MINUTES
Kidney Care Quality Alliance Steering Committee
March 6, 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

The Steering Committee once again agreed to submit the Phase I measures to the National Quality Forum (NQF) independently. A letter regarding the quality of life measures and the physician adult clinical measures will be included with the submissions. The members considered a series of requests from the AMA/RPA Physician Consortium (Consortium). The members asked staff to provide additional information about copyright law. In response to an invitation from the Consortium, KCQA members agreed to schedule a meeting to discuss a potential partnership to develop renal measures.

Review and Approval of Minutes

The members approved the minutes from the February 12, 2007, within non-substantive amendments.

Letter to NQF regarding Quality of Life Measures

Ms. Lester reviewed the draft letter circulated to the Steering Committee that would accompany the quality of life measure submission. The members agreed that the letter captured the Steering Committee’s intentions. They unanimously supported sending the letter with a clarification about the application of the measures to both facilities and physicians.

Measure Submission Process

Ms. Lester shared that Dr. Ed Jones, in his role as Chair of the Kidney Care Partners, received and passed along a letter from the Consortium regarding measure development and submission. The letter contains three requests: (1) for the KCQA and Consortium to hold a joint copyright in the harmonized set of measures; (2) for the KCQA and Consortium to submit the physician clinical measures jointly to NQF; and (3) for the KCQA and Consortium to collaborate on future physician-level measure development. It closed by asking for a meeting with representatives of KCQA, RPA, and the Consortium to discuss these requests.

There was a discussion about the intent of the letter, which may stem from concerns about the Consortium and KCQA separately submitting physician measures.

Members raised questions about copyrighting measures and whether a condition of NQF endorsement is that the measure is a part of the public domain. The group determined that CMS would use copyrighted measures unless the owner charges a user fee, which would create an undue burden.

The Steering Committee suggested that the KCQA submit the physician and facility measures on its own and acknowledge in a letter that the physician measures are similar to those developed by the Consortium. The letter would state that if the NQF finds it necessary/important/vital to develop a joint submission, KCQA would consider it.

The members raised questions about whether facility and physician measures could be separated if NQF asks for a single submission. One member explained that quality of life measures would be submitted separately. Several members noted a preference for the facility and physician measures to be submitted together.

Ms. Lester summarized that the staff will research and explain the copyright issues for the Steering Committee to review during the next call. The staff will draft a cover letter to submit with the physician measures. The Steering Committee may need to review the letter before the next teleconference due to the anticipated NQF call for measures in the coming days. All members agreed that with the letters related to the physician and quality of life measures, the Phase I measures will be submitted independently of any organization.

Measure Submission for Phase II

The members discussed the Consortium’s request to combine efforts to develop Phase II physician measures. The process would be jointly governed by the Consortium and KCQA. The work group would be populated by people recommended by both organizations. Members noted that in Phase I, some KCQA work group members also worked with the Consortium to develop physician measures.

Members noted that some aspects of the Consortium conflict with the KCQA structure. The Consortium work groups are comprised solely of physicians, while the Steering Committee advocated for balanced work groups that include patients, nurses, physicians, providers, and others. They asked what the Consortium’s perspective is on having a diverse work group. Members also expressed concern about developing facility and physician measures separately.

One member pointed out that although the community does not have the highest level of evidence to support measures, the KCQA must develop measures in anticipation of a quality initiative.

Members agreed that a meeting should be scheduled for key members of both the Consortium and the Steering Committee to have a conversation about a potential partnership. The representatives are not empowered to make a decision about the partnership during the meeting, and Steering Committee members would report back on a subsequent call.

Discussion of Next Steps

The next meeting is on April 26, 11:00 a.m.-12:00 p.m.