How states care for prison inmates has serious budget implications during incarceration, and carries important public health and public safety ramifications after release. Policymakers must rigorously monitor and evaluate the performance of their systems in order to maximize cost-effectiveness and leverage the opportunity incarceration presents to intervene and stabilize the health of inmates who have costly conditions; potentially bolstering their economic productivity and averting recidivism, fragmented episodes of acute care, and the public health consequences of undertreated illnesses. Pew is conducting a 50-state examination of these issues. The research investigates spending trends and cost drivers, systematic quality performance measurement practices, and strategies correctional and community stakeholders have in place to facilitate care continuity upon release. The presentation will include preliminary findings from this research.