Upside/Downside - Grow Your Profits and Cash Flow
Poor profits and cash flow got you down?
My name is Matt Cooley and value creation has always been central to my career, from start-ups to multi-billion-dollar product lines. As a finance executive at successful companies, I've noticed a thing or two about what creates versus destroys value. In this podcast, we explore value creation and share a few laughs on the way to higher profits and cash flow.
Check out my website at www.upsidedownsidepodcast.com where you can share your email for my FREE one-pager: "10 places to look for higher profits and cash flow right now!"
I wish you the best on your value creation journey!
Matt Cooley
Upside/Downside - Grow Your Profits and Cash Flow
Ep 41: Rise in AgeTech Meets Tectonic Shift in Demographics - meet Keren Etkin, "The Gerontechnologist"
According to my guest Keren Etkin - founder, author, podcast host, known as The Gerontechnologist - never have so many people reached old age in good health in the history of the world. This is driving business opportunity in a vast ecosystem learning to embrace what it means to grow old. Ready to explore this wide frontier for value creation?
Thank you for listening and please visit Upside/Downside podcast and enter your email for my FREE list: "10 places to look for higher profits and cash flow right now!".
Matt
Yeah.
SPEAKER_00:Welcome back, everyone. This is Matt Cooley, host of Upside Downside, where we explore value creation and how the actions we take in business drive profits and cashflow. I'm a unit CFO for a large technology company and a nerd for value creation and how it impacts companies and everyday people. Investment and innovation in the age tech space is exploding with billions in investor capital flowing into startups and research efforts. According to AARP, by 2050, The 65 and over population in the U.S. alone will double, and most of those folks will want to age in their own homes. These tectonic-type shifts are actually happening throughout the world, and this is spawning an intense interest in age technologies, or age tech for short. Joining me today is Karen Etkin, who is known as the Jaron Technologist. I love that name. She's also the host of the Age Tech podcast, author of the book The Age Tech Revolution, and founder of the Welcome, Karen.
SPEAKER_02:Thank you so much for inviting me to your podcast, Matt. It's a pleasure to be here.
SPEAKER_00:Oh, pleasure is all mine. It's great to have you here on Upside Downside and also to be a member of your Agetech Academy. Just the wealth, incredible wealth of information that I get from that is amazing. I see you, Karen. You're welcome. I see you as one of the hubs, I'll say, in a hub and spoke type view of the Agetech industry. You're really adding value to so many aspects of this growing, I'd call it a phenomenon at this point. Can we start off with, please define age tech for us and tell us about your personal journey in this space.
SPEAKER_02:Sure. So I like to define age tech as technology that is designed to tackle the challenges of aging while including older adults and other relevant stakeholders in the design process. And so I believe that this is an integral part of the definition. I don't believe you can build a successful age tech company if you are not including older adults and any other relevant stakeholder in the process from day one, even preferably before writing a single line of code. And I started out, I'm actually a gerontologist by trade, and I started out my career in the nonprofit sector in community services. And then I transitioned into tech when I was recruited to Intuition Robotics. And then I learned that we were actually part of an ecosystem. And that was way back in like 2017 or 2018 when I got into my first Aging 2.0 Tel Aviv meetup, and I was in awe of all the other cool stuff that other startups were doing. And that was sort of what drove me to research this ecosystem and start covering it on the Journal of Technology. So we published the annual Agetech market map and have been doing so for a number of years. And after Intuition Robotics, I set out on my own and co-founded another startup called Sensi AI, which is doing really well as Intuition Robotics is. And I'm super proud of both of these companies. And yeah, that's me in a nutshell, my journey in a nutshell.
SPEAKER_00:That's so cool. Can you just tell us quickly what a gerontologist does? Because I love the nexus of, you know, a profession that I know has been around a while, even though I don't know what a gerontologist does, but the nexus with age tech and your concept of the whole, you know, getting involved in the design process. What is a gerontologist and what got you so interested in the technology side specifically? Sure.
SPEAKER_02:So, you know, it's funny. I only learned that a gerontologist was a thing about a year before I signed up for my MA in gerontology.
SPEAKER_01:Really?
