Patients still have the right to use any doctor, other health care professional, or hospital that accepts Medicare, at any time. Best practice is to invite even those patients that are already claims aligned to sign the voluntary alignment (VA) form. Keep in mind these patients will likely be mailed a VA form, and you can also present the form in office. This is especially important in areas where other REACH ACOs are present to ensure your patients remain assigned to you year over year. If one of your claims-aligned patients had a visit with a provider active in an alternate REACH ACO and signed a VA form elsewhere, Medicare will prioritize this over your claims-alignment.