A pivotal strategy to improve the quality of health care while lowering costs in the United States is value-based purchasing (VBP). Advanced Practice Registered Nurses (APRNs) can lead this transformation through collaboration, coaching/mentoring, direct patient care, research, ethics, and leadership. To achieve success in improving patient safety and outcomes, leaders must focus on interprofessional, team-based collaboration to effectively lead all involved to system and process improvements in the delivery of care. APRNs should also take professional accountability to become knowledgeable about the Affordable Care Act and VBP, not just the program that applies to the APRN’s practice but about all programs, and discuss these with other providers, colleagues, and patients. Finally, APRNs must also become involved in policy making to remove barriers for all nurses and to allow APRNs to practice at their highest level of education, skill, and competency.