Climate change will have significant impacts on population health outcomes and population health management for pediatric health systems, including how institutions achieve cost, quality, and equity goals for those in alternative payment models. To bolster preparedness, health systems must be able to identify those populations at highest risk of adverse health outcomes. Population health management strategies related to the use of climate data, the deployment of community-based interventions, the formation of strategic payor partnerships, and innovation in technological applications may each help institutions to more effectively meet quality and cost goals despite this increasing public health threat.