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

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

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
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
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

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.

340B Drug Pricing Program Training
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.

Emergency Alert Systems

Any kind of emergency alert systems fall under the category of telecommunication systems and are thus NOT an allowable use of SHIP funds.

Outpatient Surveys

Surveys completed for medical clinics, ambulatory services, emergency room, specialty clinics, home health,  and other outpatient services are NOT an allowable use of SHIP funds. This includes OAS-CAHPS and CG CAHPS.

COVID-19 Community Testing and Mitigation
SHIP ARP COVID-19 Testing & Mitigation

The cost associated with COVID-19 testing education at hospitals and community locations including home health, hospice, and long-term care.

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, $1,560,000 (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.