The demands for powerful organizational alignment are particularly pronounced in the academic medical center (AMC) where continued pressure on funding sources, tremendous demands for capital investment, and intensifying market competition serve to foster competing needs across competing missions. Academic enterprises can be extraordinarily powerful when they are able to harness their vast intellectual capabilities and focus on a shared vision and complementary strategies. It is critical to design and implement mechanisms to enable their diverse components to work together more effectively and to jointly develop innovative clinical, research, and educational programs that result in differentiated market position, locally and nationally.

Aligning the AMC enterprise through consistent and coherent economic relationships and funds flow are critical to improving overall organizational performance. That said, no single funds flow model will be "right" for every AMC. The ideal funds flow model should reflect the organization's unique situation, goals, and the resources available. Funds flow methodologies are the most evident expression of the enterprise strategy and a key economic component of enterprise-wide organizational alignment.

Optimizing performance in regional health systems, or within ventures requires that the entities work together toward a unified vision, strategy, and economic model that will enable the individual entities and the collective enterprise to reach their goals and excel. Successful organizational alignment results in integrated enterprises where each entity magnifies the impact of the others in ways that create systems that are greater than the sum of their individual parts. Seamless organizational alignment results in optimized provider, patient and resource management, and stronger organizational, operational, and economic relationships.