1. 1Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN
2. 2Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
3. 3Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
4. 4Division of Endocrinology, Department of Medicine, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA
5. 5OptumLabs, Eden Prairie, MN
6. 6Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins Medicine, Baltimore, MD
7. 7Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine, Baltimore, MD
8. 8Center for Chronic Care Innovation, HealthPartners Institute, Minneapolis, MN