May 5, 2006
MINUTES
Steering Committee
May 5, 2006
Conference Call
Participants
Alan Kliger, Renal Physicians Association (RPA)
Charlie McAllister, DaVita Inc.
Maureen Michael, National Renal Administrators Association (NRAA)
David Warnock, National Kidney Foundation (NKF)
Sandra Watkins, American Society of Pediatric Nephrology (ASPN)
Gail Wick, Fresenius Medical Care North America (FMC)
Kathy Lester, Patton Boggs
and Kidney Care Partners (KCP)
Eli Tomar, Patton Boggs
Linda Keegan, Kidney Care Partners (KCP)
Summary
The majority of the conference call was devoted to addressing the status of the clinical measures and determining how to advance the stalled recommendations. The members also discussed the structure of the Steering Committee and outreach to expand Kidney Care Quality Alliance (KCQA) membership.
Status of the Clinical Measures
Dr. McAllister summarized the discussion with Dr. Haley about the next steps for the Clinical Measures Work Group. He explained that there is not consensus about the adoption of outcomes-based measures.
Dr. Haley, the facilitator of the Work Group, has expressed an unwillingness to endorse outcomes-based measures at the physician level. Instead, he encouraged the Steering Committee to adopt the American Medical Association (AMA) Consortium’s pay-for-performance proposed process-based measures.
Dr. McAllister conveyed the instructions from the KCP Board that at a minimum the final recommendations contain outcomes-based measures for the adequacy of dialysis and anemia management.
Dr. McAllister outlined the options:
1- accept the Work Group’s recommendation as presented to the Board;
2- charge the Work Group with developing separate measures for physicians and facilities; or
3- reorganize the structure of the Work Group.
The Steering Committee rejected the idea of moving forward with the existing recommendation, which the Board did not adopt by consensus. Members also discussed adding new members, such as nurses, to the Work Group.
Several members articulated their reluctance to reorganize the membership of the Work Group at this stage.
Some asked whether it would be appropriate to appoint a different facilitator.
Dr. Kliger agreed to speak with Dr. Haley before the Steering Committee made any final decisions on the matter.
The Steering Committee agreed to allow the Work Group to develop separate measures for physicians and facilities.
The former will be based upon those developed by the AMA Consortium. The latter will include outcomes-based measures. The members agreed that the measures should be linked in terms of the domains.
For example, anemia management will appear in both sets, but be a process-based measure in the physician set and an outcomes-based measure in the facility set.
The Steering Committee agreed to provide the Work Group with this charge and to indicate that the work should be completed during a face-to-face meeting within a month.
Once the Steering Committee coordinates the revisions with the Work Group, the KCP Board will consider the recommendations through conference calls. There was an emphasis during the call toward additional outreach to better educate the KCP Board on clinical measures.
Structure of the Steering Committee
The members agreed to elect co-chairs of the Committee.
Dr. Kliger and Dr. McAllister were selected.
Expanding Alliance Membership
Dr. Kliger announced that the American College of Physicians (ACP) is reconsidering their initial decision not to participate in the KCQI.
CMS has indicated their interest in participating not as a member of the alliance, but as a supporter.
Ms. Lester will draft a formal invitation letter to CMS Administrator Mark McClellan be formally invited to participate in the initiative for review by the co-chairs.
Next Steering Committee Call
The Steering Committee determined a follow up call is needed pending several action-items.
