It is not unusual for someone to expect the best quality when it comes to health care. However, with the cost of health care steadily increasing, the relationship between cost and quality in healthcare is complex at best. Although the United States (US) spends more on health care than any other developed country, the US is ranked 26th in the world for quality (Burke & Ryan, 2014). Wasteful spending on unnecessary treatments and certain practices is believed to be causing an increase in health care costs in both the private and public sectors (Burk & Ryan, 2014). It is also stated that health care costs may not be strongly related to the quality of care within the US. Fortunately, there are public and private healthcare agencies that work in…show more content… In order to maintain quality and reduce cost, the AHRQ (2017) is decreasing the use of antibiotic and eradicating healthcare-associated infections, refining care for those with numerous chronic diseases, integrating research data into electronic medical health records, and providing better treatment for opioid addiction in rural communities. According to AHRQ (2017), Quality Indicators (QIs) are measures to ensure quality health care by using hospital inpatient data to focus on quality concerns, areas requiring further investigation, and trends over time. AHRQ created the Healthcare Cost and Utilization Project (HCUP) databases to monitor healthcare costs, quality, and issues (AHRQ, 2017). With AHRQ and HCUP, there are no unintended consequences listed with the agency since it does not illicit penalties for noncompliance or infractions, but rather uses data found in various healthcare settings related to costs, quality, and other health issues. This data is then used to in research to improve quality of care and improved costs (AHRQ,…show more content… Evidence-based practice (EBP) is used by nurses to make decisions in patient care based on evidence found in research studies (Melnyk, 2016). They go on to state that EBP improves quality of care, increases safety, improves outcomes of health, reduces disparities in care, and lessens the cost. For example, EBP shows that the use of Nurse Practitioners (NPs) in place of primary care physicians (PCPs) gives the same quality of care and also reduces costs (Bauer, 2010). Nurses are the most affected by public and private healthcare agencies since they are direct providers of