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Are Family Caregivers the Secret to Improving Medicare Advantage Plans? · StartUp Health NOW Podcast

• 0:00
  By the year twenty forty, which is just around the corner by the way, roughly seventy-eight million Americans will be over sixty-five-years-old.
• 0:08
  To put that in context, in the year two thousand that number was thirty-five million, roughly half, and in nineteen sixty it was sixteen million, roughly half again.
• 0:18
  It's a vast demographic shift that is gonna shape our whole world, and healthcare will be at the epicenter. Hey, everyone.
• 0:26
  Welcome back to StartUp Health NOW, the podcast where we celebrate the entrepreneurs and the innovators who are transforming health. I'm your host, Logan Plaster.
• 0:34
  We talk a lot at StartUp Health about this idea that the aging population is shifting the needs of the healthcare system, but healthcare for seniors isn't just about the care that that older generation receives.
• 0:45
  For almost every older person with a health concern, there's an adult child who is worried and involved. We have very, very busy schedules. We have our own families.
• 0:55
  What we want at 5:00 is a report that says, "Mom's okay. She took her meds. This is what she's got on, you know, the docket for the next couple of weeks. Here's how you can engage. Um, also, how are you doing?"
• 1:08
  Right now, they are treated like some kind of awkward add-on to the system. We don't quite know what to do with them sometimes. Avonley Christine, my guest today, is on a mission to change that paradigm.
• 1:19
  With her platform, Avonley Care, she is making it easy and seamless for family caregivers to be fully integrated into the healthcare of their aging loved ones.
• 1:29
  That's great for families because they can monitor mom's health and get her what she needs, but as Avonley has discovered, it's also great for health plans, specifically Medicare Advantage plans.
• 1:39
  If we can leverage these people in to help us do the things we need to do, we're going to make more money, save money, and have happier members and actually lift up the fifty-four million unpaid caregivers who are acting as the backbone of the healthcare system.
• 1:54
  In our interview, we'll get into exactly what Avonley Care offers, including their integrations with Walmart and Mark Cuban's Cost Plus Drugs, and we'll unpack how unpaid caregivers could become the key to success for Medicare Advantage plans.
• 2:07
  Let's get into it. [upbeat music] Avonley Christine from, uh, Avonley Care, thanks for joining me today. Hi. Thanks for having me.
• 2:16
  I was excited to get this update because you've been very active with, with Avonley Care, and you've been, um, really looking at how to help Medicare plans, uh, reach folks better,
• 2:30
  um, improve the kind of care that they bring to, to older patients, but I wanna kinda unpack how you're doing that, how you're thinking about it.
• 2:37
  Let's start with what Avonley Care is, uh, if it's changed, if it's gone through any evolutions over the last year. Kind of just level set with us. Yes. So, um,
• 2:48
  Avonley Care, we-- at Avonley Care, we help, uh, Medicare Advantage plans, and we leverage informal caregivers to essentially help improve the financial performance of a health plan.
• 3:01
  Um, Avonley Care originally started as, um, an app that was B2C, kind of created for my mom, grandma, who are in Montana, while I was in Manhattan. And really, the only product on the market was Life Alert.
• 3:17
  And so my mom was about to enter the caregiving season of life again and I just thought, "Well, I can build something." Well, [laughs]
• 3:25
  build something turned into building our first product, building a platform that really did help the caregivers on resources, caregiving tools. You're entering this season of life. This is what you need to...
• 3:37
  We integrated with Walmart, um, integrated Walmart groceries, OTC health and wellness products in, um, partnered with Mark Cuban's Cost Plus Drugs, allowing for caregivers to have, uh, cheaper medications through the platform.
• 3:51
  And then we really found product market fit when we started to approach Medicare Advantage, um, health plans because these, these plans, um, so desperately need to leverage all these informal caregivers in to help with, for example, you and I are siblings, have communication with the plan around mom's breast cancer screening, her annual wellness visit, what meds she's taking, if, if, if her meds are changing, um, what she's eating, um, having insight into the food because what's ultimately important is what we are trying to do fundamentally at the core of the company is can we keep seniors happy, healthy at home for as long as possible, and can we, um, help the, uh, fifty-four million unpaid family caregivers in this country
• 4:38
  with their wellbeing, resources, caregiving tools, helping them enter this season of life, but leverage them in with- to the health plan to the core system that really keeps mom healthy at home?
