Contemporary challenges and opportunities at academic health centers.

Academic health centers (AHCs) have struggled in recent years to redefine their special position in healthcare delivery. This article presents a description of structural and process features at AHCs to serve as a framework for redesigning healthcare delivery at AHCs. We review and synthesize the literature regarding health system performance. In addition, we address attributes of healthcare delivery that represent both challenges and opportunities for AHCs, including costs of care; comprehensiveness and capacity of care; coverage; continuity, communication, and coordination of care; consistency of practice; and consolidation. Recommendations on priorities for AHCs are given, and specific features of desirable academic delivery systems for the future are described.