The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 provides an opportunity to consider and enhance the measurement of children's health care quality as a means to improve child health.1 The legislation required the identification of an initial child core set of measures for voluntary use by Medicaid/Child Health Insurance (CHIP) programs. The initial child core set was published in 2009, and after its most current update in 2014, the list now includes 23 pediatric measures.