Allowable Investments Search Tool

In general, SHIP allowable investments include activities to assist small rural hospitals with their quality improvement efforts and with their adaptation to changing payment systems through investments in hardware, software and related trainings. This includes aiding with value and quality improvement.

Unallowable investments include, but are not limited to, travel costs, hospital services, hospital staff salaries, or general supplies. Hospitals should contact their State Office of Rural Health (SORH) with questions regarding the appropriateness or fit of a certain activity or hardware/software purchase. For additional clarifications, refer to Frequently Asked Questions (FAQs).

This tool classifies a number of example investment activities as Allowable, Unallowable, or PO Pre-Approval. This is not a comprehensive list. It is only intended to provide examples of allowable SHIP activities.

Telehealth Network Fees
Unallowable

State Offices of Rural Health (SORHs) need to provide justification of how telehealth network fits or aligns with SHIP purpose and intent. Telemedicine provider salaries, such as a telepsychiatry consult, do not qualify as a SHIP allowable investment.

Mobile Health and Telehealth Hardware/Software
Allowable
Accountable Care Organization (ACO)

Training hardware or software that supports the application and implementation of telehealth and/or telemedicine is an allowable investment.

Telehealth Mobile Carts
Allowable
Accountable Care Organization (ACO)

Carts used to support the application and implementation of telehealth that are used by hospital staff to improve operational efficiencies are an allowable use of SHIP funds.

Stethoscopes
Unallowable

Stethoscopes that are manual, Bluetooth enabled, or telehealth purposed are not an allowable use of SHIP funds. 

Provider-Based Clinic Quality Measures Education/Training
Allowable
Value-Based Purchasing (VBP) Investment

Education/training for provider-based rural health clinic quality improvement reporting, including patient satisfaction survey scores, is allowable.

Pharmacy Services
Allowable
Accountable Care Organization (ACO)

Training, hardware, and software that supports remote pharmacy services are allowable.

Disease Registry Training and/or Software/Hardware
Allowable
Accountable Care Organization (ACO)

Educational training hardware and software to support the development and implementation of a disease registry for care coordination is allowable.

Community Paramedicine Hardware/Software
Allowable
Accountable Care Organization (ACO)

If the hospital and/or hospital-owned ambulance unit has a formal Community Paramedic Program (CPP), hardware and software to support the CPP to reduce emergency medical services (EMS) and emergency department misuse and readmissions are allowable investments. However, the use of SHIP funding for general EMS equipment is not an allowable investment.

Health Information Technology (HIT) Training for Value and ACOs
Allowable
Accountable Care Organization (ACO)

Health Information Technology (HIT) Training for Value and ACOs is an allowable investment.  SHIP covers hardware, software, and training; therefore, it would be beneficial to include risk assessments and/or training associated with cybersecurity. These are allowable investments.

ICD-10 Software
Allowable
Payment Bundling (PB)

Any training that updates and computerizes hospital policies and procedures, assessment and maintenance of ICD-10, and hardware/software investments that improve quality, efficiencies, and coding are allowable investments.

Remote Pharmacy Machines
Allowable
Accountable Care Organization (ACO)

Types of Remote pharmacy machines are an allowable SHIP hardware purchase for pharmacy services.

NOTE: Pharmacist services or medications are not allowable. 

Hardwired Internet Connections
Unallowable

Costs associated with the permanent installation of internet hardware are not an allowable use of SHIP funds.

Efficiency or Quality Improvement Training in Support of ACO or Shared Savings Related Initiatives
Allowable
Accountable Care Organization (ACO)

Quality improvement training such as the IHI Plan-Do-Study-Act (PDSA), Root Cause Analysis (RCA), TeamSTEPPS, Lean Process planning, Community Care Coordination and Chronic Care Management, CMS Abstraction & Reporting Tool, and other efficiency and quality improvement trainings are allowable investments.

Systems Performance Training in Support of ACO or Shared Savings Related Initiatives
Allowable
Accountable Care Organization (ACO)

Systems performance training, including adopting a framework approach to transition to value-based system planning, is an allowable investment.

ACO Fees
Allowable
Accountable Care Organization (ACO)

ACO fees are an allowable investment under the ACO category, as long as the hospital identifies how they will define progress to align with the state office’s SHIP goals.

340B Drug Pricing Program Training
Allowable
Payment Bundling (PB)

A 340B Drug Pricing Program training intended to increase efficiency or quality improvement in support of Prospective Bundling and Prospective Payment Systems initiatives is an allowable investment.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.