THE NUMBERS ARE NOTABLE. Every day, roughly 10,000 Americans turn 65. By 2030, every Baby Boomer will be over that threshold. The Medicare budget is on track to double from $1 trillion to $2 trillion within a decade. And as much as $84 trillion of Boomer-held wealth is slowly making its way to the next generations. For venture capitalists who have been building portfolios in what they call the “longevity economy,” this is not a distant opportunity — it is arriving right now.
But turning demographic destiny into venture-scale returns has proven far harder than pitch decks suggest. After several years, the investors deepest in this space are candid about what’s working and what isn’t.
Health care system is the safe bet — for now
The clearest wins so far have come not from designing for older consumers, but from redesigning the health and Medicare systems that serve them. In 2023, Daniel Kaplan and Dana Sun launched Equitage Ventures, an investment firm seeding early-stage startups in the longevity space, which now wields a $47.3 million fund.
The two investors put it plainly: The majority of successful exits in this space have been health tech plays — companies like Oak Street Health, which specializes in primary care for Medicare Advantage beneficiaries, especially those in underserved communities, sold to CVS for over $10 billion in 2023. PointClickCare, which provides internet-based health records software to senior care facilities and hospitals, is privately valued near $5 billion. “Within health care, it’s been a lot of tech-enabled services,” Kaplan says. “A lot of telehealth, or in-person care via primary care.”
What makes health care attractive to investors is predictability. “Reimbursement is something that is predictable, it is large, it’s largely guaranteed,” Kaplan notes, “and the population you’re billing for is only getting bigger.” That calculus explains why so much early-stage capital has flowed into revenue cycle management, care coordination software and back-office automation — areas that lack marketing glamor but offer clear paths to return.
Primetime Partners, cofounded in 2020 by Abby Miller Levy and legendary investor Alan Patricof to focus on early-stage investments in the longevity economy, has watched this shift up close as it deploys a second, $60 million fund. Their portfolio company DUOS recently pivoted from helping seniors navigate Medicare benefits to something more financially compelling: helping health insurers identify which of their members are under-coded or at risk of expensive health events. “One of the focus areas is our most expensive line items, which are polychronic older adults,” Levy explains. “Anything you can do to keep people out of the hospital, keep them from expensive surgeries” has become a priority.
The consumer side: harder than it looks
If health care is the beachhead, reaching the consumer directly has been the harder battle. Virtual communities, companionship apps and education platforms aimed at reducing social isolation in older adults — loneliness has been shown to pose significant health risks — have largely struggled to find sustainable business models, Levy says. Two of Primetime’s three investments in social connection platforms have shut down. The core challenge: Older adults often don’t self-identify as lonely or in need of companionship, and no one has emerged as a reliable payer.
There’s a need among older people, “the end user,” Levy says, but how you get to that end user is a challenge, “and then who pays for it?” This mismatch between user need and financial architecture is one of the most frequently cited frustrations among longevity investors.
Even physical products face the same headwind: Older consumers desperately want solutions but emphatically do not want to feel old. Max Zamkow, managing partner at Third Act Ventures and chief investment officer at the telehealth platform Bask Health, has watched multiple products fail because they were designed with caregivers’ peace of mind — not the user’s dignity — as the primary goal. “As an older adult, one of the things you’re very sensitive to, understandably, is your loss of independence,” he says. “If you have your adult child buying new things that are now monitoring you and making you feel more infantilized, you’re going to unplug it, throw it away, stop using it, or not use it at all, and anything that is in that category almost instantly fails.”
Older consumers desperately want solutions but emphatically do not want to feel old. Multiple products fail because they were designed with caregivers’ peace of mind — not the user’s dignity — as the primary goal.
The most durable consumer products, Zamkow argues, are the ones that happen to serve older users without announcing that intention — what Rob Chess, a Stanford Graduate School of Business lecturer who co-created one of the first courses on the longevity economy, calls “stealth design.” The 50+ market is significant enough that in 2020, Chess and Laura Carstensen, director of the Stanford Center on Longevity, began co-teaching a Stanford business course looking at the opportunities and challenges of developing and marketing successful products and services for the over-50 demographic. One of their favorite case studies examines how Nike developed an extra-support running shoes for “slow runners” (i.e., older customers) but found that young, superstar athletes are still its best endorsers.
“Nobody wants to buy an old person’s anything,” quips Carstensen, a professor of psychology. A generation ago, companies wanting to connect with older consumers might have tried marketing strategies that seem condescending or pitying by today’s standards.
Joe & Bella, a Primetime Partners portfolio company making adaptive clothing for people with physical and cognitive limitations, is case in point. It has succeeded because its garments look nothing like what you’d find in a 1980s medical catalog. “Personal identity — it’s just there, it’s innate,” says Joe & Bella cofounder Jimmy Zollo, who watched his once well-dressed grandmother scream in pain while getting ready for visitors. His solution is a line of clothing designed for easy on and off, with magnet clasps instead of buttons or zippers.
AI: The great accelerant, with caveats
Artificial intelligence is reshaping every corner of the longevity market, and investors are both excited and cautious. The clearest near-term wins are in workflow automation: AI that ensures skilled nursing facilities bill correctly, AI that handles care scheduling, AI that manages prior authorizations for home modifications. These may not make headlines, but they are generating returns.
More speculative — but potentially transformational — is AI companionship for older adults. Kaplan sees it as a critical steppingstone before robots can enter the home. “Before we put robots in there for more physical caregiving tasks, the most important activity of daily living is companionship,” he says. “I think that people will have to get comfortable with AI social companions first.” His co-investor Dana Sun adds a note of caution: Virtual companions still struggle with content moderation, and the risk of steering vulnerable users toward harmful psychological territory remains real.
The robotics question — when will machines reliably help older adults bathe, dress and move around their own homes — may arrive sooner than many expect, perhaps within 5 to 10 years, says Sun. But she points out that the standard isn’t just safety: It’s perceived safety. “In a lab setting, reliability is only about 80 percent,” she says. “Before you serve a senior, you want 99.99 percent.”
The structural challenge no one can ignore
Beneath all of this lies a problem that venture capital alone cannot solve. Zollo of Joe & Bella delivers the sharpest assessment: “We’re going to run out of beds in memory care and nursing communities before the end of 2027. Of the 10,000 Americans who are turning 65 every single day, two-thirds have a chronic condition. We already have nursing shortages, doctor shortages, and hospitals in rural communities that are being shut down.”
Carstensen frames the equity challenge starkly: “Ten percent of the population is going to thrive living long, and 90 percent isn’t — and that’s due to socioeconomic disparities.”
The investors are betting that technology, smart reimbursement strategies and a new generation of entrepreneurs who understand how the health care system works will close that gap. The opportunity is undeniably real. The urgency is growing by the day. Whether venture capital can move fast enough is the question that will define the next decade.
George Anders is the author of five books, including the New York Times bestseller Merchants of Debt: KKR and the Mortgaging of American Business, and has worked as an editor or staff writer at The Wall Street Journal, LinkedIn, Fast Company and Bloomberg View.
This story originally appeared on the Stanford Center on Longevity website.