Cardiovascular medicine is well suited for V-BID implementation, because clinically nuanced programs perform best when there is high-quality evidence and/or consensus regarding the benefits of care. There are potential V-BID applications along the entire continuum of cardiovascular care, from primary prevention and risk factor management to diagnosis and medical management of cardiovascular disease, through resource-intensive interventions. In fact, several large public and private organizations have already successfully applied V-BID programs. Aetna, the nation's fourth largest health insurance company, has used a copayment relief program for patients with histories of heart disease. Other public and private organizations that have implemented V-BID include the city of Asheville, North Carolina, the states of Oregon and Maine, Pitney Bowes, the Marriott Corporation, United Healthcare, and several labor groups. The Mercer National Survey of Employer-Sponsored Health Plans reports that value-based insurance design use is increasing and that 81% of large employers plan to offer it in the near future (18). In these applications, V-BID has improved quality measures, including medication adherence rates, hospitalizations, and disability days in a potentially cost-saving manner ((19),(20),21). Encouraged by the success of private-sector implementation, V-BID was explicitly included in the Patient Protection and Affordable Care Act (§ 2713[c]). V-BID has also been highlighted in the Institute of Medicine's report Essential Health Benefits: Balancing Coverage and Cost (22) and in the 2012 Medicare Payment Advisory Committee (23) report to Congress, in which V-BID was promoted as a potential direction for Medicare benefit redesign.