Preparing for HOPE: The Future of Hospice Quality Reporting

A big change is on the way for hospice providers. The HOPE for Hospice Tool (Hospice Outcomes and Patient Evaluation) is a new standardized assessment and reporting tool that will be implemented on October 1, 2025, replacing the Hospice Item Set (HIS). Mandated by the Centers for Medicare and Medicaid Services (CMS), HOPE will play a key role in quality reporting and payment refinements, with significant penalties for noncompliance.

The Purpose of the HOPE Tool 

CMS initiated the development of HOPE in 2019 as part of an ongoing effort to standardize hospice assessments across the country, with the ultimate goal of improving the quality of care provided to hospice patients. The tool underwent rigorous pilot, alpha, and beta testing to ensure its effectiveness and reliability. These testing phases included feedback from hospice teams, which helped CMS refine the tool to meet the needs of both clinicians and patients. The finalized version of HOPE was included in the FY 2025 Hospice Final Rule.

HOPE is designed to address gaps in hospice reporting by taking a more comprehensive and frequent approach to data collection. Like HIS, the HOPE tool collects data at admission and discharge, but it also collects data on additional update visits during a patient’s stay in order to provide a clearer picture of patient status and the patient experience throughout the journey of care.  

The primary goals of HOPE are to: 

• Collect better data to enhance hospice quality reporting measures. The HOPE tool will focus on standardized assessments that ensure providers can accurately measure the quality of care delivered to patients. 

• Provide clinical insights that could influence future payment models. By collecting more detailed clinical data, HOPE aims to provide insights that can be used to refine future payment models. The shift from a traditional fee-for-service model to a value-based model is one of CMS’s longer-term objectives, and HOPE is the first step in this transition.

• Support data-driven decision making for hospice providers. With more precise data, providers will be able to make informed adjustments to care plans as needed and ensure that resources are allocated effectively to better meet patient needs and improve outcomes.

Key Changes to Prepare For 

Standardized Patient Data Collection

One of the most significant changes that HOPE introduces is the requirement of real-time, point-specific assessments rather than the retrospective data collection used by HIS. The new standardized collection will require all Medicare-certified hospices to submit four key records for each patient:

• Admission: Capturing detailed baseline information once a patient enters hospice care.

• Two HOPE update visits: These assessments will track changes in patient condition and needs over time, enabling providers to adjust care as necessary.

• Discharge: The final report will include details on patient outcomes and any changes in health status during hospice care.

• Special cases: Patients experiencing moderate to severe pain will require additional Symptom Follow-Up Visits (SFVs) to assess symptom management and adjust care accordingly.

Compliance Requirements

Hospices must submit and ensure acceptance of at least 90 percent of HOPE records to remain compliant with CMS regulations. Keep in mind that failure to meet compliance can result in a 4 percent payment reduction in the annual payment update year. Compliance with HOPE is not optional—hospices must act now to prepare for this transition.

Transition Toward Value-Based Care

HOPE may lay the foundation for a future value-based payment model similar to that of home health agencies. CMS aims to shift hospice reimbursement from a per diem model to a quality-based system that emphasizes patient outcomes and data-driven care. This shift toward a quality-based reimbursement system will reward hospices that demonstrate high-quality care and outcomes, while those who fail to meet these standards could see reduced reimbursements. This transition is not just about financial changes but reflects a broader push for better, more patient-centered care in the hospice sector.

How Medbridge Helps

Medbridge is dedicated to helping hospice organizations prepare for the transition to HOPE. We offer:

Education and Training for Compliance

Our three-course training series developed with Jennifer Kennedy, EdD, MA, BSN, RN, CHC, helps ensure that hospice staff are equipped with the knowledge and skills necessary to comply with the new tool. This comprehensive training includes:

• Understanding data collection requirements, including what to capture at each stage of the patient’s care journey.

• Navigating admission, update, and discharge records to accurately record patient data at key points in the care process.

• Practical scenarios to guide compliance with reporting requirements in various clinical contexts.

Clinical Procedure Manual

The Medbridge Clinical Procedure Manual is a tablet-first digital resource that offers point-of-care guidance on hospice-specific clinical procedures. It includes essential tools and protocols, such as FAST for dementia care, spiritual needs assessments, and comprehensive hospice evaluations. With the Clinical Procedure Manual, clinicians gain quick access to best practices and evidence-based procedures that have been vetted and approved by an expert review board.

Ongoing Support and Resources

Our comprehensive Hospice Solution includes:

• Onboarding curriculums: These tailored training programs help new and experienced clinicians get up to speed with the new processes and ensure they understand the changes to documentation and data collection.

• Annual training and skill validation: Our ongoing training allows hospice staff to stay compliant and up to date with the latest requirements for HOPE.

• Compliance training: Our comprehensive, interactive courses keep your agency compliant with state and federal requirements and are verified by CHAP and ACHC.

• Point-of-care tools: We offer real-time tools that help clinicians follow best practices in the field, improving patient outcomes and supporting compliance efforts.

Staying Ahead in a Changing Environment

The HOPE assessment tool represents a major regulatory shift that requires early preparation to ensure compliance and avoid financial penalties—and Medbridge is committed to helping hospice organizations with this transition. We offer the comprehensive tools you need to successfully implement HOPE and prepare for the future of value-based care models.