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29 March 2013 FULL REPORT
AARP Confidential – Not for Distribution Keith Epstein, Senior Strategic Advisor, AARP Harry Wang, Director, Health & Mobile Research, Parks Associates 202‐434.6169. [email protected] Jennifer Kent, Research Analyst, Parks Associates
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
Significant unaddressed needs with the greatest potential for revenue, adoption and social impact
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Produced with Parks Associates Executive Editor: Tricia Parks Harry Wang, Director, Health & Mobile Product Research, Parks Associates Jennifer Kent, Research Analyst, Parks Associates Published by Parks Associates Copyright, January, 2013, Parks Associates Dallas, Texas 75248 All rights reserved. No part of this book may be reproduced, in any form or by any means, without permission in writing from the publisher. Printed in the United States of America.
Disclaimer Parks Associates has made every reasonable effort to ensure that all information in this report is correct. We assume no responsibility for any inadvertent errors.
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Table of Contents Attribution ................................................................................................................................................................... i
Disclaimer ................................................................................................................................................................... ii
Table of Contents ...................................................................................................................................................... iii
List of Figures .............................................................................................................................................................. v
Executive Summary ................................................................................................................................................... 6
1.0 Background and Scope of Report ..................................................................................................................... 9
2.0 The 50+ Market: Assessment of Needs and Existing Solutions ................................................................ 11
2.1 Living Safely and Independently ............................................................................................................. 12
Detecting falls .............................................................................................................................. 12
Preventing in‐home accidents ..................................................................................................... 13
Sending alerts when wandering or lost ....................................................................................... 14
Managing medications ................................................................................................................ 15
2.2 Aging with Vitality ................................................................................................................................... 17
Sharpening Memory/Improving Cognition .................................................................................. 17
Improving or Aiding Vision ........................................................................................................... 18
Improving or Aiding Hearing ........................................................................................................ 19
Maintaining Muscle Strength ...................................................................................................... 20
2.3 Maintaining a Healthy Lifestyle ............................................................................................................... 22
Eating Healthy .............................................................................................................................. 22
Engaging in Age‐Appropriate Exercise ......................................................................................... 23
Controlling Sodium Intake ........................................................................................................... 24
Improving Sleep Quality............................................................................................................... 24
Preventing Dehydration ............................................................................................................... 25
Boosting Daytime Energy ............................................................................................................. 26
Reducing Stress ............................................................................................................................ 27
2.4 Managing Health Risks and Conditions ................................................................................................... 28
Reducing Bad Cholesterol ............................................................................................................ 28
Keeping Glucose in Range ............................................................................................................ 29
Maintaining a Healthy Weight ..................................................................................................... 29
Keeping Blood Pressure in Range ................................................................................................ 30
Relieve Back Pain ......................................................................................................................... 31
Detecting Skin Problems .............................................................................................................. 31
Addressing Calcium Deficiencies ................................................................................................. 32
Maintaining Good Dental Hygiene .............................................................................................. 32
Managing Arthritis ....................................................................................................................... 33
2.5 Improving Quality of Life ......................................................................................................................... 34
Staying Connected Socially .......................................................................................................... 34
Keeping Mobilized ....................................................................................................................... 35
Navigating the Healthcare System ............................................................................................... 36
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Managing Healthcare Costs ......................................................................................................... 37
Evaluating Care Quality ................................................................................................................ 38
Receiving Divorce/Grief Support ................................................................................................. 39
Managing Life Phase Transitions ................................................................................................. 40
Planning for End of Life Care ....................................................................................................... 41
2.6 Evaluating Needs‐Based Challenges ....................................................................................................... 42
3.0 Evaluation of Leading Market Opportunities ................................................................................................ 45
3.1 Framework for Evaluating Opportunities ............................................................................................... 45
3.2 Comparative Assessment ........................................................................................................................ 47
3.3 Opportunities Addressing Medication Management ............................................................................. 48
