Allowable Investments Search Tool

Identifying allowable investments for a SHIP-eligible hospital does not have to be a daunting task! This search tool created by SHIP-TA through the Federal Office of Rural Health Policy helps state coordinators and hospitals navigate the possibilities.

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 June 2025

Activities that support ICD-11 readiness and/or implementation are allowable. This includes, but is not limited to:

Computer software upgrades to support a future transition to ICD-11	Computer hardware that improves quality, efficiencies, and/or coding	Social Drivers of Health and Population Health training to use Z-Codes
Efficiency or QI training to minimize ICD-11 transition impacts on patients and staff	Revenue Cycle Management training	Updating ICD-10 software or hardware
ICD-11 system and/or coding training (individual hospitals or state-wide)	ICD-11 Implementation	ICD-10 billing & coding trainings to reduce errors and improve reimbursements
Transition to an online coding system that automatically makes ICD-11 available when appropriate	Upgrading or implementing telehealth software and hardware to take advantage of new/updated ICD codes for telehealth/telemedical services.	Trainings that update and computerize hospital policies and procedures to prepare for ICD-11

Note: This category is consistently under review, and we encourage SHIP Coordinators to email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns.

See also: Subscription, Recurring Payment, Training (Hardware/Software/Services)

Definition

Accountable Care Organization (ACO)

Payment Bundling (PB)/Prospective Payment System (PPS)

Value-Based Purchasing (VBP) Investment

Updated February 2025

A subscription is defined as an arrangement to continually receive services for a preset price. Subscription services solely in support of SHIP-approved categories such as ICD software are allowable.

Generally, subscriptions for software are allowable. See the table below or email SHIP-TA@ruralcenter.org and copy your PO with questions or concerns.

Please note that subscriptions to ongoing or on-demand training (at-will training) are unallowable expenses. Subscriptions that "happen to include" a SHIP-approved expenditure should be avoided. Subscriptions must be purchased and used for the SHIP-approved category.

Examples of allowable expenses include but are not limited to:

SHIP Quality Reporting (inc. MBQIP core measures)	HCAHPS	Quality Improvement Training
Telehealth Software/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."

This card is a definition to help users understand the application of SHIP spending categories and expenses. Definitions found in the SHIP Allowable Investment Search Tool may not be the same as the Federal Government's (or departments within) definition.

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

Updated December 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)	Six Sigma and Lean	Plan-Do-Study-Act
Antibiotic Stewardship

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 functional 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. Supplies that only have use in training such as a training crash cart, silicone simulators, or mannequins/manikins are allowable.

Voice recognition system for dictation to support increased quality, efficiency, and/or coding is an allowable use of SHIP funds.

The Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS) provided financial support for this Information Services to Rural Hospital Flexibility Project. The award provided 100% of total costs and totaled $1,100,000. The contents are those of the author. They may not reflect the policies of HRSA, HHS, or the U.S. Government.

As a technical assistance provider to rural health care organizations, the National Rural Health Resource Center provides access to a wide range of resources on relevant topics. Inclusion on the National Rural Health Resource Center’s webpage or presentations does not imply endorsement of, or agreement with, the contents by the National Rural Health Resource Center or the Health Resources and Services Administration.

Allowable Investments Search Tool

Investment Status

Investment Categories

Conferences

ICD-11

Subscription (Definition)

Subscriptions

Training (Hardware/Software/Services)

Voice Recognition System for Dictation