This Microsoft PowerPoint presentation describes how States are using Quality Rating Systems (QRS) to improve the quality of early care and education programs. Common elements of QRS include: (1) standards, (2) accountability, (3) program and practitioner outreach and support, (4) financing incentives linked to compliance with quality standards, and (5) parent/consumer education. Accreditation is included in 10 of the 11 Statewide QRS. Thirty States have Statewide tiered reimbursement. State evaluations have found positive impacts of QRS on quality.