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Allowable Investments

Small Rural Hospital Improvement Program allowable investments include activities that assist small rural hospitals with their value and quality improvement efforts and adaptation to changing payment systems through investments in hardware, software, and related training.

The Small Rural Hospital Improvement Program (SHIP) supports eligible hospitals in meeting value- based payment and care goals for their respective organizations, through purchases of hardware, software, and training. SHIP also enables small rural hospitals: to become or join accountable care organizations (ACOs); to participate in shared savings programs; and to purchase health information technology (hardware and software), equipment, and/or training to comply with quality improvement activities, such as advancing patient care information, promoting interoperability, and payment bundling.

Unallowable investments include but are not limited to, travel costs, hospital patient care services, hospital staff salaries, or general medical and office supplies. Hospitals should contact their State Office of Rural Health (SORH) with questions regarding the appropriateness or fit of a certain activity, training, or hardware/software purchase.

For additional clarification, refer to the SHIP Allowable Investments Search Tool. 

Allowable Investment information is also available in downloadable PDF format:

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FY 2025 Allowable Investments
National Rural Health Resource Center
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FY 2024 Allowable Investments
National Rural Health Resource Center

 

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Looking for Allowable Investments?

State Office of Rural Health staff and hospital staff can search online to determine whether potential activities are allowable or unallowable under the SHIP Program.
Access the Allowable Investments Search Tool

SHIP Funding Priorities

Hospitals must first meet SHIP funding priorities before using resources to support investments in other areas.

SHIP funds should be prioritized by participating Critical Access Hospitals (CAH) in the following manner:

  1. Hospitals must meet MBQIP participation requirements in order to improve hospital quality outcomes. Non-federal tribal hospitals may use another culturally sensitive federally managed measure of hospital quality outcomes.

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.

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