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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Conferences

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

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.

Requires project officer pre-approval.

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

Medicare Beneficiary Quality Improvement Project (MBQIP)

PO Pre-Approval
Value-Based Purchasing (VBP) Investment

Updated September 2023

Allowable MBQIP activities include vendor fees for HCAHPS surveys.

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

See also: HCAHPS Surveys, Surveys and Assessments

Requires project officer pre-approval.

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

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

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