The Role of States in Improving Health and Health Care for Young Children

States are uniquely positioned to make significant improvements in the quality of health and heath care for young children, due to their roles as administrators of Medicaid and the State Children's Health Insurance Program, as well as mental health, public health, and education programs. Quality improvement initiatives are often hampered, however, by lack of coordination among programs within a state, by the lack of adequate data and information technology, and the tendency of state officials to focus on short-term policy projects. Even in the face of these burdens and other difficult fiscal and administrative challenges, state officials are optimistic that improvements are possible. Potential solutions that state officials consider promising include developing specific child health quality measures, measuring and monitoring performance, making information on quality performance easily available, rewarding superior performance, and using performance measures in purchasing and program decisions.