Senior Researcher
Lisa Tomai, M.S., Senior Researcher at L&M Policy Research, has over 25 years of experience in health care research and analytics across public and private sectors. She specializes in large-scale claims and administrative databases, including Medicare and Medicaid, with extensive experience conducting analyses within CMS’ Chronic Conditions Warehouse Virtual Research Data Center. Ms. Tomai combines advanced database development expertise with quantitative analytic methods to support federal and state evaluations of health care delivery and alternative payment models.
Ms. Tomai has provided analytic leadership on CMS contracts focused on accountable care and value-based primary care transformation, including evaluations of Shared Savings Program ACOs and the ACO Investment Model. Her work involved complex data integration across CMS sources and recreation of CMS attribution methodologies, enabling program- and population-specific analytic files for longitudinal evaluation. She currently leads analytic initiatives for non-CMS clients examining primary care delivery models for Medicare and Medicaid populations, including claims-based replication of CMS provider-beneficiary attribution methods, implementation and comparison of Hierarchical Condition Category risk adjustment models, and analysis of coding patterns, patient and provider mix, and spending trends across attribution approaches and payment models. Ms. Tomai has also supported CMS monitoring of Medicare Advantage and Prescription Drug Plans, delivering analyses of partial-benefit dual enrollees’ out-of-pocket costs in Medicare Advantage versus Dual Eligible Special Needs Plans (D-SNPs). She recently led an assessment of Medicare telehealth reimbursement policy during the COVID-19 public health emergency, modeling potential effects of alternative CMS payment policy scenarios.
Ms. Tomai holds a Master of Science in Public Policy Analysis from the University of Rochester.