3.4 Opportunities to Enable Aging with Vitality ............................................................................................ 50
3.5 Opportunities in Vital Sign Monitoring ................................................................................................... 53
3.6 Opportunities in Care Navigation ............................................................................................................ 56
3.7 Opportunities Enabling Emergency Detection & Response .................................................................... 59
3.8 Opportunities Addressing Physical Fitness ............................................................................................. 62
3.9 Opportunities Supporting Social Engagement ........................................................................................ 65
3.10 Opportunities Addressing Diet & Nutrition ............................................................................................ 67
3.11 Opportunities Addressing Behavioral & Emotional Health ..................................................................... 69
4.0 Market Forecasts, Investment Implications and Recommendations ........................................................... 71
4.1 Forecast Methodology and Key Assumptions ......................................................................................... 71
4.2 Market Forecasts and Investment Implications ...................................................................................... 74
4.2.1 Medication Management ............................................................................................................ 74
4.2.2 Aging with Vitality ........................................................................................................................ 77
4.2.3 Vital Sign Monitoring ................................................................................................................... 80
4.2.4 Care Navigation ........................................................................................................................... 83
4.2.5 Emergency Detection & Response .............................................................................................. 86
4.2.6 Physical Fitness ............................................................................................................................ 89
4.2.7 Social Engagement ....................................................................................................................... 92
4.2.8 Diet & Nutrition ........................................................................................................................... 95
4.2.9 Behavioral & Emotional Health ................................................................................................... 98
5.0 Summary and Conclusions ........................................................................................................................... 101
6.0 References ..................................................................................................................................................... 105
6.1 Selected Works Cited ............................................................................................................................ 105
6.2 Selected Statistical Sources ................................................................................................................... 106
Appendix A: Population Data ................................................................................................................................ 107
Appendix B: Parks Associates’ Data Highlighting 50+ Market ............................................................................... 108
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List of Figures Figure 1: Healthy Living Needs of Consumers 50 and Older ................................................................................... 11 Figure 2: Thirty‐Two Needs Captured in Nine Healthy Living Challenge Areas ....................................................... 42 Figure 3: Leading Needs‐Based Healthy Living Opportunities in the 50+ Market .................................................. 44 Figure 4: Current Solutions Evaluation Matrix ........................................................................................................ 45 Figure 5: Market Opportunity Assessment ............................................................................................................. 46 Figure 6: Opportunity Evaluation Results ................................................................................................................ 47 Figure 7: Dominant Revenue Models for Market Opportunity Forecasts ............................................................... 72 Figure 8: Forecast Methodology ............................................................................................................................. 73 Figure 9: Summary of Nine Market Opportunities ................................................................................................ 101 Figure 10: Projected Revenue Ranges: Low/High‐end Market Opportunities ...................................................... 102 Figure 11: Market Opportunity Comparison ......................................................................................................... 103 Figure 12: Market Opportunity Ranking ................................................................................................................ 104 Figure 13: U.S. Population by Age and Sex, 2010 .................................................................................................. 107 Figure 14: U.S. 50+ Population Forecast, 2011‐ 2018 ........................................................................................... 107 Figure 15: Mobile Phone Ownership, by Age ........................................................................................................ 108 Figure 16: Attitudes Towards Technology, by Age ................................................................................................ 109 Figure 17: Consumer Use of Top Web Services, by Age ........................................................................................ 110 Figure 18: Healthy Living Behaviors Among 50+ ................................................................................................... 111 Figure 19: Number of Prescribed Medication Taken, by Age ................................................................................ 112 Figure 20: Challenges Taking Multiple Medications .............................................................................................. 113 Figure 21: Prevalence of Health Conditions, Among 50+ ...................................................................................... 114 Figure 22: Health Device Ownership, Among 50+ ................................................................................................. 115 Figure 23: Van Westendorp Pricing Analysis for Fall Detection Program ............................................................. 116 Figure 24: Van Westendorp Pricing Analysis for Medication Management Program .......................................... 117 Figure 25: Van Westendorp Pricing Analysis for Home Health Monitoring Program ........................................... 118 Figure 26: Satisfaction with Hospital Experience, Among 50+ .............................................................................. 119
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Executive Summary
Rarely has such an untapped opportunity existed to generate revenues for entrepreneurs,
investors and others in the private sector to generate revenues while meeting the greatest wants
and needs of a substantial, influential and important population. Favorable demographics, maturing
technologies, the consumerization of health care and increasing certainty surrounding the Affordable Care
Act are among factors that have converged to make the health market for consumers 50 and older extremely
attractive. This research finds that it is an opportunity that could within five years generate $20 billion in
additional revenues for entrepreneurs and investors while having a significant impact on the lives of 100
million people.
