ACOs, PCMHs, and health care reform: nursing's next frontier?

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.