HOPE assessment tool implementation coming in October. Will your agency be ready?

There are key differences between HIS and HOPE that hospices should recognize early to ensure they are addressed within HOPE staff training and implementation plans. Although certain key differences are highlighted below, hospices should utilize all available HOPE training and education resources for assessing staff training and work closely with their software vendor on the development and implementation of the HOPE assessment tool.

Retirement of HART: With the implementation of HOPE, CMS will retire the Hospice Abstraction Reporting Tool (HART). HART allowed providers to collect and submit HIS data for free but was underutilized.  Beginning Oct. 1, 2025, hospices relying on HART will need to select a private software vendor to collect and submit HOPE data to CMS.

Data collection: HIS focuses on whether hospices have performed care processes using retrospective data from medical chart abstraction at admission and discharge timepoints. HOPE is more comprehensive than the HIS by capturing patient and family care needs in real-time during patient assessments and at additional timepoints during the hospice stay.

Since HOPE collection is to occur real-time during patient assessments, it will be important for software vendors to include assessment content and support workflows that maintain compliance with existing Hospice Conditions of Participation (i.e., § 418.54 Condition of participation: Initial and comprehensive assessment of the patient) in addition to supporting the assessment content and skip patterns specified in the HOPE assessment tool specifications.

Beginning October 1, 2025, HOPE will introduce additional assessment timepoints/visits:

• HOPE Update Visits (HUVs): Enables CMS to gather patient level data during the first 30 days after a beneficiary elects hospice. Hospice providers will be required to submit up to two HUVs, each at specified timeframes, depending on the length of the hospice stay.The HUV data collection time points will only apply to new patients admitted on or after Oct. 1, 2025, using the HOPE tool.
• Symptom Follow-up Visit (SFV): During the Admission or HUV timepoints, data collected for the Symptom Impact item (J2051) may trigger the need for the SFV.

Expanded assessment content: The HOPE assessment tool includes several domains that are new or expanded relative to HIS. The Hospice Item Set (V3) to HOPE (v1.00) Item Set Change Table which can be accessed in the downloads section of the HQRP HOPE webpage identifies these key differences along with the rationale and comments.

New process quality measures: CMS finalized two new process quality measures based on HOPE data collection for public reporting no sooner than FY 2028 (Oct. 1, 2027):

• Timely reassessment of pain impact
• Timely reassessment of non-pain symptom impact

These measures will determine whether a symptom follow-up visit occurs within two (2) days of an initial assessment of moderate or severe symptom impact. CMS’ decision to report these measures publicly will be based on an analysis of validity and reliability testing of quality measure HOPE data submitted in CY 2026. It will be important for hospices to understand the HOPE data sources and measure calculation used for these two new process measures along with software vendor plans to support these measures real-time for continuous quality improvement initiatives should CMS proceed with public reporting.

For more details on these new measures, draft specifications for the two new process measures can be accessed in the downloads section of the HQRP HOPE webpage.

By recognizing these differences and preparing accordingly, hospices can ensure a smooth transition to HOPE while maintaining compliance and improving care quality.