Measuring the quality of pediatric care is an important first step in improving health care services for children. Perhaps just as important, however, is communicating these results effectively and using them to improve care. Because of their role in specifying the coverage and content of health care services for low-income families, state Medicaid agencies are a critical partner in evaluating and improving the quality of child development services. This project will create a network of seven state Medicaid agencies dedicated to administering, reporting the results of, and sustaining the use of the Promoting Healthy Development Survey instruments. Its goal will be to improve the quality of preventive pediatric care provided to low-income young children by generating state-based models and technical assistance materials. If successful, the project will demonstrate to all states the value and feasibility of incorporating measures of developmental services into their ongoing quality measurement and improvement activities.