• 4:52
  Because what I remember just seeing for the last, really in the last 10 years, is I always talk to someone, and they're like, "There's just so much fractured communication. Mom's doctor says this. She says this.
• 5:02
  My sibling says this. Um, a nurse says, says one thing."
• 5:06
  And I was like, "Let's just bring that all together," because with the way that Medicare Ad- Advantage is moving and how our healthcare system is moving, we don't have enough people going into the healthcare system to care for our aging population.
• 5:20
  So you and I are doing the work. Let's bring us in to make it easier for everyone. Uh, I wanna get into the Medicare side, but first let's just make sure we really understand the product itself.
• 5:31
  You kind of mentioned, uh, affordable medications, maybe a way to communicate with other unpaid caregivers. Kinda give us exactly what the platform is today. Yep.
• 5:42
  So, uh, our core functionality, we really focus on medication, um, adherence and management.
• 5:49
  Um, separate of medication, making sure that people have the ability to get discounted medications and pharmacy fulfillment through the platform.
• 5:57
  Um, second is the, uh, really the logged health information between, uh, caregivers and care receivers. So that's tracking vitals like heart rate through Fitbit- Okay...
• 6:10
  um, taking that data through Apple Watch and HealthKit and then grocery order- And how do you organize that, that data?How do we organize the data? Yeah, yeah. Well, how is that kept on your app?
• 6:22
  And I'm just kinda curious how that then translates to a health record or how it gets sent to somebody else. Like, how do you sort of structure all of that health data? Yeah, great question.
• 6:33
  So all the health data that we're syncing in through the Avonly ca- platform is essentially owned by the, the, the caregiver... I'm sorry, care receiver using, using the platform. Um,
• 6:45
  everything like our integration into Walmart grocery, uh, that data is essentially being pulled into the Avonly Care platform.
• 6:53
  You're shopping on Walmart, um, you're in Avonly Care, it's the same experience, uh, you have access to order s- compression socks, apples, peas, pears, um, Depends, and get that, uh, delivered to an aging parent in all 50 states.
• 7:10
  Um, in terms of the data we're collecting from a, like, biometric health perspective, um, it's really interesting because, you know, with AI, which, you know, most...
• 7:21
  if you're not using AI, you're so far behind at this point.
• 7:23
  But being able to, uh, have insight and access and collect the data of what a person's eating verse- and, uh, as well as what medications they're taking, um, if they're exercising, how their mood is doing, if their mood, if they're saying they're sig- significantly more down and depressed after taking a specific t- specific type of medication.
• 7:48
  Mm. And so tr- taking that and patch- packaging it to the adult child to inform them on this is specifically how you can help, help your mom.
• 7:57
  Or to a pro- a, a, a provider or a health plan of these are the things that we're seeing, and here's the areas that we, like with predictive analytics, think that something negative could happen to their health.
• 8:10
  So how do we intervene? Got it. Okay. So the value to the, the person, the patient, and their caregivers makes tons of sense.
• 8:18
  Now, you've mentioned a minute ago that product market fit really came into focus with Medicare plans, Medicare Advantage plans, because there's this other layer.
• 8:27
  And I understand you just got back from a, a conference that really, uh, focuses on Medicare and technology. Yeah. So, um, tell me what you learned there.
• 8:37
  Tell me how it kind of fits into your, your, your theory, your- Yeah... your thes- your thesis. My thesis. Okay. So, um, what I, what I primarily heard from health plans was, um,
• 8:53
  we don't have a caregiver strategy [laughs]. We know that they're there, we know they exist. They're... Some of them are our primary point of contact with our members is their adult child.
• 9:03
  Um, this is something that we need to wrap our heads around and start to implement.
• 9:07
  Because health plans know that, um, by engaging in the adult child who is already taking mom to her doctor's appointment or her wellness visit, having a, a, a way to communicate with that person, uh, is, is key for them from a savings perspective on multiple levels, which, you know, from star ratings, and I can get into that s- soon.