Despite this potential double bottom‐line – high‐impact investing that yields individual and social
benefits as well as a financial return – current market solutions are not meeting many of the
needs and desires of this key consumer demographic, which includes many people who yearn for
healthier, higher‐quality lives in which they can feel as empowered and independent as possible. Thus large
opportunities exist for new investment, development and deployment. Investors, entrepreneurs and other
players in the private sector who heed the knowledge and forecasts provided in this report will find
themselves in a unique position to innovate and adapt technologies and business models that can enable
them to reap substantial rewards while having a meaningful impact in the lives of people age 50 and older.
Some highlights from this research:
► Current solutions on the market suffer from common drawbacks that leave the door open for new
players to capture revenues in this valuable market. Common issues with current solutions include:
Poor aesthetics, which limits usability and consumer demand
A tendency to focus marketing on society’s sickest, most frail, and oldest, with an excessive focus
on chronic conditions, which creates an unnecessary stigma
The inability of devices to share data via the Internet or with other devices, which limits the
utility of collected data
The prioritization of younger demographics by solution providers using cutting‐edge technology,
which may signal to older consumers that such solutions are not designed for their use
Low awareness among mature consumers of many cutting‐edge solutions and services
High cost of direct‐to‐consumer solutions, pricing many older consumers out of the market
A fragmented approach to addressing older consumers’ needs when a more comprehensive
solution could drive higher usage
Designs that fail to incorporate the role of caregivers
► Nine areas of the healthy living market represent the best investment opportunities for break‐through
technologies, innovative products, and disruptive services. Together, these nine areas represent
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potential adoption of new products and services for over 100 million people and as high as $20B in
revenue by 2018.
► Due to particularly favorable market conditions, three areas represent the best of these nine opportunities for new or greater investment:
o Medication Management: More than 90 million consumers 50 and older will be on two or more
medications by 2018 and more than half will need intelligent medication management solutions
by then. Current medication solutions fail by focusing rigidly on counting and dispensing pills or
sending reminders while overlooking the need to address the motivational factors of medication
compliance. An innovative solution that integrates easy pill identification, medication
consultation/education programs, and proper incentive for compliance could dramatically
improve medication compliance rate by benefiting as many as 35 million users and bring in
more than $3 billion revenues for entrepreneurs by 2018.
o Aging with Vitality: Close to 50 million people 50 and above will desire products and services
that help them age gracefully with vitality by 2018. Current products and services have done
little to take advantage of technology advances such as intuitive user interface design,
voice/gesture recognition, HD voice, and fail to provide a fun and interactive experience for
people of this particular demographic. New solutions, built on market‐tested technologies,
incorporating age‐appropriate user experience elements, and designed aesthetically
appealing, could garner interest from more than 30 million people 50+ and generate close to
$2 billion revenue for entrepreneurs by 2018.
o Vital Sign Monitoring and Management: The desire to understand chronic conditions and
proactively manage them for healthy living will be a high priority for approximately 50 million
people 50 years and older by 2018. They will be disappointed if future solutions are designed
and marketed like current ones—single‐purpose, poorly integrated, expensive, and uninspiring.
Improvement on these aspects of future vital sign monitoring and management solutions and
breakthrough products could jump‐start demand in the consumer market and benefit more
than 28 million people with such needs. A market opportunity up to $4.8 billion in revenue by
2018 is waiting for smart entrepreneurs and investors.
