Understanding & Navigating Care with the HOPE Tool for Hospice | MTEC

HOPE Implementation 101 [Free Webinar]

The hospice industry is undergoing one of its most meaningful quality-reporting shifts in years. As of October 1, 2025, the Hospice Outcomes & Patient Evaluation (HOPE) tool replaces the long-standing Hospice Item Set (HIS). This change marks the move from static, task-driven reporting to a more dynamic, outcome-focused understanding of the hospice experience.

The HOPE assessment tool offers a new chapter in how hospice patients' needs are evaluated, communicated, and supported. HOPE aligns quality measurement with what truly matters in hospice care: comfort, responsiveness, dignity, and compassionate guidance throughout the end-of-life journey.

Why the Industry Is Moving from HIS to HOPE

HIS relied heavily on process measures: did a task happen, was a field completed, was documentation present. While important, this approach didn’t always reflect the patient’s lived experience—especially in hospice, where individualized comfort and emotional support are essential.

HOPE fundamentally shifts that perspective.

What’s changing:

• Event-based data collection rather than single-point “snapshots”

• New timelines and revised data fields (e.g., A0810 replacing A0800)

• Standardized HOPE assessments at admission, HOPE Update Visit (HUV), and discharge

• Symptom Reassessment Visits (SRAs) required whenever a moderate-to-severe symptom is reported

In other words: HOPE captures how patients are doing, not just what is done for them.

By anchoring evaluation to meaningful events and symptom changes, the tool creates a clinically relevant, holistic view of the patient’s trajectory.

How HOPE Strengthens Hospice Patient Care

At its core, HOPE gives hospice teams a clearer view into the patient journey—improving both care planning and quality assurance.

HOPE’s outcome-centered approach helps providers:

• Track and respond to symptom changes more quickly

• Personalize and refine care plans in real time

• Strengthen interdisciplinary coordination

• Support caregivers with clearer insight and communication

• Improve patient comfort, quality of life, and family experience

Data is captured consistently at three required timepoints—admission, HUV(s), and discharge—with up to two HUVs depending on length of stay. This provides a richer, more accurate understanding of needs over time.

For agencies, the transition represents an opportunity to elevate care delivery while building a foundation for data-driven, continuous improvement.

The Development Behind HOPE—and What Comes Next

The HOPE tool was built through years of research, clinical testing, and national beta review. CMS’s design goals were clear: improve accuracy, strengthen quality reporting, and establish a foundation for future advancements in hospice care.

CMS intends for HOPE to support:

• Standardized data reporting through the Hospice Quality Reporting Program (HQRP)
• Future refinements to Medicare hospice payment models

CMS has also outlined potential future measures—such as timely symptom reassessment—that may be added as HOPE data matures (anticipated for FY 2028).

This reinforces a broader trend: the industry is moving toward outcome-driven insight, transparency, and accountability.

The Promise of HOPE—And the Pressures Providers Face 

While HOPE offers meaningful clinical and operational benefits, its adoption is not without challenges. Agencies are facing:

• Compressed preparation timelines

• Vendor readiness gaps

• Increased documentation responsibilities

• Risk of inconsistent interpretation or application

• Financial or reputational exposure if metrics are misaligned

HOPE has tremendous potential, but potential is not a guarantee. Successful HOPE implementation requires operational readiness, workflow alignment, and consistent training across interdisciplinary teams.

Your Roadmap to a Successful HOPE Transition 

To ensure stability, accuracy, and confidence through the HOPE transition, hospice organizations should adopt a strategic, structured approach. Maxwell TEC's hospice experts recommend:

• Audit and re-engineer workflows to align with HOPE timepoints and triggers

• Deliver layered, role-specific training for all interdisciplinary team members

• Engage vendors to validate system readiness and data mapping

• Pilot workflows before full-scale rollout to surface gaps and friction points

• Monitor internal performance metrics continually

• Facilitate open, transparent communication throughout teams and leadership

• Maintain fallback plans for vendor delays or system challenges

The HOPE transition doesn’t end with implementation. Hospice providers must validate, review, and use the HOPE assessment tool to drive better outcomes for hospice patients and families.

Maxwell TEC: Supporting Agencies Without Losing HOPE

The HOPE tool is more than a compliance requirement—it’s a catalyst for elevating how hospice care is understood, delivered, and improved. By aligning measurement with meaning, HOPE empowers providers to offer more responsive, compassionate, and data-informed care.

The transition is significant, but the opportunity is even greater.

Maxwell TEC has long helped organizations navigate complex regulatory changes and operational shifts. With the HOPE assessment tool now defining hospice quality reporting, our strategic and clinical experts are guiding agencies through:

• HOPE workflow design and documentation mapping

• Training across nursing, social work, spiritual care, and IDG teams

• System and vendor readiness evaluations

• Pilot testing and performance monitoring

• Data validation and compliance oversight

• Strategies for outcome improvement and operational efficiency

• Tech-enabled solutions for seamless hospice patient and family communication, such as nanaCONNECT – BEREAVE

Our goal is simple: help agencies transition confidently, maintain compliance, and strengthen the patient and family experience along the way.

Don’t lose HOPE. Use it to transform how your agency supports patients and families when it matters most.

This blog was originally published as "Understanding the HOPE Tool: Enhancing Patient Outcomes in Hospice" by Shea Swenson on May 21, 2024. The Maxwell TEC editorial team has since updated this article to ensure accuracy and relevance.