Lisa Tomai, M.S., is a senior researcher at L&M. She has over 25 years of experience in healthcare analytics and research in both public and private settings. Ms. Tomai has worked extensively with large healthcare claims and administrative databases from sources including Medicare, Medicaid, Worker’s Compensation, and commercial carriers.
Her recent initiatives involve analytic design and data management for the evaluation of federal and state programs for innovative care delivery and alternative payment models.
Specific projects include programming and analytic support for the evaluation of the Home Health Value-Based Purchasing Model, evaluations of the Center for Medicare & Medicaid Innovation’s (CMMI) Accountable Care Organization (ACO) Initiatives, and the assessment and testing of Medicaid claims and encounter data under a CMS Office of Minority Health analytical support contract.
Ms. Tomai is proficient in SAS programming, and has extensive experience working in the Chronic Condition Warehouse databases within the CMS Virtual Research Data Center as well as other programming environments.
Prior to joining L&M Policy Research, Ms. Tomai worked in a number of diverse settings including commercial insurance, managed care organizations, and independent business consulting. During her career, Ms. Tomai has developed and tested algorithms for various payment models involving beneficiary-ACO attribution, primary care medical homes, and value-based payment systems for private insurers. Additional areas of focus have included Medicare fraud and abuse, provider profiling design, clinical outcomes monitoring, and development of pharmaceutical opioid diversion detection and monitoring methods.
Ms. Tomai holds an M.S. in Public Policy Analysis from the University of Rochester.