The economy of longevity advisory

The world's population is aging. Between 2019 and 2034, the U.S. population is projected to grow 10.6%, from about 328.2 million to 363 million people.The population under 18 will grow by 5.6%; the population age of 65 and older, by 42.4% — primarily due to the 74.0% growth in size of the population age of 75 and older. As a result, the national prevalence and incidence of diseases that disproportionately affect older Americans will grow rapidly. If we examine this trend together with the expected shortfalls of 17,800 to 48,000 primary care physicians and the all-times high burnout rates for practitioners in 2022, one conclusion is clear - public accessibility to quality medical services will decrease in the upcoming years.

Let's look at another trend - the required number of productive years to reach financial sustainability and when these years start.

• In the academic year 2020-2021 most of the undergraduate students were aged 25 and older. This is the straightforward data from the U.S. News' Best Colleges rankings, where colleges and universities that are part of the current ranking – all enroll at least some first-year, full-time students. Obviously it wasn't the situation 10 years ago.
• Across the U.S. the one-year Value Change of a house is +14.9% in 2022 only, but the U.S. real median Average Income Growth is -0.52% in the last 10 years.

It will simply take more years of work for an average American to clear its financial obligations and to start gaining wealth. And you have to stay healthy if you want to be as productive as possible carrying the responsibility for yourself and your family.

Today, across the world, the dominating perception of the concepts of “Longevity” or “Healthy Lifespan Extension” is something that appeals to a very small, niche group of people. Most people feel “Longevity” is something they generally want, but in practice it usually falls far below other, more immediate priorities when it comes to their health.

However, the numbers above tell us a different story. The economic and demographic trends, together with a paradigm shift towards prevention and lifestyle medicine will encourage more and more people to seek professional guidance for a personalized longevity journey, reaching beyond general recommendations provided by public health authorities.

When I refer to a personalized longevity journey, I refer to a proactive, personalized, measurable long-term engagement of a healthy patient or the one that has certain chronic conditions.

Healthcare practitioners could engage their patients in longevity medicine and advise/guide them. Such an engagement establishes an additional line of business, initially provided by the practitioners to the existing pool of patients, given the fact the medical history that can direct the path to a healthspan extension, is already known (even if partially). As reflected in the recent Medscape survey, 37% of physicians in the U.S. have a side gig. Among those having a side gig in 2022, two leading specializations are family medicine and internal medicine. Physicians are looking for ways to make more money and they strongly prefer to do it as medical-related activities.

Longevity advisory

Longevity advisory is a consultative personalized service, in which HCP guides the patient towards the goals of reduction in his/her biological age, towards a slowdown in aging processes and aims to extend the healthy period in human's lifespan— lifetime free of age-related disease. Longevity advisory is a measurable, active, long-term engagement of the HCP and the patient, taking in consideration the clinical and demographical data of the patient, periodic progress, the latest evidence-based recommended practices, available protocols and therapies.

Integrating a longevity advisory into a current practice will lead to the following outcomes:

Revenue growth - consultations.

Medicare. Planned regular longevity consultations and follow-upmeetings will create a predictable revenue stream for the practice. As a part of Medicare annual wellness visit (AWV) approach, meaningful usage of healthspan extension recommendations will not only provide important preventive services to the patient but also will close the gaps in quality measures and contribute financial stability to a practice or organization.

If a practitioner works with Medicare patients, he can bill up to $320 per visit using CPT codes 99497 or 99498 for provided advance care planning (ACP). He has to include longevity advice in personalized prevention plans alongside age-appropriate preventive services, recommendations offered by both the U.S. Preventive Services Task Force and the Advisory Committee on Immunization Practices. Practitioners can bill for this service more than once, documenting the change in the patient’s health status and/or wishes about their end-of-life care. These changes can include documented progress in biological age reduction, or Telomere length. There is no limit on the number of times a practitioner can report ACP for a patient. If practice is taking part in Medicare’s Merit-based Incentive Payment System (MIPS), it is recommended to use AWVs to raise the quality scores, which leads to positive Medicare payment adjustments.

Insurers. Many private healthcare insurers provide extended plans for preventive or lifestyle medicine, which is a purely economic decision for healthcare payers for an obvious reason. The variety of these plans is too wide to discuss here, nevertheless healthy longevity services take more and more place in these plans and the demand for professionals to provide this type of consultation is constantly growing.

Private practice. Considering the fact that healthy longevity advisory can and should be provided to healthy patients also, it is performed periodically 2 to 4 times per year and lasts between 30 to 60 minutes, the cost of the consultation for a private patient will not represent a significant financial burden. But the ROI and the value of such consultation for a patient can be equal to several yearly personal incomes, which makes a decision to invest in personal healthspan extension an easy to take.

To conclude the listed above - even by starting providing healthy longevity guidance to an existing pool of patients, primary care practitioners can add several hundred billable hours to

his/herpractice revenue.

