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.

Architecture Design or Drafting Consulting Fees
Unallowable

Architecture design and/or drafting consulting costs or fees do not qualify as a SHIP Allowable Investment. Consulting fees of any kind are not allowable unless they are part of education and training.

Bank Service Fees
Unallowable

Costs or fees related to bank services that create efficiency, but are not presented as training, do not qualify as a SHIP Allowable Investment.

If training is provided to staff to increase efficiency or quality improvement in support of ACO or shared savings related initiatives, for example, revenue cycle management, this type of fee would qualify as a SHIP 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.

Patient-Centered Medical Home (PCMH) Status Application Fee
Allowable
Value-Based Purchasing (VBP) Investment

The Patient-Centered Medical Home (PCMH) process requires a fee at enrollment and then the rural health clinic implements changes by going through training that provides quality or efficiency improvement training in support of Value-Based Purchasing initiatives. This is an allowable investment. However, the application renewal fee each year would not be considered allowable.

Medical Credentialing Costs
Unallowable

Medical credentialing costs and fees do not qualify as a SHIP Allowable Investment as they are ongoing operational costs.

Library Fees and Services
PO Pre-Approval
Value-Based Purchasing (VBP) Investment

Library fees and services that are used strictly for training access or material and not ongoing operational access can be an allowable use of SHIP funds but requires PO approval.

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.

ICD-10 Training
Allowable
Payment Bundling (PB)

Any training to support coding and reimbursement, documentation, or documentation improvements that result in increased coding compliance are allowable.

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.

Security Camera Systems
Unallowable

Security camera and security systems used to provide ongoing and operational security and safety are not allowable uses of SHIP funds.

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.