SPEAKER_02:Because I was working, yeah, I was like volunteering in this space and I met a couple of gerontology students who were colleagues of mine. And I was like, what is that? And so a gerontologist is someone who either, it's an elder care professional, but you can also be a researcher. So you can also be an academic as a gerontologist. But I believe most of the gerontologists these days work in the field. So they work in organizations like home care or senior living or basically any type of community organization that works with older adults could use a gerontologist. And I think it's a really... I think it's like one of the most interesting... occupations you can have
SPEAKER_01:in
SPEAKER_02:the same age. Because when we look at the demographic shift, you see that we're in the midst of an unprecedented demographic shift. We've never had so many people reach old age in good health, in the history of humanity. So I feel like this is a really great time to be a gerontologist. And I mean, how I got interested in tech, I mean, I'm a millennial, so I sort of grew up with technology and I've always enjoyed trying out new stuff and setting up new gadgets. I mean, my favorite part when I get a new device is setting it up, which I think some people just hate that. I
SPEAKER_00:love that. Absolutely. Wow. We differ there, my friend. We differ there. The setup can be challenging.
SPEAKER_02:I mean, if I wasn't a gerontologist and I wasn't doing the gerontologist and I wasn't at the intersection of tech and aging, I would probably work in IT.
SPEAKER_00:Okay. Wow. And
SPEAKER_02:I would enjoy that.
SPEAKER_00:That's awesome. Okay. Well, that's so cool. And it looks like your timing is impeccable. How is this industry evolving? I'm not even sure if we should call it an industry, but how is it evolving? And where in general do you see the biggest opportunities for value creation? Like this podcast is about improving cash flows and profits and things like that. Where do you see those opportunities in this space?
SPEAKER_02:Well, anywhere you look, if you really are open to all the possibilities that are out there. And I think that now, I mean, the past couple of years have been a really great time for startups to, because, actually because fundraising has gotten harder. And why do I say that? I feel like in the days of 0% interest rates, when money was basically free, everyone was raising obscene amounts of money and Spending it immediately? Sorry to interrupt. the things that we've seen in this industry, even from looking back even a decade or more, is that we've seen companies that weren't exactly... like VC eligible, and I'm using like quotes with my hands, which you can't see. Because they are not necessarily the type of company that could potentially become a unicorn because they're serving a niche market. And so, and what we've seen, which is super interesting is that these companies have actually managed to either bootstrapped or get themselves off the ground using grants and become profitable. Without any VC funding or with very little VC funding. And I think when you say value creation, that's, I guess, the first thing that comes to mind for me is, at the end of the day, what you want to do is... create a product that people want to use and people want to pay for. And VC funding is one way of going about it, but not every company is VC material. And so I admire founders who decide to go the bootstrap route. And I admire founders who manage to reach profitability and build a product that people want to use and that they love and they want to buy it and they want to tell their friends about it without raising funding or with raising very little funding or with grants. And when you say buy the correction, that's what I think of.
SPEAKER_00:No, I think that's great. And that's actually inspiring because it shows discipline and focus that maybe as a native of Silicon Valley, probably some of us aren't used to seeing as much that That's really cool. That's really cool. I'm curious, what do business models look like right now? Because there is so much going on in this space. We just talked about where the money can come from and it can be broader than a typical VC funding mechanism. What are the business models looking like? And my sense from being in your Age Tech Academy and just paying attention to this space is that a lot of companies are trying to monetize through insurance, not Not all, but a lot, and that has its own complexities. Direct-to-consumer sales channels don't really seem to exist in a strong way, et cetera, et cetera. So just in terms of business models, what are you seeing and how do you think that's going to evolve over the next couple of years?
SPEAKER_02:So we see a bit of everything. So what I see over the past few years as we've been tracking the ecosystems is that actually a lot of the companies, especially the ones that make consumer electronics, they start out as direct-to-consumer with or without going to home care and senior living in parallel. And then what they learn sooner or later is that direct-to-consumer is incredibly expensive, but they still like to leave the door open. So what you see more than a few companies in this ecosystem do is they have the same product, basically, that they're offering, both to consumers who go on their website, they can buy it directly from the company, and to home care providers, and they sort of build a another portal or dashboard for the providers, and then also to senior living, again, with a separate portal or dashboard than what a consumer might have. And I think that is a really interesting approach, but it also makes it incredibly, incredibly challenging for the company, not just because you have to basically adapt your product to three separate types of buyers, but also you have to market the two or three separate types of barriers, but I've seen companies doing it and doing it successfully for years. So that is a valid business model. And when it comes to insurance, there are companies who go through insurance and there are, especially since Medicare Advantage and like supplemental benefits, We definitely see companies go that route, which is, as you know, better than anyone, is a really, really, or it can be a really long sales cycle, especially compared to, I guess, selling to a single site home care agency or a single site senior living in which you meet the owner and they like you and they buy the product. Well,
SPEAKER_00:I see the insurance ecosystem is just, you know, it could be the right decision for people. you know, companies in this space. But, you know, with my CFO hat on, I see cash burning, you know, over a two to three year period. Maybe that's a bad assumption, but that's kind of what I visualize with all these companies that are trying to monetize through insurance.
