On Jan. 19, the Office of Management and Budget requested public comment on recommendations for changes to OMB’s metropolitan and micropolitan statistical area standards. The recommendations, made by the Metropolitan and Micropolitan Statistical Area Standards Review Committee, included increasing the minimum urban area population to qualify a metropolitan statistical area from 50,000 to 100,000. The analysis assumes that Core-based Statistical Area lines, state rural floors and rural wage indexes remain the same as they were with the federal fiscal year or calendar year 2021 final rules. It does not include any recalculation of wage indexes by CBSA or adjustments to the rural floor, which we recognize would directly impact all providers. An estimated impact on hospitals moving from urban to rural within the 144 effected CBSAs in the U.S. shows some states gaining, while others lose funds. If adopted, this would likely start in FFY 2025. The recommendations are published in the Federa...