Transforming Hospice Care: Key Updates to the HQRP and HOPE Instrument
The hospice care landscape is evolving with new measures under the Hospice Quality Reporting Program (HQRP). These changes are designed to enhance care quality, improve patient outcomes, and ensure timely symptom management. Here’s a breakdown of what’s coming and how it will impact hospice providers.
New HQRP Process Measures (FY 2028)
Starting in FY 2028, two new process measures will be introduced:
- Timely Follow-up for Pain Impact
- Timely Follow-up for Non-Pain Symptom Impact
These measures require follow-up visits within 48 hours after identifying moderate or severe symptoms. This ensures that patients receive prompt care, improving overall symptom management and quality of life.
The HOPE Instrument (FY 2025)
Replacing the current Hospice Item Set (HIS), the new HOPE (Hospice Outcomes & Patient Evaluation) instrument will be implemented in FY 2025. Unlike HIS, which collects data only at admission and discharge, HOPE gathers comprehensive patient data throughout the hospice stay, including:
- Admission
- HOPE Update Visit (HUV)
- Discharge
HOPE covers key areas such as sociodemographics, diagnoses, symptom impact, skin conditions, and imminent death, providing a fuller picture of patient care.
Updates to the Hospice CAHPS Survey
The Hospice CAHPS Survey is getting a makeover based on a 2021 experiment. Key changes include:
- A web-mail survey distribution option
- A shortened and simplified survey
- A new two-item Care Preferences measure
- Updates to communication and training items
- Removal of certain nursing home-related questions
These changes aim to streamline feedback collection and improve the quality of responses.
The Hospice Special Focus Program (SFP)
The Hospice Special Focus Program (SFP) will monitor poor-performing hospices. Using data from quality measures like caregiver experience, the SFP will identify hospices needing additional oversight to ensure continuous improvement. The Overall Rating measure will change slightly but won’t affect the SFP algorithm.
Addressing Social Determinants of Health
CMS is also exploring the collection of data on social determinants of health, such as housing instability, food insecurity, utilities, and transportation. Understanding these factors is crucial for improving patient care and outcomes.
Conclusion
The updates to the HQRP, the introduction of the HOPE instrument, and changes to the Hospice CAHPS Survey demonstrate CMS’s commitment to improving hospice care quality. By focusing on timely follow-ups, comprehensive data collection, and addressing social determinants of health, these measures aim to improve patient care and outcomes.
Is your hospice ready for this new era of compliance and quality improvement?
Key Take Aways
| Name |
Key Points |
| 1. New HQRP Process Measures |
- Follow-up within 48 hours for moderate-to-severe symptoms |
| 2. HOPE Instrument |
- Collects data at Admission, HUV, and Discharge. |
| 3. CAHPS Survey Updates |
- Web-mail, shortened, Care Preferences measure new admin protocols. |
| 4. Hospice Special Focus Program |
- Monitors poor performers, and focuses on pain, timely help, recommendations, and overall ratings. |
| 5. Social Determinants of Health |
- Housing, food, transportation, and utilities challenges. |
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