Namaste Dear Patients and Friends,

I’m writing to you today to share the new vision I have for the Hirsch Center for Integrative Medicine. I’m calling it HCIM 2.0! This is something I have thought about daily for the past year. Changing a model that has worked (for the most part) for ten years isn’t easy and it has taken some soul searching to recognize that now is the time.

 

On this page, I am going to tell you

  • why we are making this change
  • the details of our new model
  • how to register for HCIM 2.0

 

When reading this information, know that these changes will NOT take place until June 1, 2017. So no matter whether you decide to continue with us or not, you can continue your care AS IT IS until May 31st.

 

To view our FAQ (Frequently Asked Question) section, please CLICK HERE. This is a live document that we update as new questions come in.

 

If you already have the information you need to make your decision as to stay in the practice or not, you can click the appropriate button below. Otherwise continue reading for more details:

Here are the challenges we are facing and the solutions we have come up with:

  1. Stacy and I are wearing too many hats – we are having a hard time being owners, administrators, managers and practitioners at the same time. My chronic fatigue is much better, however, I need to follow my own advice and slow down my life. The solution: We are going to hire an office administrator and another medical practitioner.
  2. Our administrative staff is stretched too thin. The solution: We are going to hire another medical assistant, decrease the administrative paperwork coming through the office and decrease the number of patients we are serving.
  3. Patients are getting better, but I want them to get better even faster! Our providers need more time with patients to integrate all that they have learned. The solution: We are going to increase the time of each visit and frequency of visits.
  4. Our providers want to focus on functional medicine in order to focus on treating the root cause of our patient’s health issues. The solution: We will stop offering some primary care services (annual exams, well child exams and urgent visits) to focus on functional medicine.
  5. I have new therapies that I want to implement, but don’t have the staff to do so. The solution: We are going to hire more staff to help us implement these new therapies and we are asking patients to commit to the lifestyle changes we recommend.

 

To summarize, we are investing in better technologies, better protocols and hiring more people to enable us to serve you at the highest level.

 

If you would like to watch a video of Dr. Hirsch talking about the HCIM 2.0 changes, please CLICK HERE, or scroll to the bottom of the page.

 

Our protocols have been proven to work and we’re excited about making them even better. Our system is unique because:

  • We create customized, individualized plans for every patient
  • We bring together the unique combination of functional and environmental medicine
  • We utilize the most advanced laboratory testing to determine the true cause of your medical problems
  • We use preventative laboratory and genetic testing to determine your risk of having future medical problems (like a heart attack, stroke or Alzheimer’s)
  • We offer the best treatments available for your medical conditions. From the highest quality supplements to nutrition, sauna, IV, ozone therapy, and coming soon: Heart Rate Variability (to treat stress), Neurofeedback (for fatigue, emotional trauma), Pulsed EMF therapy (for pain and fatigue), and Low Dose Antigen therapy (for allergies) and Low Dose Immunotherapy (for infections).

 

This is how these changes will affect you:

 

You are going to get:

  1. Even longer appointments. Our follow-up visits will increase from 40 to 50 minutes.
  2. More frequent appointments for my (Dr. Evan’s) patients. On average providers will see patients every one to two months.
  3. A focus on functional medicine and disease reversal. By following our recommendations and with our new therapies, you should see resolution of your symptoms in 1-2 years.
  4. New therapies that work to speed up the healing process. In the coming months we will add Low Dose Antigen Therapy (to resolve food and mold allergies), Low Dose Immunotherapy (to reset the immune system-infection relationship), PEMF (for pain and improved circulation and absorption), Neurofeedback (for insomnia, fatigue and memory loss) and bio-meridian therapies (to reset your body’s energy fields (meridians)).

To make this happen, we need to:

  1. Stop providing some primary care type services (urgent care, annual exams and well child exams) in order to focus on your main medical concerns. You will need to work with a primary care provider in our community (or use urgent care). We have included a list of some of these local providers further below.
  2. Hire more staff to provide new therapies and support our other staff
  3. Work with patients who can commit to the lifestyle changes we recommend
  4. Increase the investment to engage with us

 

Right now, we have 700 active patients and 300 people on our waiting list who want to work with us. The total we are going to be able to serve in this new model is 381 patients.

