Investing in the Future of Healthy Living with Abby Miller Levy, Managing Partner and Founder at Primetime Partners

0:00I have been very interested in the topic of aging prompted by my own personal experience of watching and supporting my parents as they age. And I was pretty dismayed that the experience is lacking the robustness of offers that exist at other life stages. We have always thought about aging and older adults as really the government's responsibility, what entrepreneurs can bring to the table. And so I said, where's the entrepreneur in this? Why are we not seeing amazing companies being built and designed for to redefine how we age? And so that's how I got started in this kind of connecting aging with entrepreneurship.

0:32Instead of starting a single business, maybe I should start a venture fund to back dozens of businesses. That's kind of how I got interested in this space. It started from my own personal experience, frankly, to frustration, to identifying a solution. Hello, I'm your host, Mike Gelb, and this is The Consumer VC, where we discuss the intersection of venture capital and consumer innovation. This show is brought to you by Propeller Industries, the leading strategic finance and accounting partner for venture stage companies. Now, I know this is free content, but that doesn't mean I don't have a favor to ask.

1:04If you're enjoying the show, please subscribe on YouTube or whichever channel that you're listening on. And if you really love the show, I highly recommend subscribing to the newsletter at theconsumervc.com. There, I send fundraising updates of all the latest deals in the world of consumer and even brand expansions that are happening. You'll also receive new episodes straight to your inbox. All content and episodes are for informational and entertainment purposes only. It is not investment advice. Our guest today is Abby Miller-Levy, who is a managing partner and founder of Primetime Partners.

1:37Primetime Partners is an early stage venture capital firm focused on the aging sector. Previously, Abby spent her career helping businesses and consumer brands grow as an operator. She was a senior executive at SoulCycle. She also co-founded Thrive Global with Ariana Huffington. I'm very excited for this episode. This episode is a breakdown of investing in the aging sector. Without further ado, here's Abby.

2:05Abby, thank you so much for joining me here today. How are you? It's great to be here, Mike. Thanks for having me. Oh, really, really appreciate you spending time today. So talking from the very kind of beginning from your primetime partner's journey, what was the aha moment or the attraction to actually starting your own venture capital firm and primetime partners and also focusing on this particular consumer segment? I have been very interested in the topic of aging, prompted by my own personal experience of watching and supporting my parents as they age. And the big aha moment was about five years ago when I recognized that my father, who had been retired for about 15, 20 years previously, that there wasn't as much kind of of a role for him in our society when you're not in the working role.

3:03And so it just beg the question of in our 60s, 70s, 80s, 90s, you know, because as healthspan and lifespan increases, we're going to have potentially up to a 50 year retirement. What does that look like? What does that mean? And so it kind of started with this question for how should my dad spend his time to then really a deep dive into what does aging, the experience of aging really mean. And I was pretty dismayed that the experience is lacking kind of the robustness of offers that exist at other life stages. And a big reason for that is that, well, part of it is ageism, of course. But another part of it is that we have always thought about aging in older adults as really the government's responsibility.

3:47and as the government's responsibility, you know, that's very different than what entrepreneurs can bring to the table. And so I said, where's the entrepreneur in this? Why are we not seeing amazing companies being built and designed for, to redefine how we age? And so that's how I got started in this kind of connecting aging with entrepreneurship. And then it became pretty obvious that as opposed for me as a former entrepreneur, I'd started a business before with Ariana Huffington. I'd always been in kind of smaller growth businesses like OXO and SoulCycle. So instead of starting a single business, maybe I should start a venture fund to back dozens of businesses.

4:24And it was great because I floated this idea by a good friend of mine from business school, John Patrickoff. And he said, wait, that's what my dad wants to do. And Alan Patrickoff is a notable venture investor. He started first the private equity firm, Apex, which is now a global multi-billion dollar firm, as well as he started Graycroft, the large venture firm. So Alan and I teamed up. We had known each other previously since he had been on my cap table at Thrive Global. And so we teamed up to start the business. So that's kind of how I got interested in this space. It started from my own personal experience, frankly, to frustration, to identifying a solution.

