Young EW, Kapke A, Ding Z, et al. - Given the introduction of a new Medicare prospective payment system in January 2011 has led to a rise in peritoneal dialysis (PD) use in the United States, researchers investigated in this prospective cohort study how PD discontinuation and patient mortality were influenced by PD expansion. Participants were patients treated with PD at 90 days of ESKD. They categorized the participants by study commencement date relative to the Medicare payment reform: prereform (July 1, 2008 to December 31, 2009; n = 10,585), interim (January 1, 2010 to December 31, 2010; n = 7,832), and reform period (January 1, 2011 to December 31, 2012; n = 18,742). They reported a higher rate of PD discontinuation in patients managed in facilities with less PD experience vs those treated in facilities with the most experience. During the late interim period and most of the reform period, a decline in the risk of PD discontinuation was noted. Findings revealed a reduction in the risk of PD discontinuation, in the context of growing PD use and declining facility PD experience, and mortality was not adversely influenced.