How to Finance Longevity: A Wellness Program that Picks Up Where Long-Term Care Insurance Leaves Off

Hello and welcome to the Living to 100 Club podcast and another premium episode. Thanks to all of our dedicated listeners for tuning in. I'm your host, Dr. Joe Casciani, and here's today's episode. Well, hello to everyone joining us today on our program. You're listening to one of our premium podcasts on the Living to 100 Club, and I'm your host, Joe Casciani. Each week, our conversations educate and inspire. Helping you get the best out of all the years we are given, regardless of what obstacles come our way. Premium subscribers have access to all episodes, including 2 exclusive episodes per month. Thank you for being a subscriber. Your support allows us to continue this mission without sponsors. We hope you're receiving value from every conversation with our experts, presumably much greater value than the price of a subscription. On today's program, our guest discusses the Assured Allies program that makes successful aging more accessible to its members with new incentives. Andy Friedman, VP of Marketing and Experience at Assured Allies, is our guest. He shares the ways that his company offers prevention measures, support, and solutions to help older adults maintain their independence and delay or prevent the need for utilization of long-term care services. In short, can we make aging better by filling in the gaps before the physical decline? Can we respond quickly and effectively to a signal event at home without placement that would otherwise trigger long-term care? First, a little background. Andy Friedman leads marketing and customer experience at Assured Allies, where he works closely with insurance carriers, partners, and the Assured Allies team to deliver a positive and valuable experience for policyholders. Prior to joining Assured Allies, Andy served as an operating executive at several technology startups and global companies, including General Mills, Visa, and LevelUp. Andy received an MBA from the Center for Brand and Product Management at the University of Wisconsin-Madison and a Bachelor of Business Administration from Emory University. He lives outside Boston with his wife and two children and also co-founded Miles for Migrants, a nonprofit using donated airline miles and reward points to reunite separated refugee and immigrant families. Andy, welcome to our program.

Jo, thank you for having me.

You're very welcome. I'm looking forward to our conversation. I always like to open by asking our guests to tell us a little bit about the journey that brought you to where you are today. You've had a long, successful journey, but tell us maybe the highlights that you've encountered.

Yeah, well, I'm one, again, grateful to kind of be a part of this conversation and have an opportunity to talk with you, who's really being a champion for what, in our mind, successful aging can look like, how to make that possible. So once again, thank you for having me. As part of my story, I started my career working with very large companies, as you mentioned. And one of the things that I quickly realized is to make an impact at a large company, sometimes it's like moving a big ship very slowly. And so from a career perspective, about 12 years ago, I decided that I wanted to be a part of the innovation system that helps to bring new ideas to market quicker. And that's where I've been focusing. And I think it was probably for me a combination of two reasons that led me to our team at Assured Allies. One of them is a desire to spend my time and my energy helping to solve more bigger social problems, really having mission drive the decisions I was making professionally. And the second was personal motivation. As someone who's supporting the caregiving of my now 98-year-old grandmother, who's still living independently at home, I saw some of the challenge not only faced by her, fearlessly independent, living in the same apartment that she's been living for over 50 years, but also the strain that was having on my family and my parents specifically who are working to care for her. And when you dig into kind of more stories, you start to quickly understand that most people will either be a caregiver of someone or be cared for. In their lives, and often without either the knowledge of how to kind of tackle some of these challenging situations, or equally importantly, the financial stability to be able to support what might turn into a long-term care situation or need. And that's what led us to— led me to meeting my co-founders. Both also were family caregivers and led us on to a mission to figure out what we could do to change the story and help create both the financial mechanisms and the wellness solutions that make aging better.

Mm-hmm. Sure. So the professional work, the professional journey combined with the personal experiences of being a caregiver, watching your grandmother and knowing about others who are needing this caregiving, that's really fostered this position now at Assured Allies. So tell us about the company. What is it? How did it get started? Why did it get started? Yeah.

