The Institute of Medicine report and the passage of the Patient Protection and Affordable Care Act present significant opportunities for the nursing profession. As the largest group of primary care providers, nurse practitioners are the critical element in the provision of comprehensive primary care, and a critical element to the success of the redesigned health care system. Nurse practitioners can bridge the gap between coverage and access and provide the patient-centered innovative approaches needed. There are, however, significant barriers that need to be addressed. This article presents a framework for creating innovative approaches to the redesign of nurse practitioner clinical education.