 

Our hope is that we fill HCIM 2.0 with our current patients who are committed to lifestyle changes. Why? Because here at HCIM we are about developing deep relationships and long-term transformations. We want you better in 1-2 years and then you only need to see us occasionally after that! That’s the culture we are building.

 

Functional medicine requires more of an investment upfront, but because we are treating the root cause you are investing in your quality of life now and into the future. The cost of a heart attack or managing symptoms through conventional medicine dwarfs the cost of functional medicine and without the quality of life we offer.

 

Below is an outline and explanation of the program and investment options that are available to you. Since HCIM 2.0 is starting in June 2017, you will notice that our fees are all prorated fees for June-December 2017. Full annual fees (12 months) will start in January 2018 and are listed further down this page.

 

You have FIVE payment options to choose from. Please choose ONE option when registering. 

OUR INSURANCE PROGRAMS

  • Option 1: Annual Fee paid + Insurance Program
    • For those who want to use insurance and
    • Need to be seen MORE frequently by their providers.
    • Fee paid annually (monthly if needed), insurance billed for visits, etc
  • Option 2: Cash Pay + Insurance Program 
    • For those wanting to use their insurance and
    • Need to be seen LESS frequently by their providers
    • Fee paid at each visit, insurance billed for visits, etc

 

OUR NON-INSURANCE PROGRAMS

  • Option 3: Cash Pay Program (cash)
    • Cash paid at each visit with your provider.
    • See cash rates
    • No monthly or annual fee
  • Option 4: Concierge Basic Fee
    • Subscription paid annually (monthly if needed)
    • See concierge basic rates for your provider
  • Option 5: Concierge Premium Fee 
    • Subscription paid annually
    • See concierge premium rates for your provider

These will most likely be simplified to cash pay and concierge in 2018.

 

Here’s the shortcut to interpreting the different options:

  • If you have great health insurance and you want to use it to pay for part of your care with us, then you will want to choose the Annual Fee Program or the Cash Pay + Insurance Program.
  • If you have a high deductible insurance plan, have an insurance that we don’t take or don’t have insurance, then you will want to choose on of the Concierge Programs or the Cash Pay Program.

 

Here are the highlights of the programs:

 OUR INSURANCE PROGRAMS

Option 1: Annual Fee Program + Insurance Program

This program is for people who want to use their insurance for their office visits. This covers the costs that insurance doesn’t cover. Your annual fee is in addition to the cost associated with your insurance (copay, coinsurance, or office visit cost before your deductible is met).

Investment for June-December 2017:

  • Evan Hirsch, MD: $1,165 when paid in full or $180/month
  • Allison Hamza, PA-C: $582 when paid in full or $90/month
  • Angie Thompson, ARNP: $582 when paid in full $90/month
  • When two parents are paying, dependents are half off.

Option 2: Cash Pay + Insurance Program

This program is for patients who want to use their insurance for part of the cost of their visit. There is a cash fee that will need to be paid beyond what we bill your insurance. This investment is in addition to the cost associated with your insurance (copay, coinsurance, or office visit cost before your deductible is met). This program is for established patients who have been through our other programs and only need to be seen a few times a year for maintenance.

  • Evan Hirsch, MD: $400 per visit + any costs associated with using your insurance
  • Allison Hamza, PA-C: $150 per visit + any costs associated with your insurance
  • Angie Thompson, ARNP: $150 per visit + any costs associated with your insurance

OUR NON-INSURANCE PROGRAMS

Option 3: Cash Pay Program

This program is for established patients who have been through our other programs and only need to be seen a few times a year for maintenance.

  • Evan Hirsch, MD: $550 per visit
  • Allison Hamza, PA-C: $300 per visit
  • Angie Thompson, ARNP: $300 per visit

Concierge Program (Basic and Premium options)

This program is for you if you’re interested in getting the highest level access to us and you are not going to use health insurance. We have Basic and Premium Programs available to you.

Option 4: The Concierge Basic Program:

This investment is for people who are NOT going to use their insurance for their office visits (if you don’t have insurance or we do not take your insurance). This covers ALL of your office visits and anything we do for you outside the visit. It does not cover supplements or other services.

