Hospitals and other providers see combating racial and ethnic health care disparities as key to reducing costs and emergency room visits, and the state this week unveiled several initiatives to bolster their efforts.

The Maryland Health Quality and Council and its Health Disparities Workgroup released its final report and recommendations Tuesday, culminating an eight-month review.

Among the report’s recommendations were establishing community zones designed to lure primary care physicians to underrepresented areas; prize incentives for new ideas to mitigate disparities; and racial and ethnic tracking of performance incentive data.

“This makes a lot of sense,” Gene Ransom, CEO of MedChi, the Maryland State Medical Society, said of the initiatives. “We need ways to get resources into communities where they are desperately needed.”

Ransom, whose physicians’ group has more than 7,500 members and also reviewed the disparity issue, emphasized the lack of primary care physicians.

The Maryland Health Enterprise Zones, which are at the heart of the initiatives, would provide incentives for physicians in those zones. They could include student loan assistance, tax credits and help with implementing health information technology. Community organizations would be responsible for applying for the incentives in their zones, which would be determined based on factors such as high rates of chronic diseases, health disparities and lack of access to primary care.

The goal is to set up two to four of these zones by fiscal 2013, if funding allows.

Health disparities between blacks and whites are evident in Maryland, where blacks contract HIV at 12 times the rate of whites, and their infant mortality rates are three times higher, according to the report. Blacks also are twice as likely as whites to lack medical insurance. These factors have contributed to Maryland ranking 35th in geographical health disparities in national studies.

The group that studied the issue consisted of experts from major academic health centers such as John Hopkins University School of Medicine and hospital groups such as Adventist HealthCare in Rockville and Southern Maryland Hospital in Clinton. Lt. Gov. Anthony Brown (D) established the group.

“If patients are cared for appropriately on an outpatient basis, that affects readmission rates,” said Marcos Pesquera, executive director of Adventist HealthCare Center on Health Disparities. Pesquera was part of the work group.

He particularly lauded allowing community organizations to apply for the zone designations rather than just designating certain ZIP codes.

Health care can vary throughout ZIP codes, Pesquera said.

“This will enhance access to care and reduce preventable hospital and [emergency room] visits that drive up health care costs,” said Lisa Cooper, a professor at Hopkins and work group member. “When people delay primary care, it becomes more expensive.”

She said she looks forward to the opportunities the zones will present for health care systems to partner with other organizations and practitioners.

“This is something the hospitals would definitely want to support,” said Jim Reiter, spokesman for the Maryland Hospital Association, adding that health disparities is a national concern.

“Maryland is in a great position to be a leader in this,” Cooper said.

CareFirst BlueCross BlueShield also has focused on this issue and recently donated $1.5 million to Mary’s Center in Washington, D.C., to establish a community health center in Adelphi.

“We applaud the governor and lieutenant governor for working to develop creative new approaches to address pressing health care needs in the community,” Michael Sullivan, a CareFirst spokesman, said in an email.

Implementing the new ethnic and racial tracking set out in the initiatives will be trickier, health care officials said.

Aside from refining electronic medical records, staff must also be trained to use a standardized method of reporting racial and ethnic factors, Pesquera said. Not all providers do this the same way, he said.

“It’s more a matter of turning focus than doing an upheaval,” Reiter said. “It’s also a matter of knocking down some of the barriers. ... Better communication equals better care.”

Better tracking will enable centers to tie data to different types of treatment and incidence rate, Pesquera said.

“If you don’t measure at all, you will not be able to see if you’re making progress,” he said.

Pesquera also said the prize component among the initiatives could encourage more organizations to look into the disparity issue.

“We’re very excited about it,” Ransom said. “It does a good job of integrating public, academic and private sources and bringing everyone together.”

He said he looks forward to working with other health care organizations to get these initiatives passed by the legislature.

Brown said he hopes these measures are approved in this session, so reporting targeted data can start by 2013 and then be reviewed every three years.

lrobbins@gazette.net