This page is dedicated to providing comprehensive information and resources about the Hospice Outcomes and Patient Evaluation (HOPE), a vital Comprehensive Assessment Reporting Evaluation Care Tool recently introduced for hospice care. Here, you will find direct access to HOPE tool item sets, the HOPE Guidance Manual, and other essential documents. We also provide updates on HOPE-related news and activities, ensuring you stay informed about the latest developments.
The Foundation of HOPE: Enhancing Hospice Care
The Centers for Medicare & Medicaid Services (CMS) has developed HOPE as the new patient assessment tool, designed to replace the Hospice Item Set (HIS) within the Hospice Quality Reporting Program (HQRP). This significant change was formalized in the FY 2025 Hospice Wage Index Final Rule (CMS-1810-F). For detailed information, please refer to the Hospice Final Rule: Hospice Regulations and Notices | CMS.
HOPE is designed to deliver assessment-driven quality data that strengthens the HQRP through consistent data collection. It aims to foster a deeper understanding of patient care needs, contribute effectively to individualized patient care plans, and offer expanded clinical data that can guide future improvements in payment structures. CMS has thoughtfully incorporated key elements from the HIS into HOPE v1.0. This ensures the continued collection of data relevant to the Comprehensive Assessment at Admission (CBE #3235), while also gathering new data to support the development of enhanced quality measures.
Objectives and Impact of HOPE in Hospice Services
CMS has already established two quality measures based on HOPE, with potential for more to be developed as future versions of the tool evolve and incorporate additional data points. Further details on the evolution of these quality measures are available on the Quality Measure Development page.
The implementation of HOPE is expected to equip hospice organizations with valuable insights to refine their practices and enhance decision-making at both patient and organizational levels regarding care delivery. Furthermore, the public reporting of quality measures derived from HOPE assessments will empower patients and their families to make more informed choices when selecting a hospice provider.
Key Differences: HIS and the HOPE Comprehensive Assessment Tool
Until September 30, 2025, CMS will maintain data collection at both admission and discharge points using the HIS. This data is crucial for calculating measures within the HQRP. It is important to note that while HIS serves as a standardized method for extracting data from medical records, it is not a direct patient assessment tool. HIS primarily focuses on retrospectively evaluating whether hospices have adhered to specific care processes using chart abstraction. CMS envisions HOPE as a more comprehensive assessment reporting evaluation care tool than HIS. HOPE aims to capture real-time patient and family care needs at multiple points during the hospice stay, offering the adaptability to cater to patients with diverse clinical conditions.
Starting October 1, 2025, HOPE will enhance quality data collection through the introduction of HOPE Update Visits (HUVs) at additional time points. HUVs will allow CMS to gather patient-level data within the initial 30 days after a patient chooses hospice care. Hospice providers will be required to submit up to two HUVs, each within defined timeframes, depending on the duration of the hospice service. HOPE is carefully designed to align with hospice workflows and Medicare Conditions of Participation. The data gathered through HOPE, reflecting patients’ initial status and changes in outcomes, will contribute to care planning, inform quality measurement for the HQRP, and support ongoing quality improvement initiatives by providers. For a clearer understanding of HOPE data collection timelines, providers can access an explanatory video via the HQRP Training and Education Library page.
The Development Journey of HOPE
The development of HOPE followed a rigorous process that included comprehensive information gathering, active engagement with stakeholders and a Technical Expert Panel (TEP), and thorough testing. Summaries of the TEP reports are available in the Downloads section of the Provider and Stakeholder Engagement webpage. HOPE underwent several testing phases including cognitive interviews, pilot studies, alpha testing, and a national beta field test. The national beta testing, concluded in October 2022, enabled CMS to collect valuable feedback from participating hospice teams regarding the assessment instrument and field testing processes. This feedback was crucial in refining and finalizing the items and data collection timelines for HOPE. More detailed information can be found in the HOPE Development and Testing Report (PDF). CMS also presented the HOPE tool in rulemaking and invited public comments. Upon its full implementation in FY 2026 (October 1, 2025), HOPE is poised to deliver significant value to hospice providers, patients, and their families through enhanced comprehensive assessment reporting evaluation care.
Engaging with Stakeholders for Continuous Improvement
CMS is committed to ongoing engagement with stakeholders as it continues to develop quality measures, particularly those derived from HOPE. Relevant opportunities, information gathering reports, and Technical Expert Panel (TEP) reports are accessible on the Provider and Stakeholder Engagement (PDF) page. You can also find HQRP Forum materials on this page.
For any communication with CMS regarding HOPE or quality measures, please reach out to the Hospice Quality Help Desk via email at [email protected].
Hospice Quality Reporting Program Archives (PDF)
In conclusion, HOPE represents a significant advancement in hospice care assessment, offering a more comprehensive assessment reporting evaluation care tool to improve quality, enhance patient care planning, and provide valuable data for future improvements in the hospice care system.