SPEAKER_02:It could happen, but what I have seen companies do successfully with insurance, particularly with long-term care insurance, is go with the rev share model. So off something to the insurance carrier that will allow them to support their long-term care insurance policyholders in a way that would delay the transition to a facility and save the insurer money. And I've seen companies do that and they've been successful. And I've seen also entrepreneurs who have a background in insurance and then they go build a product for insurance carriers.
SPEAKER_00:Right. Like insure tech or stuff like that. And is that evolving right now?
SPEAKER_02:So first and foremost, your customer is the older adult. Whether they are your user or they are impacted by your product, let's say, even if you're building an ambient monitoring device and the older adult is not actually using any user interface, they are the most important persona that you have to make happy. And you have to keep in mind that there is no single persona it's a very diverse population so you have to sort of really segment the market and really understand who who are the personas that you're serving who are the older adults that will be using or impacted by your product that's one type of persona and on top of that if you're selling to consumers more often than not you'll have the family caregiver in the picture either as a proper user with their own dashboard or as someone who influences decision-making or even makes the buying decision and buys the product for their older loved one. And then if you're a B2B company, that's a whole other world because you have, I mean, if you're selling for home care, for example, it really depends what you're selling to. Because even if you're selling like home care management software that does scheduling, billing, and payroll, you have the owner and you have the office staff and you have the caregivers, the frontline workers who you might want them to like to use an app to log in and out. And so you have multiple stakeholders. And that, again, is what makes this ecosystem so interesting, but also so, so challenging for founders. So it does take time and dedication to really crack that who exactly you're serving and really understand the problem area from their point of view. Because even if you are solving something, let's say, like falls, which, I mean, obviously no one wants to fall, but the older adult sees this one way, the family caregiver sees it another way, and the home care provider sees it in a whole
SPEAKER_01:different way.
SPEAKER_02:The insurance carrier sees it in a different way. So you really have to sit down with people who match your personas and interview them with lots of open-ended questions and do a lot of listening and not a lot of sense Because if you don't understand people's motivations, it's going to be really hard to build a product for them.
SPEAKER_00:Right. Wow. I mean, fascinating. It's not this simple, build it for the persona and sell it. It really is an ecosystem, which you've used that word several times while we've been talking here. So, wow, super complex. I imagine that changes the profile of the founder to a Because you do have to have, it seems, some experience somehow navigating or you have to have really good partners to navigate that ecosystem and not waste time, quite honestly, in building your business. It's fascinating.
SPEAKER_02:and building their products because they've encountered the challenge that they are solving in their personal lives. And so they have some experience, but it's a one-person experience. So they still have to go and do a lot of research to figure out how other people are experiencing this problem and whether or not they're willing to pay for the solution.
SPEAKER_00:Right. Fascinating. Last question, my friend. If you could give age tech startups one key piece of advice... about the next five years, what would that be? There's so much going on. What would you say folks should focus on?
SPEAKER_02:Well, the number one piece of advice that I always give any founder that reaches out to me is you're not your user and your grandma is not your user. So you have to talk to other users early and often and get their take on this. That's one. And you have to do this on an ongoing basis because it's not just the technology landscape changes, but also the world around us changes. And 2025 users are not 2020s users, right? January 2025 is completely different than the world we live in. In January 2025 is completely different than the world we lived in in January 2020. And that's just five years.
SPEAKER_01:So
SPEAKER_02:you never know what's going to happen five years into the future. And I feel and I know that having a close relationship with your users and having those early adopters who are willing to give you feedback and tell you the harsh truth and tell you the stuff that you don't want to hear is the stuff that's going to propel you forward and keep you on your toes and make sure that you are not just building the right product for right now, but you are continuing to evolve the product and continuing to evolve as a company in a way that continues to serve your users.
SPEAKER_00:Wow, that's wonderful. That's a great place to end, actually. What a dynamic time for the age tech space, Karen. Thank you for being with us today. And I really appreciate Appreciate this discussion.
SPEAKER_02:Thank you so much for inviting me over, Matt. It's always a pleasure chatting with you.
SPEAKER_00:All right. Same here. And thank you to the listeners of Upside Downside. Tell your friends about us. And if you need help with a specific value creation problem, please reach out. Have a great day, everybody.
