continued * Per-beneficiary Medicare spending * Skilled nursing care minutes per routine home care day * Skilled nursing minutes on weekends * Visits near death ▌ CMS is finalizing the proposal to add composite HCI measures to the HQRP as of FY 2022 and will monitor the measure. The measure will be publicly reported in Care Compare no earlier than May 2022. ▌ CMS will continue to monitor the HCI after implementation to ensure the measure reflects hospice quality, differentiates between hospices, and does not become topped out. C. Update regarding the Hospice Outcomes & Patient Evaluation (HOPE) development ▌ CMS thanked commenters for their feedback on the HOPE tool. CMS states that they " will continue to host HQRP Forums to allow hospices and other interested parties to engage on the latest updates and ask questions on the development of HOPE and related quality measures. " ▌ CMS has also established a dedicated email account to the HOPE assessment at HospiceAssessment@cms.hhs.gov to receive ongoing questions and comments. ▌ CMS will use field test results to create a final version of HOPE to propose in future rulemaking for national implementation and they will continue to engage all stakeholders throughout this process. ▌ Future updates and engagement opportunities regarding HOPE can be found at: https://www.cms.gov/Medicare/QualityInitiatives-Patient-Assessment-Instruments/ Hospice-Quality-Reporting/HOPE.html D. Update on Quality Measure Development for Future Years ▌ CMS received many comments on the development of future quality measures. ▌ Commenters urged CMS to monitor duplication of measures when HOPE-based and other future measures are under development. Many commenters emphasized the need to engage providers to share information and for CMS to seek feedback when developing quality measures. ▌ CMS thanked all the commenters for their thoughtful suggestions and feedback related to future of quality measure development for the HQRP and appreciates suggestions for new quality measures, as well as comments about the public reporting of quality measures. ▌ CMS will take these comments under advisement for future consideration of quality measures and the Meaningful Measures System Blueprint. E. CAHPS® Star Ratings ▌ CMS will display CAHPS® Hospice Survey Star Ratings no sooner than FY 2022. ▌ CMS intends to build additional claims-based measures in the future as well develop outcome measures from the HOPE assessment tool. ▌ CMS is also considering developing hybrid quality measures that would be calculated using claims, assessment (HOPE), or other data sources to allow for more comprehensive set of information about care processes and outcomes (Assessment data can be used to support risk-adjustment). ▌ CMS will also explore the feasibility of conducting a dry run of the Star Ratings with reporting to hospices via preview reports, which would occur prior to the start of the public display of the ratings. 26 Newsline / Fall 2021https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/HOPE.html https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/HOPE.html https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/HOPE.html