Together, the nine health innovation frontiers—from medication management to
behavioral/emotional health—represent a vast and under‐addressed market opportunity for
entrepreneurs and investors. Breakthrough technologies, innovative services, and disruptive business
models could bring new innovations to fruition and benefit more than 100 million people 50+ by
2018. The nine frontiers collectively represent as high as $20 billion in revenue opportunity by 2018.
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Market Opportunity Summary
High‐end
Estimates
Low‐end
Estimates
Revenue
Variance
Highest
5‐Yr CAGR
Product
Sales
Monthly
Service
Technology/
Software
Ad
Sales
Medication Management 1 52M Up to 34M $3.3B $2.0B 1.64 16%
Aging with Vitality 2 49M Up to 42M $1.9B $1.2B 1.59 17%
Vital Sign Monitoring 3 49M Up to 28M $4.8B $2.3B 2.07 16%
Care Navigation 4 39M Up to 27M $3.3B $400M 8.36 23%
Emergency Detection & Response 5 28M Up to 15M $2.4B $1.5B 1.65 25%
Physical Fitness 6 42M Up to 22M $1.8B $1.2B 1.61 23%
Social Engagement 7 70M Up to 49M $1.0B $243M 4.26 23%
Diet & Nutrition 8 59M Up to 24M $1.6B $210B 7.61 20%
Behavioral & Emotional Health 9 29M Up to 24M $428M $145M 2.95 30%
Dominant Revenue Models
Opportunity AreaOverall
Ranking
Targeted
Users
(2018)
Projected
Users
(2018)
2013‐2018 Cumulative Revenues
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1.0 Background and Scope of Report
As the Baby Boomer generation ages, the portion of the United States population age 50 or above is growing
rapidly. At the end of 2012, the 50+ population in the U.S. numbered 101 million and is expected to hit 113
million in 2018. The aging of the Baby Boomer generation brings with it certain challenges, particularly in the
areas of health and wellness, as well as opportunities. Rising rates of chronic illnesses, the desire of consumers
to live safely and independently in their own home, the increasing responsibilities of care givers, and
government healthcare reforms that incentivize consumer self‐care and the greater use of technology in
healthcare make this market ripe for investment.
It is the position of AARP, and independent research analysts at Parks Associates, that the healthy living needs of
consumers ages 50 and older are not being met by the market and large opportunities exist for new investment.
In addition the favorable demographics, a number of macro trends are driving the 50+ healthy living market
forward:
Technology is ready to disrupt the personal health and well‐being market. Parks Associates strongly
believes that after more than ten years of development, core technologies that have propelled the
growth of many industry sectors during the past decade are finally mature and ready to bring
innovations to the healthcare industry—traditionally a laggard in high‐tech adoption. Such technologies
include digital signal processing, networking protocols, Internet software, cloud computing, and
telecommunication infrastructure.
Healthcare stakeholders are increasingly strong believers in preventive care and population health .
Health care providers and payers now have more faith in technology‐supported personal health
products and services; some are aggressively pursuing a consumer‐centric care model driving health
behavioral changes across the care continuum. The consumerization of health care – people taking more
control of managing their health and well‐being – is being enabled by widespread broadband Internet
access, growing mobile health solutions, growing adoption of electronic health records by health
providers and new government initiatives that incentivize cost savings by pushing treatment away from
facilities and into the home.
There is less policy and legislative uncertainty surrounding healthcare reform. For the past three years,
market uncertainty associated with the implementation of the Affordable Care Act (ACA) passed in early
2010 has put a damper on healthcare stakeholders’ strategic plans,which in turn has complicated the
investment community’s market risk and opportunity assessments. With the Supreme Court finding the
major tenets of the ACA constitutional and President Barack Obama’s re‐election to a second term, it is
likely that the major overhaul efforts laid out in the legislation will move forward, which removes a
significant amount of business uncertainty for health stakeholders as well as for investors and
entrepreneurs.
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Investors new to the 50+ healthy living market are likely challenged by some very significant business model
questions. Who should be our target popuation? What specific needs are critical to driving consumers’
purchase or usage decisions? What revenue models will be most effective for which products and services and
at what price points? The purpose of this report is to help investors gain insight on these points at a crucial
moment in this market’s development.
This report on Health Innovation Frontiers: Untapped Market Opportunities for the 50+:
1) assesses the healthy living needs of consumers 50 and older,
2) evaluates the ability of current solutions on market to address those needs,
3) identifies the best opportunity areas for new investments, and
4) provides 5‐year forecasts of adoption and revenue for the identified market opportunity areas.
