What is HQRP? Hospice Quality Reporting Program

HQRP is the pay-for-reporting program CMS created for hospices under 42 CFR §418.312. Every Medicare-certified hospice submits HOPE data through iQIES; missing the submission threshold triggers a real financial penalty in the following fiscal year.

By Goodwin Hospice Academy Editorial Team· Published February 16, 2026·Last reviewed February 16, 2026· 5 min read

HQRP, in one sentence

HQRP is the CMS quality-reporting program hospices must participate in to receive the full annual payment update. Non-participants receive a 4-percentage-point reduction to that update.

What HQRP measures

HQRP currently includes HOPE assessment items, the CAHPS Hospice Survey (family experience), and claims-based measures. The full measure set is published in the annual Hospice Wage Index Final Rule.

How submission works

HOPE items are submitted to CMS through the iQIES (Internet Quality Improvement and Evaluation System) portal. CAHPS data is submitted by a CMS-approved survey vendor. Hospices should reconcile submission acknowledgment against CASPER reports.

The 4-percentage-point penalty

A hospice that fails to meet the annual HQRP compliance threshold receives a 4-percentage-point reduction to its Hospice Wage Index update in the subsequent fiscal year. For a mid-sized hospice, this can translate to hundreds of thousands of dollars in reduced payment.

Frequently asked questions

Is HQRP participation optional?

Practically no. Non-participation triggers a substantial payment penalty. Every Medicare-certified hospice should treat HQRP as mandatory.

What is the compliance threshold?

CMS publishes the threshold annually. Historically it has been 90% of records submitted timely, but confirm the current threshold in the current Hospice Wage Index Final Rule.

What is CASPER?

CASPER (Certification and Survey Provider Enhanced Reports) is the CMS reporting system that provides hospices their submission-compliance and quality-measure feedback reports.

Sources & further reading

Educational content only. Not a substitute for your organization’s policies, your medical director’s clinical judgment, or current CMS guidance.

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