The driving forces that are motivating many advanced practice nurses (APNs) to create new, high-value practices within the ambulatory care setting reflect the need for better, higher quality patient care, a deep commitment to spending healthcare dollars wisely, and most importantly, the relentless search for nursing interventions that lead to real improvement in the health of patients. Business planning provides the path through which new APN-run ambulatory practices become a reality and a success. A well-developed and sophisticated business plan is an essential first step in setting up a successful APN practice that reinforces APNs' contributions to health care, and leads to real rewards for patients and families, APNs, and the healthcare industry.