HIS Out, HOPE In: How Hospice Care is Evolving for the Better

At AutomationEdge, we’re always tuned into the evolving landscape of home care — sharing insights, highlighting innovations, and helping pr,iders stay ahead of the curve. Today, we're spotlighting a significant shift in the world of hospice care that’s already making waves: the transition from the Hospice Item Set (HIS) to Hospice Outcomes & Patient Evaluation (HOPE), effective October 1, 2025.

The hospice industry is no stranger to complexities. Between navigating tight regulations, workforce challenges, and delivering compassionate, quality end-of-life care, agencies operate in an increasingly high-stakes environment. And now, with HOPE replacing HIS, the focus sharpens even more on measurable patient outcomes.

So, what is HOPE, and why is it replacing HIS? Let’s find out in this fascinating piece of the article. 

What Is HOPE — And Why It Matters

HOPE (Hospice Outcomes and Patient Evaluation) is more than just a new reporting requirement. It’s a comprehensive framework built to enhance patient-centered care, providing rich, standardized data at multiple time points across the patient’s hospice journey.

HOPE's Core Principles:

•  Patient-Centered Care: Prioritizing individual values and preferences
•  Quality of Care Assessment: Measuring care effectiveness, not just process
• A Holistic Lens: Addressing physical, emotional, spiritual, and psychological needs

This evolution ensures that care isn’t just about checkboxes — it’s about impact, dignity, and outcomes that reflect what truly matters to patients and their families.

The Challenge of Transitioning from HIS to HOPE

1. Hospices have been using the HIS dataset since 2014, with a focus mainly on process metrics. HOPE changes this, replacing process metrics with real-time assessments, direct patient evaluations, and a sharper emphasis on clinical quality.
2. The introduction of HOPE brings with it stricter compliance expectations for hospice agencies. One of the key requirements is the timely submission of assessments — agencies must ensure that at least 90% of HOPE assessments are completed and submitted within 30 days of the assessment event. Falling short of this threshold can have significant financial consequences, including a 4% payment reduction, a notable increase from the previous 2% penalty set in FY2024.
3. Also,  CMS is implementing two new process measures under the HOPE framework: 

1.  The Timely Reassessment of Pain Impact 

2. The Timely Reassessment of Non-Pain Symptom Impact.

 These measures emphasize the urgency of care by mandating that patients experiencing moderate to severe symptoms must be reassessed within two calendar days.

How can Hospice Agencies Prepare for HOPE?

Preparing for the transition to HOPE (Hospice Outcomes and Patient Evaluation) is not just about compliance — it's about evolving hospice care to be more patient-centered, data-driven, and outcome-focused. As the October 1, 2025 implementation deadline approaches, hospice agencies must take a proactive and strategic approach to readiness. Here's how they can prepare effectively, with a special emphasis on the role of nurses, strategy, and the power of automation and technology.

1. Empower Hospice Nurses as Key Change Agents

Hospice nurses will be on the front lines of the HOPE implementation. Their role will evolve beyond clinical care to include comprehensive patient assessments, collaboration across disciplines, and documenting patient-centered outcomes. To prepare:

• Provide role-specific training on the HOPE framework and new assessment tools.
• Encourage holistic engagement with patients and families, integrating emotional and spiritual well-being alongside physical care.
• Promote interdisciplinary collaboration, ensuring that nurses are active voices in care planning meetings.

2. Strategize Early and Holistically

Preparation for HOPE requires more than operational tweaks — it demands a full strategic review of how your agency assesses and delivers care.

• Audit current practices against HOPE requirements to identify gaps.
• Build an internal roadmap for the transition, including timelines, accountability checkpoints, and contingency plans.
• Engage leadership and care teams early to foster buy-in and reduce resistance to change.

3. Leverage Automation and Technology Solutions

Technology will play a critical role in helping agencies navigate the complexities of HOPE.

• Use intelligent automation platforms to streamline documentation, reminders, and reporting processes.
• Implement AI-powered assessment tools that guide nurses through standardized evaluations, reducing manual errors.
• Ensure that EMR and documentation software are HOPE-ready, supporting the new workflows and meeting CMS compliance requirements.

4. Focus on Data-Driven Care

HOPE is built on outcomes and quality. Hospice agencies need to shift from checklist-based compliance to continuous quality improvement.

• Train teams to analyze HOPE data for insights on patient outcomes and care effectiveness.
• Use real-time dashboards to track assessment completion, compliance rates, and areas for clinical improvement.
• Turn data into action — using it to refine care strategies and elevate patient experiences.

5. Prepare for Compliance and Reimbursement Risks

Missing the 90% timely submission threshold can result in a payment reduction of up to 4%, so it is essential to set up internal alerts and tracking systems.

• Automate compliance checks and reminders for timely reassessments, especially for symptoms flagged as moderate or severe.
• Document and reassess patient needs within two calendar days as per the new process measures from CMS

Industry News  Update

1. Expert Schedulers: The Hidden Backbone Of Successful Home Health Agencies

In home-based care, schedulers are the unsung heroes behind every successful patient visit. Acting as expert puzzle solvers, they balance staff availability, patient needs, and operational logistics to keep everything running smoothly. This blog explores the critical role schedulers play in care coordination, why their expertise is vital for both quality outcomes and agency performance, and how poor scheduling practices can quickly derail even the best-laid care plans.

2. Rural Home Health Care Surges, But Providers Must Adapt To Meet Growing Demand

As the Baby Boomer generation ages, the demand for in-home care, especially in rural areas, is rising faster than ever, driving significant growth in the home healthcare industry. But while the need is clear, providers face a unique set of challenges in these regions, from staffing shortages to geographic hurdles. This blog explores how home care agencies can overcome these barriers by embracing innovative technology and adopting a more holistic, future-ready approach to delivering quality care in rural communities.

3. A Balanced Hospice Dashboard - Key Data to Aid in Running a Better Business

Improving your business operations is the key to driving long-term success, and it starts with understanding the right metrics. Join this insightful webinar where you'll learn how to build a balanced hospice dashboard that goes beyond just tracking census data. Walk away with actionable tools and strategies to boost your agency’s efficiency, effectiveness, and overall impact.

Video Testimonial- Amanda Marean’s Experience with AutomationEdge CareFlo

Discover how Amanda, CEO of Vibrant Home Healthcare, revolutionized her agency with CareFlo AI by AutomationEdge. By automating manual tasks, she reduced errors, eased staff workload, and sped up client care. The transformation boosted compliance and streamlined operations. Hear her powerful story of success in a challenging industry.

About AutomationEdge

AutomationEdge CareFlo is an AI agent cloud for home and post-acute care. Our AI agents use AI, RPA, NLP, and IDP tools for end-to-end automation. Speed up the intake to revenue cycle management to improve the experiences of clients, clinicians, caregivers, and staff. AutomationEdge is a trusted choice for industry leaders like Elara Caring, Devoted Guardian, and the University of Massachusetts Medical School (UMMS). Our innovations boost efficiency by 90%, cut costs by 50%, and make care simpler.

What’s Next?

That’s a wrap on this edition of AutomationEdge Newsletter: Insights from the Frontlines of Home & Post-Acute Care — but don’t hang up your stethoscope just yet!

Because here’s the deal: technology isn’t here to replace your heart — it’s here to supercharge your hustle. From streamlining the small stuff to making big-picture care smarter and more human, we’re just getting started.

So grab your coffee, charge your tablet, and get ready for more bite-sized brilliance headed your way soon. Until then — stay awesome, stay innovative, and above all, stay human.