups to provide additional information that would allow the domains identified in the recommendations to be developed into full clinical measures.
Although the Steering Committee agreed that the starter set of recommendations that will be presented to Congress and the Administration may not need to include the specific, defined measure charts for purposes of initial discussions, it will be important to fully develop the measures. The group discussed recommending NQF approval for those fully developed measures that have not already been approved by the organization.
The Steering Committee agreed that the charge for Phase I was to identify existing, evidence-based measures. The Steering Committee further agreed that the Clinical Measures and Pediatric Work Groups should consider additional process based measures, particularly measures addressing patient safety and immunizations during the coming weeks.
KCP Board Approval
Once revised, the approved documents will be circulated to the KCP Board. The Board will consider these documents and vote on their approval.
Phase II
The Committee discussed the structure of the Ambulance Quality Alliance (AQA); particularly, the focus of its work groups. The AQA has three work groups that address the following:
(1) measure development;
(2) data sharing, aggregation and acquisition; and
(3) reporting. The Steering Committee discussed adding data sharing and reporting work groups for Phase II.
Some members indicated that they believe the Pay for Performance Work Group should address these issues during Phase II. No discussions about the formal structure were finalized.
During Phase II, the Work Groups will take on more responsibility for the recommendation documents. Given the tight timeframe of Phase I, this responsibility rested with the Administrative staff. During Phase II, Patton Boggs will continue to provide administrative support, but it will also enlist the help of KCP member organizations to meet the needs of the Work Groups.
Kidney Care Quality Alliance
Several organizations have expressed an interest in participating in the Alliance. To date, three entities have agreed to participate: Americas Health Insurance Plans (AHIP), American Federation of Hospitals (AFH), and Nabi Pharmaceuticals. In addition, the following organizations have also been approached:
- American Association of Retired Persons (AARP)
- American College of Physicians
- American Diabetes Association
- National Association for the Advancement of Colored People (NAACP)
- National Association of Hispanic Nurses (NAHN)
- National Black Nurses Association, Inc. (NBNA)
- National Council of La Raza
- National Hispanic Medical Association (NHMA)
- National Medical Association
- National Urban League
Next Steps
Ms. Lester will finalize and circulate to the Steering Committee a copy of all of the documents being submitted to the KCP Board. Each document will include a reference indicating it is a final document and a date. Ms. Lester will also send additional information about for Phase II Work Groups.
