Academic health centers are currently facing enormous changes that will impact their roles in education, research, and patient care. The aging and diversity of the population will create new health care needs and demands, while rapid advances in technology will fundamentally alter the health care systemsa (TM) capabilities. Pressures on health care costs, growth of the uninsured, and evidence of quality problems in health care will create a challenging environment that demands change. Academic Health Centers explores how AHCs will need to consider how to redirect each of their roles so they are able to meet the burgeoning challenges of health care and improve the health of the people they serve. The methods and approaches used in preparing health professionals, the relationship among the variety of their research programs and the design of clinical care will all need examination if they are to meet the changing demands of the coming decades. Policymakers will need to create incentives to support innovation and change in AHCs. In response, AHCs will need to increase the level of coordination and integration across their roles and the individual organizations that comprise the AHC if they are to successfully undertake the types of changes needed. Academic Health Centers lays out a strategy to start a continuing and long-term process of change.