This study is based on findings from a national survey of Medicaid and CHIP programs as well as focused discussions with selected program officials. Conducted by Health Management Associates, the survey and discussions addressed current approaches being used by states to improve quality of care and health outcomes for children and adolescents, the barriers states experience as they pursue quality improvement activities, and their assessment of what resources or strategies would lead to further improvements. 

From the report:

Medicaid and Children’s Health Insurance Program (CHIP) leaders are  assessing and improving the quality of care provided to children and adolescents, but many states are finding the resources available to them are inadequate for the job. This report identifies states' priorities for measuring and improving child and adolescent health outcomes and points to opportunities for foundation and government support of states' needs. States see a need for measures that focus on outcomes, not processes; measures that are standardized across programs and agencies serving children; and measures that indicate progress toward specific program goals. In addition, state officials want to be able to compare their state's performance against others in national data sets, using common metrics and methodologies. They would like additional strategies for tying their quality improvement efforts to reimbursement methodologies for health plans and individual providers, to encourage higher performance.

Full report: http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Jul/Medicaid-and-CHIP-Strategies-for-Improving-Child-Health.aspx

The Commonwealth Fund. (2009). Medicaid and CHIP strategies for improving child health. Smith, V.K., Edwards, J.N., Reagan, E. & Roberts, D.