This study used a sequential explanatory equal-status mixed-method design to investigate whether Maryland’s child care tiered reimbursement system incentivized child care centers to be rated at least 3 (and receive an incentive payment) on Maryland’s 5-level Quality Rating and Improvement System (QRIS). The first stage of research consisted of multilevel logistic regressions to determine the association between centers’ reliance on child care subsidy payments and whether the center had a rating of 3 or higher. Reliance on subsidy payments was defined as the percentage of licensed slots filled by children receiving a child care subsidy. State administrative data on 1003 centers that received a subsidy payment in January 2018 were combined with demographic data from the U.S. Census. The second stage of research consisted of 14 interviews with center directors to understand how they made decisions about which QRIS rating to attain and how tiered reimbursements factored into their decisions. Results from the quantitative research showed that a greater subsidy density was associated with a greater likelihood of a center being rated 3 and receiving an incentive payment. However, results from the qualitative research showed that few center directors reported that tiered payments factored into their decision on what QRIS rating to reach and no directors were singularly motivated by the incentives. Rather, directors reported being intrinsically motivated to improve QRIS ratings or motivated by technical assistance providers. Additionally, directors who did not attain a rating of 3 experienced capacity challenges. Policy implications are discussed. (author abstract)