Abstract: Health reform in Australia is focused on the establishment of Medicare Locals which will operate as regional integration and coordination platforms for primary health care linking to Local Hospital Networks. The health reform juggernaut is charging ahead with less than an 18 month timeframe for establishment of Medicare Locals across Australia. Medicare Locals will be new entities emerging from a diverse set of stakeholders and service providers from the public and private sectors and non-government organisations (NGOs). The establishment of these new entities, and the desired integrated health system will be challenging. While much of the focus and activity in health reform has been on negotiating state and commonwealth government agreements, policy development and boundary debate, the real challenge will be at the agency and provider level when we seek to blend differing organisational cultures, work practices, models of care, individual and organisational values, industrial conditions, remuneration processes and management practices. Cross agency service models are a “taster” for the imminent health reforms. This paper seeks to highlight some of the lessons learned in developing and establishing cross agency models that could be considered as Medicare Locals are progressed.