 This study examined the early development of four Australian academic health science centres, HSCs, which are designed to facilitate knowledge transfer and exchange. Despite increased investment in these centres, there is limited empirical evidence on how they are enacting their intended role. This study found that while each centre has its own unique approach, there is a common focus on structure and governance rather than action-oriented roles and processes to achieve strategic goals. Additionally, balancing collaboration and competition between partners can be challenging, as well as identifying appropriate methods to measure impact. This article was authored by Alexandra Edelman, Robin Clay Williams, Michael Fisher, and others.