Despite notable disparities in health status and access to high-quality health care in communities of color and other minority populations, the United States health care system has not prioritized achieving health equity. Health care quality initiatives have exploded over the past two decades, yet most payers and providers still do not collect sufficient data to examine the quality of health care across racial, ethnic, and linguistic minority groups. Adequately measuring these disparities, which is not yet common practice, is an essential step toward eliminating them. States, localities, and health care systems collectively must commit to tracking progress toward health equity through meaningful measurement approaches. This primer describes approaches state advocates can pursue to advance equity-focused quality measurement within their Medicaid programs.