For several years, the Centers for Medicare & Medicaid Services (CMS) has been developing a tool designed to better evaluate patient outcomes in hospice care. They named it HOPE, which stands for Hospice Outcomes and Patient Evaluation. It was officially finalized in the 2025 Hospice Final Rule and is set to roll out later this year on October 1st, 2025.
What is the Role of HOPE?
HOPE is designed to replace the current Hospice Item SET (HIS) as part of the Hospice Quality Reporting Program (HQRP). While HIS is primarily a reporting tool for quality measures by reviewing retrospective data from patient charts, HOPE’s focus is more immediate and clinical based. HOPE is all about improving patient outcomes, supporting care planning, and enhancing overall quality.
HOPE will utilize real-time data collected during specific key intervals throughout a patient’s stay in hospice. There’s admission and discharge and two additional HOPE Update Visits (HUVs) depending on the patient’s length of stay. Here’s how these assessments are designed to take place:
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- Admission Assessment–– Occurs between days 1-5
- HUVs (HOPE Update Visits)–– Within the first 30 days after entering hospice
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- HUV1––Should occur between days 6-15
- HUV2––Should occur between days 16-30
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- Discharge Data––Collected when patient leaves
HOPE also includes two new standardized patient assessment data points, designated J2051 and J2053. These data elements assess common symptoms hospice patients face such as pain, shortness of breath, anxiety, nausea, vomiting, diarrhea, constipation and agitation. During the first HOPE Update Visit, if a symptom is rated moderate or severe, a patient receives an in-person follow-up visit.
Compliance Requirements
Hospice organizations are urged to submit HOPE records within at least 30 days of each key timeline or earlier. 90% of all HOPE records must meet the deadline to be compliant or be subject to a 4% reduction in the annual market basket update.
If you haven’t already, review the CMS Hospice Quality Reporting Program (HQRP) Quality Measure (QM) User Manual Chapter for HOPE Process Measures. For your convenience, you can download it here.