This market assessment focuses primarily on consumer‐facing solutions and business models. As such, Parks
Associates analysts evaluate solutions and potential innovations that address healthy living but are not
medical or diagnostic in nature. Medical‐grade devices and pharmaceuticals do not fall into the scope of this
report, nor do those products or solutions that are merely cosmetic in nature.
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2.0 The 50+ Market: Assessment of Needs and Existing Solutions
Taking a holistic view of the individual as he or she ages, Parks Associates identified over thirty needs of the 50+
population. All of these needs are common to a significant portion of the population and present at least one, if
not many, challenges to the ability of older adults to live a healthy, safe and independent lifestyle. These needs
fall broadly into five categories: living safely and independently, mitigating the common symptoms of aging,
maintaining a healthy lifestyle, managing health conditions, and improving quality of life. Each need is assessed
according to the problem or challenge it presents to older adults as well as the scope of the problem within the
50+ population. Additionally, an overview of current solutions designed to address the need is provided.
Figure 1: Healthy Living Needs of Consumers 50 and Older
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2.1 Living Safely and Independently
Detecting falls
Falling in the home is a major problem among older people living independently. Stairs
leading to a second floor or to the basement, slippery bathroom floors, and walkways
around the home that are slick or uneven are hazards to people with mobility or balance
issues.
According to an analysis of injury episodes by the CDC, falls are the leading external
cause of injury among people age 65 and older, and the home is the most common place
for a fall to occur. These falls can result in major medical issues; people ages 65 and older
are three times more likely to be hospitalized as a result of a fall as those ages 25‐64.1
According to a separate CDC study of injuries sustained in bathrooms, one third of adults
age 65 and above who were injured in bathrooms were diagnosed with fractures and 38%
of adults age 85 and older were hospitalized as a result of their injuries.2 In‐home falls
also are a major concern among the adult children of older consumers: 71% of those
caring for, or anticipating caring for, an aging family member are concerned that that
person may fall and hurt themselves.3 Falling is especially dangerous for older adults who
live alone: in 2010, 19% of men and 37% of women ages 65 and older, or about 11.3
million people, lived alone.4
Current prevention techniques commonly pursued by seniors and their adult children
include easy and relatively inexpensive steps that involve physically altering the home.
Removing throw rugs, installing handle bars and a seat in the bathtub, and adding rubber
mats to stairs for better traction are common solutions to the problems of imbalance and
unsure footing experienced by many seniors.5
The most prevalent technological approach on market today for responding to falls is a
Personal Emergency Response System (PERS). The leading solutions from providers such
as Life Alert and Philips Life Line provide users with a panic button on a pendant or watch
that alerts a professionally‐monitored call center of an emergency when pushed. Parks
Associates estimates 1.8 million consumers used a PERS solution in 2011, or about 4.3%
1 CDC, “Injury Episodes and Circumstances: National Health Interview Survey, 1997‐2007,” Vital and Health Statistics, Series 10, No. 241 (September 2009). 2 CDC, “Nonfatal Bathroom Injuries Among Persons Ages ≥ 15 Years, United States, 2008,” Morbidity and Mortality Weekly Report, Vol. 60, No. 22 (June 2011); pp. 729‐733. 3 Parks Associates, Personal Health Tools and Applications, 2Q 2010. 4 Federal Interagency Forum on Aging‐Related Statistics, Older Americans 2012: Key Indicators of Well‐Being, Washington, D.C.: U.S. Government Printing Office, June 2012 5 Parks Associates focus groups with seniors and their adult children.
The Need
Population Data
Current Solutions
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of the 65+ population. People 75 years and older are the primary users of PERS solutions,
accounting for 70% of the total user base.
In recent years, device manufacturers have introduced innovations to a relatively static
market. ADT and Mobile Help offer emergency monitoring outside of the home, for
instance, which is a major advancement over the in‐home‐only range of traditional PERS
devices. Philips, AMAC and other leading PERS providers are integrating automatic fall
detection into the panic button form factor so emergency services can be contacted even
in those cases where the user is unconscious or unable to press the panic button. Finally,
home monitoring sensors, such as those from Halo Monitoring or BeClose, can be
installed in users’ homes to detect falls and alert emergency services if necessary.
