Ideal Option grew from one to 65 clinics over eight years

A nondescript and unassuming collection of buildings along Kennewick’s busy West Gage Boulevard provides a lifeline to patients saddled with opioid addiction, including the rising use of fentanyl pills. 

What started as a small clinic grew into a veritable campus and epicenter for a national chain of treatment clinics that currently serve 11,000 patients.

Dr. Jeff Allgaier and Dr. Ken Egli opened the first Ideal Option at 8508 W. Gage Blvd., Suite A-101, in Kennewick in 2012 after recognizing the overwhelming need for long-term treatment options for patients with substance addictions.

“As soon we started this, we had waiting lists through the roof,” said Dr. Jeffrey Allgaier, Ideal Option co-founder and chief medical officer. 

“It was hundreds and hundreds of patients. So we knew we had to grow because there wasn’t anybody else. We had people coming from all over the state to here.” 

Together with Dr. Brian Dawson, Ideal Option’s senior medical director, the two were rushing to meet the demand for their method of treatment.

“We treat opioid use disorder, but also other addictions like alcohol and benzodiazepine (commonly known as Valium). We just have the really good tools for opioid use disorder,” Allgaier said. 

The single Tri-City location grew to an eight-state operation with more than 65 clinics in the Northwest, Maryland, Minnesota and North Dakota. In 2018, the founding doctors sold a majority stake in the company to private equity firm Varsity Healthcare Partners. Blue Cross Blue Shield also owns a stake in Ideal Option, while the original founders retained a small portion of ownership. 

“It’s nice now. We get to be doctors,” said  Allgaier.

Most patients are self-referred and can be treated for not just substance addiction, but for Hepatitis C, sexually transmitted diseases and screened for HIV. 

The Kennewick clinic, across from Costco, also offers on-site counseling for chemical dependency and mental health. 

“We see about 70 percent of people face-to-face and 30 percent through telemedicine,” Allgaier said. “We’d like to flip that because it gives us the ability to see more people.” 

The Tri-City headquarters includes laboratory facilities that process medical samples from Ideal Option clinics nationwide. 

“We have it all in one shop. It’s all here,” Allgaier said. 

Locally, Ideal Option employs about 300 people across five buildings in Kennewick, plus locations in Pasco dedicated to administrative support.

Allgaier was key in relocating Blue Mountain Heart to Heart to its current spot near Ideal Option when the needle exchange program became a source of concern to when it moved to Kennewick’s Vista Way from downtown Pasco. 

Allgaier said it hasn’t fielded any complaints about the exchange since it opened on the site not far from Columbia Center mall. 

“The cool thing was, here, we’ve been doctors in the Tri-Cities in all the hospitals. We’ve known most of these folks, so it’s surprising with even with this being a conservative area, not a lot of resistance. This was the ideal location because there’s nobody around us. This has been a wonderful location,” he said.

Ideal Option runs like a typical medical practice, accepting all private insurance, Medicaid and Medicare, with only a small percentage of patients who self-pay. Dawson said this is uncommon for most practices doing this kind of work. 

“Most addiction clinics around the nation are cash-based. ‘Show up, give us $500, we’ll give you treatment.’ You can help so many more people when you take Medicaid,” he said.

“The reality is, most doctors don’t really want to take care of folks with addiction and folks with Medicaid, so that’s what we do. We do both,” Allgaier said. It helps that Washington is a “good state,” for Medicaid coverage. “They don’t cover everything, but that’s OK. There’s still a lot of educating we need to do with our payers to help them understand what we do as well,” he said.

The demand for help continues to grow as Ideal Option operates 28 clinics in Washington alone. It treats about 1,500 patients in the Tri-Cities and 7,500 across the state. 

More than 30,000 patients have received treatment since Ideal Option opened. The number might be higher if it weren’t for federal limits on a provider’s total number of patients. 

“What we’ve learned over the years is that this is a medical disease treated by medical providers,” Allgaier said. The doctors agree that, in most cases, patients need to be treated medically for the remainder of their lives to have the best possible outcome. 

“The evidence tells us that if somebody’s been dependent or addicted to opioids for many years, you have to keep them on medication indefinitely, which is not perfect, but that’s what the evidence tells us. Or 91 percent go back out. So you do the best you can,” Allgaier said.

Allgaier and Dawson are board certified in both addiction and emergency medicine, having cut their teeth as emergency room doctors together 15 years ago. 

“It was frustrating to take care of these people in the emergency room, bring them back from overdoses, discharge them and then see them two weeks later for the same thing,” Dawson said. 

“It’s nice to be in a situation, like this, where you see them on a weekly or monthly basis, and you can see that they’re doing well, and you’re actually doing something for their long-term health, as opposed to just patching them up like you do in the ER.”

The doctors have great concern for the increasing number of Tri-City patients they see using fentanyl, a concentrated opioid in pill form known as “mexi.” 

“We have some of the highest rates of fentanyl here in the Tri-Cities than all over the United States. It’s the most lethal. It kills more people than other drugs by far,” Allgaier said. 

Allgaier said people often accidentally overdose on fentanyl when they think they’re taking hydrocodone, but have taken the inexpensive, but deadly, fentanyl instead. 

Ideal Option frequently treats patients with opioid addiction using medication like Suboxone or Vivitrol. The doctors do not prescribe methadone.

Ideal Option is a teaching facility for addiction medicine for local medical schools and residents at Kadlec Regional Medical Center. The hospital’s former chief executive officer, Lane Savitch, believes in the clinic’s mission and came out of retirement to serve as vice president of community development for a year at Ideal Option. He retired from the clinic at the end of 2019.

The doctors say they haven’t had to do any advertising for their services, as the demand far outpaces the providers. 

“About 90 percent of the clinics we open do well and are self-sustaining,” Dawson said. Those that have closed have usually been in states with Medicaid changes, rather than a lack of demand for treatment. 

“It’s neat that the Tri-Cities gets to be the hub for this national operation,” Dawson said. 

The doctors say they hover in the top three largest companies for the services they provide. 

“As doctors you want to really be needed, and in this population, you are really needed. There’s not enough people that do this, so when you do it, you’re doing something that really helps folks.”

Allgaier calls Ideal Option’s patients the most rewarding: 

“It’s a hard population, but they’re some of the most rewarding patients because you can take them and their families. They’re in jail, or they lost everything, but you see that all change. You help flip it back. They get their family back, they get their kids back, and it’s pretty cool to see.”

Ideal Option: 1-877-522-1275; 8508 W. Gage Blvd., Suite A-101, in Kennewick; idealoption.com; Facebook, Twitter, Linkedin.