%201.svg)
The Centers for Medicare & Medicaid Services (CMS) has set October 1, 2025, as the date when the Hospice Outcomes and Patient Evaluation (HOPE) tool will officially replace the Hospice Item Set (HIS). This marks a significant shift in how hospice care quality is documented and evaluated. For years, HIS has served as a compliance tool, but it has been largely retrospective in nature. HOPE, on the other hand, is designed for real-time data collection that links directly to patient care planning.
This transition is more than an administrative update. It is part of CMS’s broader push to standardize quality reporting across care settings and to align hospice with outcomes-based measures already seen in home health and other Medicare programs.
Providers who are not adequately prepared could face operational disruptions, compliance risks, and reimbursement penalties. Readiness now will determine how smoothly agencies adapt to this new era of hospice quality reporting.
The HOPE tool represents a fundamental shift in how data is captured and used in hospice care.
The most striking difference is the transition from retrospective to real-time reporting. Instead of waiting until discharge, hospice teams will now record data throughout the patient journey. Clinical staff, rather than back-office teams, will be responsible for completion. This shift ensures that documentation reflects the patient’s current condition and informs ongoing care planning, rather than serving purely as a compliance record.
CMS has provided a clear timeline for the transition.
While a 4% reduction might seem modest at first glance, the cumulative effect on annual reimbursement can be significant. More importantly, falling behind on HOPE compliance could also affect agency reputation, survey readiness, and long-term competitiveness in the hospice market.
The transition deadline may be more than a year away, but waiting until the last quarter of 2025 will create unnecessary risk. Early preparation allows providers to identify gaps and build new workflows before HOPE becomes mandatory. Key steps include:
Starting now ensures that new processes become routine by the time HOPE goes live, reducing the risk of compliance gaps.
The operational shift from HIS to HOPE requires more than clinician education. It calls for systemic adjustments to how hospice providers manage data across admission, care delivery, and billing.
These adjustments will not only prepare agencies for HOPE but also create more efficient and integrated operations overall.
For many organizations, the HOPE transition will require additional bandwidth. Coding and documentation teams may already be stretched, and clinical staff will need time to adapt to new reporting requirements. External partners can play an important role in bridging the gap.
Hospices that leverage external expertise often find the transition smoother and less disruptive. By building capacity before October 2025, agencies can avoid rushed changes that strain staff and increase error rates.
The HOPE tool is not just a compliance mandate. It represents a cultural shift in hospice care toward real-time quality measurement and patient-centered outcomes. By capturing data at admission, during care, and at discharge, HOPE ensures that quality reporting reflects the entire patient journey.
Hospice providers that prepare thoroughly will not only avoid penalties but also strengthen their clinical practices. Improved documentation leads to better symptom management, clearer care planning, and more reliable quality benchmarks. In the long term, this positions providers to thrive in a healthcare environment that increasingly rewards transparency, accountability, and outcomes.
The transition from HIS to HOPE is one of the most significant changes hospice providers will face in the coming years. CMS has made clear that beginning October 1, 2025, compliance will no longer be optional, and penalties for delays will be steep.
Hospices that act early by adjusting workflows, preparing systems, training staff, and seeking external support where needed will be ready, not just to comply, but to improve the quality of care delivered. The countdown to HOPE is underway, and readiness today will define success tomorrow.
