Preparing for HOPE: A New Era in Hospice Care Assessment

Hospice Outcomes and Patient Evaluation

Hospice providers across the nation are gearing up for a significant change in how we assess and report patient care. The Hospice Outcomes and Patient Evaluation (HOPE) tool is set to replace the current Hospice Item Set (HIS), ushering in a new era of comprehensive patient assessment and quality reporting. In an episode of Home Health Revealed, we sat down with BetterRX’s Sara Nigro and hospice consultant Courtney Tonks to present what you can expect with the upcoming HOPE Assessment tool.

Understanding HOPE

The HOPE tool represents a major shift in hospice assessment practices. Unlike the HIS, which only requires assessments at admission and discharge, HOPE mandates up to four assessments per patient:

  1. Admission assessment (within first 5 days)
  2. Update visit between days 6-15
  3. Update visit between days 16-30 (if applicable)
  4. Discharge assessment

This more frequent assessment schedule allows for a more nuanced understanding of patient needs throughout their hospice journey.

Compliance and Quality Measures

With the introduction of HOPE comes new compliance requirements. Hospices must transmit 90% of HOPE data within 30 days of the event or completion date. Failure to meet this threshold could result in a 4% payment reduction in subsequent years. It’s worth noting that the 4% payment reduction for non-compliance was implemented in the FY 2024 hospice final rule, increasing from the previous 2%.

Two new process measures will be implemented using HOPE data:

  1. Timely Reassessment of Pain Impact
  2. Timely Reassessment of Non-Pain Symptom Impact

These measures will assess whether patients with moderate or severe symptoms are reassessed within two calendar days.

Preparing for the Transition

While October 2025 may seem distant, the time to start preparing is now. Here are some steps hospices can take:

  1. Familiarize staff with HOPE: Begin educating your team about the new assessment tool and its requirements.
  2. Review current processes: Evaluate your current assessment practices and identify areas that may need adjustment to align with HOPE requirements.
  3. Engage with software vendors: Ensure your documentation software will be updated to incorporate HOPE while maintaining compliance with Conditions of Participation.
  4. Plan for training: Develop a comprehensive training plan to ensure all staff are proficient in using the HOPE tool before the implementation date.
  5. Monitor CMS updates: Stay informed about any additional guidance or changes from CMS regarding HOPE implementation.

Looking Ahead

While the transition to HOPE may present challenges, it also offers opportunities for improved patient care. The more frequent assessments will allow for better understanding of patient needs and more responsive care planning.

As we navigate this change together, let’s approach it with a spirit of flexibility and a commitment to providing the highest quality care to our patients and their families. The HOPE tool, while requiring adjustment, has the potential to enhance our ability to meet the unique needs of each individual in our care.

Remember, the goal of these changes is to improve the quality of hospice care. By embracing HOPE and preparing thoroughly, we can ensure that we continue to provide compassionate, patient-centered care in this new era of hospice assessment.

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