This issue of the journal deals with a number of important selected topics. This journal has an abiding interest in changes in the Medicaid program-many of which are headed in the wrong direction. At the same time, positive developments are also occurring, especially from a management point of view. Both policy and implementation issues pertaining to Medicaid-in particular State Children's Health Insurance Program (SCHIP)-are highlighted in this issue. Matt Broaddus and Edward Park at the Center for Budget Priorities provide a policy overview of challenges and opportunities facing this all too critical program offering a veritable lifeline for many of our country's children. Pete Welch and his coauthors next examine the use of data within Medicaid programs in a number of states. This article lays the groundwork for the next 2 articles, which focus on data analysis and quality improvement within specific states. These articles focus on the tools and techniques that Medicaid programs have used, particularly from a data management point of view, to manage their ever increasingly complex programs. John Neff and colleagues from the state of Washington provide a private and public perspective on the identification and management of children with special needs. Patrick Roohan provides a state perspective on the many efforts, most of which are data driven, that the New York State Office of Managed Care is making. From the state of Wisconsin, Espeseth and Riportella close this special issue of Medicaid/SCHIP with an analysis of the critical relationship between administrative rules and enrollment. As the latter authors point out, while budgetary increases are needed, administrative rule changes can have the same negative or positive impact.

Lewis Kazis from the Veterans Administration System sums up his series on the use of health status measurement in healthcare delivery. Together with Ren and colleagues, who contribute the last article in this series, Kazis and colleagues have provided the reader with an important set of benchmarks for the use of this important type of information to improve healthcare systems. Giovanni Apolone and colleagues continue our interest in this journal in patient-centered care with an article on certainly the most common symptom in ambulatory care-pain. While the article focuses largely on pain related to cancer, the same principles apply-from both a research and practical point of view-to virtually all other ambulatory conditions that have pain as a major symptom. We conclude with our regular human rights feature together with a report from the Republic of Texas.

Norbert Goldfield, MD, Editor