South Dakota's Medicaid program is launching a new effort to trim spending by coordinating the care of chronically ill people in the state-federal program that pays the medical costs for poor people.

A team known as a "Health Home" typically will be led by a primary care doctor and will include health coaches, nutritionists and others to manage care for people with heart disease, diabetes and other chronic problems.

It's part of the national health care overhaul and is aimed at keeping patients healthier while avoiding trips to emergency rooms and other expensive care.

For patients with private insurance, hospitals and clinics also are stressing coordination among doctors and others as a way to improve care and tackle the rising costs of health care.

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