State Office of Rural Health

Small Rural Hospital Improvement Program (SHIP)

The HRSA Federal Office of Rural Health Policy’s (FORHP) Small Rural Hospital Improvement (SHIP) grant program provides funding for participating rural Virginia hospitals with 49 staffed beds or less, to support activities related to:

  1. Value-Based Purchasing (VBP)
  2. Accountable Care Organization (ACO) or Shared Savings Plan (SSP)
  3. Payment Bundling (PB) or Prospective Payment Systems (PPS) 

The SHIP program enables small rural hospitals:

  • To become or join accountable care organizations (ACOs);
  • To participate in shared savings programs; and
  • To purchase health information technology (hardware and software), equipment, and/or training to comply with quality improvement activities such as advancing patient care information, promoting interoperability, and payment bundling.

The overarching goal of Virginia’s SHIP program is to enhance the health or rural communities by assisting rural hospitals with the transition to value-based care models. 


If your hospital system is interested in participating in the SHIP Program contact Brandon Rivenbark at


SHIP American Rescue Plan (ARP) Funding Resources:

SHIP Program Eligibility & Requirements:

Eligible small rural hospitals are non-federal, short-term general acute care facilities located in a rural area of the United States and the territories, including faith-based hospitals. They may be for-profit, not-for-profit or tribal organizations.

1) "eligible small rural hospital" is defined as a non-Federal, short-term general acute hospital that: (i) is located in a rural area as defined in 42 U.S.C1395ww(d) and (ii) has 49 available beds or less, as reported on the hospital's most recently filed Medicare Cost Report;, 

2) "rural area" is defined as either: (1) located outside of a Metropolitan Statistical Area (MSA); (2) located within a rural census tract of an MSA, as determined under the Goldsmith Modification or the Rural-Urban Commuting Areas (RUCAs) or (3) is being treated as if being located in a rural area pursuant to 42 U.S.C. 1395(d)(8)(E); and, 

3) Eligible SHIP hospitals may be for-profit or not-for-profit, including faith-based. Hospitals in U.S. territories as well as tribally operated hospitals under Title I. and V. of P.L. 93-638 are eligible to the extent that such hospitals meet the above criteria. 


SHIP Program Partners:


Virginia SHIP Program Resources:

For more information about the SHIP program, contact Brandon Rivenbark at