5:01I really appreciate that, how that went from personal and then all the way to actually seeing a real opportunity within this segment. Can you talk a little bit about when you were thinking about what experiences were actually missing for your father and also for other people of that age? What do you actually mean in terms of experiences that you would have liked to see and how that actually develops into maybe real problems that are actually worth solving? So if you think about, you know, this question of longevity, it's really a question of both health span and wealth span. Those are really the two biggest challenges as we start to push, you know, our numeric age that we live to.

5:49There was a study done recently by a Danish research firm that said that 50 % of people born after 2007 in the developed world are going to live to be 100. Like, think about that. Like, think about I'm turning 50 this year. That means I'm only at the halfway point if really we're going to move towards this centenarian society. And so that's a very big deal in terms of how we need to rethink how we take care of ourselves, our health, how we need to rethink retirement, retirement savings, wealth, experience. rethink our employment, how long are we working, rethink housing, do we have the right housing stock and way to be living in our 90s and 100s.

6:28And so it was really just this notion that across every industry, every category of our economy, that aging into 100 is going to have a profound implication. So that's kind of the starting premise, right, which is there's this big dislocation coming from living longer. So what does that actually mean? We do about two thirds of our funds health tech, not life sciences or biotech, but health tech investing. And so what that means is really that we're in this place of needing to figure out how we actually do increase health span by making sure we live healthier years, just not longer years. So advances in science have gotten basically over the past hundred years have gotten us living 50 years longer, but only half of that healthy.

7:15So we still have a long period of time where we're sick. So a lot of our investments and what we're looking at is how do we switch our healthcare system from a sick care to a well care? How do we make sure there's not only care capacity, we have a care shortage in our country and globally, not just care capacity, but healthier, healthier aging overall. So healthier aging is kind of one of the themes that we invest around. It sounds pretty generic, but it can be really pinpointed into a couple key areas around brain health and weight and a lot of other proactive care. How do you, how would one increase the healthier years of their life?

7:55Because certainly, you know, when it comes to totally see that obviously as a macro that from the macro perspective that we're living a lot longer. And I'd imagine, you know, a lot of those years, a lot healthier as well within the longer lifespan. But how have you found through investing, through talking with, you know, experts, you being an expert yourself, how, what are kind of like the specific areas that actually could increase, you know, healthier years based off of all the different conversations and all the research that you've done? Yeah. I mean, listen, longevity is like been the cover of The Economist and Business Week and Blue Zones on Netflix and major author, major doctors having New York Times bestsellers like, you know, Peter Atiyah and David Sinclair.

8:40And, you know, this whole, I'd say, scientific approach to longevity. And there's a lot of that that is very valid. But, you know, at the core of it, there's a few basic things that pretty much everyone agrees with. You know, if you look at blue zones and again across and a lot of it's common sense you know what you eat how you exercise sleep stress alcohol you know all of those things that we all know well and good to do but it's interesting one of our investments is in a business called cenogenics cenogenics is a has about 22 clinics across the u.s that are longevity clinics they specifically work with their clients um on a program that is very much focused, not just on both on health, but on healthier aging.

9:30And the core of that, Mike, I think you'd be interested to know, is really starting with quarterly blood draws. In other words, what we've learned, especially with the advances in microscopic and kind of genomics, is that we can, as opposed to your annual PCP visit or primary care doctor visit, there you go in 15 minutes, they listen to your blood pressure, they knock your knees, they ask if you're feeling okay, you see them next year, you really have to understand your body, your body's chemistry, especially at a cellular level, which is why having full panel of blood work done regularly, which is what Cynogenics does, and that uses that to make recommendations.

10:06They do the blood panel, they do a lot of other testing to understand how your body works and gut health and all of these things, so that you have a personalized prescription. Yes, sometimes it is medication, but you have really a personalized approach to what is specific to your body. And so if I had only a few recommendations, other than the generics, like the generics of how you live a healthy life, is that, you know, the more you can track and understand your body, then the more you can, can, can make recommendations take, for example, hormones. Um, I, you know, menopause is a topic that we invest in at prime time.

