When someone in Jackson County is admitted to the hospital, it’s often just the beginning of a much longer health journey. Many patients return home still facing systemic challenges that limit their access to follow-up care, including everything from housing insecurity to chronic illness, confusion about treatment plans or mental health needs — all of which make long-term recovery difficult.

Jackson Care Connect (JCC), part of the CareOregon family, and Mercy Flights, a southern-Oregon based nonprofit ambulance service and air medical provider, have teamed up on two groundbreaking pilot programs. Through investments and collaboration by JCC, these programs aim to reimagine how care is delivered in rural communities, focusing on overcoming barriers and meeting members’ needs.

For many people in southern Oregon, getting the right kind of care at the right time isn’t always easy. This is because when health concerns arise — especially for those without reliable primary care, or stable housing — calling 911 can feel like the only option. This leads to overcrowded emergency rooms and limited access to care.

“Right now, our local hospitals are over capacity. People with time-sensitive emergencies are waiting longer, and it’s creating stress on everyone; patients, providers and first responders,” said Janet Holland, Regional Operations Director for Jackson Care Connect.

Through the innovative Mobile Integrated Healthcare (MIH) and the Alternate Destination pilot programs, Mercy Flights and Jackson Care Connect are working together to ease those pressures, helping people stay healthier, longer. The programs are reducing repeat 911 calls and ER visits, connecting patients to follow-up care and ensuring faster, more appropriate treatment for thousands of Oregonians.

“At Jackson Care Connect, we’re proud to collaborate to help increase access, improve affordability or solve a local health care challenge. This partnership is exactly that—it’s community problem-solving in action,” Holland said. “These programs help decompress the overwhelmed systems by getting people to the right place at the right time.” 

Preventative care — Mobile Integrated Healthcare (MIH) Program

According to the National Library of Medicine, a substantial share of hospitalized patients across health systems lack timely follow-up care; roughly one-third of patients did not receive care within 30 days of discharge, increasing the likelihood of future emergency room visits.

The MIH partnership began nearly a decade ago, when Mercy Flights and JCC recognized this cycle of repeat ER visits for issues that could be managed earlier with the right support. The idea is innovative: if paramedics could provide preventive care and education after discharge, they could help patients stay healthy and reduce strain on the emergency system.

Since then, the program has grown to serve more than 3,000 JCC members annually, focusing on complex care coordination and health education.

The MIH team—made up of field-experienced paramedics and EMTs with advanced training in behavioral health and chronic disease management—starts in the hospital. When a patient is identified as needing extra support, the MIH team visits them bedside before discharge. They explain the program, listen to what the patient needs and ask if they’d like continued help once they return home. If the patient agrees, the MIH team stays connected through regular check-ins, coordinating with primary care providers, providing referrals and ensuring follow-through with medications and appointments.

For John (name changed for privacy), a 47-year-old battling alcohol use disorder, that kind of follow-up changed everything.

After years of emergency visits and declining health, John had reached a breaking point—he needed help but had little access to post-discharge support. Following his most recent hospital stay, the Mercy Flights MIH team met with John while he was still in the hospital prior to discharge and offered him continued support once he got home. The MIH team called and visited regularly, helping him navigate a medical detox program, coordinating with outpatient services, and ensuring he had both the emotional and practical tools he needed for recovery.

Thanks to his determination and coordinated care provided by MIH and community partners, John continues to make steady progress in his recovery journey.

In another case, the MIH team supported a patient who was unable to leave his home due to anxiety and fear. His provider urgently needed updated lab results to adjust his medication. Within 24 hours of receiving the referral, the MIH team conducted a point-of-care lab draw at the patient’s home and delivered the results to the clinic.

That timely intervention allowed the provider to make critical medication changes and stabilize the patient’s condition without requiring him to leave the safety of his home.

Right care, right place — Alternate Destination pilot program

This past year, the partnership launched a new effort: the Alternate Destination pilot. When a 911 call comes in, Mercy Flights paramedics assess whether a patient’s condition requires the emergency department or if an urgent care visit is a better fit.

With protocols designed by Mercy Flights’ medical director, patients who meet specific criteria can choose to be transported to one of two participating urgent care clinics—Providence Medical Group or La Clinica—instead of the hospital.

“Emergency rooms are built for heart attacks, strokes and trauma. This program offers a real alternative for patients who call 911 but don’t actually need to be in the ER,” said Rob Hibner, Assistant Vice President of Operations and Mercy Flights. “Paramedics can now assess the situation and, if appropriate, transport them to urgent care instead. It’s a smarter, faster and more compassionate use of our health care resources.”

It’s a small shift, but the model helps reduce emergency department overcrowding, shortens wait times, and frees up critical resources for life-threatening emergencies, all while ensuring patients receive timely, appropriate and affordable care.

Redefining what access to care looks like in rural Oregon

By combining the expertise of Mercy Flights’ paramedics with JCC’s coordinated care approach, this partnership is redefining what access looks like in rural Oregon.

CareOregon is currently the only Medicaid payer participating in this model, working to ensure that Oregon Health Plan (OHP) members receive the right level of care without financial or logistical barriers. The results are promising: healthier outcomes for patients, reduced system strain and a stronger safety net for southern Oregon communities.

As these programs continue to grow, they serve as a blueprint for rural health innovation statewide and proof of what happens when organizations work together to get everyone to the appropriate level of care they need and deserve,” Holland said.

Investments in Action series

Our "Investments in Action" series highlights the transformative power of CareOregon's strategic investments in health and wellbeing. Through these stories, we explore how our support goes beyond traditional funding roles and is helping to close gaps in health care access and community services. Despite challenges within the Medicaid space, we remain committed to centering these important narratives of community strength and resilience.