GIRARD — Multiple area health providers attended the regular meeting of the Crawford County Commission Tuesday, to discuss the possibility of the county contracting with Drs. William and Trisha Sullivan as part of its new employee benefits plan.

Don Orender, the husband of Dr. Jacqueline Orender, said he did not like the possibility of the county contracting with the Sullivan Clinic, as it would draw business away from other primary care providers, such as Dr. Orender — and Dr. Mindi Garner who was also in attendance.

As part of its search for a more cost effective employee benefits plan, the county had looked at adding a direct primary care element — an effort to minimize trips to the emergency room and urgent care. The county had discussed possibilities with its consulting firm, IMA Benefits Consulting.

The doctors Sullivan offer a membership-based style of care in which patients can pay a flat monthly fee to cover visits to the clinic, rather than paying for visits through an insurance company. The county had looked at the possibility of contracting with Sullivan, offering a lower-cost package if employees would go to Dr. Sullivan for small injuries, sickness, etc. This would keep insurance claims to the county lower.

No contract has been signed with the Sullivan clinic, and no employee benefits plan has been accepted by the county.

Orender said the lower-cost plan with Sullivan would drive patients from his wife’s clinic and others, where they have been for many years. He said his wife’s clinic, as well as Sullivan’s and Garner’s are part of a group called Pinnacle Care, which includes 159 area health care providers.

“You aren’t going to directly force them to leave, but you’d be double paying if you didn’t incentivize them to go to Sullivan,” Orender said. “You could have a similar deal with Pinnacle Care and give employees over 150 options.”

The commission said it is happy to provide Pinnacle Care with the information it needs to create a proposal. The commission agreed it could be a win-win for the county if something can be worked out with multiple options.

Orender expressed dissatisfaction that the county and IMA did not send out a request for bids on the matter.

Rick Beins of IMA said the consulting firm approached doctors with platforms set up for direct primary care. Based on the criteria that IMA considers a director primary care platform, Beins said Sullivan Clinic and Dr. Brent Cosens were the two that met what the county was looking for.

He said it was not IMA’s responsibility to reach out to Pinnacle Care or other area providers that did not have a direct primary care model in place, as IMA had no way to know they could offer similar services.

“If they do not already have an established direct primary care model in place, we have no way to know they can offer the county what it is looking for,” Beins said. “They only way we can know they want to create a similar platform is if they reach out to us, which no one from Pinnacle Care did.”

The county will put IMA in touch with Pinnacle Care to start discussions about creating a proposal for the county. Time is short as the county must have at least an insurance plan in place by January 1, 2018.

The commission told IMA its main concern is who would be responsible for keeping track of a primary care plan involving so many doctors. The money paid by the county would have to be distributed to the providers based on how many county employees went to each clinic, and records of those visits would need to be kept. The county does not want to be saddled with that responsibility.

— Chance Hoener is a staff writer for the Morning Sun. He can be emailed at or follow him on Twitter @ReporterChance.