In December 2023, the Centers for Medicare and Medicaid Services (CMS) asked for public comments regarding the ESRD Dialysis Patient Life Goals Survey (PaLS) as a potential quality metric in the ESRD Quality Incentive Program (QIP), a federal program that reduces payment to dialysis facilities for failure to meet quality metric targets.1 The PaLS contains 4 questions for patients receiving dialysis about their life goals (Fig 1). According to the Partnership for Quality Measurement (Battelle), a quality measurement development entity, PaLS data will generate a “patient-level t-score that reflects patient-reported satisfaction with how well the dialysis care team is doing in discussing life goals as part of the treatment planning process.”2,3