Whereas the previous chapters of this book focused on how to deliver evidence-based CBTx at the patient level, this chapter seeks to consider and challenge readers on how to design, deliver, and implement CBTx for insomnia scale. It outlines the strengths of different delivery methods of CBT (e.g., individual, group, telehealth, books, and digital) and puts forth the case that digital therapeutics (DTx) can serve as a means of fulfilling clinical guideline care for insomnia at scale. Next, the chapter focuses on how guideline-recommended treatment can be delivered in an efficient manner through a stepped care approach that utilises the variety of delivery methods available. The chapter proceeds to outline a care-delivery model at the ecosystem level to treat the widest possible population, taking into account treatment guidelines and real-world examples such as the role of medication and different care pathways. It goes on to describe how to provide a specialised insomnia service within different clinical services and concludes by highlighting key partnerships and alliances for the future of insomnia CBTx.