Navigating Care with the New HOPE Tool

3 min read

Dec 04, 2024

Navigating Care with the New HOPE Tool | Maxwell TEC

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The Center for Medicare and Medicaid Services (CMS) is finalizing the new Hospice Outcomes and Patient Evaluation (HOPE) tool, a tool that will not only ensure quality care and patient satisfaction through its Hospice Quality Reporting Programs (HQRP) but also revolutionize the perception of hospice care. As CMS has been testing and implementing the new HOPE tool to replace the current Hospice Item Set (HIS) tool, it is crucial for hospice agencies to understand that their quick adjustments will be essential in this transition.  The switch from the HIS to the HOPE tool provides more meaningful insights into hospice care and increases patient satisfaction, heralding a new era of improved hospice healthcare. By understanding all aspects of the new tool—from developmental stages to HOPE objectives and to future tool enhancements—healthcare providers will be set with a strong foundation of knowledge during this transitional time. 

HOPE Development  

Development of the HOPE tool for hospice began in 2019 with information-gathering activities, which led to the first draft of HOPE. In 2020, the tool was tested over several phases, including an initial cognitive evaluation of staff, pilot, and alpha testing. These phases evaluated the feasibility of completing HOPE at multiple time points throughout the hospice stay. Lastly, CMS conducted national beta testing to assess the collected data's validity, feasibility, and reliability through participating hospice locations.¹ The national beta testing phase was completed in October 2022 after a total of 901 data forms were distributed by RNs, SWs, and chaplains across 60 hospices, totaling 381 patient reports throughout multiple time points (i.e., admissions, symptom reassessment, discharge).1 After testing, CMS proposes to begin collecting HOPE standardized patient data by October 1st, 2025, replacing the HIS tool.   

Objectives of the HOPE Tool for Hospice   

CMS's goal for the HOPE tool for hospice is to be more comprehensive than the HIS tool by capturing better patient evaluation data and family care needs in real time.² One way to achieve this goal is by adding a third timepoint evaluation, the HOPE Update Visit (HUV). Caregivers will be required to submit up to two HUVs, depending on the length of the patient's stay, allowing for time points to gather patient data, increasing quality measures and provided care. The HOPE tool will also utilize a dual objective approach, including:   

Provide data for the Hospice Quality Reporting Program (HQRP) through standardized data collection.
    
Provide clinical data that may inform potential future changes to Medicare hospice payments.³

The collected data is planned to be used by CMS to develop additional measures based on the needs and outcomes of HOPE data after implementation in hospices. CMS has named two potential process measures:   

Timely Reassessment of Pain Impact 
Measures the percentage of patients who receive a pain reassessment within two days of when their pain is determined to be at a moderate to severe level.
Timely Reassessment of Non-Pain Impact 
A percentage of patients who received a non-pain symptom reassessment within two calendar days of when their non-pain symptom was initially assessed to be moderate or severe.

These measures are anticipated to begin in FY 2028.⁴

While additional quality measures may be added after the HOPE tool, CMS states that this will help hospice agencies identify opportunity areas with patient- and agency-level decisions. To learn more about how the HOPE tool enhances patient-outcomes in hospice care, check out "Understanding the HOPE Tool: Enhancing Patient-Outcomes in Hospice".

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This blog was originally published as "Navigating Care with the New Hope Tool" by Shea Swenson on May 24, 2024. The Maxwell TEC editorial team has since updated this article to ensure accuracy and relevance.