Health Care Value SIG

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The APA HCV SIG Goals:

  • To support and recruit APA members who are working on issues relating to value (defined as health and healthcare outcomes/cost) in pediatric healthcare
  • To develop a national curriculum on healthcare value for pediatric trainees
  • To facilitate discussions and projects within the field of pediatrics surrounding the financial crisis affecting US healthcare

SIG Background:

Healthcare costs in the US are ~$3 trillion per year, comprising almost 20% of the GDP. Despite these substantial expenditures, which dwarf all other developed countries, outcomes such as life expectancy, infant mortality are suboptimal. Reductions in rampant over-testing and overtreatment that are currently plaguing the health care system would increase value both by improving outcomes (through reduced harm) and by decreasing costs. Underuse of cost-effective care is also commonplace in pediatrics, which further reduces value. As pediatricians, we have a professional obligation to deliver high-value care that improves the health of children while reducing the financial harms borne by families and society.

Much of the current dialogue surrounding value and healthcare overuse occurs in adult medical fields, but it is imperative that the field of pediatrics is similarly engaged. The encourages and facilitate sharing of ideas and collaboration on projects relating to research, education, quality, and policy to support value for child professionals nationally.

Other Links:

HCV SIG Annual Report (2016-2017)

Co-chairs: Alan Schroeder, Stanford, term 3 years (2019), Ricardo Quinonez, Baylor College of Medicine, term 2 years (2018), Adam Schickedanz, UCLA, term 3 years (2019)

SIG purpose/mission: To highlight health care value within the activities of the Pediatric Academic Association and support academic pediatricians interested in promoting value-based care

Current SIG goals:
1. To increase awareness of barriers to and facilitators of healthcare value in pediatrics
2. To create a learning community within APA to support the growing interest among academic pediatricians in health care value

Annual summary:

Value Success Stories, Journal Editor Panel at Annual HCV SIG Session

Our second annual meeting of the HCV SIG at PAS built on the success of the first by focusing on community building through our second "Value of Stories" competition. This year, we chose to highlight not stories of low value pediatric care but stories of trainees and their teams improving care value at their institutions to increase quality and lower cost for pediatric patients and families. This national, peer-reviewed competition received dozens of entries for five oral story presentations during the annual meeting. Trainees were asked to describe the clinical value problem they tried to improve, the approach they took, and the human impact on patients and providers of their value improvements. They were also encouraged to speculate on factors that may have facilitated their success in achieving higher-value care. We received many exceptional stories, which were all evidence of the tremendous work being done nationally around pediatric value (especially at the residency level). The presentations from trainees were uniformly excellent and highly engaging for the packed-room audience.

We also hosted a panel discussion of journal editors from major academic journals in pediatrics and internal medicine with a focus on value. The editors provided thoughtful insight into everything from the definition of value in pediatrics to how academic publishing can further the value discussion in our field.

PedsValue Modules Publication

Another major initiative of the SIG this year continued to be pediatric value-based education and curricular resources. After the development and dissemination by HCV SIG members of a series of online, case-based educational modules (The PedsValue Modules) focused on preparing pediatric trainees to deliver high quality, cost-effective care in the management common pediatric diagnoses last year, SIG members this year co-authored a manuscript in Academic Pediatrics ( reviewing existing high value care curricula in pediatrics and describing the process leading to the development of these PedsValue Modules, which represent the first nationally-developed pediatric high value curriculum. Use and utility of the PedsValue modules continues to be tracked by their authors and members of the SIG, who have plans to evaluate their uptake and effectiveness in the coming year. The PedsValue Modules are available at

Other groups that work in your area of interest:

Pediatric Academic Societies National Meeting - Joint SIG Session and Value of Stories Contest

This year, we are partnering with the Patient and Family Centered Care SIG to focus on family perspectives on costs and value. Although efforts to better connect physicians and families with the costs of healthcare have been proposed as a means to reduce waste and improve value, there is a paucity of data surrounding whether and when families want to engage in discussions about cost. Similarly, little is known about the impact that health care bills have on the families of our pediatric patients, particularly our complex ones.

We are interested in stories from trainees (students, residents, fellows) that detail the impact that healthcare costs have had on families. In 400 words or less, please describe:

  • Brief details of your patient's illness/story
  • How the costs of medical care have impacted your patient and his or her family
    • These can include direct costs (i.e. medical bills) or indirect costs (missed work, lost job, travel, daycare for other children, etc)
    • If applicable, discuss any associations between the costs of medical care and the patient’s health (e.g. a medication or intervention were deferred because of affordability)
  • What actions were taken/are being taken to remedy the situation

We encourage trainees to interview families directly about some of these issues when appropriate. Video/audio recordings of snippets of interviews are welcome (and do not count towards the word count max), with the family's consent, of course. Please submit your story by e-mail to Alan Schroeder, MD ( with "Value of Stories" in the subject line no later than February 1, 2018. The stories will be reviewed by co-chairs of the two SIGs and high scoring stories will be selected for oral presentation during our session. The meeting is in Toronto from 5/5 - 5/8/18, but the exact date of our session is still TBD. Final decisions will be sent no later than 3/1/18.

Current SIG Co-Chairs:

Ricardo Quinonez, MD
1102 Bates Avenue
Houston, TX 77030
Phone: (832) -82-5447

Adam Schickedanz, MD
10960 Wilshire Blvd., Suite 960
Los Angeles, CA 90024
Phone: (314) 303-3309

Alan Schroeder, MD
780 Welch Road
Palo Alto, CA 94305
Phone: (650) 725-0551

Current SIG Mentor:

Paul Chung, MD, MS
10833 LeConte Ave, B2-433 MDCC
Los Angeles, CA 90095
Phone: (310) 794-3571



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