Association for Public Policy Analysis & Management

Blockchain’s utilization in the health care space has been primarily considered from a clinical setting as a mechanism to exchange protected health information (PHI). Little research has been done into using it for health care billing or for the detection of fraud, waste, and abuse in the processing of claims for services. We compare the existing state of the art claims billing and audit system used for in home supports assurance (ISAS) as part of the long terms services and supports (LTSS) system built in Maryland for managing the Community First Choice (CFC) program to a theoretical blockchain implementation. We consider the ISAS implementation from the perspective of the primary stakeholders such as home health workers, staffing agencies, and those receiving care. As well as providing a historical background of the CFC program and its purpose, we examine the costs associated with the LTSS system and consider the implications of using a blockchain solution from policy and technology perspectives.