What I love about the way it is handled in Witcher 3 is that I felt like there was fully-realised pay-off occurring in the middle of the story.
One thing Mass Effect got wrong, I feel, is that it kept promising the pay-off would come later. You freed the Rachni? This is one of the biggest choices in the original Mass Effect game, but all that happened was they said "thank you" and fluttered away. The game promised that the pay-off would come later. I remember that, finally, in Mass Effect 3, some lady comes up to you and says, "Psst. You know those Rachni you saved? They're grateful and would like to help you fight the big bad. Here's a boost to your 'war asset' score." (I think they did a little more with it in some DLC but I never bought it.) Anyway, Mass Effect kept promising a pay-off, and then when we got to the end of the trilogy, it had too much to do and it struggled to deliver on all those promises. A lot of the pay-off ended up being half-assed.
Most of the big consequences in Witcher 3 are short term. The outcome of the Baron, for instance, isn't likely to be referenced in any sequels, but we did get immediate meaningful pay-off. And the (playable) epilogue of Witcher 3 was awesome because it was so small in scope. Only a couple of decisions actually affected it, and so much work had gone into the bad ending that I actually kind of prefer it over the good ending. (Geralt is seriously badass when he's on a vendetta.)
I would like Larian to focus on paying-off on decisions sooner rather than later, and minimise the number of things saved for the epilogue.