10:42And it's been a big topic within, um, femtech investing. Uh, and that is because while only a portion of women, uh, have babies, almost all women go through menopause. Uh, and so the target, the TAM is quite big. Um, and so within that, um, there is this question of, and back to Cynogenics is personalized medicine. How do we think about our hormone makeup? So with the personalized medicine, understanding your hormone levels for both men and women. Men and women both need testosterone. Men, women need estrogen, of course. And, you know, part of the opportunity when you talk about healthy aging is just understanding your body to then be able to invest in the products and services to support your healthy aging.

11:33One thing that really, really struck me was the quarterly blood testing as well, that actually makes sense. When I think about the annual physical, I think that probably a lot of, hopefully a lot of people participate and actually get their annual physical done. I've been told by doctors, some doctors have told me, you're too young to get an annual physical, that you actually should just do it once every few years, which I thought that was kind of strange. But I mean, I get an annual physical, but I think that was kind of interesting was you point to that a company that they invested in that is, is talking about quarterly blood testing.

12:10When you think about, you know, a duration of a person's life, when does it actually make sense to do maybe to, to increase the amount of, of testing of that person to really understand in order, in order to engage in, um, I assume preventative health where then, where then you kind of understand what you're, what, what you maybe have before, before it's maybe too far along, which, uh, which of course can, um, which, which of course is much better. But how, how do you think about going from maybe like an annual, physical, and early quarterly, when does it actually make sense in your mind or should always be kind of quarterly?

12:43You know, listen, I'm not a doctor. I'm not medically trained. But what I would say is that owning your health, understanding it, that's why the aura ring and whoop and all of these things have been really fantastic. The glucose monitoring, you know, all of these things that are super helpful for you to get a baseline on your health. And so I I think it's the baseline when you're younger that's super important, plus the genetics. You need to understand what is genetically in your family, which is why whenever you go to any doctor, they always ask you for your family's medical history. And you'd be surprised the number of people that don't know.

13:25They don't ask their parents, what did your parents die from? Like, you know, do you know everything that your grandparents had? Probably not. And so I think when I mean talking about own your health and we think about healthy aging, I think there's a piece of this that is about just having the information and then what you do with it. Then you've got all the behavioral stuff of the choices you make day in, day out. And then we've got a lot of environmental issues around mental health, not environmental, but the issues that are really in some ways impacting, especially a younger generation, social isolation, mental health, stress, financial insecurity.

14:04these are real health issues. They're called social determinants of health. Um, and they have an impact as well on your health. And so how you can manage some of those things, but to answer your question, I think it's totally fair in your annual physical to ask for a blood pound. Um, and you should know, that's, that's, that's, um, that's really helpful. Uh, and yes. And I, and I can understand that it obviously is very determinant on, on, on, on who the person is, as well as their own history in terms of how often you obviously should go or not go. The other interesting thing, and as long as we're kind of getting personal on this, is that majority of people do not use their available health care benefits.

14:48So in my world, Medicare age 65 plus, there's about$6 billion of unused Medicare benefits that Medicare enrollees are not using. There's about$30 billion of federal, state, and local healthcare subsidies like food, you know, food programs and transportation programs. And so for a younger audience to really look into their health plan that their employer offers them and understand all the different things you have available to you. In fact, we've made an investment on the B2B side in a company called Duos Health, which helps individuals navigate their health plans, their benefits of their health plans.

15:25And we also invested in a business called Connie Health, which is a Medicare Advantage brokerage, which helps Medicare age individuals, age 65 plus, pick the right health care plan for them so that they can optimize their benefits that they get. And so I think part of this is that, you know, none of us actually want to engage with our health plans. You know, think about it. Do you have you downloaded your health plan app? Do you know all the things you have available to you? Most of us don't. And that's a loss. That's really a loss. That's a great point that I think when it comes to picking and choosing a health plan as well, I also think that there's a lot more information about picking maybe the right health plan for you that actually makes sense for you and your family.

