NIC Chats Podcast with Abby Miller Levy

Lisa McCracken: 

Hi, everyone. Welcome to this episode of the NIC Chats podcast. I'm super excited for our guest today. We have Abby Miller Levy. She's a managing partner and founder of Primetime Partners and also a NIC Volunteer. Abby, thank you for joining us today. 

Abby Miller Levy: 

Great to be here. Nice to see you. Happy New Year. 

Lisa McCracken: 

Yeah, happy New Year. Okay. Before we dive into all kinds of fun stuff to talk about, I'm really excited about our topics and to pick your brain and have you share with others. Just for those that don't know you, we’d love a little background on you and Primetime partners, just so they have a little sense of your orientation and the lens that you'll be, you know chatting about here today. 

Abby Miller Levy: 

So my lens is, as an investor, I run a venture fund called Primetime Partners. We are an early stage venture fund, think pre-seed, Series A startups focused on aging and longevity. What that means is we are looking for companies that are using technology to improve the quality of living of older adults. About two thirds of what we do is health tech. About one third is FinTech or consumer, and we are very excited about all of the, I'd say, media and consumer and zeitgeist attention on aging and longevity. For me personally, I started the fund in mid-2020 with my partner Alan Patrick. Alan comes from the investing side. He is often dubbed the grandfather of venture capital, having started a firm called Apex and Greycroft Partners. And for myself, I spent most of my career in product management, business development, and as a founder myself, starting a business with Ariana Huffington called Thrive Global in the employee wellness space. So, we're now a team of five based in New York City. We had a $50 million fund One, we are close to closing our fund Two and within what some people call age tech, but I more call longevity tech. There are a bunch of other specialized venture funds like us, one of which is frankly AARP who I know NIC works closely with. So excited to share more and to learn more from you. 

Lisa McCracken: 

Yeah so I think that that's so super cool. I mean, I've been in the industry about 25 years, and it's just been amazing to see the blossoming and the growth around a lot of these tech solutions and platforms. And you know, I do think that there's a lot more attention on our space right now, I think, which is incredibly exciting. And there's so much opportunity. There's gonna be such a need across so many levels. So, one of my first questions for you, and I've always been impressed that with investors that go into this space, because there's a lot of what I call noise out there right now, and there's so many companies and entrepreneurs and innovation happening. Are there specific areas that you focus on? You know, and as part of that, how do you sort of sort through that noise and prioritize where you want to invest, but also, any insights in terms of, how you narrow down the potential list of companies knowing that there's a lot out there, for sure? 

Abby Miller Levy: 

Yeah. I mean, we look at about 800 startups a year. These are just startups that are focused in our area at our stage of investing. There's tons more companies obviously that are ultimately touching the lives of older adults. I think one of the hardest things that I've come to realize is there are tons of products and services that would improve the quality of living of older adults. It doesn't mean that they make good businesses, right? And so just because a consumer end user, a health plan member or a resident wants or needs this doesn't mean that there's a business model that can make it be so. And so, I think it's a much narrower solution set if you really look at not even commercial viability, but what we've started calling commercial velocity. How do you find businesses that it's so easy to get the enterprise customer, whether it's senior living or home care or health plan or hospital system, whether you get the enterprise customer, it's so easy for them to say yes. 

Lisa McCracken: 

Right? 

Abby Miller Levy: 

And it's that velocity of the sales cycle that can really help a startup within a couple of years go from zero to 20 to 30 million and more in sales. And so there's a very long tail of startups that are really languishing in this space because of not having the commercial velocity. A great example of that is remote patient monitoring. That is a space where the product totally makes sense. You say, okay, we're gonna help mom or dad if they're in a senior living setting or at home, we're gonna make sure that, you know, if they fall, that we can be notified right away, that if they're lonely, we can use an Alexa type product to communicate with them, that if they need their blood pressure, glucose, whatever, monitored in their home, we can take care of that. All of that makes sense. 