And so my two co-founders started the company about 5 years ago, both through their own personal caregiving situations. One caring for an aging grandparent, one caring for aging parents, and one, a physician by training, had spent most of his career working in healthcare system, coming up with managed care programs and other programs that were designed to help patients and the payers get better outcomes. The other was a technology entrepreneur, had worked in machine learning model companies in the advertising space. And really his path to starting the company was after a successful exit selling his prior company, he was telling his grandmother about the great news and didn't get the warm reception that he expected because there wasn't as strong a mission. It wasn't something that he could be as proud telling his grandmother he had just built and sold. And that was the start of the story. I think when we entered the space of what we now call successful aging, we didn't really know what the product was going to be. And ultimately where we ended up is figuring out that the financing of longevity, of post-retirement years was greatly underserved. This came through both conversations we started to have with big insurance companies and in our inner circles. Something I never knew, but quickly discovered as we were starting on our mission was that even my own parents had tried unsuccessfully to buy a long-term care insurance product not too long ago. And it didn't take too long to realize that they weren't alone and that today about 50% of people who try to buy long-term care insurance are rejected. Led us to understand that there was a big opportunity to help people who have long-term care insurance products be able to make sure that resource lasts as long as possible, but also how we could introduce new financing options to a population that's aging and lacking support.

Hmm. Right. So we're talking about financing. I mean, we are living longer, as we all know, and this longevity brings with it some great benefits, but also some challenges, as you've talked. About. So, how do we finance this longevity? What's going to support it? Yeah.

It's a great question. And I think as we started to dig into the space, there's often misconceptions or lack of understanding of how it all works, right? Many people often incorrectly believe that if they are in a situation where they may need a long-term care service like private duty home care or living in a nursing home versus living facility, that that will be subsidized or covered by the health system or Medicare. And that simply is not the case for the majority of the population. Those are dollars that will have to be self-financed unless there's another vehicle to cover those. And so I think we started to understand what was available, the history of this industry called long-term care insurance, and realizing that there was a big gap to be solved. We think about the equation to successful aging by combining both health and wealth, and we don't see one living independently without the other. They build off one another. And so that really led to kind of our structure as a company, why we started to bring on people who represented a range of backgrounds, clinicians. So on our team, we have PhDs in neuroscience and occupational therapy, and we have data scientists and developers and physicians all working together to figure out how to kind of combine both the financial part of the solution with the wellness component. So an actuary working very closely with occupational therapists is not something that you see in most companies. We think it's the key to kind of bringing the right types of products to the market.

Hmm. So kind of filling that gap, as you say, almost a replacement for long-term care insurance. Is that fair?

Yeah, I think we look at it as there are right now about 7 million policyholders who have an existing long-term care insurance policy today. And maybe some of your listeners are the lucky ones who currently have that safety net. But the reality is that isn't a solution that most people are finding available to them on the market today. So really a core to the way we think about solving the problem is helping to promote both the need for financing solutions. You know, we want to be a part of that, of course, but I think there's a lot of opportunity that can be done on both the federal or state level, as well as private insurance products that can be brought to market. So we are, see ourselves as both an intelligence source of how new products can be built. And also one of the things that we are really doing is building out a very large-scale clinical study of how you can implement wellness programs to prove out that you can make those dollars last longer.

Sounds exciting. That's a much-needed service. And to recognize the value that we put on lifestyle improvements and kind of incentivizing those lifestyle improvements, that's huge. I, you know, just speaking from personal experience, I've had a long-term care insurance policy for many years, my wife and I, and seen in recent years the premiums go up, you atmospherically, it's like 4 or 5 times what it was even 5 years ago. So what's that all about? What's behind that? Yeah.

