As nephrologists, we strive to minimize the number of people whose survival depends on dialysis. However, for the foreseeable future, dialysis remains lifesaving for more than 550,000 people in the United States and for millions worldwide. High-quality dialysis is critical to public health. Because the vast majority of US maintenance dialysis patients receive in-center hemodialysis, access to dialysis largely depends on hemodialysis facility number and distribution.