Some changes are coming to health care coverage even as Republicansstruggle to replace the Affordable Care Act with their own view ofhealth care coverage—but those changes could pay off for patientsin lower costs and better health.

A New York Times report about value-based insurance design—acarrot approach, rather than a stick—says that while V-BID doesn’tnecessarily lower costs, it does result in patients being morediligent about taking medication and getting recommended screeningsand care.

There’s a V-BID provision in the Affordable Care Act thateliminates cost-sharing for more than 100 preventiveservices, such as vaccinations and cancer screenings, that’sendorsed by four committees of medical experts, the reportsays.

The change is that insurers provide more generous coverage ofhigh-value care, while cutting coverage of services that aren’t asnecessary to a patient’s health.

Studies show that value-based “carrot”programs, which help patients with chronic illnesses stay out ofthe hospital by cutting cost-sharing on high-value medications,boost patient use of medication, at least alittle.

But while patients may be paying less for their medications, theremaining cost has to be paid by someone—usually employers andhealth plans.

Still, cutting the cost of those high-value drugs can save moneyin other areas, as one study of heart attack patients indicated.

Those who got their medications at no cost were compared withthose who had regular insurance that came with copays of $10 to$25. The former group increased use of the medications, and theextra expense to the insurer for drugs was offset by a decreasedneed for hospital procedures.

Large employers and state governments are getting in on the act bycutting cost-sharing for high-value care and medications used totreat chronic illnesses such as depression and heart disease.

And they’re not the only ones, with the Centers for Medicare andMedicaid Services launching a five-year testof value-based design this year that allows Medicare Advantageplans in seven states to reduce cost-sharing and boost benefits forenrollees with specific chronic conditions.

And there’s actually bipartisan legislation in both the Houseand Senate that would expand the program across the country—if itmakes it through Congress.

The military, too, is evaluating its use, with a planned 2018Department of Defense pilot V-BID program that will cut cost-sharingfor high-value medications and services, in an attempt to improvethe care and outcomes for American military personnel.