In 1988, America had a tremendous amount of addiction treatment resources available, access was achievable and much of the country was receiving help, but the industry was poised on the brink of the "managed cost" correction. In less than 5 years, 35,000 treatment beds shrunk to less than 3,000. Many treatment providers were defenseless, having little or no ability to demonstrate to the funders and payers that the services being delivered, and that payers were purchasing, were indeed making a difference in communities across the country.
In response to this veritable earthquake in addiction treatment funding, the National Council on Alcohol and Drug Dependence (NCADD) created C4 Recovery Foundation's predecessor organization, the Committee on Benefits (COB). COB was tasked with finding ways to address the challenges created by the managed cost revolution.
In 2000, COB spun off from NCADD and became a 501(c)(3), The Coalition of Outcomes Based Benefits (COBB). The new organization's goals expanded, primarily the organization sought to improve access and accountability for the treatment of substance use disorders. COBB sought to advance these goals by initiating constructive dialogue among all interested groups; educating and motivating policymakers to embrace new strategies and aiding in the design and implementation of programs. COBB worked diligently to implement outcomes-based treatment models and educate the providers across the country. In 2001, as its range of services expanded to meet the needs of a broader group of constituents, COBB evolved into C4 Recovery Foundation Inc maintaining its public charity structure.