He has been associated with a Downtown New York City movement known as totalism, and is best known for his operas, including Dennis Cleveland, about a television talk show host, which Rouse wrote and starred in.
One of the basic rhythms of Rouse's opera Failing Kansas is a five-beat isorhythm (rhythmic ostinato) against which either the harmony or drum pattern often reinforces the four- or eight-beat meter.
Rouse's association with Ben Neill and Kyle Gann in New York in the early 1990s led to the recognition of a new rhythmic complexity in minimalist-based music that came to be referred to as totalism.
In 1995 he premiered a one-man "opera" Failing Kansas, based on the same story as Truman Capote's In Cold Blood, and in 2000 he produced an entire film with music by himself, rather pointedly titled Funding.
In an opposite direction, he premiered a technologically innovative opera called Dennis Cleveland at The Kitchen in 1996, based on a talk show format and with some of the singers/actors spread out among the audience, though with a dense libretto drawn from John Ralston Saul's critique of Western society in the latter's book Voltaire's Bastards.