This study was supported by a grant from the Anthem Public Policy Institute. Brian Powers reports employment by Humana, stock ownership in Humana, and previous employment by Anthem, Inc., and Fidelity Investments. Kristin Linn has received grant support from Hawaii Medical Service Association. Sachin Jain reports employment by Anthem, Inc.; stock ownership in Anthem, Inc.; and honoraria from Elsevier Press. Jennifer Kowalski reports employment by Anthem, Inc., and stock ownership in Anthem, Inc., and Amazon. Amol Navathe has received grants from the Hawaii Medical Service Association, Health Research and Educational Trust, Cigna Corporation, Ochsner Health System, UnitedHealthcare, Blue Cross Blue Shield of North Carolina, Blue Shield of California, and Oscar Health; personal fees from Navvis Healthcare and Agathos, Inc.; personal fees and equity from NavaHealth; personal fees from YNHHSC/CORE; personal fees from the Maine Health Accountable Care Organization; personal fees from the Maine Department of Health and Human Services; personal fees from the National University Health System, Singapore; personal fees from the Ministry of Health, Singapore; personal fees from the Social Security Administration, France; equity from Embedded Healthcare; speaking fees from the Cleveland Clinic; an honorarium from Elsevier Press; and personal fees for serving as a commissioner of the Medicare Payment Advisory Commission. He also has served as a board member of Integrated Services, Inc., without compensation. None of these are related to this article. All other authors declare no conflicts of interest. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US government. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of their employers, the Department of Veterans Affairs, or the US government.







