This chapter argues that the management of change toward integrated care requires the combination of two principle sets of processes: a stepwise progression of managerial tasks that come together to represent the core components of a change management plan (“management”) and the ability to adapt these strategies for change in the context of the complex and multidimensional nature of practical reality (“environment”). Both tasks require key individuals with the managerial skills, and both have a strong relationship-building component and are inherently interrelated.