IHS provides first-in-class consulting and education services to healthcare organizations in accreditation, quality management, and compliance.
We are group of veteran healthcare consultants with unmatched experience in URAC and NCQA standards and accreditation.
We work with insurers, MCOs, policymakers and providers from all sectors of healthcare to tackle the tough problems. We’ve invested in smart technology and a qualified team to be the only global accreditation partner you’ll ever want.
We founded IHS in 2002 to address the specific needs of healthcare organizations that operate in the worlds of URAC or NCQA accreditation.
Compliance has become a central issue in today’s healthcare management system. Whether it’s URAC or NCQA accreditation, HIPAA, ObamaCare, Medicare Advantage, or the thousands of federal and state regulations, navigating the maze of healthcare compliance requires more than just competence or expertise; it needs creativity, breadth of vision, and the ability to integrate experience with diverse ways of thinking. more
For over ten years we’ve served scores of clients across the USA and around the world, from the largest health insurers and PBMs to the smallest MCO vendors and contractors.
Our compliance and accreditation consultants and healthcare researchers are not only veteran executives of the managed healthcare system, but are also pioneering whole solutions to persistent challenges.
At IHS, we help our clients thrive in an ever evolving, increasingly complex accreditation and regulatory environment.
Integral Healthcare Solutions improves the delivery of health care services around the world by helping health care organizations meet quality, ethical, and legal standards.
The mission of Integral Healthcare Solutions is to provide world-class consulting and education services to healthcare organizations in accreditation, quality management, and compliance.
Very simply, IHS offers unequaled expertise in the key areas of accreditation encountered by the modern healthcare organization.
The dynamic world of healthcare poses challenges across the board:
- Accreditation requirements for health plans to participate in PPACA Exchanges (HIX)
- Emergent pharmacy organizations (e.g., specialty pharmacies, PBMs, mail-service pharmacies)
- Deciding between URAC and NCQA accreditation
- Integrating accreditation requirements with legal and regulatory requirements
- Increasingly complex delegation relationships
- The impact of new health privacy rules on compliance and accreditation
- Integrating offshore business process organizations (BPOs) into accredited processes
- Strategic planning in mergers and acquisitions among accredited organizations
We serve our clients better by looking not only at the surface symptoms, but by tackling the subsurface causes.
- Expert Consultation
- Gap Analysis
- Mock Reviews
Throughout your accreditation process, our top experts will answer your questions, review your documents, and work with you to develop processes and policies to make your organization compliant and accreditation-ready.
All our clients have access to our policy templates. We can also work with you to transform your practices into URAC and NCQA-ready policies and procedures.
We are adept at the URAC and NCQA document submission platforms. Let us navigate you through the application submission process, or turn the task over to one of our specialists to do the uploading for you.
Day-Before Preparation for Onsite Review
We offer “day before” onsite reviews to assure that your environment and all your documents demonstrate full accreditation preparedness. We’ll also run some last-minute "touch-up" interviews to make sure every member of your staff is fully prepared.
Onsite Review Support
We can also attend your onsite review to provide live support including document preparation/amendment as may be required. Onsite Review Support can also be offered remotely.
Assessing where you are compared to where you need to get in order to achieve your accreditation or compliance objectives.
We begin by sending one or more of our senior consultants to your office for an initial planning session with relevant client staff members. During that session, we review the accreditation process, establish a tracking table designed to map staff and consultant activities to application-preparation tasks, and agree upon a schedule for delivery. Most importantly, we will interview your staff to assess which documents you have, and which documents you still need to develop to submit to the accreditation organization. For clients who prefer, we offer this service remotely as well.
We leverage our veteran experience and insights into the “eye of the reviewer” to conduct mock desktop and onsite reviews, helping prepare your staff for the actual accreditation reviews or compliance audits.
Mock Desktop Review
After you assemble your documents but before you submit it to URAC or NCQA, IHS will conduct a comprehensive mock desktop review. This involves a close reading of all the documents submitted to the accreditation organization, along with all the citations and notes submitted with those documents. The deliverable is a report that outlines our findings and recommendations for actions you should take to address any shortcomings discovered during the review process.
