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.

Active Shooter Training
Unallowable

Active shooter training does not qualify as a SHIP Allowable Investment.  Active shooter training is required under the CMS Emergency Preparedness Rule.

Academic Mentorship Program
Unallowable

Costs or fees used to coordinate a mentorship program, training or educational event do not qualify as a SHIP Allowable Investment.

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.

Alternative Payment Model and Quality Payment Program Training/Education
Allowable
Value-Based Purchasing (VBP) Investment

Software or training to prepare staff and physicians for Quality Payment Program (QPP), which determines payment based on quality, resources use, clinical practice improvement, and meaningful use of certified electronic health record (EHR) technology is allowable.

Computerized Provider Order Entry Implementation and/or Training
Allowable
Accountable Care Organization (ACO)

Any educational trainings that support provider use and implementation are allowable.

Mid-Level Manager Training/Education for Value-Based Care and Population Health
Allowable
Accountable Care Organization (ACO)

Mid-level manager (MLM) training/education for the “why” and “how” of Value-Based Care and Population Health, and tools and strategies to help MLMs lead others in this time of change are allowable.

COVID-19 Education Materials
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Covid-19 related education materials (including vaccination education materials) for dissemination to the public. 

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.

Efficiency or Quality Improvement Training in Support of PB or PPS Related Initiatives
Allowable
Payment Bundling (PB)

Trainings that improve processes through adoption of best practices and transition to value-based payment strategies such as financial and operational improvements are allowable investments.

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.

Mobile Language Line Workstation for Interpretation Services
PO Pre-Approval
Accountable Care Organization (ACO)

Mobile language line workstations, iPads, and tablets can potentially be allowable SHIP investments if used by hospital staff to support operational efficiency and increase equitable patient satisfaction.

Note: These investments require Project Officer pre-approval. If a hospital is interested in this investment, the State SHIP coordinator should email their project officer with justification of how these services will support operational efficiency and increase equitable patient satisfaction.

Tablets/iPads for In House Patient Care Surveys
Unallowable

iPads/Tablets to be used for patient care surveys are not an allowable use of SHIP funds. In general, iPads and tablets to be used by patients and non-hospital staff are unallowable.

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.