General Pediatricians and Value-Based Payments

Pediatrics. 2018 Oct;142(4):e20180502. doi: 10.1542/peds.2018-0502.


Background and objective: In an effort to transform the health care system, payers and physicians are experimenting with new payment models, mostly in an effort to move from a volume-based system to one based on value. We conducted a national survey to evaluate pediatricians' experience with and views about new value-based models of payment.

Methods: An American Academy of Pediatrics 2016 member survey was used to assess provider and practice characteristics, provider experience with value-based payments (VBPs) (through accountable care organizations [ACOs] or pay for quality performance), and provider views about new payment models. We used descriptive statistics and multivariable logistic regression models to examine relationships between experience and views.

Results: The survey response rate was 48.7% (n = 786 of 1614). Of practicing general pediatricians, 52% reported experience with VBP, 32% believed payment for quality metrics have a "positive impact" on pediatricians' ability to provide quality care for patients, and 12% believed ACOs have a positive impact. Adjusting for covariates, respondents experienced with payments for quality metrics (adjusted odds ratio: 2.01; 95% confidence interval 1.26-3.19) and ACOs (odds ratio: 6.68; 95% confidence interval 3.55-13.20) were more likely to report a positive impact.

Conclusions: Although experience and views vary, just more than half of surveyed pediatricians report receiving some form of VBP. Pediatricians reporting this experience are more likely to feel that these payment models have a positive impact on patient care when compared with pediatricians without this experience.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pediatricians / economics
  • Pediatricians / psychology*
  • Surveys and Questionnaires*
  • United States
  • Value-Based Health Insurance* / economics