Investment for June-December 2017:

  • Evan Hirsch, MD: $2,332 when paid in full or $365/month
  • Allison Hamza, PA-C: $1,165 when paid in full or $180/month
  • Angie Thompson, ARNP: $1,165 when paid in full $180/month
  • When two parents are paying, dependents are half off.

Option 5: The Premium Program: The Fast Track to Wellness

This premium program is for you if you’re interested in getting the highest level access to us, and don’t want to worry about ANY other fees associated with us throughout the whole year. This investment covers ALL of your office visits. ($4,380 value), Sauna 2x per week (8 per month) ($624 value), IVs 1x per week (4 per month) ($8,320 value), ALL supplements recommended by your provider ($9,000 value), B12 shots, other ozone therapies (sinus, rectal ozone), and coming soon PEMF, LDA/LDI, Neurofeedback ($15,000 value).

Total annually = $37,324 but discounted to…$25k/year

Investment for June-December 2017:

  • Evan Hirsch, MD: $14,583
  • Allison Hamza, PA-C: $11,667
  • Angie Thompson, ARNP: $11,667
  • When two parents are paying, dependents are half off.

 

There are a select number of spots available for those wanting to apply for a discount due to financial hardship. Please email John, our Transition Coordinator, at john@doctorevan.com (or 360-763-5240) if you wish to apply.

 

You have until March 24, 2017, at midnight to sign-up. However, acceptance is on a first come, first serve basis so please do not delay. After this date, if there are any open slots left, we will offer them to the people on our waiting list.

 

If you decide to leave, you can still continue your care with us through May 31, 2017. We want to make sure you have enough time to find another provider if you need to.

 

June 1, 2017 is the start date for this new model.

Then, find another primary care provider if you are currently using us for your primary care needs (see list of providers we recommend below), or use urgent care for any primary care needs that may come up.

 

We feel very privileged to be a part of your life and your healthcare!

 

Let’s make it the best year yet!

 

With gratitude,

Dr. Evan

Please read the details below for more information.

To view our FAQ (Frequently Asked Question) section, please CLICK HERE. This is a live document that we update as new questions come in.

More time with your provider

Our follow-up visits will increase from 40 to 50 minutes. Our experience has shown us that to provide the depth of care we offer in each visit we need more time. More time to ask you more questions, more time to answer your questions and more time to create a more thorough plan for your care and success.

More frequent visits with your provider.

On average we will see patients every one to two months. Currently, I (Dr. Evan) am seeing patients every 3-4 months. This is not acceptable to me. We are not able to see our patients as frequently as we would like due to the number of patients we are serving and the range of conditions we are treating. There is a great demand for the services we provide and it has been difficult to turn people away. With HCIM 2.0, we will decrease the number of patients we are serving and consequently, will have more frequent appointments available.

We will specialize

We want to focus on reversing your current complex medical problems and prevent any future problems. This means treating chronic fatigue, fibromyalgia, autoimmune diseases (like Rheumatoid Arthritis and Lupus), hormone imbalances (thyroid, adrenals, sex hormones) and resolving the symptoms you have that are affecting your quality of life. This also means preventing heart attacks, strokes and Alzheimer’s (to name a few). This means specializing in Functional Medicine. As I have learned more over the years and I’ve seen more success, I have come to realize that it is difficult to provide primary care and specialize at the same time. Therefore, I have decided not to offer primary care in this model so we can focus on Functional Medicine and focus on disease reversal and prevention.

 

What does this mean for you? This means that you will need to work with a primary care provider outside of our office for your primary care needs, such as:

Acute illnesses:

  • Common cold, flu, stomach flu, cough, sore throat
  • Nausea, vomiting, diarrhea
  • Broken bones, sprains
  • Rashes, boils, lumps

Prevention:

  • Annual exams
  • Well-child exams
  • Screenings
  • Any symptom not related to your treatment at HCIM

 

As part of our transition, we will recommend providers to you who specialize in primary care. We have included a list of these providers at the end of this letter.

