Hospice HOPE Tool Compliance in 2026: What Agencies Are Getting Wrong and How to Fix It
The Centers for Medicare & Medicaid (CMS) launched the Hospice Outcomes and Patient Evaluation (HOPE) tool on October 1, 2025, replacing the Hospice Item Set (HIS) and introducing substantial changes to the Hospice Quality Reporting Program (HQRP).
The changes are a part of a broader effort to improve quality and accountability, but for providers, they’ve added new layers of documentation and oversight. With the first full year of compliance now underway, many agencies are still working to get it right.
The right tools can make a big difference.
What the HOPE Rule Requires for Hospice Compliance
Key requirements include:
- New quality reporting measures tied to patient-level HOPE data
- Data submission through the iQIES platform required for payment compliance
- Increased scrutiny of documentation accuracy and completeness across four structured assessment timepoints
Agencies that fall below the 90 percent timely submission threshold face a 4 percent reduction in their annual payment update, with FY 2028 reimbursement on the line for data collected right now.
nVoq Voice evaluates critical content, which can speed up our auditing process significantly. The increase in information, from gathering additional details upfront to evaluating what’s been documented, leads to higher-quality documentation overall.Dr. Andrew Mayo, St. Croix Hospice
How nVoq Supports Hospice Agencies Through HOPE Compliance
The pressure on clinical operations right now is real: more documentation, stricter timepoints, payment consequences tied directly to submission compliance. What your teams need are tools that reduce that burden without creating new ones.
nVoq Voice is powered by ClinicalCore AI and built for the complexity of real hospice interactions. Voice helps clinicians capture accurate, HOPE-aligned documentation at the point of care, through dictation or conversation, so assessments are complete, on time, and defensible. Your team will have less time spent fixing notes, which means more time focused on patients. When your agency’s FY 2028 payment rate reflects this year’s data quality, you’ll have the records to back it up.
Stay Ahead with nVoq
HOPE is alive, but compliance is an ongoing process. Agencies that invest in the right documentation infrastructure now will be better positioned as CMS begins analyzing results and public reporting takes effect in 2028. Don’t wait for an audit to find the gaps.Talk to an Expert
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