Abby Miller Levy. (05:22): 

But the business model, the reimbursement, the distribution through providers, it's just not working yet to the extent of making a big venture-backable business. Right. So you asked me, it's a long winded way to say, what am I excited about? I'm excited about the things where we see commercial velocity. We see commercial velocity on things that are around the care shortage and care capacity. How can we use AI and technology to improve workflows, reduce workloads, reduce paper documentation needs train people, cross train them, care capacity is an area we're seeing a lot of enterprises investing in because it's just a critical need and it's a huge pain point, right. We're seeing a lot of momentum on risk stratification and risk escalation. How do we prevent that call to 911. How do we really prevent the emergency room visit, which is a $22,000 per visit expense, for most health plans. And so, those are areas where we see a lot of movement in terms of enterprise demand because the ROI is so high. 

Lisa McCracken: 

Right. Well, you touched on a couple things that I want to follow up on. I know sometimes there can be some barriers to a really great concept, like you said, the whole, the velocity and the scalability and so forth. One of the things, and this is a question, as you referenced some of these workforce solutions or caregiver staffing solutions is sometimes a barrier to growth of the companies and the platform is who's gonna pay for it. And I know sometimes on the senior living side of things, the operators, so where is this something that we pay for and eat the cost? Is this something we can get reimbursed for? Is there something that the customer will pay for, maybe their adult children and so forth. Are there any barriers that you see out there as common ones where you say that this is generally a hurdle that we're seeing in the industry that that blocks some of that adoption? The pay one comes up a lot in our world and sort of the cost of budgeting for some of these IT platforms and so forth. I'm just curious for your observations there. 

Abby Miller Levy: 

Yeah, I mean, I think that there's just some assumptions that entrepreneurs make. Sometimes they'll say, we're gonna market to the adult child. And always I shake my head and say, have you ever tried to convince your mom or dad to buy something? It's not how decisions are made for the most part, unless dementia is involved, in which case the adult child is much more involved in decision making. Another one I commonly hear is, oh, we're gonna ask the senior living provider to upsell their resident to add this charge to the residents’ bill. That's not happening. It's hard enough to upcharge based on actual use of healthcare services and care services, let alone some new technology or things we often hear issues around you know, the direct to consumer. 

Abby Miller Levy: 

Well, we'll just find them on Facebook. Yes, we can absolutely find this audience on Facebook. But the conversion, to buying on Facebook or buying from a digital sales, is very different from the accessing and creating awareness. It's a marketing channel. It's not a sales channel yet. And then I think the last one that we often hear is, we're gonna have a digital only product. And engaging and also converting older adults usually does still require some human interaction. And especially when we're talking about healthcare, the word care in there is still a big piece of the puzzle. And so, a hundred percent digital solutions, we tend to push harder on them to really make sure that they're able to really solve the issue. 

Abby Miller Levy: 

And then of course, the last piece, which I keep saying the last piece, but is financial means. There was an article in the Wall Street Journal last week that talks about, even for the very affluent retiree, they are very concerned about running out of money. The psychology of spending is very different for older adults than for younger adults. And understanding the psychology of spending, I mean, you do a ton of research, you know this. That scarcity mentality really does impact decision making. And understanding the psychology of the consumer is another, I wouldn't say misconception, but it's another thing we see our founders not taking full account of. 

Lisa McCracken: 

Right. Well, and I would assume that that's where you provide some perspective and support to those that you do invest in. You feel like it's a good and smart investment because, you know, there can be a great concept, but they need an additional infrastructure with them to get to the finish line of a more mature product and so forth. So, what does that above and beyond, these questions of the decision making of do we invest or don't we, what does that partnership look like throughout the life of the investment? 

Abby Miller Levy: 

We believe strongly that in the early stages of investment, your investors are an extension of your team. We're on your bench. And so we are very flexible as to what the founders need. Everything from once a week meetings to once a month, we have someone on our team who's dedicated to working with the portfolio, which for a small fund is pretty unusual. And I'd say it really varies depending on the team and what their needs are and the cycle of what they need. Typically, founders will reach out to their venture investors when they need to fundraise, when they need to hire, when they need to make a big sale and are asking for introductions. So, I'd say we're very strong on tapping into our ecosystem and our network to be helpful where we can be. 

Lisa McCracken: 

What is your goal for the timeframe for the investment before there's an exit or you step away. There might be goals, and then reality. I was just curious what’s the typical. 

