Recent research findings that insured children in the United States get recommended medical care less than half of the time highlight the need for health reform to focus not only on increasing the number of insured, but also on improving the quality of care. The study was published in the New England Journal of Medicine in 2007.

"Health insurance alone doesn't guarantee good health," said Mark D. Smith, MD, MBA, president and CEO of the California HealthCare Foundation (CHCF), which cofunded the study. "Quality improvement — supported by health information technology and public reporting of clinical data — must be part of the health reform agenda."

Nearly all of the 1,500 children in the nationwide study had health insurance, yet the study concluded that doctors gave children the appropriate outpatient medical care only 47% of the time. Study authors include researchers from the Seattle Children's Hospital Research Institute and RAND Corp. CHCF funded development and testing of the medical-record abstraction software used in the study. Other funders included the Robert Wood Johnson Foundation and the federal Centers for Medicare and Medicaid Services.

CHCF has been engaged in state and national efforts to improve the quality of care for over 10 years. Currently, the foundation is supporting demonstration projects to increase the effectiveness of health care professionals to improve clinical outcomes.