Study setting {9}
Kaiser Permanente Washington (KPWA) is an integrated healthcare delivery system in Washington State that serves approximately 700,000 enrollees annually. About two-thirds of members are in the Integrated Group Practice (IGP), in which members receive KPWA insurance coverage and care from KPWA providers; the other one-third are insured by KPWA but see contracted providers outside the KPWA healthcare system. This trial is limited to enrollees of the IGP which allows for access to complete medical utilization data.