Introduction: Caring with Compassion provides core background information to support clinical care for homeless, underserved, uninsured, and at-risk populations. It was designed by an interdisciplinary team of educators from the fields of medicine, nursing, and social services. The team identified practical knowledge objectives using an iterative, expert consensus approach. Content validity was addressed by incorporating national internal medicine milestones and feedback from national educational leaders. This content is designed for graduate medical learners, advanced medical students, and nurse practitioners. Methods: Caring with Compassion is divided into two major content domains: Domain 1 provides an overview of US public health care systems; Domain 2 presents the bio-psychosocial model of health care and special care needs of underserved populations. This submission includes the content for Domain 1: U.S. Public Healthcare Systems. Domain 2 is separately published by MedEdPORTAL. Results: Nationally, over 350 learners have registered for the online version of the curriculum, and feedback has been highly positive. Preliminary quantitative outcome data demonstrates highly significant improvement in multiple choice examination scores following exposure to the modules for all assessed content areas [n, pretest, posttest, t test p value]: epidemiology of populations in need (42, 49%, 81%, p < .0001); public health insurance (30, 52%, 80%, p < .0001); health care delivery systems knowledge (19, 53%, 67%, p < .002). Discussion: This content has benefited from continual revisions based on learner and faculty feedback, including results of the formal focus groups as detailed above. Expansion of content is ongoing based on requests from faculty users nationally. Further plans include expansion of faculty development tools and continual content revisions based on new research and curricular feedback.
By the end of the module, the learner will be able to:
- Understand the definition of homelessness by federal standards.
- Understand the numeric trends relating to homeless persons in the US.
- Understand the prevalence of severe mental illness, substance abuse, victims of domestic violence, physically disabled, and combined comorbidities among homeless persons.
- Understand the scope of unmet need for shelter housing for the homeless.
- Understand the 2012 federal poverty line, average annual cost of employer-sponsored health care coverage, and the resulting approximate ratio of health care cost to income for a low-income family.
- Understand the multipayer system of health insurance in the US.
- Understand the core benefits and financing mechanisms of Medicare components A, B, and D.
- Understand the purposes and structures of MediGap and Medicare Advantage plans.
- Understand the eligibility criteria for Medicare, including age-based and disability-based criteria.
- Understand the core benefits and eligibility criteria for Medicaid.
- Understand the core benefits and eligibility criteria for Children’s Health Insurance Program.
- Understand the expected Affordable Care Act effects upon public health insurance programs.
- Understand the number, demographic characteristics (age, race/ethnicity), and health care costs of dually eligible Medicare/Medicaid beneficiaries.
- Understand the dually eligible Medicare/Medicaid beneficiaries.
- Understand the major components of the US health care delivery system.
- Understand the eligibility criteria for Veterans Administration health coverage.
- Understand the size and range of services of the Veterans Administration health system.
- Understand the Veterans Administration health system services targeting the needs of homeless veterans.
- Understand the financing mechanisms, structure, and number of persons served by Federally Qualified Health Centers.
- Understand the funding mechanisms, governance structure, and range of services free clinics.
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