To effectively engage consumers in the work of AF4Q, Alliances should seek out groups that truly represent consumers. Sometimes the lines appear blurry and it may seem like a health plan, employer group, or even a provider organization could serve as a consumer representative. While they may aim to speak for consumers and patients, these representatives have additional interests to consider, as with any stakeholder group, and cannot be regarded as authentic consumer voices. Defining consumer representation will help ensure that your Alliance includes genuine consumer representatives.