Governor John Kitzhaber and his health care chiefs have invested two years to the cause of winning converts in their efforts to fix Oregon’s health care system, including reigning in costs. One healthcare initiative is the state’s new coordinated care organizations, which will be responsible for taking a more active role in the care of low-income patients on the Oregon Health Plan.

The first of these organizations goes live this week with 260,000 patients, with more organizations launching in the months to come. They will eventually cover most of the 600,000 people on the Oregon Health Plan.

According to state officials, patients on the plan don’t need to worry about immediately dramatic changes in their care. They will keep the same doctor and their benefits will remain the same. But eventually patients with complex conditions should be prepared for their doctors , nurses and other healthcare providers to coordinate their work and to be better prepared to help them with treatment between visits.

Now that the system is in place, doctors, hospitals and other organizations are responsible for implementation and ideas for saving what could potentially be billions of dollars. This will be accomplished by reducing unnecessary procedures, treating patients in primary-care clinics instead of pricey emergency rooms and better managing chronic conditions to avoid hospitalization when possible.

The exact model is different for each coordinated care organization. In general, executives said they’ve prepared for the transition by hiring staff to handle calls from patients and to coordinate their care and investing in new computer systems to share patient records.

Many of the first coordinated care organizations have existed for years, initially created to manage medical care for Oregon Health Plan patients. Now as a CCO, they will integrate mental health and addiction treatment into their medical programs.

The federal government has approved a request from Oregon to change the Medicaid payment model . Now coordinated care organizations will get a fixed budget with leeway to spend the money how they deem appropriate. The federal government has promised Oregon almost $2 billion over the next five years to make sure the CCOs will have enough money to invest in those programs. In exchange, the state must lower long-term costs significantly.