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.

Transferring Unused SHIP Funds to Another Participating Hospital
Unallowable

Unused SHIP funds cannot be transferred to another participating hospital.

Efficiency or Quality Improvement Training in Support of VBP Related Initiatives
Allowable
Value-Based Purchasing (VBP) Investment

Efficiency and quality improvement processes including: Six Sigma, Lean, Plan-Do-Study-Act, and others that address the following VBP initiatives patient experience of care, clinical care processes and outcomes, patient safety, care management and discharge planning, reducing readmissions, antibiotic stewardship, and emergency preparedness are allowable.

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.

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.

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.

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.

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.

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.