In 1992, two hospital executives began exploring community-based options for the most challenging health care scenario they had yet encountered: when patients would exhaust their “lifetime” inpatient days, but required, due to severe and persistent mental illnesses, further hospitalization.

• What they found was a disjointed delivery system suffering the latest round of “de-institutionalization”, confused state Medicaid authorities (in multiple states) ensconced in siloed departments unable to work across disciplines, and confounded payers who understood very little of their own, and Medicare’s, coverage rules.
• What they decided was that the rules varied so greatly, busy providers operating in multi-payer systems had little chance of success.
• What they did was create The Compliance Consortium, a national consulting firm dedicated to working at the intersection of health plans, state Medicaid authorities, and providers.