Labs and Prescriptions

Our relationship with these will remain the same. Whether we are contracted with your insurance company or not, your labs and prescriptions will most likely be covered by your insurance as long as they are contracted with them. They depend on your insurance’s relationship with the laboratory and the pharmacy, not our relationship with your insurance company.

Referrals to other providers

Depending on your insurance company, we can still make referrals to other providers (i.e. cardiologists) when needed even as specialists. It is rare, but some insurance companies (e.g. Molina) require those referrals to come from the patient’s primary care provider, so you may need to see them for these referrals.

Your Commitment to your health

For the last 10 years, we have found that the patients who are most successful in our practice prioritize their health and have certain attributes that make them successful. These attributes include the following:

  • Maintaining a gluten free diet
  • Not smoking cigarettes
  • Modifying your diet significantly if recommended by your provider (e.g. paleo, food elimination diet or anti-yeast diet)
  • Keeping a record of everything you eat (occasionally)
  • Taking supplements as part of the plan you created with your provider
  • Prioritizing your sleep
  • Drinking 2-3 Liters of filtered water per day to stay hydrated
  • Practicing a relaxation technique and stress management techniques
  • Engaging in regular movement/exercise as able
  • Having periodic lab tests to track your progress
  • Scheduling and attending regular appointments with your provider and for therapies
  • Working exclusively with us to avoid multiple practitioners managing the same symptoms with differing protocols
  • Having the support of the people you live with in changing your lifestyle for the better
  • Removing chemicals and fragrance from your body and your environment

 

If you want to have success with our protocols, you need to be willing to commit to these items. We enjoy treating people who get better and when you do these things, you will.

Leaving Our Practice

If you choose not to continue with us, we understand. Your care is still very important to us and we want you to have a smooth transition to your new provider. We will continue to see you until May 31, 2017. We will have 70 minute appointments available with our providers to create a plan for you as you transition to another provider. If you are on a stable regimen, you will be able to continue purchasing supplements from us even if you are no longer seeing one of our practitioners. See below for a list of recommended providers.

Records Requests

We are happy to send your records to your new provider. Just have your new provider fax us a request.

Prolozone injections

For those who do not want to continue with our practice but still want Prolozone injections, we will have cash packages available. A package of 6 is $1200. For Medicare patients, we will bill the procedure to Medicare, however, you will be responsible for a $50 fee per injection for the additional materials that are not covered by Medicare.

Financial Hardship Discounts

There are a select number of spots available for those wanting to apply for a discount due to financial hardship. Please email John, our Transition Coordinator, at john@doctorevan.com (or 360-763-5240) if you wish to apply.

Pricing for 2018

2018 Annual Fee Program

This program is for people who want to use their insurance for their office visits. This fee is in addition to the cost of your office visits. Office visits cost an average of $150 depending on your insurance. You will owe this amount until your deductible is met depending on your insurance plan.

Investment for a full year (starting in 2018)

  • Evan Hirsch, MD: $1,997/year when paid in full or $180/month
  • Allison Hamza, PA-C: $997/year when paid in full or $90/month
  • Angie Thompson, ARNP: $997/year when paid in full $90/month
  • When two parents are paying, dependents are half off.

 

Remember, this annual fee is in addition to the other fees associated with your care, such as your office visits, supplements, IVs, saunas and laboratory fees. I recommend that you budget $6,000 per year total when going through active treatment with us. Because we work to resolve the root cause, as your health improves, the cost of your supplements and therapies should continually decrease.

2018 Cash Pay Program

This program is for established patients who have been through our other programs and only need to be seen a few times a year for maintenance.

  • Evan Hirsch, MD: $550 per visit
  • Allison Hamza, PA-C: $300 per visit
  • Angie Thompson, ARNP: $300 per visit
2018 Cash Pay + Insurance Program

This program is for patients who want to use their insurance for part of the cost of their visit. There is a cash fee that will need to be paid beyond what we bill your insurance. This program is for established patients who have been through our other programs and only need to be seen a few times a year for maintenance.

  • Evan Hirsch, MD: $400 per visit + billing your insurance (~$150)
  • Allison Hamza, PA-C: $300 per visit + billing your insurance (~$150)
  • Angie Thompson, ARNP: $300 per visit + billing your insurance (~$150)
2018 Concierge Program (Basic and Premium options)

This program is for you if you’re interested in getting the highest level access to us and you are not going to use health insurance. We have Basic and Premium Programs available to you.

