The State Scorecard released by the Commission on a High Performance Health System in June 2007 was the first-ever multidimensional assessment of state-by-state health system performance. Its findings stimulated much discussion among policymakers about the wide variations in performance that were documented, and about ways to address performance gaps. With this grant, the Rutgers Center for State Health Policy will work with the Fund to prepare the first update of the State Scorecard and improve measurement of health system performance using new indicators and data where available. The new scorecard will also highlight trends in state performance in the previous two years. Findings will be targeted to state and federal policy leaders and health system leaders, who will likely use the information to help set priorities for remedial action.