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- Health policy
- Hospital outcome/efficiency and patient safety measures
- Hospital value-based purchasing
- Medicaid statistical information
- Program integrity
- Medicaid and CHIP
Candace Natoli has broad experience in health reform, public and private health coverage, and provider reimbursement. She has played key roles in numerous projects aimed at developing, reevaluating, and implementing hospital outcome, efficiency, and patient safety measures and pay-for-performance programs.
Natoli currently directs a project that helps the Yale Centers for Outcome Research and Evaluation in its quality measure development and reevaluation work. She also leads a project to calculate inpatient hospital outcome, efficiency, and patient safety quality measures for public reporting on the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website, and for use in its Hospital Value-Based Purchasing and Hospital Readmission Reduction Programs. For that project, she assists CMS in the reevaluation of its scoring methodology for the Hospital-Acquired Condition Reduction Program, a new hospital pay-for-performance initiative. Natoli has also worked on evaluating a large Medicaid expansion in Indiana, improving the Medicaid Statistical Information System and Medicaid Analytic eXtract (MAX) for CMS; she also assisted the Children’s Hospital of Boston in developing pediatric hospital readmission measures by analyzing MAX inpatient claims data.
Natoli came to Mathematica in 2008 from Navigant Consulting, Inc., where she was a senior and managing consultant for the Health Care Public Payer Practice. Natoli holds an M.P.P. in health and development policy from the University of Chicago.
Using State Data to Paint a National Picture: MAX and Alpha-MAX Data Production
Mathematica produces Medicaid administrative files, including MAX and Alpha-MAX, specifically designed for researchers. MAX contains annual, person-level data files containing Medicaid eligibility, service utilization, and payments, which are derived from the Medicaid Statistical Information System files...
Production and Implementation of the CMS Hospital Outcomes and Efficiency Measures
In 2009, CMS assessed a broad range of health care activities that affect patients’ well-being and made that information publicly available, to help improve health care quality and decision making. Mathematica implemented measures based on mortality and readmissions for six medical conditions to help...