Key takeaways
- HOPE replaced the Hospice Item Set on October 1, 2025, adding assessments during the stay.
- Hospices that don't meet HQRP requirements face a 4 percentage point cut to their annual payment update.
- Pick a handful of measures that fit hospice work, such as symptom follow-up and bereavement contacts, and give each one an owner.
- Watch your measures between CMS reports so you find problems before they appear in public data.
Quality data scattered across notes, forms and conversations
Many small and mid-sized hospice programs have no formal quality reporting system. Events are documented in EMR notes, on paper forms or in conversations with supervisors. When CMS or accreditation surveyors ask for quality trends, pulling them together can take days, and the result rarely tells a coherent story because the data was never captured consistently.
Hospices that share a hospital system's quality tools face a different problem: those tools were built for acute care. Hospital incident categories don't match hospice events, and the measures that matter in hospice, such as symptom control at the end of life, care plan follow-through and family caregiver experience, don't fit dashboards designed for surgical outcomes.
Federal reporting keeps changing. On October 1, 2025, the Hospice Outcomes and Patient Evaluation (HOPE) tool replaced the Hospice Item Set, adding assessments during the stay as well as at admission and discharge. The CAHPS Hospice Survey captures family caregivers' experience. Hospices that don't meet Hospice Quality Reporting Program (HQRP) requirements face a 4 percentage point reduction in their annual payment update.
Measuring what matters in hospice
Measures that fit hospice work produce useful data, and borrowed acute care categories produce noise. A hospice quality program can define its own measures, such as symptom follow-up, care plan completion, bereavement contacts and caregiver experience, and give each one an owner.
HOPE records go to CMS through iQIES, usually from your clinical software. Your quality program sits around that submission: it's where your team watches the measures between CMS reports and acts when one slips, instead of discovering a problem months later in a public report.
ImprovementFlow
Quality Reporting
Quality Reporting lets a hospice program define the measures that matter in its own work, give each one a named owner and review it on a cadence that fits the decision it informs.
A starter measure set for a hospice quality program
Start with a handful of measures, give each one a single owner and review them at your monthly QAPI meeting.
- Symptom follow-up: moderate or severe symptoms that received a timely follow-up visit.
- Visits in the last days of life.
- Care plan updates completed on schedule.
- Bereavement contacts made on schedule.
- Family caregiver experience, from your CAHPS Hospice results.
Getting set up
Whether you're starting from paper or moving off an acute care system that never quite fit, we set up your measures and categories with you and import whatever past records you want to keep.
How ImprovementFlow supports this
- Teams define the measures that matter in their own work, without waiting on an analyst.
- Every measure has a named owner and a review rhythm that matches the decision it informs.
- An off-target measure can be linked to the improvement project working on it, so you can see whether the fix is moving the number.
- HIPAA compliance, a BAA and SSO are included in every package.