• 9:32
  But primarily what I wanna, like, come back and focus in on is just the point that health plans recognize that they need to have a relationship with the informal caregiver, and that they lack necessary, necessary tools to leverage them in.
• 9:48
  So that was the one thing I heard, um, across the board from multiple, multiple plans that were speaking.
• 9:54
  But two was, um, the, um, wanting to deploy app-based, uh, solutions into rural communities, um, to, uh, help, uh, their members.
• 10:09
  And so that was one of the bigger issues, which is like the, you know, something you see out in the Midwest, Rocky Mountain region, where I'm originally from, Montana, is you have, um, a lot of seniors who are up on the Hi-Line, top of the state, and all the kids move down to the cool cities like, you know, Missoula and Bozeman, and that's where they're raising their family, but they're still three, four, five hours away from their parent.
• 10:33
  Mm. And so getting them in for an appointment... Here's a prime example. My great, uh, grandfather is 100 years old. Wow. Still living on his [laughs] ranch- Wow... in Montana.
• 10:45
  And his doctor, his closest doctor, is, uh, six hours away. No way. [laughs] So every time Earl, uh, has to go to the doctor, he is, you know, he... we have to get him in. And so- Wow... it's... Yeah.
• 11:01
  It is, it's a, it's, it's hard in states where you have just- He's maybe an extreme case, but he's representative of a category [laughs] of patient who is, who has lack of access.
• 11:11
  You could live a lot closer and still have extreme lack- Yeah... of access. You might not have a car, right? Yeah. You might have other barriers. Um, okay. So you w- you went to, what was it called? Rise? Rise.
• 11:21
  You went to Rise. You heard sort of what you wanted to hear, which was that they saw the value in the unpaid caregiver, the family caregiver. They wanted to deploy app-based solutions. Good. That's good for Avonly. Yeah.
• 11:36
  Um, why, why haven't they, um... let's, like, let's explore some of the wrinkles in this. You know, why haven't they done it? Are they prone to working with startups versus building their own system?
• 11:50
  Uh, where do you see that going? Yeah. So I think a lot, a lot of plans have deployed products.
• 12:00
  Uh, what I have learned in the last, you know, two years in studying this market and starting to get integrated into the market and seeing, you know, what vendors are out there, is there's just so many, like,
• 12:14
  kind of like one-trick pony type solutions. Mm. We're gonna focus on med management, and then over here we're gonna focus on X.
• 12:21
  Um-What's very interesting to me is there's also a, a deep frustration of, like, there's an app or a platform or a software for everything, and I really wanted to get away from that when we originally started Avonley Care.
• 12:37
  I wanted us to be a all-in-one comprehensive solution.
• 12:41
  But what makes us unique and different, which most of these platforms, especially on the health plan side, really lack, is what we specialize in at the core is caregiver resources, support, and tools. Um,
• 12:56
  that's really what I've s- I've noticed a, a lack of.
• 13:01
  Um, y- you'll find that when you build technology, you have to really build it for the end user, and our end user is an adult child who's in her 40s, 50s, and 60s, and an aging parent.
• 13:15
  But you wanna make it sticky and useful. So you and I are at work all day. We have very, very busy schedules. We have our own families. What we want at 5:00 is a report that says, "Mom's okay. She took her meds.
• 13:28
  This is what she's got on, you know, the docket for the next couple of weeks. Here's how you can engage. Um, also, how are you doing? Let's track your mental health, your wellbeing.
• 13:38
  Do you have the time to take off from work?" Mm-hmm. "How far in terms of distance are you to your mom? Do you have the ability to get there?"
• 13:47
  And so, um, that's where I saw a very different opportunity and approach to this market, was can we go in and help the person living at home, the health plan, because it's just so broken on, on the healthcare system side, but also, what about the people that are doing the unpaid work?
• 14:10
  Yeah. How do you better support them with technology? So you just met with these folks, um, at RISE. You talked to folks from, from Medicare.
• 14:19
  The ultimate outcome there is that there are new partnerships that, you know, are born that you can, you can deploy what you've created to, um, millions more people. What are the barriers to that happening?
