About

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.

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