The document outlines changes to the Small Rural Hospital Improvement Program (SHIP) in 2010. It discusses that SHIP funds can now be used for costs related to delivery system changes like value-based purchasing, accountable care organizations, and payment bundling per the Affordable Care Act. It provides guidance on using SHIP funds for activities that support these areas, such as purchasing software/hardware, providing staff education and training, and improving data collection and care coordination. The document also notes SHIP will continue supporting costs associated with implementing prospective payment systems.