Kidney failure affects more than 115,000 U.S. adults every year. Patients who develop this condition must choose from a variety of treatments, such as dialysis or a kidney transplant, each of which has advantages and disadvantages that may vary depending on the individual. Unfortunately, kidney failure often occurs before patients are aware of the extent of their illness, forcing them to quickly make decisions with lifelong consequences without being fully prepared or able to make informed decisions. Dr. Jamie Green is the co-principal investigator of a PCORI-sponsored project to measure the effectiveness of a new healthcare delivery process to improve the care of patients with advanced kidney disease. The PREPARE NOW study will employ a new care strategy to help patients understand their risks of kidney failure, understand their treatment options, obtain needed support and choose treatments that are aligned with their personal values. In a randomized controlled trial, researchers will measure the effectiveness on the new care strategy on patients’ outcomes. This study is in collaboration with Duke and Johns Hopkins.