To enhance the quality of care in hospice settings, the Centers for Medicare and Medicaid Services (CMS) has developed the Hospice Outcomes and Patient Evaluation, or HOPE, as part of the Hospice Quality Reporting Program (HQRP). Set to take effect on October 1, 2025 , HOPE will replace the Hospice Item Set (HIS) and aims to standardize data collection and highlight patient outcomes.
Axxess has developed a reference guide that outlines the HOPE tool and offers practical steps providers can take now to prepare for the upcoming changes.
Raianne Melton, RN, BSN, CHPN, Director of Clinical Services at Axxess, created the guide and offers insight into how the HOPE tool will impact the hospice industry.
Understanding HOPE
Melton explains that through the introduction of the HOPE tool, CMS seeks to ensure hospice care remains patient-focused while also meeting evolving healthcare standards. She adds that while the HIS serves solely as a data collection tool, HOPE will serve as an assessment tool, functioning much like the Outcome and Assessment Information Set (OASIS) used by home health providers. She also notes that CMS will likely look at data gathered from HOPE to better inform payment structures in the hospice industry.
“The primary objective is to provide quality data for the Hospice Quality Reporting Program through standardized data collection,” Melton said. “That will support surveys and certification processes, but also it’s to inform future payment and quality improvement refinements.”
The introduction of the HOPE tool is set to transform how hospice organizations document, measure, and report patient care.
Preparing Data and Assessments
As HOPE prioritizes data and metric reporting, Melton encourages organizations to start to focus on data collection processes to prepare.
Organizations are also encouraged to proactively reverify the eligibility of all Medicare patients to ensure the updated MBI numbers are accurately reflected in the system, preventing any future claim rejections due to outdated information.
“Really look at your policies and processes around how you do quality audits on the HQRP data that needs to be submitted at admission and discharge,” Melton said.
Melton also recommends that leaders examine trends and patterns in incomplete HIS data.
“If you’re having a problem now with getting timely completion of HIS documentation, that’s going to be multiplied when we move to HOPE,” Melton says.
Melton also encourages hospice leaders to prepare for changes by focusing on their change management processes and developing strategies for transitioning staff to the new tool.
“In terms of preparing, I think that looking at how you address change management is key,” Melton said. “Look at who’s going to be providing the training and start early planning to ensure competency for staff with HOPE data collection responsibilities. Educate staff that, per CMS guidance, patients admitted prior to October 1, 2025, will have an HIS admission and HOPE discharge as data collection points.”
Training Staff
To help staff members prepare for the changes, Melton suggests leaders first look at point-of-service documentation and the time it takes staff to complete current questionnaires.
“Really looking at point-of-service documentation to learn what percentage of your staff is completing those HIS questions at the time of service rather than waiting 24 or 48 hours to complete that documentation will provide insight,” Melton said.
Melton stresses that staff need to be adequately trained on the new data items to be collected so the assessment is completed accurately and organizations can remain compliant.
Melton also urges leaders to strategically consider the timing of training to optimize its impact on staff.
“We don’t implement until October 1, 2025,” Melton said. “How likely is your staff to remember and implement the changes if you train now? Timing really matters.”
Melton outlined upcoming opportunities for leaders and staff to learn strategies for HOPE at the 2025 Axxess Growth, Innovation and Leadership Experience (AGILE) conference in May.
“We’re not only going to be training on HOPE, but also giving participants the opportunity to learn teaching strategies for their staff and providing a takeaway toolbox with the idea of starting training in May or June of 2025 for your staff to be ready and remember everything they need to be successful at HOPE,” Melton said.
To download Melton’s guide on the HOPE tool, click here.
Axxess Hospice, a cloud-based hospice software, includes simple tools such as intuitive medication management and real-time plan of care updates to help organizations navigate the transition to HOPE.