2018 The Basic Program

This is for people who are NOT going to use their insurance for their office visits (if you don’t have insurance or we do not take your insurance). Please note that even if we don’t accept your insurance, it can still be used for most labs and prescriptions.

 

This INVESTMENT covers your Annual Fee and ALL of your office visits.

Investment for a full year (starting in 2018)

  • Evan Hirsch, MD: $3,997/year when paid in full or $365/month
  • Allison Hamza, PA-C: $1,997/year when paid in full or $180/month
  • Angie Thompson, ARNP: $1,997/year when paid in full or $180/month
  • When two parents are paying, dependents are half off.
2018 The Premium Program: The Fast Track to Wellness

This premium program is for you if you’re interested in getting the highest level access to us, and don’t want to worry about ANY other fees associated with us throughout the whole year. This is the ideal plan for someone who wants to optimize their health over the next 12 months. No bills, no invoices! Leave your wallet at home!

  • This INVESTMENT covers your Annual Fee and ALL of your office visits. ($4,380 value)
  • Sauna 2x per week (8 per month) ($600 value)
  • IVs 2x per week (8 per month) ($15,360 value)
  • ALL supplements recommended by your provider ($9,000 value)
  • B12 shots, other ozone therapies (sinus, rectal ozone) ($8,000 value)

Total = $37,340 but discounted to…

 

Investment for a full year (starting in 2018)

  • Evan Hirsch, MD: $25k per year
  • Allison Hamza, PA-C: $20k per year
  • Angie Thompson, ARNP: $20k per year
  • When two parents are paying, dependents are half off.

Recommended Providers

If you are transitioning out of our practice, or you now need another primary care provider, here are the providers we recommend. Please call them to establish a relationship with them. There are many great providers in Olympia. These are just a few of the ones we are most familiar.

 

Functional medicine consultants: If you are NOT continuing with HCIM and you want someone who practices functional medicine.

  • David Lerner, LAc, MTCM at the Heart of Wellness (Tumwater, WA). David is a Functional Nutritionist and used to work with us at HCIM. Takes insurance (not Medicare)
  • Natalie Kather, MD, Anti-Aging Medicine (Olympia, WA). Takes insurance.
  • Marty Ross, MD, Lyme disease (Seattle). Cash pay.
  • David Ellis, MD, integrative medicine and Lyme disease (Winlock, WA). Cash pay.
  • Dietrich Klinghardt, MD, PhD, Lyme disease and complex illness (Seattle, WA). Cash pay.
  • Nazanin Kimiai, ND, Lyme disease and complex illness (Seattle, WA). Cash pay.

 

Primary Care: If you are continuing with HCIM and you need a provider for primary care. These providers see adults and children of all ages.

  • Marnie Frisch, ND – Primary Care and Homeopathy (Olympia, WA). Takes insurance.
  • Jennifer Martin, ND – Primary Care, complex illness (Olympia, WA). Takes insurance.
  • Burnell Schatzel-Hill, MD (in our office complex). Conventional medicine and open to integrative medicine (Olympia, WA). Takes insurance.
  • James Simmons, ARNP (in our office complex). Conventional medicine and open to integrative medicine (Olympia, WA). Takes insurance.
  • Marius Laumans, MD. Group Health patients only. Conventional medicine and open to integrative medicine (Olympia, WA).
  • Daniel Katz, DO, Conventional Medicine and Osteopathic Manipulation (Olympia, WA). Takes insurance.

 

Pediatrics:

  • Brad Stephens, MD at Olympia Pediatrics. Takes insurance.
  • Bridget Sipher, MD at Olympia Pediatrics. Takes insurance.
  • Jenny Ash, ND. Takes insurance (not Medicare)
  • Marnie Frisch, ND. Takes insurance (not Medicare)

Still have questions? Please contact John, our Transition Coordinator. You can email him at john@doctorevan.com or call him at 360-763-5240 (Mon-Fri 9:00a-5:00p).

Watch Dr. Hirsch talk about the transition to HCIM 2.0