Tuesday, December 16 | Post-Acute Care, Care Coordination

HOPE Early Impressions: How Hospice Teams Are Navigating the New Era of Quality Reporting

By Lisa Selman-Holman, Vice President, Clinical Services, McBee

October 1, 2025, marked a major milestone for hospice care: the official implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool. Designed by the Centers for Medicare & Medicaid Services (CMS) to replace the Hospice Item Set (HIS), HOPE introduces a more comprehensive, patient-centered approach to quality reporting. Now, two months into its rollout, we are reflecting on what these early days reveal about the tool’s impact on care delivery, interdisciplinary collaboration and patient outcomes.

Why HOPE Matters

The HOPE tool was developed to address limitations of HIS, which primarily captured retrospective data at admission and discharge. HOPE shifts the focus to real-time assessments, requiring data collection at multiple points during a patient’s stay:

  • Admission Assessment (within 5 days of election)

  • HOPE Update Visits (HUVs) at days 6–15 and 16–30

  • Discharge Assessment

  • Symptom Follow-Up Visits (SFVs) within two days for moderate or severe symptoms

 

Early Adaptation: Interdisciplinary Teams in Action

One of the most notable shifts has been in Interdisciplinary Group (IDG) meetings. Teams are now leveraging HOPE data to inform discussions, prioritize symptom management and refine care plans. Providers report that the standardized data elements, such as symptom impact scores and functional status, are fostering more structured, evidence-based conversations across nursing, social work and spiritual care disciplines.

However, this transition hasn’t been without challenges. In conversations with providers, several pain points have emerged. Staffing strain is a top concern, especially for QA teams who feel they must perform extra validation before submitting HOPE data. Submission errors and technical issues have added to the workload, creating delays and frustration. And in the field, there continues to be confusion around the timing and requirements for HOPE Update Visits (HUVs) and Symptom Follow-Up Visits (SFVs), highlighting the need for clearer education and streamlined processes.

Emerging Trends in Care Quality

While it’s too early for definitive outcome data, initial feedback suggests several positive trends:

  • Improved Symptom Management: The two new quality measures, TimelyFollow-Up for Pain Impact and Timely Follow-Up Non-Pain Symptom Impact, invite us to look at the full picture (pain, non-pain symptoms, emotional and functional burden) and design care plans that reflect the reality of the patient’s experience. *1

  • Enhanced Care Planning: Frequent updates allow teams to adjust goals of care more dynamically, particularly for patients with complex needs.

  • Greater Accountability: The HOPE tool’s granular data will help providers identify ways to improve care decisions and practices, while future public reporting will give patients and families better insight when choosing a provider. *2

 

Challenges on the Horizon

Despite these benefits, hospices are navigating operational hurdles. Common concerns include:

  • Scheduling Issues:Scheduling additional HUVs/SFVs and capturing documentation requirements within the allotted timeframe has been challenging for some agencies.

  • Technical Issues: Some agencies are reporting errors and issues with data submission to iQIES, along with lack of access to CASPER reports since the transition to iQIES.

  • Education Needs: Many clinicians are still unclear on the timing and requirements for HOPE Update Visits (HUVs) and Symptom Follow-Up Visits (SFVs), making targeted training essential to help reduce confusion and ensure compliance.

 

Looking Ahead

Public reporting of HOPE-based quality measures won’t begin until 2028, but the groundwork being laid today will shape the future of hospice care. As providers refine workflows and embrace the tool’s potential, HOPE aims at delivering richer insights into patient experiences, driving improvements in both clinical outcomes and family satisfaction.

Bottom Line: The first impressions of HOPE are a mix of optimism and realism. While the tool introduces complexity, it also offers an unprecedented opportunity to elevate hospice care through data-driven decision-making. For agencies willing to adapt, HOPE could become more than a compliance requirement; it could be a catalyst for better care at life’s most critical stage.

HOPE Resources & Support

The transition to HOPE is a significant step for hospice care, but it doesn’t have to be overwhelming. Our team is here to help you navigate every aspect of HOPE implementation with technology and consulting solutions designed to streamline compliance, optimize workflows and enhance care quality.

Explore our HOPE success page for essential tools, best practices and expert insights: https://www.ntst.com/hope

 

*1 https://mcbeeassociates.com/insights/blog/hope-holistic-compassionate-care/

*2 https://www.cms.gov/medicare/quality/hospice/hope

 

Meet the Author

Lisa Selman-Holman
Lisa Selman-Holman · Vice President, Clinical Services, McBee

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