Value-based care has evolved differently for pediatric versus adult systems of care and clinically integrated networks (CINs) for children's hospitals look different in nearly every market. While differences abound, pediatric CINs have had to overcome similar challenges, including how to best engage providers, how to deliver evidence-based, high-quality care, how to position the CIN to be strategically relevant in the shadow of larger adult CINs and how to evolve and sustain their networks. Over the past five years, the Pediatric Care Network (PCN) has grown its membership, executed value contracts, advanced care coordination initiatives and quality coaching to improve pediatric health across Colorado. The network has experienced and overcome many challenges along its journey and despite its early successes, still has much more to accomplish in partnership with its highly engaged and committed pediatric primary care and specialist providers.