And so I don't sit at an insurance company, but I can tell you what we've learned. I think the reality is when these products were sold and they were very popular in the late '80s, '90s, up until early 2000s. And the reason they were so popular is it was a great value proposition. It was a very strong way to sell an insurance product. The idea being that We're all going to get old. We can't fight that. We should embrace that. But in the case that we might need support, how can we finance that and not be a burden to our family? And pricing that in an economical model, which it sounds like you benefited from. The reality is, is that there were probably some miscalculations. And this is well documented that the actuarial models that were behind these insurance products missed on 3 key dimensions. The first being the longevity of the policyholders they insured. We live longer than the actuaries predicted back then. 20 years ago. The second piece of that miss was the underestimation of how the cost of these services would skyrocket. So not only is your premium changing, but it's likely that the cost of living in an assisted living facility today is more expensive than it was 20 years ago. And I think there was a lack of understanding of how much that cost would, would increase. And the third piece of this was probably one that maybe people would think differently today is there was an expectation that more people who bought long-term care insurance would stop paying their premium at some point in time. They would feel that, why am I paying this $5,000 or whatever the number was every year? I'm not going to need it. I could use this money elsewhere. And that never happened. I think the calculation that people made was that every year they were getting older, it was very likely they were seeing people in their orbit, parents, family members, others need long-term care services. And that felt them much more positive about having this premium they were paying every year. And that was— assumption that was missed again by the actuaries. And so what that led to was a lot of these insurance companies either went bankrupt or absorbed by other companies or government entities. And the only way that they can really maintain a reserve balance that can make sure that the policyholders they do have are able to kind of get the benefit should they need it was to pass along rate increases to their insured. It's not what they want to do, but it's the only way that they currently or historically thought about making sure that they would not become insolvent. And that really led to kind of our insight of how we could help tackle that problem in another way. So is there something that doesn't involve charging more to the policyholder that might deliver the same benefit to the insurance company, which is making sure that they have enough money to pay claims when they come? So our approach to that was really taking a playbook that has been well proven in the healthcare system. It's known as managed care or population health management and taking that core model and applying it over in long-term care insurance. The idea being, well, what if your insurance company knew more about you today and didn't wait until you called them saying, hey, I'm ready to move into a facility, and could offer you access to support and proven interventions that might help you be able to delay the need to use that insurance product?

Which makes a lot of sense. I mean, incentivizing prevention and like I mentioned earlier, the whole notion of taking some steps to live longer and change those lifestyle habits. I mean, that's what healthcare ideally is, right? I mean, we don't want to just pay for when people are sick. We want to help people stay healthy. You know, just parenthetically, with my long-term care insurance policy, we were offered a buyout last year, and that was one way to reduce their rolls, I'm sure. And we researched it carefully and we decided to accept it. And it was great. I mean, who knows what, what it's going to mean down the road, but I think that's another way some of these insurance companies are going to stick around, to reduce their roles. That's right.

That's happening.

Yeah. So, we talked about the Age Assured program at your company. Tell us about that. Sure.

So, the Age Assured program was launched just over 2 years ago, and really, it's done in partnership with these long-term care insurance companies. The idea being that unlike the healthcare system, long-term care insurance companies haven't done a great job at keeping in touch and continuing to maintain a relationship with their policyholders. It's very likely in your own personal experience that before you got that offer to kind of buy you out of the product, the only time you really heard from your insurance company was either by delivering a statement or a rate increase. And we think that's the myth. And that was the story that we started to take to insurance companies a few years ago, which was, well, what if you knew more about where your policyholders were today? And you were able to use such information to accurately predict what they might need. The fact that someone might need access to safe home modifications, or maybe they were in a situation where there was an active family caregiver and the burden levels of that individual were getting to a peak of unsustainability. If you knew that information, how could you act on it in a cost-effective way that might be able to avoid the need or reduce the need for future rate increases or other things that you're trying to do to stabilize your company? And that was really the story that we started to bring to the insurance companies. Fast forward to today, we're now working with some of the largest insurance companies in the world. We have over 50,000 policyholders that are on our platform. We call them our members. And each of those members has access to an ally. In our language, an ally is the individual, the health coach, the social worker, the person who will help to kind of build a relationship gather information and help recommend proven interventions that might be able to help people meet their goals. And so that's where we are today. We, we launched the program. What's even better than just being able to deliver great service to consumers is that we're actually seeing great results. So for the initial program that launched about 2 years ago, um, we're showing that we've been able to reduce the claims, the percentage of people or the number of people who actually use long-term care by about 15%, which is huge in terms of both both the value that that has to the individual's lives that are being supported, but also to the insurance company, because that is a significant cost saving to them as well.

