The Centers for Medicare and Medicaid Services (CMS) is currently testing a new hospice patient assessment framework: The Hospice Outcomes and Patient Evaluation (HOPE) tool. As reported on the CMS website, the tool entered its beta test recruitment phase on May 12, 2021, with data collection from the new tool expected to begin in fall 2021.1
But what does this tool mean for hospices? How does it change data collection? Reporting? And what impact will it potentially have on existing processes? Here’s what you need to know.
What is the HOPE Tool?
Per the CMS Hospice Outcomes and Patient Evaluation FAQs, “HOPE is the name for the new standardized hospice patient assessment that CMS’s Hospice Quality Reporting Program (HQRP) is developing to propose in future rulemaking. It will be an assessment of the clinical, psychosocial, spiritual, and emotional status and needs of the hospice patient during regular patient care.”2
The tool is designed to provide a standardized reporting and measurement mechanism for hospice care that will allow CMS to identify differences between hospice providers. As noted by the National Hospice and Palliative Care Organization (NHPCO), “the tool will also provide information to hospice providers to help them identify opportunities for performance improvement.”3
How Does HOPE Differ from HIS?
While the current Hospice Item Set (HIS) reporting method extracts specific process measures data from patient records and supplies this information to CMS for review, HOPE is a patient assessment tool designed to assess hospice care at differing points along the patient’s care journey. The goal of HOPE is to provide actionable data for hospices and CMS around both process and outcome measures for a more comprehensive view of hospice care services.
CMS says the tool will capture data at specific time points, including:4
- Admission
- Interdisciplinary group (IDG) meetings
- Other key times during the hospice stay
- Discharge
The tool will also capture detailed clinical data and patient information such as:
- Diagnosis
- Comorbidities
- Symptoms
- Patients’ functional status
- Patient, family and caregiver preferences
Data will be collected using both electronic questionnaires and reports in addition to real-time meetings with patients to gain their perspective on their experiences in hospice.
What Does HOPE Mean for Hospices?
With HOPE still in its beta testing and data collection phase, hospices remain uncertain about its long-term impact. As noted by Hospice News, however, there are emerging concerns around how data will be collected and what it will mean for patients, caregivers and providers.5 Depending on the approach taken by CMS around reporting and submission of this data, HOPE may easily align with existing processes or may prove burdensome for hospice providers to integrate with existing operations.
Best bet? With HOPE on the (relatively) near-term horizon, it’s worth the work for hospices to assess current reporting and documentation frameworks to ensure they’re as streamlined and straightforward as possible.
When Will HOPE be Deployed?
HOPE remains in the data collection phase, after which CMS will refine the tool with further analysis and then finalized in rulemaking. As a result, it’s difficult to say when HOPE will be deployed to hospices at scale — but providers should expect at least a few months lead time after the announcement of the finalized tool before implementation begins.
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Resources:
1 CMS, “HOPE Provider and Stakeholder Engagement,” July 28, 2021.
2 & 4 CMS, “Hospice Outcomes and Patient Evaluation (HOPE) Frequently Asked Questions,” December 2019.
3 NHPCO, “Hospice Outcomes & Patient Evaluation (HOPE),” 2021.
5 Hospice News, “Hospices Preparing for HOPE Quality Tool Coming from CMS,” April 6, 2021.