• 14:32
  Are you in a competitive market? Are they choosing between you and other folks? Is it just a resource-constrained market that, that say, "I, I'd love to use Avonley, but I just can't. I got no money"?
• 14:42
  What are, what are the barriers there? Yeah. So I think the barriers, uh, they're o- on with health plans, um, is just sales cycles are really long. But the cool thing is, is there's spots to...
• 14:56
  that you can work with, like, with quality and risk prior to selling into these bid seasons. Okay. And so, um, we've started to pick up traction.
• 15:05
  We're releasing a SOC 2 compliant product in, like, days, which is very exciting. The dev team is very tired. We have very short calls- Remind me what SOC 2 compliant is.
• 15:14
  It's a s- it's a s- it's a type of security that your platform h- has, and then so i- it's kind of required to work with these Medicare Advantage plans, so- Got it. Okay...
• 15:24
  um, takes about, if you're quick, five months, usually- Okay... eight months- Okay... to go through. Uh, pretty- It's a compliance barrier necessary for Medicare. Yeah, and it's pretty rigorous. The,
• 15:36
  but the, um, the s- the second piece to that is I'm encouraged because, uh, you know, walking,
• 15:45
  studying the market, looking at products that have been available, and, you know, the last couple years have been very tough on, uh, tech companies, especially in the caregiving space.
• 15:54
  We saw a super rise of funding in 2021 and 2022, and then a lot of these companies could not find product market fit. And so, um, we have, I believe, found product market fit.
• 16:08
  The employer side is very, uh, lots of competition, very saturated. I did not wanna go to the employer market, uh, even though many, uh, VCs kind of thought, you know, this is a quicker sell for you.
• 16:22
  The reason why, and I, I'm glad we didn't, is because, um, although it... you know, we could if we wanted to, um, not discounting people who are working. That's [laughs] why I built this for my mom.
• 16:36
  But on the employer side, you know, we have i- in the news in the past, like, six months, a lot of, you know, CEOs have come out and said, "We offer a lot of benefits, but they just don't get used."
• 16:48
  And so, um, I think we're gonna see a cut back of benefits for, that employers are purchasing for, um, employees. And so what I really wanted to focus in on is, well, yes, this is for caregivers.
• 17:02
  How do we get to the senior? And how can we push the adoption for the senior and the caregiver? And I believe that that path is through, uh, Medicare Advantage plans. Okay.
• 17:12
  So, so you had, uh, an optimistic reception at this conference. You're, you're- Yes... starting to lay, lay the groundwork with these plans. You're, you're seeing the pr- the progress.
• 17:22
  What are the next steps, and where do you hope to be, let's say, a year from now? Yeah. Um, next steps in a year from now, uh, hopefully I'll have taken vacation.
• 17:35
  Um, [laughs] but, uh, a year from now, you know, we are gearing up- Let's not get ahead of ourselves. Let's not get ahead of ourselves. [laughs] I know. I know. I know. I know.
• 17:42
  [laughs] Um, you know, a year from now, um, I think we'll be working with, uh, multiple, uh, Medicare Advantage plans, and I would like to see, from a product standpoint, deeper integrations with some of our larger retail partners in terms of vaccine scheduling through the, through, through the platform.
• 18:01
  We've started to talk about that, in-store vaccine scheduling, um, and, uh, full pharmacy, uh, rollout of, uh, a couple more full pharmacy integrations, uh, through the platform.
• 18:13
  Um, and, uh, yeah, I, I'm sure we'll have closed around- What are some of the data points? Obviously, you could present an amazing idea to a Medicare Advantage Plan, and they might say, "Sounds great.
• 18:26
  Um, we can't do it for a range of logistical, bureaucratic reasons," whatever. Um, so you've gotta come with the right data and the right, like, "Here's how I'm gonna help you."
• 18:36
  Um-What are some of the killer data points, uh, things that they're looking for where- Yeah... you can help, you can help them in kind of like the perfect way? Yeah.
• 18:45
  So great question, 'cause why do health plans care about this?
• 18:48
  You know, I would say number one from a star ratings perspective, the number one feature in our platform from the beginning, even when we launched Avonly 1.0 into the B2C market, was med management adherence.
