In 1992, two hospital executives began exploring community-based options to care for the most difficult patients they encountered: those with severe and persistent mental illness who had used their “lifetime” inpatient days, but were almost certain to need hospitalization in their lifetime.

  • 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 coverage rules, and less about Medicare’s.
  • 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.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s