16:17And then also not really thinking about what other options are, or even have you actually utilize everything that's actually in your health plan. So that makes the last sense. How do you think about the current regulatory landscape for aging care services and technology? Is there any regulations or policies that have maybe enabled or hindered innovation within this space? It has been awesome tailwinds. Mike, I got to say. So the big kind of elephant in the room is that Medicare spend is about a trillion dollars a year. And it's growing at 8.4 % a year. So here we have a very big piece of the U.S.

17:02economy. In fact, all of health care spend is forecast to be 50 % of our federal spending by 2060. So 50 % of every taxpayer dollar federally is going to go towards health care by 2060. And so that creates a tremendous amount of regulatory pressure to figure out how to reduce costs, slow down health care costs, et cetera. So that has been the major driver. I wish it was quality, but it's not quality. It's really cost that is driving regulation. So what that means is that things that can reduce the cost of care are getting approved from a regulatory perspective. So let me give you a few examples.

17:47One, which was a necessity during COVID, was the reimbursement of telemedicine. Before COVID, telemedicine was only used as a, you know, in specific examples, as kind of a, if you can't meet in person, then we'll use telemedicine. fast forward during covid it had to be approved and reimbursed from a regulatory perspective for for most use cases and now the question was once covid was over was that a short-term regulatory change and we're back to in person the answer is no the the yes a lot most people have gone back to in person for some of it but i'm sure you've had a bunch of telemedicine you know have had have seen doctors over over video over the past a year or two um as have i and i think that's pretty common for Americans.

18:32And so that's an example of a regulatory change that stuck because ultimately telemedicine is more efficient, better quality in terms of being accessibility for people in remote rural areas, as well as cost savings. Another area of regulatory support has been around family caregiving. Family caregivers, what that basically means is it means that you are not a professionally trained certified caregiver, but you are taking care of a loved one, whether that's an older parent or a spouse or even a disabled child. And in our world, there's about 50 million family caregivers in the U.S. taking care of a loved one.

19:09Think about that 50 million. You know, it's like one in every seven Americans is a family caregiver. And so some of the regulatory change there has been around how you can reimburse or somehow compensate family caregivers for the time they're spending effectively as, you know, in some ways as as healthcare workers or kind of healthcare aides in the system. So there's been positive regulatory support there. And then there's been a whole other bunch of things, as we talked about earlier on the quantified self, being able to measure your heart rate, your glucose, a lot of what we call remote patient monitoring, a lot of changes there.

19:45So there's a lot of different examples where there's been regulatory tailwinds, particularly on the healthspan side. And then on the wealth span, the biggest regulatory change has been Secure Act 2.0, which has mandated the need for 401ks for employers of a certain size. And, you know, we have globally a trillion dollar savings gap. In other words, the average American needs about 1.4, and the data keeps shifting a bit, but around 1.4 million dollars to retire, assuming they retire in their 60s. And the average American as$100 ,000 in their retirement accounts. This is all averages. So think about that shortfall.

20:25And there's not many ways to change that shortfall. You can work longer, so we got to work longer, but you also need to start saving earlier because of compound interest and corporate matching. So getting 401ks, and actually it's interesting, Mike, I get asked all the time since I run a fund on longevity, what's my advice? And people always think I'm going to recommend some pill or potion or some funny ingredient to add to their diet. But the number one thing I always say is I say, max out your 401k, like whatever the maximum amount you can put in, do it. From a wealth span perspective, talk to me a little bit about maybe the opportunities that you see as an investor to actually help bridge that gap in terms of getting it to, I guess, you know, maybe it's education from, from, from bringing that up from, from a hundred K to, you know, 1.4 million to, to retire.

21:15Because then you have to imagine and target a different customer set to people that are retired, actually targeting people that are much, much, much earlier in order to encourage them to actually utilize their 401ks. What's the opportunity from an investor perspective? From an investor perspective, there's a bunch of startups in the retire tech. Again, I love it. You can put any noun plus tech together and it's a new category. But in the retire tech space, so there's companies that help with retirement planning. We have an investment in one called Retirable, which, you know, 50 % of Americans don't have a retirement plan.