Abby Miller Levy: 

Our goal is the next day at a very big premium. 

Lisa McCracken: 

Right. You get the right offer. Right. 

Abby Miller Levy: 

It's been changing in venture. Historically, it was seven to 10 years in which you would expect an exit horizon. Data has come back that says that's really being pushed more up to 12, up to 14 years. Part of that's because it's taking longer to IPO, not just because the IPO cycles have been kind of closed. One, I was reading a report that said there's 1400 unicorns, i.e., startups valued over a billion dollars that are waiting to IPO. There's 1,400 waiting. And so because capital markets have been, for a variety of reasons, closed over the past couple years, are not really accessible. That is delaying things. And then there's just also a sense of the metrics you needed it, you know, five, six years ago that the bar keeps moving. So, the answer is we'd love it as soon as possible. We tell our own investors, it's probably 10 to 12 years. 

Lisa McCracken: 

Yeah. Interesting. You mentioned AI already. That's one of the things I want to ask you about, because you know, you say that in some circles and people are like, oh my gosh, I'm tired of the AI stuff, because I think it's been overplayed in some respects. There's the real AI that's got some traction, some real cool stuff's happening, and then there's the AI that people are like, I don't even know what this is and what it's supposed to do. What's your take on AI and where does it play a role in the companies that you're investing in or not? 

Abby Miller Levy: 

AI is like Excel. You can't run a business without it. I mean, I truly believe that. Now the question is it the core of your product? Like one of our investments, Butler, which does movement monitoring, heat sensing movement monitoring, and in the senior living does detect falls. The core of their product is proprietary data that uses AI to crunch their own data. That is AI at the core of a product. Right? Then there are other companies where AI is a data and analytics tool to do predictive modeling, or AI is a customer service tool that powers their chat bot. Right? In all of those cases, whether it's core to the product or core to a business operating process, AI is and will be as embedded in companies as Excel, PowerPoint, and Salesforce. 

Lisa McCracken: 

Right. Just to varying degrees and for different purposes. Yeah. Never heard it differentiated that way. That's very helpful because again, I think because it's used to represent so much, right. Such a wide range of activities and support and so forth. So, you talked about what you see as some hot platforms, products and, and so forth. You mentioned caregiving, some risk related tools and so forth. What do you see as lacking in the industry right now? Is there anything where you feel like we need more on innovation? There's, you know, there's some real opportunity here for senior housing for entrepreneurs, and maybe it's a little bit more of what you referenced earlier. 

Abby Miller Levy: 

So I think we're seeing AI being applied and technology being applied to tons of areas of health span. I mean, one of the areas that is a hotspot that is very positive is diagnostics and predictive testing. And whether that's on dementia, to gut health, to cancer, a lot of things that can, that as we learn more about what the end state of a health condition is, we can work backwards on how to predict it and do the diagnostic. So that's also an area of interest. The area where we have not seen a lot of innovation is on financial longevity, which is very much an issue for the senior housing community, which is 50% of Americans, they're gonna run out of money. And even if we had enough senior housing product, most people can't afford it. And so how are we using technology for the predictive modeling. 

Abby Miller Levy: 

Of the choices we make to help people afford things better? To think about pricing of long-term care insurance on a personal, not a generic calculator, but on an individualized basis. I think we really haven't applied enough innovation to long-term care insurance, although we do have one company in the space that is thinking about it. And I think we haven't applied it to financial longevity because right now the math doesn't work. We have increased our lifespan without increasing our health span and definitely without increasing our wealth span, and so that's where it would be great to see more solutions and that see more solutions and workforce longevity. In fact, the World Economic Forum is very much focused on how we keep people working longer. And I also think that's an opportunity for senior housing. 

Abby Miller Levy: 

How is there, in colleges, we've got a work study program, right? What's the work study equivalent for,  not work, live equivalent in senior housing? How do we think about financial aid? How do we think about different types of you know, it's called tontine where everyone puts money into a pot and then you share it as people die or leave the pot. So, I think that's an area we haven't seen a lot of innovation in which we would love to see more of. And then I think the other piece is on the actual consumer experience of what it's like to be in our seventies and eighties. And it's been very hard because there's so much ageism that prevents solutions that make older adults feel good about being who they are. And I haven't heard this term before. Maybe you have self-ageism. 

