With the Affordable Care Act expanding coverage for millions of Americans over the next several years, increasing the supply of primary care available is essential. It is difficult, however, to rapidly increase the number of primary care practitioners, especially primary care physicians and advanced practice nurses. Therefore, immediate term access and affordability challenges must be addressed through utilizing medical personnel more effectively and efficiently. Fortunately, there is substantial evidence to suggest that this is consistent with comparable if not improved healthcare quality and health outcomes as well as cost savings.