The American Academy of Pediatrics and its members are committed to improving the health care system to provide the highest-quality and safest health care for infants, children, adolescents, and young adults. This statement is intended as a guide for pediatricians and pediatric leadership on the appropriate uses of quality measures and the criteria on which they should be based. The statement summarizes the current national efforts on quality measurement and provides a set of principles for the development, use, and evaluation of quality measures for improving children's health and health care. The American Academy of Pediatrics recommends that these measures address important issues for children; be appropriate for children's health and health care, scientifically valid, and feasible; and focus on what can be improved. In addition, the American Academy of Pediatrics supports reasonable principles for the oversight and implementation of pay-for-performance programs.