21:55And it's never too early once you have 401ks and you've been, you know, never too early, meaning like in your 40s, to start to think about your retirement plan. And so that kind of advisory, kind of retirement advisory 2.0, 3.0 businesses, that's an interesting space. Another space in the kind of world of thinking ahead for retirement is actually the 401k space. So there's been a fair amount of innovation on different types of retirement plans, like a portable retirement plan and SEPs. And so there's kind of some new products out there. And then how those new products might be good for hourly workers or solopreneurs.

22:38So in other words, 401ks used to be just Fidelity and Vanguard and design for large corporate America. We're seeing a lot of innovation in the solo to small business side. And that's actually one of our investments in a company called Penelope in that space. And then the other piece we've been super interested in from a retirement perspective is really how you plan for your future health care costs. Most Americans, their number one concern financially is future health care costs. when they're, sorry, older for older adults. And one of the things is that you need to plan for your future care needs in the home.

23:1790 % of Americans think that in-home care, like having a professional home health aid in the home for you is covered by Medicare. It is not. That is a private expense. If you would like someone to come into your home and you need someone to come into your home to help you with your activities of daily living. And because of that, there's kind of this need for long-term care 2.0, as we call it. One of our investments is a business called Home Care Genie. And that's what they do is they really help you think about how to plan for and have insurance against future home care needs. So those are just a couple of the things as we think about financial longevity and wealth span.

23:52And then, of course, there's all like, you know, estate transfer and end of life, you know, kind of death tech, if you will, that also exists in our sector. In terms of Medicare, why do you look at a company that's trying to innovate within care, for example? How do you think about it in terms of who you're actually maybe selling to from a customer perspective? If their savings is, for example, only, you know, 100K, let's say on average, right? Is it that you're trying to actually get involved or is this even possible to get involved in the Medicare programs with some of these companies? And then this is one of the benefits of being on Medicare, one of the companies that you actually invest in?

24:40Or is it also directly selling to consumers the actual products? The commercial viability for a startup is mainly through an enterprise partner like a payer, which is a Medicare Advantage plan, or a hospital provider, or a life insurance company, or even AOL, which, by the way, is 23 million older adults that are clicking on AOL.com every month because there's about, you know, they still have this amazing business from their email and web business. And so most startups need to go through a affiliate or a channel to get to the end user. And that's not because older adults aren't online. You know, 59 % of boomers use social media.

25:29About 167 million Americans, 50 plus are on TikTok. So, you know, there's a lot, a lot of use of social media, but not a lot of buying it. And so most the playbook for how you launch a D2C brand is different when you're talking about an older audience so far than a younger audience. And so that is why most of our companies do sell, we say, B2B2C is because that's the channel that can get access to them most easily. But it also is not reflective of where the market's moving. every day in the U S 12 ,000 people, 12 ,000 turn 65. And think about that. Those 65 year olds are all digitally native. They were 30 when the internet was invented, right?

26:24Like they're, they're, they're, they're going to be shopping and engaging and doing things online very differently, um, than an older cohort. So I think we're about to see a lot more DTC businesses take off. because the marketing channels are starting to be more developed. But that D2C channel, when it comes to services, would that still look like B2B2C in that see if you actually maybe qualify through Medicare or different kind of programs? Or do you think that will be actually paid directly online or some type of combination? I think it'll be some type of combination. I mean, the reason why the payers or the Medicare Advantage, you know, channel has been the easiest way to get to the consumer is because it's free for the consumer.

27:14If it's included in the plan, then it's free. So that has always been, although it's very hard to convert that channel because, you know, your health plan is like Charlie Brown's mom, like, wah, wah, wah. Like, you know, who listens to your health plan? And then, of course, you also have to get into that health plan, too. You actually have to sell it into that health plan. And I imagine that's also pretty, pretty difficult to do. Yes. So I think that, however, one of some of the areas we are seeing a lot of traction on the D2C side is around, first of all, email marketing and affiliates. That continues to do really well.