@article{ee2dd032fdc847c691fb4dc9bd36b713,
title = "The Maryland health enterprise zone initiative reduced hospital cost and utilization in underserved communities",
abstract = "The State of Maryland implemented the Health Enterprise Zone Initiative in 2013 to improve access to health care and health outcomes in underserved communities and reduce health care costs and avoidable hospital admissions and readmissions. In each community the Health Enterprise Zone Initiative was a collaboration between the local health department or hospital and community-based organizations. The initiative was designed to attract primary care providers to underserved communities and support community efforts to improve health behaviors. It deployed community health workers and provided behavioral health care, dental services, health education, and school-based health services. We found that the initiative was associated with a reduction of 18,562 inpatient stays and an increase of 40,488 emergency department visits in the period 2013–16. The net cost savings from reduced inpatient stays far outweighed the initiative{\textquoteright}s cost to the state. Implementing such initiatives is a viable way to reduce inpatient admissions and reduce health care costs.",
author = "Gaskin, {Darrell J.} and Roza Vazin and Rachael McCleary and Thorpe, {Roland J.}",
note = "Funding Information: The state provided each zone with resources and incentives to attract private health care practitioners to medically underserved communities. The lead organization received the funds and subcontracted with partners in its coalition to provide an array of services to residents of the zone, specifically targeting diabetes, cardiovascular disease–related illnesses, asthma, obesity, and behavioral health problems. (See online appendix exhibit S1 for a description of each zone.)17 The resources and incentives included grant funding from the Community Health Resources Commission, priority for entering Maryland{\textquoteright}s multipayer Patient Centered Medical Home Program, loan repayment assistance, and tax credits for income and hiring. The zones used these resources to, for example, open new community health centers; operate mobile medical, mental health, and dental care units; deploy community health workers; implement healthy food programs; and offer school-based services. In addition, the initiative encouraged leaders of local health care and social service organizations to work together to address the health needs of residents in their communities. Publisher Copyright: {\textcopyright} 2018 Project HOPE.",
year = "2018",
month = oct,
doi = "10.1377/hlthaff.2018.0642",
language = "English (US)",
volume = "37",
pages = "1546--1554",
journal = "Health Affairs",
issn = "0278-2715",
publisher = "Project Hope",
number = "10",
}