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.

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.

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.

Voice Recognition System for Dictation
Allowable
Payment Bundling (PB)

Voice recognition system for dictation to support increased quality, efficiency, and/or coding is an allowable use of SHIP funds.

Safe and Efficient Laboratories
Allowable
SHIP ARP COVID-19 Testing & Mitigation

Alterations and renovations that do not qualify as construction to update laboratories or other key spaces for safer and more efficient COVID-19 testing.

Population Health and Social Determinants of Health Screening Software/Training
Allowable
Accountable Care Organization (ACO)

Software and training for analysis of population health needs by chronic disease, geographic location, or analysis of social determinants of health in improving health outcomes and care management programs 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.

Wellness Streaming Services
Allowable
Accountable Care Organization (ACO)

IT software and hardware SHIP infrastructure for a wellness streaming services as a population health project is an allowable use 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.