Revenue growth - diagnostics and supplementation.

Healthy lifespan extension planning and execution lays on the six pillars of the lifestyle medicine, but it goes far beyond the general recommendations. Fundamental, evidence-based personalized journey requires a detailed initial assessment of aging biomarkers as a start point. Many of the reliable diagnostic providers, providing home kits and portals for practitioners, have referral or incentive programs for the HCPs to help the provider not only to make the diagnostics more accessible, but also to include him/her in a revenue sharing stream. For example, HealthyLongevity.guide runs a marketplace, where several diagnostic options from vetted providers are available, together with a straight-forward cashback program for theHCPs.

The same applies to supplements. Quality supplements used in accordance with recommended dosage and frequency, become necessary to maintain health and even more critical for improvements. Active longevity approaches and the progress towards advancements in slowing the aging process does involve supplementation. Supplements are well studied, readily available, easy to use, and can improve many conditions. Several reputable suppliers with proven scientific rigor behind their products offer the same revenue share model for the practitioners - incentive or referral program. It depends on the way the program is designed, but if the practitioner is capable of running a small dispensary for the supplementation for his patients, there is an additional persistent revenue stream available. We at HealthyLongevity.guide, alongside the cashback rewards, offer order management and fulfillment services for the supplements for our partners. For example, the practitioner can purchase the supplements for his/her patients, and to ask for the delivery to the patient's address, combining several products from different suppliers in one box, branded to the practice. A typical cashback reward from a combinedpurchase for a single patient - one testing kit ($348), a supplement to support the immune system ($38), and a multivitamin ($14.25) - can get as high as $83. Multiplying is by 35 customers engaged in a longevity journey, with a purchasing frequency of 4 times a year on average, the additional income for a practitioner is over $11,500 yearly.

Revenue growth - market share.

From the timing perspective, now it is probably one of the best moments in history to consider the integration of the longevity advisory into the practice. The demand for such services is constantly growing and it is expected to double its size by the year 2027. There is a significant shortage in qualified longevity professionals as of today, but there is a rising interest for such services in public. Simple research in Google Trends will show the 3,800% growth in the popularity of a search term “fight aging” in the US between August 2021 and August 2022. 1.5 million people follow 15 longevity evangelists- MDs and scientists on Twitter. But there are not enough education options available right now - only 14% of the american physicians have been trained in healthy longevity to different extents.

The sooner health and wellness professionals start developing longevity guidance as a specialization, the better they will be prepared in their career path for the future. The sooner the longevity advisory will begin, the bigger pool of customers the physician will be able to gain, simply because of the longevity services differentiation in a certain geography or with certain subspecialization. And the great news is that you can start with your existing customers base, with generally healthy patients and expand it further via available acquisition vehicles specific to this type of customers seeking professional guidance.

Revenue growth - financial health.

Covid pandemic has particularly been a difficult phase especially, in terms of revenue generation or at least maintaining the revenue generation similar to pre-covid years. As a result, to recover the losses caused by the pandemic, many practices are increasingly looking to improve patient retention and engagement rates as a more effective approach to increase the patient lifetime value (LTV). Active longevity advisory is one of the more effective ways to do so. It is a long-term, 5to 10 years, or even life-time engagement with a patient. The more successful the patients and the practice are in this journey, the longer the engagement lasts. It creates a predictable revenue stream due to the planned nature of the longevity advisory for a particular patient, the follow up diagnostic tests and regular supplementation. Furthermore, it has a good potential to upsell and cross sell, as the coverage for the preventive services will grow in the near future. To summarize - healthspan extension services is one of the most effective ways to increase a patient's LTV and retention along with a contribution to healthy aging.

Personal brand development - differentiation.

Thechoice to add healthy longevity specialization into your practice now will not only help boost your revenue, but it will put you on the way to a personal brand development and while giving you the opportunityto differentiate yourself in the professional community. As of today, many patients struggle to find guidance in longevity medicine from a professional, and are willing to go the extra mile to find a doctor with experience in this field.

The available opportunities will increasefor longevity professionals in the coming years. Opportunities, to speak, tutor, career advancement, consulting for healthcare payers, academia and government, startup industry and more. Specializing in longevity medicine now will help you not only add health to people's lives, but will put you on a clear career path and professional growth.

One last reason why you should start longevity practice now. Diving deep into longevity training and education will allow you to extend the healthspan for the most important person on earth - you. By having access to unbiased education, practical training, and quality products,you will benefit from the latest scientific discoveries and interventions, while reducing your biological age and to add more quality in your personal and professional life. There's no finish line when we talk about healthy lifespan extension. It's a lifestyle that will continue for the rest of your life.

Yakov Ozer is co-founder and the CEO of HealthyLongevity.guide. His is a technology executive with 20 years of experience, a digital health enthusiast and strategic thinker. He previously worked for Microsoft as an Industry Executive and Healthcare Council member.