Joint Preservation Therapy Solutions in Albuquerque, NM

CDC PLACES vs. JH: two files, not one brochure

Joe Bradley will tell you the same thing he tells his own staff: epidemiology first, then MAC, then SKU. CDC PLACES (2023, crude) estimates 11.3% of adults in Albuquerque have diagnosed diabetes — 0.7 points below the U.S. 12% figure. 14.4% of adults 18–64 here currently lack health insurance (CDC PLACES ACCESS2, 2023). Cash-pay PRP and Medicare CTPs cannot share one consent script. Then we pick joint preservation therapy against that mix.

Cash PRP and Medicare CTPs in the same hallway

• Adult arthritis here is 24.2% (CDC PLACES 2023, crude). That is the joint-pain backdrop for PRP and orthobiologics — not a promise that every arthritic knee is a candidate. 14.4% of adults 18–64 here currently lack health insurance (CDC PLACES ACCESS2, 2023). Cash-pay PRP and Medicare CTPs cannot share one consent script. PRP is autologous and not a 361 allograft, but “patient prefers regenerative” is still not medical necessity in New Mexico.
• A city of 500k–1M usually means mixed payer mix: Medicare FFS under JH, Medicare Advantage, workers’ comp, and cash-pay sports medicine. One SKU list rarely serves all four without a utilization policy.
• PRP is autologous and not an HCT/P 361 allograft, but payers in JH still expect diagnosis-driven documentation. A 1-minute spin does not replace a medically necessary indication or a procedure note.

Uninsured mix and Medicare CTPs in the same building

JH reviewers still want serial wound measurements and conservative-care history before CTPs, whether diabetes in Albuquerque is 11.3% or not. PLACES is planning data. The LCD is the claim.

How we’d stand this up in clinic