Mock Onsite Review
Similar to the mock desktop review, IHS will conduct a mock onsite review to: (1) give your staff members a realistic preview of the onsite review process and (2) provide them with feedback on how to improve their performance during the onsite review interviews. At the conclusion of this review, we provide a written report of our findings and recommendations.
Preparation for URAC's Unannounced Monitoring Onsite Reviews
In 2005, URAC began conducting Monitoring Onsite Reviews. With as little as one day's notice, and no more than five days' notice, URAC reviewers are likely to show up on the doorstep of URAC-accredited companies to conduct an onsite focusing on the most heavily-weighted URAC standards. We help our clients prepare for these pop reviews both before and after they have received notice that the URAC reviewers are coming.
We offer expert training through multiple modalities: onsite seminars, webinars, and our proprietary online accreditation training application: AccrediTrain™.
Integral Healthcare Solutions is a collective of the world’s best healthcare experts, all of whom share a passion for making a profound difference. Let’s get to know each other.
- Thomas G. Goddard, JD, PhD, CEO
- Lesley Malus Reed, MHSA, President
- Evelyn Burde, BSN, MBA
- Kathryn Charbonneau, RN, BSN, Chief Clinical Officer
- Diane Blair Williams, MSHCA, BSN, Senior NCQA Consultant
- Michael A. W. Hattwick, MD, Medical Director
- Michael D. Ricketts, CISSP, Senior IT Consultant
- Jonathan Van Lare, PharmD
Thomas G. Goddard, JD, PhD, CEO
Thomas G. Goddard, PhD, JD, the founder and CEO of Integral Healthcare Solutions, has nearly 35 years of experience in law, health and insurance policy research, and management consulting.
His healthcare consulting practice focuses on helping healthcare organizations with accreditation, particularly URAC and NCQA, and compliance issues.
In the last decade, he has participated as a consultant in over 200 accreditation processes with applicants for both URAC and NCQA accreditation.
Before going into health care consulting, Dr. Goddard was Chief Operating Officer and General Counsel of URAC. While at URAC and more recently as a consultant to URAC, he served on accreditation review teams of more than 175 HMOs, PPOs, and health Web sites.
In addition, Dr. Goddard served as the Project Manager in URAC's successful effort to obtain deemed status as an accreditation organization (AO) from the Centers for Medicare and Medicaid Services (CMS).
Dr. Goddard also has served as:
- Vice President and General Counsel of NYLCare Health Plans of the Mid-Atlantic;
- Counsel for Government and Media Relations for the National Association of Insurance Commissioners;
- President and CEO of the Goddard Public Affairs Corporation.
Dr. Goddard received his B.A. in political science, his law degree from the University of Arizona, and his M.A. and Ph.D. in ndustrial-organizational psychology from George Mason University. His doctoral dissertation was on physician decision-making.
Kathryn Charbonneau, RN, BSN, Chief Clinical Officer
Kathryn Charbonneau, RN, BSN, has more than 36 years of experience in the health care industry; the last 14 years in managed care quality improvement and accreditation and the preceding 22 years in the public health sector.
From 2007, Kathryn Charbonneau has worked with URAC as an independent consultant, conducting over 170 accreditation reviews and monitoring onsite audits in the areas of health utilization management (including workers compensation), case management, credentialing, disease management, health network, health plan, health call center, independent review organizations, pharmacy benefit management, mail service, specialty drugs, drug therapy management, credentialing verification organization, consumer education support, etc. Additionally, Ms. Charbonneau has provided updated reviewer electronic audit tools for many accreditation modules, enhanced the reviewer inter-rater review process and managed grievance investigations.
