Forty-year-old Jeremie Seals had a heart attack when he was 35. He has congestive heart failure, and nerve pain in his legs that he says is "real bad." By 2011, he was sleeping in his car, and that's when his medical problems started having a big financial impact. That year, he visited the emergency room at Oregon Health & Science University in Portland 15 times and was admitted to the hospital 11 times. His regular visits to the ER brought him to the attention of one of Oregon's new coordinated care organizations. One way Oregon is trying to reduce Medicaid costs is to encourage people who constantly turn up in the emergency room—so-called frequent fliers like Seals—to get their healthcare from regular doctors instead.