Value-based insurance design (VBID) is an approach to designing insurance to align the use of health care services with some notion of value. While there is substantial federal interest in VBID and a growing body of evidence of its effects among populations covered by employer-sponsored plans, much of the focus has been on VBIDs that solely reduce cost sharing for certain treatments. The minority of VBIDs that have identified and increased cost sharing for low-value treatments have produced some promising results. Looking to the future, health plans should continue to develop and benefit from innovations in formulary design and health information technology that distinguishes and incentivizes high-value drugs in a patient-specific manner. DISCLOSURES: No funding contributed to the writing of this article. The author has nothing to disclose.