What is the difference between HIS (Hospice Item Set) and HOPE (Hospice Outcomes and Patient Evaluation)?

HOPE introduces the removal, modification and addition of specific assessment items and new update visit time points between the admission and discharge.

Changes between HIS and HOPE include:

• HOPE Update Visits (HUV 1 and HUV 2) are reportable in the first 30 days of care.
• A1000 was removed and replaced with A1005, ethnicity, and A1010, race.
• A1110 was added to admission assessments for patient preferred language.
• A1802 was added to admission assessments to identify the patient’s admission source.
• A1905 was added to admission assessments to identify the patient’s living arrangements.
• A1910 was added to admission assessments to identify the level of in-person assistance the patient is receiving from available and willing caregivers, excluding hospice and facility staff.
• I10010 was modified on the admission assessment to include the ability to choose comorbidities and coexisting conditions.
• J0050, death is imminent, was added to the admission assessment and HUVs to determine if the patient’s death is imminent.
• J0915, neuropathic pain, was added to the admission assessment to determine if the patient has neuropathic pain.
• J2050, symptom impact screening, was added to the admission assessment and HUVs.
• J2051, symptom impact, was added to the admission assessment and HUVs.
• J2052, symptom follow-up visit (SFV), was added to the admission assessment and HUVs.
• J2053, symptom impact, was added to the admission assessment and HUVs.
• M1190 and M1200, skin conditions and treatments, have been added to the admission assessment and HUVs.
• N0500, N0510 and N0520, medications and bowel regimens, were added to the HUVs.

If my patient was admitted prior to October 1, 2025, with a HIS admission, do I need to discharge and readmit?

No, patients that are admitted prior to October 1, 2025, will have a HIS admission and a HOPE discharge. Per CMS guidance, these patients do not need to be discharged and readmitted.

When do HUVs need to be completed?

HUV 1 is required on or between days 6 and 15 of the hospice stay. HUV 2 is required on or between days 16 and 30 after hospice election. Both visits are required to be completed in person to inform updates to the plan of care.

How do HUVs impact the payer fee schedule?

Axxess is updating the visit list for existing organizations to include HUVs. Users can edit their Medicare fee schedule and all other insurances to enter rates independently or use the load rates feature to load rates from another payer that has rates defined.

How do HUVs impact pay rates?

Organizations will need to add HUVs to the pay rates in the user’s profile. When appropriate, organizations will need to set a default rate in Company Setup.

Do SFVs need to be reported to CMS?

No, the four HOPE reportable visits are the initial assessment, the HUV 1, HUV 2 and the HOPE discharge.

Are we submitting HOPE assessments via QIES?

CMS is archiving the Quality Improvement and Evaluation System (QIES) for HOPE. The agency is transitioning to the Internet Quality Improvement and Evaluation System (iQIES) for data submissions, with the transition set to be completed by October 1, 2025.

Where can I find additional information?

If you have any additional questions, please post them in the Axxess User Community.