During 8 years at WellPoint, Kathryn Charbonneau implemented a wide range of quality improvement initiatives from several positions of management, beginning at Blue Cross of California as Director, Regulatory and Accreditation Initiatives, and concluding as the WellPoint Corporate Director, Quality Assessment Systems. While at Blue Cross of California, she developed and implemented new accreditation (NCQA, HCFA, and the California Department of Managed Care) and regulatory compliant processes and increased efficiency of all related activities. As Director, Quality Assessment Systems, Ms. Charbonneau facilitated WellPoint’s national quality improvement program and accreditation/regulatory initiatives at both the corporate level as well as for all WellPoint subsidiaries, developed and implemented a national quality committee structure and managed accreditation preparation (URAC, NCQA, CMS, and state regulatory filings and audits) at the health plan level for 6 health plans. Later, she co-led the integration of all 13 WellPoint and Anthem health plans accreditation and quality improvement activities and established successful national level accreditation activities for both URAC and NCQA that included compliance assessment and standardized processes.
Prior to joining WellPoint, Ms Charbonneau spent 4 years at Prudential Health Care and promoted to QI Director-Western Region. In this position, she was responsible for QI program development, implementation, and oversight, which included the NCQA and HCFA (now CMS) accreditation and compliance initiatives for the Western Region.
Lesley Malus Reed, MHSA, President
Lesley Malus Reed, MHSA, President of Integral Healthcare Solutions, has served as accreditation reviewer and/or consultant to more than 250 healthcare entities. Her focus is in the areas of quality improvement, network management, credentialing, customer service, and information systems. She is one of the nation’s leading experts in provider credentialing and has extensive experience in restructuring and organizing departments.
Before joining Integral Healthcare Solutions in 2003, Ms. Malus Reed served as Manager of URAC's HMO, PPO, Credentials Verification Organization and Worker’s Compensation Network accreditation programs. In that capacity, she was an active participant in standards development, applicant education, and government relations.
Ms. Malus Reed also worked in the Canadian Health Care system, where she played a key role in the merger of the first department of McGill’s five teaching hospitals. Ms. Malus Reed also worked for Aetna of the Mid-Atlantic, working in information systems with an emphasis on statistical data tracking and trending, network management, contracting, quality management and credentialing.
Ms. Malus Reed’s graduate degree is a Masters in Health Services Administration, with a specialty in hospital mergers.
Evelyn B. Burde, BSN, MBA, Consultant
For nearly 20 years, Evelyn Burde has brought her blend of nursing and business experience to a variety of settings in the managed care and healthcare provider worlds. She has served as a clinical nurse and as a nurse coordinator in hospital, long-term care, and home health settings. In addition, she served as a claims examiner for Blue Cross/Blue Shield, and a senior healthcare consultant specializing in Medicare and physician practice operations.
More recently, she served as coordinator of clinical resource management at a major university medical center, where she coordinated medical management, QA, and risk management programs. She gained extensive experience in utilization management and patient care management. At that same medical center, she was promoted to a position from which she oversaw the clinical resource management program, including allocation of personnel to cover all clinical services at the medical center and the integration of the social work department. She also developed and implemented a case management information system and handled appeals of denials by third party payors.
Ms. Burde also has recent experience working at a health care services company that automates the insurance claim reimbursement process for consumers. Her experience there included the development of coding, billing, and reimbursement materials for staff and customers, as well as testing solutions for potential customers.
Diane Blair Williams, MSHCA, BSN, Senior NCQA Consultant
A nurse for nearly 30 years, Diane Williams has worked in the world of managed care quality improvement since the late 1980s. An NCQA surveyor since 1995, she has expertise in the following NCQA accreditation and certification products: HP, HIP, DM, CVO, SNP, MBHO, Quality Plus, OC, POC, NHP, and WHP.
Ms. Williams received her Bachelor's degree in nursing from Oregon Health Sciences University, and her Masters of Science in Health Care Administration from Trinity University. In addition to her work with NCQA, she has served as Editor in Chief of Lippincott’s Case Management: Managing the Process of Patient Care, Manager of Utilization and Case Management Services for Aetna Health Plans, Associate Manager Medical Services and Quality Improvement for The Prudential Insurance Company of America, and a nurse in the U.S. Army Nurse Corp.
