In the United States, health care expenditures for patients with end-stage renal disease (ESRD) are steadily increasing, with Medicare fee-for-service (FFS) spending on ESRD care exceeding $30 billion in 2016. Inpatient hospitalizations alone accounted for $10 billion.1 In an effort to curb Medicare spending while promoting high-quality ESRD care, the Centers for Medicare & Medicaid Services (CMS) established the Comprehensive ESRD Care (CEC) initiative in 2015.2,3