SHIP Allowable Investments: Spending Categories

Allowable Investment Spending Categories

Hospitals participating in the Small Rural Hospital Improvement Program (SHIP) are permitted to make investments in one (or potentially more) of three areas as they seek to meet value-based payment and care goals:

  • Value-Based Purchasing (VBP)
  • Accountable Care Organizations (ACO)
  • Payment Bundling (PB)/Prospective Payment System (PPS)

Allowable purchases within these three categories are hardware, software, and training.

Unallowable investments include, but are not limited to:

  • Travel costs
  • Hospital patient care services
  • Hospital staff salaries
  • General medical and office supplies

Examples of allowable SHIP activities can be found in the FY 2026 Allowable Investments

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 more information or for addition support, please contact the SHIP TA team at ship-ta@ruralcenter.org

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