Kidney failure affects over 800,000 people in the United States.1 Hemodialysis is one of a few life-saving treatment options for kidney failure, but it comes with a price. For many patients, in-center hemodialysis is associated with high morbidity, loss of freedom to travel, physical limitations, and disruptions in social life.2,3 Further, for patients and families who are ill prepared, the transition to kidney failure is overwhelming and scary.4 While there is clear infrastructure to establish new patients on hemodialysis, there is little infrastructure to physically and emotionally support patients through this transition so that they feel empowered to choose a modality that fits their needs, and feel empowered to navigate that modality to get to the outcomes that matter to them.