Updated January 2023
ACO costs are an allowable investment under the ACO category. The hospital should identify how they will define progress to align with the state office’s SHIP goals.
Updated September 2023
Conferences may be allowable for hospital staff if most of the training sessions are within SHIP allowable investment categories. Costs for CMEs or CEUs or travel associated with the conference are unallowable. Project Officer approval is required for attendance. Please email the conference agenda along with session titles and corresponding SHIP categories to your Project Officer and ship-ta@ruralcenter.org.
Updated October 2024
SHIP supports HIT hardware/software and training, including risk assessments for cybersecurity.
Cybersecurity refers to any technology, measure, or practice for preventing cyberattacks or mitigating their impact. A strong cybersecurity strategy protects all relevant IT infrastructure layers or domains against cyberthreats and cybercrime. Examples of allowable expenses include but are not limited to:
|
Critical Infrastructure Security |
Subscriptions for Cybersecurity Software |
| Endpoint Security | Application Security |
| Cloud Security | Information Security |
| Mobile Security |
Network Security |
Updated October 2024
Mobile language line workstations, dual handset phones, or two-way translation devices may be allowable SHIP investments if used by hospital staff to support operational efficiency, improve patient safety, and increase equitable patient satisfaction. Salaries, wages, or fees for in-person interpreter or translator services are unallowable.
Note: These investments require Project Officer pre-approval. If a hospital is interested in this investment, the State SHIP coordinator should email their project officer with the justification of how these services will support operational efficiency, improve patient safety, and/or increase equitable patient satisfaction.
Updated January 2023
Project ECHO educates health care professionals in rural communities to treat chronic complex diseases in value-based care and payment models. This videoconferencing technology is used to create learning networks and may be a disease registry and population health training activity, and is an allowable SHIP investment.
Updated February 2025
Training, hardware, and software that support the application and implementation of remote pharmacy (telepharmacy) services are allowable.
Some examples of allowable expenses include but are not limited to:
| Telepharmacy Software | Telepharmacy Apps in Support of After-Hours Pharmacy Services | Telepharmacy Machines/Hardware |
| Telepharmacy Machines that can also dispense pre-packaged medication (automated medication dispensing systems) | Printer and Printer Supplied Used Exclusively with Telepharmacy Operations | Computer |
Both the purchasing of a remote prescription dispensing machine and the subscription for software to run a remote dispensing machine may be allowable if a grantee can confirm:
NOTE: The cost of personnel, medications, medication delivery, refilling pre-packaged medication, assistants, or hardware for direct patient care are unallowable.
Allowable
Accountable Care Organization (ACO)
Payment Bundling (PB)/Prospective Payment System (PPS)
Value-Based Purchasing (VBP) Investment
Updated February 2025
Subscriptions for products that provide critical services are becoming more prevalent in rural hospitals.
Generally, subscriptions for software are allowable. Please see the table below or email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns.
Examples of allowable expenses include but are not limited to:
| SHIP Quality Reporting (inc. MBQIP core measures) | HCAHPS | Quality Improvement Training |
| Telehealth Platforms (Excluding Provider Fees) | Disease Registries | Population Health Databases |
| ACO Subscriptions or Fees | ICD-10/11 Software Subscriptions | Cybersecurity and/or IT security software |
| HIPAA Compliance | Interoperability software | Provider Databases for Care Coordination |
| Data Collection (e.g. intake software or SDOH screening for Quality Improvement and/or Care Coordination) | EMR/EHR | Price Transparency software |
| S-10 Cost Reporting software | HIPAA-compliant web and video conferencing platforms exclusively for telehealth |
Note: A common example is ICD Software. Whereas a hospital purchased one program that could be downloaded to multiple computers (or server accessed), many ICD companies have now moved to cloud-based subscription services where the hospital pays a "per user" license. This specific example would be allowable under "Payment Bundling, A: ICD-10 Software."
Updated January 2023
Software and web applications that facilitate swing bed services are allowable uses of SHIP Funds.
Updated February 2025
Training, hardware, and software supporting the application and implementation of telehealth services (telemedicine, remote healthcare, telepharmacy, etc.) are generally allowable expenses under ACO (G). For further questions and clarification, please email your FORHP Project Officer and SHIP-TA
Examples of allowable expenses may include but are not limited to:
| Computers | Telehealth Software | Carts (For Free Movement of Telehealth Hardware) |
| Cameras | Microphones | Wires, Connections, and Cables |
| HIPAA-compliant web and video conferencing platforms exclusively for telehealth |
*Computers, iPads, and Tablets used for other purposes are unallowable. Hospitals must use them for telehealth applications and implementation.
Costs associated with diagnosis, treating, and stabilizing a patient through telehealth options are unallowable expenses. Example: The hospital can purchase a camera, but is not allowed to pay the tele-physician's fees for treatment.
Note: Telecommunication training, hardware, and software are unallowable. This is defined as supplies or equipment that provide communication aid but not patient care/efficiency. An unallowable example would be a conferencing subscription for staff meetings. Allowable web and video conferencing platforms must be exclusively used for telehealth implementation and be HIPAA-compliant.
See also: CAH Telehealth Guide
Updated February 2025
Training concerning an approved SHIP category/sub-category is allowable. This includes costs associated with hardware, software, trainer (SME), and supplies (such as training manuals).
Training should not include tests, testing, certification, accreditation, credentialing, or any associated costs. Some training will conclude with a knowledge test for "training completion." This is allowable so long as it is not for certification, accreditation, or credentialing.
Conference fees need to be pre-approved by your FORHP Project Officer. Please send the request with a copy (or link) of the conference agenda to your PO and SHIP-TA.
Examples of allowable training expenses include but are not limited to:
| Provider-Based Clinic Quality Measure Training | CPOE Implementation Training | Alternative Payment Model Training |
| Quality Payment Program Training | Disease Registry Training | Population Health Training |
| Social Determinants of Health Screening Training | Systems Performance Training in Support of ACO or Shared Savings Initiatives | Mobile Health and Telehealth Software Training |
| Community Paramedicine Hardware and Software | Health Information Technology Training for VBP and ACO | ICD-10/11 Software and Training |
| S-10 Cost Report Training | Price Transparency Training | 340B Drug Pricing program Training |
| Billing and Coding Training | Strategic Planning Development and Implementation | Mid-Level Manager Training |
| Value Based Care | HIT training associated with cybersecurity, hospital pricing, transparency | Training related to Telepharmacy Machines that can also dispense pre-packaged medication (automated medication dispensing systems) |
| Culturally and Linguistically Appropriate Services (CLAS) |
Supplies associated with training(s) are allowable. Such supplies may include, but are not limited to, staff-use training whiteboards, training manuals, training books, training modules, and other necessary-to-the-efficiency supplies.
Note: Training for direct-patient care is unallowable. Examples of unallowable training would be CPR training, wound care, medical treatments, and training on medical equipment. It is important to note that medical or direct-patient care training that benefits a SHIP category (such as patient safety) is still unallowable.