Back in the 1980s, the late conservative Congressman Jack Kemp promoted tax-free "enterprise zones" to encourage investment in blighted inner-city neighborhoods. A health care version of Kemp's ideal was announced this week in Prince George's County when Capitol Heights was named one of Maryland's first five Health Enterprise Zones.
Under the Maryland Health Improvement and Disparities Reduction Act of 2012, signed last year by Democratic Gov. Martin O'Malley, HEZs will be set up throughout Maryland to reduce racial disparities and health care costs by expanding primary care in areas with a high percentage of poor people in poor health.
Capitol Heights, located right across the D.C. border, was chosen from among 19 HEZ applicants. The program will be run by the county's Health Department as part of County Executive Rushern Baker's Transforming Neighborhoods Initiative.
The town certainly meets the criteria of the $4 million program: 97 percent of its 4,337 residents belong to racial minorities, and their average life expectancy is just 72.6 years compared with 88.7 years statewide. State and federal efforts to improve their health, including Medicaid and the Women, Infants, and Children supplemental nutrition program, have failed to have an effect. Capitol Heights still leads Prince George's County in per-resident rates of diabetes, cardiovascular disease, asthma and infant mortality.
Maryland already has the second-highest number of primary care providers per-capita in the nation, but they're not in Capitol Heights. The HEZ program is trying to induce 25 physicians, nurse practitioners, dentists and other providers, including substance abuse counselors, to set up a "patient-centered medical home" there to provide residents with comprehensive primary care that could improve their health while reducing expensive hospitalizations.
In return, the HEZ program will provide generous loan repayment assistance, hiring tax credits up to $10,000 per employee, a grant of $15,000 per primary practitioner for setting up an electronic records system, and tens of thousands of dollars more in Medicaid incentives.
They will also be able "to claim a credit against the state income tax in an amount equal to 100 percent of the amount of the state income tax expected to be due from the HEZ practitioner from income derived from the practice in the HEZ" -- essentially canceling out O'Malley's income tax hikes for them.
HEZs rely on a smorgasbord of financial and tax incentives to get health care providers to set up shop in places where state and federal programs have consistently failed to deliver results. Jack Kemp would be pleased.