The U.S. health system is in the midst of an extraordinary transformation. This paper, co-authored by KPMG LLP and the Mailman School of Public Health at Columbia University, examines the effort by public officials to include “social” interventions into health delivery systems. This paper explores the innovative approaches that governments are taking to integrate social services into healthcare delivery systems. Drawing on insights from the academic literature and lessons from two key New York DSRIP case studies, the authors highlight both the opportunities and successes as well as the tactical and policy challenges that states face in creating effective integrated health systems.