2011 (Nursing Economics) Quality access and cost of health care are high-priority global concerns. In the United States, these issues are pressing due to the escalating cost of managing chronic diseases (Department of Health and Human Services, 2009), the variation in quality of care delivered (Kuehn, 2009), and the inadequate number of primary care physicians (Freed & Stockman, 2009; Kuehn, 2009; Lakhan & Laird, 2009). At this critical time, we still do not know which models of care are best, how to integrate advanced practice registered nurses (APRN) providers, or to what extent APRN providers can contribute to improved access to and quality of health care. These deficits are untenable when the health care needs of society are great and the health reform debate progresses in legislative arenas. How to expand health care services for the American public, at an affordable cost, is central to this dispute.