Abby Miller Levy: 

Self ageism is our own critical view of aging that has us saying, oh, I'm having a senior moment, or whatever it is. Or I don't wanna grow old. And so it makes us not actually wanna be part of older related communities. Because we don't want to be associated with that. But being part of that community could be one of the best things for us. Right. So we still haven't cracked the ageism and, and how to create wonderful experiences, joyous, purposeful, fun experiences for older adults. Other than the cruise lines. The cruise lines are the only ones probably who've figured it out. 

Lisa McCracken: 

Yes. Sort of that hospitality lens. I mean, not that that's not present in our space, but it's interesting. I appreciate you commenting on affordability. That's the, particularly that middle income group is a big thing for NIC, and we've got a long way to go with that. And I feel like we make progress. I feel like it's much more incremental than the reality of the situation out there. And because really our, for the most part, our products and our services, our reimbursement, everything ability to pay. It's for a limited group, it's either the private pay or the government subsidies and so forth. So, yeah. Yeah. So if I am a company, I'm one of those entrepreneurs, and, I feel like I've got something really great and really special and I'm looking for investors, beyond friends and family, what advice do you have for them to be as strong as they can be in their fundraise? And any advice for those individuals? 

Abby Miller Levy: 

I think at the early stages, there's a pretty textbook answer to this, but I'll have a little spin specific on businesses focus on older adults in aging. I think having relevant, it's who you are as a founder, having relevant operational know-how and whether you've had a job in a similar space to what you're building, or you somehow build that expertise. This can't just be because you have vision and an idea, you actually have to have some depth behind it.  

And so I think the founder background and the founder know-how is a very important piece of the puzzle and something that you need to highlight and emphasize because, at the end of the day, we are betting on you. Your idea may morph, the market may change, but ultimately you are the constant through it all. Right? So I think that's one piece. I think the second piece on the commercial velocity. Is very important to this industry, which is, and the number of senior living operators I talk to where they are fatigued with all the time, they get pitched by some startup founder. And so the commercial velocity is saying you've already figured out what your sales in is. Not even an angle. Somebody, it's your brother's best friend who's gonna pilot it. It doesn't matter if it, you know how you get it, but you need that anchor customer to get the wheel going, to get the case study, the pilot data to then be able to show that it works. And so I do think unfortunately we've had to bring forward proof of concept earlier than, hey, I'm someone smart with a great idea. And then I think the third piece always is ability to attract a team and attract other people. Your number one job as a founder is sales, sales to your customers, but sales to future hires. And so the question of who you can bring, whether they're advisors, other investors who you can bring around the table, that's a very important skillset that I think indicates a lot. 

Lisa McCracken: 

Right, yeah. Building the team is a huge part of obviously growing and maturing as an organization. And I appreciate the comment about the pitch and the end with operators because I think there's fatigue, quite frankly, with a lot of the senior living operators and there's pilot fatigue and observe a lot of companies and I call pilot purgatory. They're just like, they're floundering and they're struggling. And it's like, oh yeah. It's just getting beyond that is, is interesting. You mentioned earlier you being a founder in partnership with Ariana Huffington of a Thrive Global. So that's around wellness and workplace wellness. I'd love to hear about that a little bit. I know it's a little sidebar, but would love for others to hear about that too. 

Abby Miller Levy: 

Oh yeah. Ariana is amazing. She has written over a dozen books and five or six years ago she wrote back to back a book called Sleep Revolution and then one called Thrive. And both of those books were really her personal start with her personal journey, and then ended up really a scientific deep dive into sleep and wellness. And she realized that this, all this information can and should be productized to the benefit of everyday Americans or everyday, individuals. And the way to business model to support that was through the employer. To offer training digital tools, technology to make it easier to manage stress, burnout, all of the elements of wellness. And it was amazing, you know, I was co-founding president, we worked together for a couple of years before I resigned and stayed on the board. 

