This article explores the development of academic nursing centers within an environment of evolving health policy and changing priorities and resources within nursing education during the past 3 decades. Etheredge's framework for this discussion identifies three health policy eras: the Age of Traditional Health Insurance (1965-1982); the Age of Regulated Prices for Government Programs (1983-1992); and the Age of Markets, Purchasing, and Managed Care (1993-2000). In this article, I suggest the current era is the Age of Uncertainty and Opportunity. Within each era, health policy changes are summarized, and changes in nursing education that influenced the evolution of academic nursing centers are identified. The uncertainty and opportunity of the current era is explored within the context of the Institute of Medicine (IOM) reports issued in 2000 and 2001. The new vision for clinical education in the health professions described in the 2001 report provides new opportunities for academic nursing centers. To take advantage of these opportunities, these centers must focus on quality issues as they continue to maintain a precarious balance between meeting the service needs of their clients and the academic needs of the nursing programs that own them. Centers that maintain this balance will be a bridge to the future for quality health professions education.