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Small Rural Hospital Improvement Grant Program (SHIP)

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The Small Rural Hospital Improvement Grant Program (SHIP) is a federally funded program administered by the Ohio State Office of Rural Health (SORH). SHIP provides a framework and structure for hospitals to pursue performance improvement in the areas of value-based purchasing, Accountable Care Organizations (ACOs), ICD-10 implementation and payment bundling through the Quality, Financial and Operational Improvement (QI) Network. Hospitals participate in the CAH QI Network, which was established in 2004.


The SHIP grant is an avenue to address unmet needs of small rural hospitals regarding ACOs, value-based purchasing, payment bundling and PPS activities and training.  


The goals of the Ohio SHIP Program are:

  • To encourage small rural hospitals to utilize value-based purchasing to address data collection, quality improvement and data reporting to CMS Hospital Compare.
  • To encourage and support small rural hospitals to transition and implement ICD-10 standards. 
  • To encourage and support SHIP eligible hospitals in implementation of ACO activities.
  • To improve collaborative efforts between SHIP and other community agencies such as the Ohio Hospital Association, Ohio Health Information Partnership (OHIP), Rural Health Clinics (RHCs), rural Federally Qualified Health Centers (FQHCs), and rural EMS providers to provide supportive services to SHIP hospitals.  

Additionally, the SHIP Program has supported and administered the implementation of Ohio’s Medicare Beneficiary Quality Improvement Project through the QI Network structure (see the Rural Hospital Flexbility (Flex) Program page for more QI network information) utilizes this structure to support SHIP activities.

The QI Network has allowed participating hospitals to benchmark performance in Ohio and nationally, share best practices, discuss lessons learned, and communicate with other small rural hospitals about their experiences with implementing quality improvement projects. The message board and listserv that the QI Network administers have been significant tools in bringing the small rural hospitals together.


Federal government funding for the SHIP Program in Ohio is distributed to eligible hospitals in the state for activities related to one, two, or all four of the goals identified above. SHIP staff provides technical assistance to hospitals in identifying potential projects as well as assistance with implementation and evaluation. Both the SHIP and Flex Programs have been integrated where possible. This allows for efficient utilization of resources and for information, education, and assistance to be targeted appropriately.