National health reform includes an emphasis on integrated service delivery models including Accountable Care Organizations and Patient-Centered Medical Homes. These value-based models of care delivery may offer opportunities for nursing to advance its patient care and profession. This paper presents four pillars of health care delivery reform–team-based care; cross-team communication, coordination and collaboration; infrastructure and technology; and aligned payment incentives –intended to improve quality of care while reducing cost increases. Opportunities and challenges for nursing are discussed in this context.
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