Abby Miller Levy: 

And I think being a founder has helped me to be a better investor because you really understand that zero to one journey and really understand how many competing interests there are and why focus is so important. I also think that the science of wellness and health is moving so quickly right now. I mean, the innovation on, I mean, even just think about the Covid vaccine. Think about how quickly we were able that we, the pharmaceutical companies were able to make that build that, get that distributed. I mean, that's what's going on with Ozempic right now. And the GLP ones, I mean, the pace of innovation on the biotech. We don't do life sciences or biotech investing, but the pace of innovation on that side and the openness to talk about women's health issues like menopause in the workplace and mental health and stress and all of this is coming to the forefront. Especially because healthcare is after our military, the second largest piece of our GDP. And so this was, Ariana and Thrive really was this ahead of its time. Opening a conversation around wellness that is now becoming much more germane. So being a founder was amazing. I realized how hard it was. It's a lot easier to be an investor but it also really wet my appetite in this space around health. 

Lisa McCracken: 

Yeah. And man, we've gotta be investing in wellness, certainly for the workforce, for the employees. And it's just that I think we've been reminded in the last five years of the importance of those individuals. And I think we all spend way too much time in the workplace not to be you know, have some tools and so forth to be better focused on wellness, stress management and so forth. 

Abby Miller Levy: 

Well, and also Thrive is very focused. There's an ROI for employers. If you think about employee absenteeism, churn, productivity, you know, there is a business case for wellness, particularly in senior living. There's a business case for this. It's not just because it's nice to have the right thing to do. 

Lisa McCracken: 

Correct. So my final question for you is, we've used the term longevity economy. What is your hope for where the longevity economy will be 10 years from now? And what do you think is gonna be needed to get us from here to there? 

Abby Miller Levy: 

I'm not sure the listeners are gonna like the answer. But one of the coming in as an outsider to the industry, five years ago, I had always assumed that older adults were just the responsibility of, and the domain of government. And frankly, in most economies around the world, they are. And what I see as a major opportunity is much closer go public private collaboration, because we have these two worlds in senior living. We have the public funded nursing home business, we have the private funded senior living business, but they/we have to figure out, and in the middle, we've already talked about, there's not a lot we need to figure out where there's regulatory support, tax support, financial support, because this is something that ultimately will fall on the shoulders of government because people will spend down into Medicaid. And if we cannot figure out better public, private, better public support of older adults in the right ways, and of enterprises like Senior Living that support older adults, that to me is a bit of an unlock, even take retirement Savings, secure Act 2.0. CMS and they're supporting telemedicine. All of these regulatory changes have been positive so far for seniors. We need more of them. 

Lisa McCracken: 

Right, right. Yeah, we were super excited last spring that Dr. Mina, the director of Medicare was at our conference. That's the first time we've really had a link with the CMS and Senior housing. Because it is generally seen as that private pay. But we agreed that we think there's a lot of opportunities there for some of these public private partnerships to solve some of the, maybe the affordability issues and so forth, because the government's not gonna be able to carry the weight of all of the private sector I think needs some little additional support to nudge and so forth. But I think that there's some innovative models I think that can come about out there for sure. So anything that's gone unsaid that you'd like to share before we wrap up? 

Abby Miller Levy: 

We are always looking for allies in what we do. Whether they're innovative enterprises that are saying, Hey, I wanna try something new. I wanna know something new who just would like to learn about what we're seeing. We are happy to do lunch and learns. Just the sharing of information is really important. In fact, I think, we've also talked about this, that there's the sense of we go to conferences and it's always the same thousand people, same 500 people. We need more recruits, right? To be thinking about this. And so I think to the extent that someone's interested, I'm abby@primetimepartners.com. Drop me a line, say, Hey, we'd love to figure out how we can help work together, share information. I think it's gonna take a lot of folks thinking creatively and differently to continue to push the ball forward. 

Lisa McCracken: 

Yeah. Fantastic. Yeah, we all are doing our work here today, but we're building the future for sure. Thank you to Abby Miller Levy with Primetime Partners. I appreciate your time with us today. And I would encourage everybody to check out our other episodes of the NIC Chats podcast. Lisa McCracken, signing off from NIC. Thank you.