Brightpath Logistics

Across 55,730 claim lines, Brightpath Logistics paid $30,751,250 in allowed amounts against a Medicare benchmark of $13,522,500 — a blended 227.4% of Medicare. That is $17,228,750 above benchmark. Against your 1.50x (150% of Medicare) target, the modeled carve-out savings opportunity is roughly $12,100,000.

The spend is highly concentrated. A small number of high-cost facilities and surgical/imaging procedures drive most of the excess. Calderwood Regional alone accounts for $10,353,000 over benchmark on just 430 lines (310% of Medicare), and Hollowell Imaging — Hospital adds $4,992,000 over benchmark at 420% of Medicare. By contrast, your high-volume primary care (99213/99214) sits near 120–125% of Medicare and is not the problem.

The largest levers are site-of-care steering for two orthopedic procedures (knee and hip replacement, CPTs 27447 and 27130) and direct carve-outs at Calderwood. This is decision support based on pre-computed benchmark aggregates, not a guarantee of savings and not legal, actuarial, or medical advice.

Why these stand out

• Calderwood Regional — $10,353,000 over benchmark — At a blended 310% of Medicare on only 430 lines, Calderwood is your single largest dollar outlier; the excess is driven by high unit pricing on a small volume of expensive procedures rather than utilization.
• CPT 27447 site-of-care (knee replacement) — 230 cases ran at hospital outpatient at high multiples; steering to an ASC at 150% of Medicare models ~$5,945,500 because the same procedure runs as low as 140% at Caldova Surgical Center versus 310% at Calderwood.
• CPT 27130 site-of-care (hip replacement) — 200 cases at hospital outpatient drive ~$5,640,000 in modeled savings; like 27447, the same code ranges from 140% (Caldova) to 310% (Calderwood), so the price gap — not the care — is the cost.
• Hollowell Imaging — Hospital — 420% of Medicare — At 1,500 lines and the highest multiple in the data (420%), this hospital-based imaging is an outlier on price per line; the standalone Hollowell Imaging Center runs at 150%, pointing to a clear lower-cost alternative.
• CPT 27447 — 285% blended, $5,489,000 over benchmark — This knee-replacement code is the top overpaid procedure by dollars; its excess is concentrated at high-multiple facilities and is the leading carve-out target.
• Facility variance on 27447 and 27130 — Identical procedures vary from 140% to 310% of Medicare across facilities, confirming the overspend is a contracting/site-of-care issue that carve-outs or steering can directly address.
• 99213 / 99214 office visits — At 120–125% of Medicare across 53,000 lines, these are near target despite huge volume; they are not outliers and should not be a carve-out focus.

AI-assisted summary of your own figures — decision support, not legal, actuarial, or medical advice.