Yeah, that really makes a lot of sense, Andy. I mean, to understand where all of these beneficiaries are, where the members are, and what can be done with these people when a need arises rather than waiting for time for placement. I mean, it's all about prevention, right? Makes so much sense. I mean, it's brilliant, but at the same time, it just makes so much sense. It should have been in place well before this, right?

And that's what we hope. We hope that, you know, things really start to take off. I think the things that I get most excited about is what we're learning, what we're seeing in the data. You know, one of the things, and maybe, you know, not surprising to you, is that there's differences in terms of how different genders both engage with programs like ours, but also proactively manage their health. Found in our program that women are far more likely to engage and kind of develop that relationship and follow the advice of kind of their ally than men. And it's one of the questions that we're trying to kind of better understand is what are the things— and it doesn't mean that men have less need, it just means that we haven't effectively cracked the code at how to get them to respond. But if we can, we think that could also, you know, make great strides in improving both the wellness and the financial positions of these populations. Sure.

And if women are living longer, there's a greater payoff when the women take these extra steps. I can see that. Sure. That's why my wife's buyout was much higher than my buyout. Interesting. I saw that right away. It made sense. Yeah. Yeah.

Of course.

So this is, this is great. You're, you're dealing with 50,000 insurance holders or policyholders and helping to offer these incentive programs. What about people that don't have long-term care insurance? That's gotta be a much bigger gap to fill.

Of course. And I really, you know, for me, I think about my parents who are now in their 70s and are lacking a solution like this. And how do we develop new opportunities for them? And, and that's a big part of the way we see the future of both our company and the models and the solutions that are made to market. Just a few months ago, we launched our first venture in this space. It's a new form of long-term care insurance being sold in partnership with with insurance companies, and one of the things we're doing there is both creating new financing options. The first deployment was, not to get too technical, but an annuity product that came with a long-term care insurance rider. But what's more exciting for us is that we also created an entirely new wellness program that goes along with it. We launched this program called Never Stop that is included in the purchase of these new insurance products. And we think it's pretty exciting because never before has there been a wellness program that's really thinking about the needs of older adults so holistically. We're not just concerned with one element of potential need. Think about everything from brain health to mental health to finding purpose in life, as well as prevention, right? Staying in shape and, and eating right. But we think that's only one part of the puzzle. So I think that's a lot of what we're trying to come up with is again, going back to that calculation of health plus wealth. How do we develop new products and solutions that meet both of them? And we think the world could benefit from lots of innovation in the space because we think that there's over 45 million 1 million people, 65 and up, who currently don't have access to the right type of financing for their longevity.

Right. So you're creating a version of a long-term care insurance policy with different protocols, of course, different buy-ins, but it's also going to be including all of these extra incentives for people to stay healthy. Is that— that's right.

I think our goal right now, we're, we're today, we're not an insurance company. We, work with insurance companies to help them come up with new ideas to address this gap that you're calling out, right? The fact that while it's great for the 7 million people who have long-term care insurance, what about everybody else? And so our role is to help to both think about the actuarial or the financing models that might work, that might not repeat the errors of the past, and make sure that it's actually an attractive proposition to consumers. It's something that they would want to buy and participate with. And so we're brand new into this. We just launched the product, as I mentioned, a few months ago, but we're really excited about what can be done in the prevention space here. I think, you know, there are a lot of things that are possible to do in your 60s that have long-term impact that might not be possible in your 80s, for example. As an example, preventing hearing loss. There's a lot, and, and I'd be curious to get your take if you've seen any of this literature, but our clinical team has studied pretty rigorously the linkage between hearing loss and dementia or Alzheimer's. And there's a strong correlation there. And hearing loss is treatable, and there's a lot of reasons why we don't treat our hearing loss as it starts to occur. But if we were, and we were able to reduce kind of dementia as a result, that's kind of a, a win-win. And so a big part of what we're making sure that we try to promote is around the science of aging. How do we make sure that the great science that's out there and continuing to be discovered is able to be kind of accessible to, you know, people earlier in life.

