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required to manage their costs within a fixed rate of growth.

Some coordinated care groups are hiring staff to work intensely with Medicaid patients who frequently visit the emergency room.

"We try to deal with the medical part. But everything they go through, we have to take into account,cheap jordan shoes, because if you don't have money to pay your bills, you're going to have stress" that complicates medical problems, said Ruby Ibarra, a community health specialist for Multnomah County,amass denver, which is part of a coordinated care organization in the Portland area.

Elsewhere in the state, Trillium Community Health Plan in Eugene has a program starting this month that gives up to $200 in prepaid debit cards to pregnant mothers who quit smoking.

Oregon's law also has led to the rapid expansion of "health homes," supporting a system of primary care that calls for clinics to stay open longer and offer same-day appointments.

The health home model has been successful at improving preventive care in Enterprise, Ore., a town of 2,000 in the remote northeastern corner of the state.

"You don't feel like you're just pushing papers around here. You really feel like you have an important part to play in improving people's health,www.amassdenver.com," said Dr. Elizabeth

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