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On Thursday September 12th at 2:00pm EDT, CCSQ will host a Special Open Door Forum (SODF) to allow for questions on the development of the Hospice Outcomes & Patient Evaluation (HOPE). There will be a series of SODF's CMS will host on this tool and other topics related to the Hospice Quality Reporting Program. The presentation for the SODF on September 12th is available for review at:

In the Fiscal Year 2020 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements Final Rule, the hospice patient assessment instrument is identified as the Hospice Outcomes & Patient Evaluation (HOPE). This tool is intended to help hospices better understand care needs throughout the patient's dying process and contribute to the patient's plan of care. It will assess patients in real-time, based on interactions with the patient, as opposed to the HIS retrospective chart review. Finally, the HOPE will support quality improvement activities and calculate outcome and other types of quality measures in a way that mitigates burden on hospice providers and patients. 

Currently CMS collects data at admission and discharge via the Hospice Item Set (HIS) that are used to calculate measures in the Hospice QRP. However, while HIS is a standardized mechanism for extracting medical record data, it is not a patient assessment tool because the data is not collected during a patient assessment.

CMS's goal for the HOPE is to be more comprehensive than the HIS by capturing patient and family care needs in real-time and throughout the hospice stay, with the flexibility to accommodate patients with varying clinical needs. The HOPE will take into consideration hospice workflow and the Medicare Conditions of Participation. Data in patients' baseline status and changes in their outcomes from the HOPE will contribute to care planning and inform quality measurement for the Hospice QRP, including outcome measures, and support providers' quality improvement efforts.

The two primary objectives of the HOPE are to:

  1. Provide quality data for HQRP requirements through standardized data collection
  2. Provide additional clinical data that could inform future payment refinements.

CMS seeks to develop quality measures associated with the new assessment tool that are meaningful to all stakeholders and reflect critical outcomes of care throughout the hospice stay. The measures will meet the Meaningful Measures Initiative objectives to identify high priority areas for quality measure development while reducing burden on hospice providers. They will focus on outcomes and also fit well with the hospice business model.

The documented process for development of the HOPE tool is currently underway and includes open door forums, focus groups, expert interviews and a technical expert panel (TEP). They are seeking a diverse TEP of approximately 12 individuals with perspectives and areas of expertise including the following:

  • Clinical experience delivering hospice and palliative care services
  • Experience with hospice care as a patient, family member, or caregiver
  • Health care disparities
  • Culturally and linguistically appropriate services
  • Public reporting
  • Performance measurement
  • Quality improvement
  • Data collection and implementation
  • Potential TEP members should not have served on a CMS-project TEP within the last calendar year.
  • Participation on the TEP is voluntary. 

The TEP nomination period opened August 30th, 2019 and closes September 30th, 2019. There is still time to get your nominations in and participate on the TEP for the HOPE tool. To learn more about participating follow this link: 

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article is a summary from a CMS press release and website.