Expanding Access to Accountable Care for Medicare Beneficiaries

JOIN THE MOVEMENT

The Coalition for Aligned Care (CAC) brings together ACOs, provider organizations, and policy leaders to advocate for Signed Voluntary Alignment (SVA) in the Medicare Shared Savings Program (MSSP).

Your voice matters in this critical planning process. By advocating to make voluntary alignment accessible through simple paper or electronic forms—as successfully demonstrated in ACO REACH—MSSP will be able to expand access to coordinated, high-quality care for millions of beneficiaries and generate meaningful cost-savings for our healthcare system.

SIGN THE LETTER TO CMS

The Opportunity

Millions of seniors still lack access to the coordinated, high-quality care that ACOs provide

  • Graphic showing 50% of Medicare patients are not in an ACO, with an upward trending arrow and stacked coins icon.

    PROBLEM

    Voluntary alignment lets Medicare patients choose their main doctor, but fewer than 1 in 400 (0.25%) MSSP beneficiaries use this option today—leaving half of all FFS beneficiaries not connected to an ACO.

  • Infographic showing a stack of coins with an upward arrow, indicating increased financial or strategic goals. Text states "20X" and "Higher voluntary alignment rate in ACO reach," highlighting a twentyfold increase in alignment rate.

    SOLUTION

    The ACO REACH Model offers a proven alternative—over 100,000 beneficiaries have chosen their doctor through simple paper or electronic forms, nearly 20× the MSSP rate.

  • Illustration of coins with an upward arrow, with text indicating 140 million dollars in annual Medicare savings.

    IMPACT

    Adopting ACO REACH’s alignment process in MSSP could connect 560,000 more seniors to care and save Medicare $140 million annually.

A diagram illustrating the concept of signal flow, with an arrow pointing to the right, a horizontal line representing the signal path, and a hyperbolic function showing a mathematical relationship.

ACO REACH has demonstrated a streamlined, auditable, and scalable voluntary alignment process that can be replicated within MSSP and future ACO programs

The Policy Ask

Cover page of a report titled 'Strengthening the Medicare Shared Savings Program Through Voluntary Alignment,' with a subtitle and executive summary discussing accountable care organizations, ACO REACH model, and potential savings, dated November 2025.
Document titled 'Strengthening the Medicare Shared Savings Program Through Voluntary Alignment,' discussing applying lessons from ACO REACH to improve accountable care, with sections on executive summary, benefits, and statistics including beneficiary alignment, effectiveness, and savings.

We’re calling on CMS to:

  • Adopt Signed Voluntary Alignment (SVA) from ACO REACH into MSSP

  • Leverage the efficiencies and learnings the SVA process in ACO REACH by allowing paper and electronic attestation forms

  • Institutionalize flexibility and consistency across future ACO models

DOWNLOAD THE WHITE PAPER
DOWNLOAD THE LETTER TO CMS

Join the Movement

Add your organization’s name to our open letter urging CMS to bring patient choice and proven alignment practices into MSSP.

And join these organizations advocating for change in MSSP

A senior woman sitting on a patterned armchair in a cozy room, wearing a blue sweater and floral shirt, with a calm expression and a bookshelf in the background.

“Voluntary alignment empowers patients to choose the physician they trust most, rather than being passively assigned through claims. We’ve seen firsthand that when seniors have an active role in selecting their main doctor, engagement rises and outcomes improve. Bringing the ACO REACH alignment framework into MSSP would make this level of patient choice accessible to millions more beneficiaries.”

— Dr. [Name], Chief Medical Officer, [MSSP ACO Name]