Zhejiang University (ZJU) is a nationally ranked (in the top five) comprehensive university in China, with strengths in earth sciences, natural sciences, applied sciences, information sciences, medicine, and engineering. The university, the Yuhang District Government, and donors have invested resources for the development of a new academic medical center (AMC) with the intention of integrating the university's health-related research, teaching, and care activities; and building world-class comprehensive biomedical and clinical research infrastructure to provide vital patient care, support public health initiatives, conduct cutting-edge biomedical and clinical research, and educate the country's future health care workforce. This report identifies and assesses potential models of organization to help the AMC achieve its goals. The authors conducted four case studies of AMCs in the United States to illustrate and assess potential models for the organizational structure of ZJU's AMC. The findings were used to develop recommendations for the future development of the AMC. The report emphasizes that there is no out-of-the-box solution, but that the model ultimately chosen for the Zhejiang University AMC will require ongoing monitoring and adjustments to ensure its optimal performance for meeting stated goals.--.