Last updated: April 2026
Healthcare Program Development & Standards Development
IHS does not only help clients meet standards — IHS helps clients build programs and standards from the ground up. Program development engagements produce the operational infrastructure that a healthcare organization needs before it can pursue accreditation, launch a new line of business, or satisfy regulatory requirements for program structure. This is architecture work: designing the policies, procedures, workflows, quality management systems, and governance frameworks that define how a healthcare program operates.
Program development is IHS's third practice line alongside accreditation consulting and compliance services. While accreditation consulting helps organizations meet existing standards, and compliance services help organizations stay current with regulatory requirements, program development creates the foundational infrastructure that makes accreditation and compliance possible in the first place.
Every IHS program development engagement is led by Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC. His experience designing and overseeing accreditation programs at the national level gives IHS a unique perspective on what a well-built healthcare program looks like — not just what the standards require, but what makes a program operationally effective, audit-ready, and scalable.
Program Development Service Lines
CVO Design & Certification
Credentials Verification Organizations (CVOs) perform primary source verification of provider credentials on behalf of health plans, hospitals, and managed care organizations. IHS designs CVOs from scratch — organizational structure, verification workflows, data management systems, turnaround time standards, quality assurance processes, and the documentation architecture needed for NCQA CVO Certification. For organizations that already have a credentialing function, IHS can assess readiness for CVO certification and remediate gaps.
Credentialing Program Design
A credentialing program is the infrastructure that verifies, evaluates, and monitors the qualifications of healthcare providers participating in a network or practicing at a facility. IHS designs credentialing programs that satisfy NCQA, URAC, Joint Commission, and state regulatory requirements — including provider application workflows, primary source verification procedures, credentialing committee governance, re-credentialing cycles, and ongoing monitoring between credentialing periods.
Healthcare Compliance Program Development
The OIG's Seven Elements of an Effective Compliance Program provide the framework, but building a compliance program that actually works requires translating those elements into an organization's specific operational context. IHS builds compliance programs from the ground up — written standards of conduct, compliance officer role design, training programs, internal monitoring and auditing, response protocols, enforcement mechanisms, and board-level reporting structures.
Certificate of Need (CON) Applications
Thirty-five states and the District of Columbia require Certificate of Need approval before healthcare facilities can be built, expanded, or equipped with major capital investments. IHS prepares CON applications that satisfy state health planning requirements — community need demonstrations, financial feasibility analyses, quality assurance commitments, and workforce impact assessments.
AI Governance Program Development
Healthcare organizations deploying AI and machine learning tools — clinical decision support, predictive analytics, automated prior authorization, natural language processing — need governance frameworks that address algorithmic bias, clinical validation, regulatory compliance, data privacy, and organizational accountability. IHS builds AI governance programs that satisfy emerging CMS, state, and accrediting body requirements.
Regulatory Readiness & Gap Assessment
Organizations entering new markets, launching new service lines, or preparing for regulatory changes need a comprehensive assessment of their current state against applicable requirements. IHS conducts regulatory readiness assessments that identify gaps across accreditation standards, state regulations, federal requirements, and payer contract obligations — and produces a prioritized remediation roadmap.
Additional Program Development Capabilities
Beyond the service lines with dedicated pages above, IHS builds programs in the following areas. These engagements are scoped through a discovery call.
Quality Management System (QMS) Design
A quality management system provides the organizational framework for continuous quality improvement — performance measurement, outcomes tracking, corrective action processes, and governing body oversight. IHS designs QMS architectures that satisfy accreditation requirements (URAC, NCQA, Joint Commission, DNV) while producing actionable quality data for operational decision-making.
Policy & Procedure Architecture
Many organizations have policies and procedures that accumulated over years without a coherent architecture — inconsistent formatting, overlapping scopes, outdated references, and gaps that only surface during accreditation surveys. IHS designs policy architectures from scratch: hierarchical structure, numbering systems, approval workflows, review cycles, version control, and cross-reference mapping to applicable standards and regulations.
New Line of Business Program Build
Organizations entering a new line of business — a health plan launching a PBM, a pharmacy adding specialty services, a hospital system starting a home health agency — need program infrastructure built before operations begin. IHS designs the operational programs, compliance frameworks, credentialing processes, and quality management systems required for new service lines, often in coordination with accreditation readiness for the new program.
Pre-Accreditation Readiness Programs
Organizations pursuing accreditation for the first time often need foundational program development before the accreditation consulting engagement can begin productively. IHS offers pre-accreditation readiness programs that build the organizational infrastructure — governance, documentation, quality management, compliance — needed to support a successful accreditation process.
How Program Development Differs from Accreditation Consulting
Accreditation consulting assumes a program already exists and helps it meet specific accreditation standards. Program development builds the program itself — the operational infrastructure, governance, policies, and workflows that did not previously exist.
In practice, many IHS engagements span both: an organization entering a new market may need program development (build the credentialing function), followed by accreditation consulting (achieve NCQA CVO Certification for that function), followed by compliance services (maintain ongoing regulatory compliance). IHS coordinates all three practice lines as a unified engagement.
Typical program development clients include:
- Organizations entering a new line of business (e.g., health plan launching a PBM)
- Organizations building a compliance function from zero
- Organizations designing new healthcare delivery models
- Organizations that need foundational infrastructure before pursuing accreditation
- State agencies or health systems developing new program standards
Schedule a Discovery Call
All IHS program development engagements begin with a complimentary discovery call. During the call, Thomas Goddard will assess your program design needs, current infrastructure, regulatory requirements, and timeline, and provide a scoped proposal.