Building on earlier initiatives, Cincinnati Children's Hospital Medical Center launched an Asthma Improvement Collaborative in 2008 to enhance the quality and coordination of asthma care for low-income, Medicaid-insured children in Hamilton County, Ohio. A multidisciplinary team made improvements across the continuum of care and strengthened linkages with managed care and community-based organizations to help patients and families overcome barriers to asthma control. A lengthening time between hospital encounters among those who received intensive care coordination services suggests a positive effect of this approach for participants. Hospital data showed promising improvement in a combined rate of readmissions or emergency department revisits for asthma at Cincinnati Children’s, although an analysis of Medicaid data found the initiative had not yet achieved its objectives at the county level. Findings from this initiative should be of interest to others seeking to achieve ambitious goals for population health improvement.