One of the fundamental questions states face when seeking to integrate health and social services is: how will this be paid for? There is no right answer; each state is unique and must capitalize on available resources. Many states will pursue a gradual transformation toward financing integration, characterized by three phases: (1) pilot or demonstration; (2) intermediate ramp‐up/expansion; and (3) advanced, fully operational (see Exhibit 1). During this process, states will move from small‐scale, local demonstration projects—likely funded by one‐time grants or seed money—to statewide efforts, paid for with a combination of Medicaid dollars . . .

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