Yeah, I think that makes a lot of sense. I was just pulling out some materials and I've kind of been immersed in some of the research on preventable dementias. And you're familiar with this, but the Lancet Commission out of the UK has identified 12 factors that are preventable, but if they're not addressed, they can lead to dementia, or at least that, you know, increased confusion, disorientation. It's a preventable form of dementia, which is huge. They say 40% of the world's dementias fall into this category. I mean, 60%, the majority are true Alzheimer's types of, you know, dementing illnesses. So that makes so much sense to address some of these factors like hearing loss that can produce bigger problems down the road. So the Never Stop program that, I mean, I think that you mentioned Larry Nysensen is the lead of that. Larry was a guest on my podcast a couple years ago and very passionate about successful aging and helping individuals do what can be done to live longer and healthier. So kudos to you and company for the Never Stop program. Are there other programs that people can buy into or join to stay healthy?

I think the reality is one, a lot of the work that our allies do is to help identify things that might be available in local communities, for example. One of the things that, you know, we hear often from our program members especially, you know, since COVID social isolation had a huge impact in the lives and mental wellbeing of people across the country. Sometimes there's just lack of awareness of what might be available or accessible in local communities. And when we're able to do resource mapping or help people understand, you know, what is kind of, you know, happening in the local community, uh, we're able to kind of at least provide awareness and education that things exist. Think about opportunities for community engagement, finding purpose in life, matching people with volunteerism opportunities. As being sometimes equally important to kind of staying, you know, in shape and eating right. If that's something that we believe is a major risk factor for an individual. So I think there aren't specific— there are some companies that, you know, we work with that we have been testing. We're very science-driven in terms of like who we're kind of willing to promote as part of the company. So there has to be efficacy that the intervention is proven to work in order for such a solution to be a part of something we would recommend. To people who participate in our programs, but, but these things exist on a local level across the country.

Yeah, you've really got some sound thinking there. I mean, not only offering the programs, but connecting people with programs that are already in place in their communities. I had an individual on just a few weeks ago who talked about SilverSneakers and, you know, it's, it's available around the country and anybody with insurance often has free subscription to SilverSneakers. People don't know that, right? And people don't know they can go to their local gyms or local community organizations and, you know, take advantage of some of that. So it's educating.

Just to build on that, Joe, like anecdotally, some of the things that we see all the time is we'll be, you know, speaking with people and we'll be talking about how prescription medication, for example, and how are they getting their prescriptions filled. And oftentimes there's a family member who's supporting that and running to multiple pharmacies to get the various prescriptions filled. And in those situations, we're very quick to make sure that there's awareness of other opportunities, right? Prescription delivery has become very popular over the last number of years and, and can be available through your local pharmacy or companies like PillPack. But often people just aren't aware of that. And the opportunity for that family member who's responsible for going out and filling this prescription, saving them 3 hours of their life every week, can go a long way to kind of making caregiving more sustainable. So these are the types of things that, you know, often people just don't have the, the understanding of, and we want to make sure we're promoting.

Yeah. And I'm just thinking there's some cost in that education, but the payoff is so much greater for people when they can be more efficient, be more economical, save time, and also stay healthy and stay involved and stay engaged. So, um, small price to pay for that return on the investment. Makes sense. Yeah. I wasn't even aware that our pharmacy out here, Walgreens, offers free delivery, you know, through FedEx. And I didn't know that. So, I'm sure I'm not the only one that didn't know that. Yeah, but that education is so important. So when we talked also, you mentioned the use of data analytics and how that helps you make more informed policy decisions. Can you give us an example of what you found from some data to, you know, inform your choices?

