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.
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13 results found

ACO Fees

Allowable
Accountable Care Organization (ACO)

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.

Allowable investment

HCAHPS Surveys

Allowable
Value-Based Purchasing (VBP) Investment

Updated January 2023

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys completed for inpatient services are an allowable use of SHIP funds.

NOTE: Currently, HCAHPS is the only allowable SHIP survey. Costs associated with conducting surveys and assessments (including overhead, fees, payments, contractors, etc.) are unallowable. 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. 

Allowable investment

ICD-11

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

Updated September 2023

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  

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)

Allowable investment

Indirect Costs

Allowable

Updated September 2023

Indirect Cost Calculation - Grantee may request the lesser of 15 percent of the award total or their current federally negotiated indirect cost rate agreement. Indirect costs are deducted from the total award amount, not in addition to the total award amount. Grantees are not required to take indirect costs.

Allowable investment

Patient Safety (Training)

Allowable
Value-Based Purchasing (VBP) Investment

Updated January 2023

Costs for patient safety training to address performance issues related to Value-Based Program initiatives are allowable.

Examples may be training on recommendations, protocols, or information regarding best practices for patient safety and the quality of health care delivery or training on preserving confidentiality. According to the Agency of Healthcare Research and Quality (AHRQ), "safety" reduces the risk of harm and injury. Additionally, "quality" suggests striving for excellence and value. 

Examples of allowable costs include but are not limited to: 

Quality Reporting Data Collection Related Training or Software HCAHPS Data Collection Process Related Training Efficiency or Quality Improvement Training in Support of VBP Related Initiatives
Provider-Based Clinic Quality Measures Training Active Shooter Training (Non-medical Response)  

Note: Patient healthcare safety, security, and equipment that aids in treating a patient may also increase patient safety. The three are not the same, and direct patient care and hospital security measures are unallowable even if those measures increase patient safety measurements.

Allowable investment

Patient-Centered Medical Home (PCMH) Status Application Fee

Allowable
Value-Based Purchasing (VBP) Investment

Updated May 2022, See definition: "Recurring Payment."

The Patient-Centered Medical Home (PCMH) process requires an initial fee at enrollment. Then the rural health clinic implements changes by going through training that provides quality or efficiency improvement in support of Value-Based Purchasing initiatives. This is an allowable investment.

Note: The application renewal fee after the initial enrollment is unallowable.

Allowable investment

Project ECHO (Extension for Community Healthcare Outcomes)

Allowable
Accountable Care Organization (ACO)

Updated January 2023

Project ECHO educates health care professionals in underserved 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.

Allowable investment

Remote/Telepharmacy Services

Allowable
Accountable Care Organization (ACO)

Updated January 2023

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 Printer and Printer Supplied Used Exclusively with Telepharmacy Operations Computer

NOTE: The cost of personnel, medications, medication delivery, refilling pre-packaged medication, assistants, or hardware for direct patient care are unallowable. 

Allowable investment

Subscriptions

Allowable
Accountable Care Organization (ACO)
Payment Bundling (PB)/Prospective Payment System (PPS)
Value-Based Purchasing (VBP) Investment

Allowable

Accountable Care Organization (ACO)

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

Value-Based Purchasing (VBP) Investment

Updated June 2024

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

 

 

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."

Allowable investment

Swing Bed Software and Web Applications

Allowable
Accountable Care Organization (ACO)

Updated January 2023

Software and web applications that facilitate swing bed services are allowable uses of SHIP Funds.

Allowable investment

Telehealth Application and Implementation

Allowable

Updated January 2023

Training, hardware, and software supporting the application and implementation of telehealth services (telemedicine, remote healthcare, telepharmacy, etc.) are allowable expenses

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

*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 example would be a Zoom subscription for staff meetings.

See also: CAH Telehealth Guide

 

Allowable investment

Training (Hardware/Software/Services)

Allowable
Accountable Care Organization (ACO)
Payment Bundling (PB)/Prospective Payment System (PPS)
Value-Based Purchasing (VBP) Investment

Updated August 4, 2022

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 a PO. 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 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    

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.

Allowable investment

Voice Recognition System for Dictation

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

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

Allowable investment