The importance of primary care in the prevention and management of chronic diseases is widely understood, yet the role of primary care providers (PCPs) in the care for people with end-stage kidney disease (ESKD) receiving hemodialysis (HD) is less well characterized.1 The pillars of high-quality primary care include comprehensiveness, first contact access, coordination, and continuity.2 Intuitively, the complex needs of patients receiving HD would be served well by integrating these primary care pillars into their care.