Yeah, and I think this is something that comes, which is providing support to everyone is a great thing, but it has to be done in a cost-effective manner. Someone has to pay. And I think part of the way we think about using data is to make sure that we are providing personalized, or in other words, targeted solutions to people who have specific needs that we believe we can support. So as an example, everyone should take steps to make sure that their home is safe. And sometimes that might mean adding specific DME, durable medical equipment, or putting in place things like a shower bench or raised toilet seat. But those things cost money and those things are expensive. And as part of our programs, we actually pay for those types of interventions. And if we were to provide a grab bar for every single person, you know, in the population, that wouldn't be economical for the person who's paying. So the way we think about using the data is making sure that we understand like where these interventions can be most effective with a, what I'll call a short kind of time horizon for return on investment. And that's really important because, you know, our programs are available to everyone and we want to help everyone, but it has to be done in a smart way. And this is the common playbook. So when I mentioned earlier this model of managed care or population health management, that is the approach taken. It's really about providing targeted solutions and interventions. And that's where the data is so critical, being able to kind of look at specific data elements or things that we might learn about a person that are very predictive at being able to indicate if this this individual might be at high risk for a specific—

So when you see the incidence of maybe falls and admissions to the ER, you can target that population to grab bars in the shower, for example. I mean, simple example, but powerful just the same. Sure.

Yeah, exactly.

Sure. Yeah. Well, Andy, I'm really happy to be kind of a messenger for your program. I'm really impressed with it. I'm happy to provide this platform for you to share this. Understanding of Assured Allies. I think it's a great program. So we're just about out of time, but I wonder if you have a takeaway that you'd like our audience to remember from our conversation.

Absolutely. I, I think I have two. The first is that we look at the challenge of longevity as one of the both biggest potential social crises that our country and the world are facing. The demographics are drastically changing. There will be more people over 65 and under 65 within a matter of years. And the fact that many of these individuals do not have the proper financing solutions or successful aging plan to be able to live the way they want is a huge problem that affects the entire population. And I think if anyone who's listening has interest in being a part of coming up with innovation in this space, there's no shortage of need. So I think it would be a call to all innovators and entrepreneurs who are out there to kind of start thinking about their own ways that they can tackle the problem. And then on a more personal level, I think the reality is that it's never too early to start thinking about your own trajectory and what you can be doing. I think being a part of this industry, I'm healthy. I have two young kids, but I am starting to think about my own longevity in different ways and what are the things that I can do to prepare. I think there's much written about the fact that younger demographics are not saving properly for retirement. And I think broadening that conversation to not just include retirement savings, but, but long-term care financing is something I wish will be more a part of the conversation that we all have over the years to come.

Well, that's great. That's great. Thanks very much for sharing that important insights. So, as I mentioned, Andy, um, looks like we're out of time, but before we wrap up, I just wanna remind our listeners to visit my website, livingto100.club, sign up for our email list and download a free copy of my 9 Tips to Make Living Longer Enjoyable.. You'll also see an option to contact me with your questions and comments. I welcome your feedback. And finally, thank you again for being a premium club member. Your support helps us keep the program going. I believe that the messages we share each week can lift our spirits, help us to stay engaged, and look forward to getting older no matter what gets in the way. Andy, thanks so much for being a guest on our show today. For those who might want to contact you, how can they do that?

So I am available. My email is andy@assuredallies.com. And anyone could also visit our website, assuredallies.com. That's A-S-S-U-R-E-D-A-L-L-I-E-S.com.

Assuredallies.com. Okay. I'll be sure to put that in our published notes. Thanks again. And thanks to all of our listeners for tuning in. Hope to see you next time.

Hi everyone, this is Meredith from the Senior Fitness with Meredith podcast where I discuss all things for seniors, from fitness, your health and wellness journeys, how to be all over strong and beyond. I also have my mini podcast called Motivation with Meredith. It's a great, quick motivational pick-me-up for your days. Join me.

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