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Considers the situation facing Gary Gottlieb, President of Brigham and Women's Hospital (BWH), prior to the opening of BWH's integrated cardiovascular center. This case allows students to develop an appreciation of the strategic, financial, organizational, clinical, and physical aspects of integrating health care delivery around specific categories of disease. It provides an opportunity to evaluate BWH's approach to integration along all of these dimensions and to identify the nature of the tradeoffs that hospitals - specifically, academic medical centers - face as they attempt to create disease-specific models of integrated care. Finally, students have the opportunity to evaluate the degree to which integrated models of care can be developed within academic medical centers.