Ms. Williams has published articles on disease management, case management, and managed care accreditation since the early 1990s.
Jonathan Van Lare, PharmD
Jonathan Van Lare, PharmD, received his Doctorate of Pharmacy in 2006 from Massachusetts College of Pharmacy and Health Sciences in Worcester, MA. In 2007, he joined the Henry Ford Health System and helped to build Pharmacy Advantage Specialty Pharmacy where he now serves as Manager of Clinical Services. In addition, Dr. Van Lare sits on numerous committees, several of which include Henry Ford/HAP Oncology Pharmacy and Therapeutics Committee and Excelera ©Data Committee. He also serves as chair person for Pharmacy Advantage’s Quality Assurance Committee and the Clinical Advisory Committee.
Dr. Van Lare has utilized his skills of leadership and clinical background knowledge to implement several professional projects including:
- Pharmacy Advantage prior authorization program
- Therapy Management Programs for hepatitis C, multiple sclerosis, rheumatoid arthritis, psoriasis, Crohn’s disease, cancer and diabetes
- Editor-in-Chief of Pharmacy Advantage’s specialty pharmacy newsletter
- URAC Specialty Pharmacy accreditation, attained April 2013.
Michael A. W. Hattwick, MD, Medical Director
Michael A.W. Hattwick, M.D., is a practicing physician in a primary care internal medicine practice in Fairfax County, Virginia. He was born in Illinois, raised in Texas, and educated at Harvard, Georgetown, and the University of London.
Dr. Hattwick is board certified in Internal Medicine and in Preventive Medicine with a subspecialty interest in Preventive Cardiology. He is a Clinical Assistant Professor of the Departments of Medicine and Community and Family Medicine of Georgetown University School of Medicine, a Member of the Governing Council of the Virginia Chapter of the American College of Physicians, and a Past President of the Virginia Society of Internal Medicine. Dr. Hattwick is a Fellow of the American College of Physicians, and is a Doctor of Integrative Medicine.
Before he entered full-time medical practice, Dr. Hattwick served as Chief Medical Advisor and Director of the Health Examination Survey of the National Center for Health Services Research, as Director of the Surveillance and Assessment Center of the National Influenza Immunization Program, as Director of the Special Pathogens Branch of the Viral Disease Division Epidemiology Program at the Center for Disease Control, and as a Registrar and Visiting Lecturer at St. Thomas's Hospital Medical School. He participated in the Institute of Medicine's Study of Medicare: A Strategy for Quality Assurance, published in 1990, was a member of the IOM Committee to Advise the Public Health Service on Clinical Practice Guidelines, whose report also was published in 1990, the IOM Committee on Clinical Practice Guidelines, published in 1992, and the IOM Committee on Telemedicine, published in 1997.
Since 1978, Dr. Hattwick has been actively using computers to implement preventative medicine guidelines in his clinical practice. He has been the American College of Physicians Appointee to the Blue Cross Blue Shield Association Technology Evaluation Center from 1993 to the present. In 1994 he founded NoVa HealthCare to provide assistance to physicians using clinical practice guidelines. Since 1995, NoVa HealthCare has used Guidelines for Utilization Management for Trigon Blue Cross Blue Shield of Virginia and other organizations.
Dr. Hattwick received the 1997 Distinguished Internist Award from the Virginia Society of Medicine. The American Society of Internal Medicine honored Dr. Hattwick with its 1997 Special Recognition Award for his interest and activity in the development and implementation of clinical practice guidelines.
Michael D. Ricketts, CISSP, Senior IT Consultant
Michael D. Ricketts, CISSP, has over fifteen years of professional experience in telecommunications design, implementation, analysis, and maintenance. He has provided technical services and solutions for federal and commercial clients nationwide, resolving complex connectivity issues and security concerns.
With over ten years of professional experience in network security design, deployment, and management of firewall systems infrastructure, Mr. Ricketts has served such clients as the National Institutes of Health, the District of Columbia (including the DC Department of Health), and Verizon.
Valerie Nosek, Senior Consultant