Hospitals participating in the Small Rural Hospital Improvement Program (SHIP) are permitted to make investments in hardware, software, and training that help to participate in or prepare for delivery system reforms such as accountable care organizations (ACOs) other shared savings programs. Created by Centers for Medicare and Medicaid Services, ACOs are groups of physicians, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to the Medicare beneficiaries they serve.
The example activities listed below — from the FY 2022 SHIP Allowable Investments — are not intended to be a comprehensive list, but can assist eligible SHIP hospitals in planning and selecting appropriate investments.
F. Systems performance training in support of ACO or shared savings-related initiatives
Hospitals interested in systems performance training should consider adopting a framework approach in transitioning to value-based system planning such as one of the following:
Training hardware/software that supports the application and implementation of telehealth and/or telemedicine. This does NOT include telecommunications. Tablets and hardware/software investments are allowed if they are used by staff to improve operational efficiencies and telehealth services.
H. Community paramedicine hardware/software and training
Community Paramedic Program (CPP) training. If the hospital and/or hospital-owned ambulance unit has a formal CPP, then hardware/software can be purchased to support the CPP to reduce emergency medical services (EMS) and emergency department misuse and readmissions. However, use of SHIP funding for general EMS equipment is not allowable.
I. Health Information Technology (HIT) training for value and ACOs
SHIP supports HIT hardware/software and training, therefore, it would be beneficial to include risk assessments and/or trainings associated with cybersecurity.
It is important for state Flex Programs to understand the community needs of CAH and RHC service areas to develop or leverage program activities in support of health system development, community engagement, and population health improvement.
State Flex Programs can help CAHs transition into value-based systems, population health models, and future opportunities through education, network support, facilitation of new partnerships, and technical assistance.
The Flex Program and CAH designation was established and remains in place because of the financial vulnerability of small rural hospitals. CAH financial and operational improvement is one of the required program areas of the Flex Program.
