Wilson County insurance committee narrows candidates for employee clinic, delays final selection

The Wilson County Insurance Committee met Aug. 28 to review bids for the county employee clinic and decided not to make a final contract award at the meeting, instead scheduling a reconvening for Sept. 9 to continue deliberations.

The committee’s discussion focused on comparative costs, contract language and billing practices among several bidders. Committee Chair (presiding) opened the agenda item as “the solo business tonight, which is the employee clinic,” and staff presented a page-by-page comparison of proposals and pricing assumptions.

Committee staff flagged several areas of concern in the bids. A presenter identified only as Staff member (presenter) said Vanderbilt seeks a guaranteed 15% profit margin and could retain up to 30% of clinic revenue, while other bidders priced services as a per-employee monthly fee or flat fee. The presenter said, “They want us to guarantee them 15%. They can keep up to 30%.” The same presenter noted language in one bid that “all medical services offered on-site will be billed for reimbursement through qualified health insurance coverage,” which would mean the county’s plan could be billed rather than the county paying a flat per-employee amount.

The committee compared vendor cost estimates and models discussed by staff: the county’s current clinic cost shown in the materials was about $700,000 for the fiscal year ending June 30, 2025. Health by Design’s proposal was presented as an annual operating cost of about $1,100,000. Care ATC’s projected clinic operating cost started about $910,008 in year one, rising toward $960,000 by year three under one staffing model. Medical Analysis submitted a base clinic fee of $40,000 (a flat-fee approach) and later provided an equivalent per-employee figure of about $46 based on 952 employees; staff converted that to an annual total of roughly $525,504, with prescription drugs and lab work treated as pass-through costs. Family Medical listed a $23 per-employee-per-month fee (times 952 employees), and when staff added pass-through staffing costs the presenter calculated an annualized combined figure of about $472,374.

Several committee members and staff raised procedural and contract concerns. Staff member (legal/administrative advisor) told the committee that public notice had not been posted on the county website before the meeting, and recommended the group avoid taking final votes until the notice issue was resolved; the advisor suggested recessing and reconvening to allow proper publication. Committee members discussed whether to invite the two most competitive vendors back to give presentations and whether to request draft contract language before a decision. One member urged ensuring continuity of clinic staff if a new operator is selected: “whatever whoever we go with, we need to make sure we keep...our staff,” the member said.

A committee member who identified themselves as having no financial interest in Medical Analysis told the panel, “I don't get any kickback,” and said local access and continuity of care were priorities. Staff said the current provider had agreed to remain through December if necessary to support a transition.

No final vendor selection or contract award occurred. The committee approved the meeting minutes at the start of the session; at the end, a motion to recess was moved, seconded and approved. The committee set a reconvening for Sept. 9 at 5:30 p.m. to continue evaluation, potentially narrow the list, and arrange presentations or draft contracts for the finalists.

The committee’s next steps will include resolving the public-notice posting, asking vendors to provide or clarify contract terms (including performance expectations and liability/insurance certificates), and deciding whether to invite presentations from selected bidders before making a recommendation to the county commission.