• 19:01
  Uh, when we launched our first product amongst like 6,000 people, we delivered 125,000 medication adherence reminders. It was off the charge and- Mm... chart.
• 19:11
  So med, uh, you know, star ratings are weighted three times by medication adherence. And so- Got it... that's number one. Two, um, member retention and satisfaction.
• 19:25
  You and I having a relationship with a mom and health plan to make sure she does certain things and ensure, you know, a health plan is offering, wow, me, the caregiver, a product that lets me, you know, manage my mental health, manage my ability to engage with them, make it easier to care for my mom.
• 19:47
  Satisfaction and retention is really important because members wanna have, um, health plans wanna have their members for a long time.
• 19:53
  And then two, you have a healthy, strong relationship established with the children, who's to say they won't come, you know, and consider your health plan? Um,
• 20:02
  so star ratings and the member, uh, satisfaction, retention, and I would say, you know, third to that is really medication adherence, um, because the med management piece, as I said, is just so important.
• 20:18
  Having the full pharmacy delivery for families to ensure that medications are being shipped to a, to a member that is probably going to have chronic conditions and on multiple medications, it's very important that their meds are being taken, and that they have them readily available.
• 20:36
  And then lastly, which has always been, you know, my dream and why I built this, this for my mom, is, uh, uh, the integration with Walmart and having, uh, OTC and health and wellness products, having insight into what your mom, your dad is eating, um, making sure they have food, 'cause food insecurity is a real issue for people in this country.
• 20:59
  Um, but also too, the health plan having insight into what they're eating, um, and, uh, OTC health and wellness products. So that's, that...
• 21:10
  I think that in terms of why do health plans care, it's really a full package deal of if we can leverage these people in to help us do the things we need to do, we're going to make more money, save money, and have happier members, and actually lift up the
• 21:26
  54 million unpaid caregivers who are acting as the backbone of the healthcare system. Yeah. Very interesting. Um, I wanna close by shifting gears.
• 21:35
  You know, we've talked a lot about kind of go-to-market strategy, Medicare Advantage plans, but at the end of the day, you're trying to help caregivers. And so I actually wanna finish by, you know,
• 21:47
  hearing some of your thoughts about caregiving today, more on the personal side. Um,
• 21:54
  having, having helped folks through your app, do you have any sort of wisdom to share about people who might be in that sandwich generation right now, kind of worried about, uh, their, their parents, their aging loved one?
• 22:07
  Um, your advice for them, just like how to thrive in that environment, uh, in 2025. Yeah. Caregiving is tough.
• 22:18
  You know, whether even it's, you know, ch- little kids, uh, y- aging parents, um, my advice and what we do in our platform is the first thing we ask is, "Who are the people in your life that we can add to the platform?"
• 22:33
  'Cause you need a team of people around you. Do you have sib- siblings? Do you have an aunt? Do you have an uncle? If you don't have any relatives, do you have a family member?
• 22:42
  Um, having somebody and pushing that community to come in is really, really important. You know, they say it's a, it takes a village to raise a child. I think it kind of takes a village to care for an aging person, too.
• 22:55
  Right. I think I might coin that. [laughs] Yeah. Or, or to do anything great? Or to do anything great. Yeah. To do... Yeah. Run a company. Like [laughs] all these, all these things that we do, it really, I...
• 23:05
  You know, we were created to have relationship with other people. And so, um, I would just encourage people that if they're in this season, it's a tough season, but caring for an aging parent is an honorable thing to do.
• 23:21
  It's the right thing to do. And so I would just encourage you to get a community around you while you do it. Very nice. Very nice. Well, Avonly, thank you for the update. Keep pushing on what you're doing.
• 23:32
  Um, you're addressing an important gap in the market, and, um, I hope that these Medicare Advantage plans, um, embrace it quickly. Yeah.
• 23:40
  Uh, uh, you know, I know this is long sales cycles, so even a, even a plan that sees the value, uh, can be a challenge. And so I wish you the best in all of those, in all of those processes. Awesome. Thank you.
• 23:55
  [upbeat music] Thanks for listening to Startup Health NOW. We'll be back again with another episode next week. [upbeat music]