Preventing in-home accidents
The desire of older adults to live independently may be compromised by severe in‐home
accidents. While falls, discussed in the previous section, are the most common in‐home
accident among people age 65 and above, other in‐home risks include leaving the stove
on or candles burning, lawn care accidents, burns and cuts sustained while cooking or
performing common chores, poisoning from household chemicals or carbon monoxide,
and weather‐related health issues such as heat exhaustion and hypothermia.
Incidence rates of in‐home accidents naturally vary by type. The U.S. Census Bureau
reports 12% of adults ages 45‐64 and 15% of adults ages 65 and older were injured or
poisoned in 2009.6 FEMA estimates 1,000 senior citizens die in fires each year, many of
which are preventable.7 People 75 and older have double the national average rate of
dying in a fire at home, a rate that is more than tripled once people reach age 85.8 The
CDC reports 3,442 deaths from exposure to excessive heat or hypothermia for a four‐
year period between 1999 and 2003. People 65 and above accounted for 40% of the heat
and hypothermia deaths for which age information was available.9
Ensuring that batteries are working properly in smoke and carbon monoxide detectors
and checking in on elderly relatives and neighbors during severe weather events are
common prevention techniques.
New technologies on the market allow for remote monitoring, alert and control
capabilities. Wi‐Fi/Zigbee‐enabled smoke and carbon monoxide detectors currently on
market from Visonic and Kidde can send alerts to family members or emergency
6 U.S. Census Bureau, “Table 200. Injury and Poisoning Episodes and Conditions by Age and Sex: 2009.” 7 U.S. Fire Administration, “Home Fire Prevention and Safety Tips,” http://www.usfa.fema.gov/citizens/home_fire_prev/ 8 U.S. Fire Administration Topical Fire Research Series, “Older Adults and Fire” Vol. 1, Issue 5 (January 2001). 9 CDC, “Morbidity and Mortality Weekly Report,” July 28, 2006, 55 (29) pp. 796‐798.
The Need
Population Data
Current Solutions
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responders if a concentration of either is detected. Similarly, connected thermostats
from Honeywell or the Nest can alert loved ones if the in‐home temperature is too hot or
cold; family members can adjust the temperature remotely if necessary. Safety sensors
from Cookstop and Guardian automatically turn off the stove and oven if left on for a
predetermined length of time (e.g., 15 minutes, 90 minutes). Companies such as
Wellaware Systems, GrandCare, and AFrameDigital also offer home sensors installed on
doors, under the chair, or underneath the bed sheet to monitor fragile adults’ in‐home
activities; if the sensors detect an abnormal pattern, these systems alert caregivers.
Sending alerts when wandering or lost
Memory loss is a common side effect of aging and a very serious symptom associated
with specific medical conditions like Alzheimer’s disease. Forgetfulness can cause in‐
home accidents, like those discussed above, and can cause confusion when away from
the home. Six out of ten people with dementia will wander from their homes, often
repeatedly. Still, even those suffering from some form of dementia who live alone prefer
to stay in their homes as long as possible, until their deteriorating condition requires a
safer living arrangement.
16% of women and 11% of men ages 71 or older suffer from some form of dementia. Up
to 60% of people with dementia will wander from their homes or living facilities.10 An
estimated 5.4 million Americans have Alzheimer’s disease today, 96% of whom are 65
and older. Alzheimer’s disease affects 12.5% of people 65 and older and 45% of people
85 and older; nearly twice as many women as men have Alzheimer’s. Due to longer life
expectancy and the aging boomer population, the Alzheimer’s Association projects
Alzheimer’s incidence rate to increase 30% by 2025 to 6.7 million people affected.11
800,000 people in the U.S. have Alzheimer’s disease and live alone.
Solutions to assist people who are lost or who wander from home are available from the
private sector and government programs. Twenty‐nine states have some form of
recovery program targeting missing seniors, often referred to as “Silver Alerts.” There is
movement at the federal level to provide similar support and funding for recovery
assistance for older people who are lost.
From the private sector, growing mobile phone adoption among seniors is addressing
some of this need.12 People who are lost or confused can call relatives or friends to help
orient themselves. Solutions from Healthsense and the Alzheimer’s Association use a
10 Medic Alert Foundation and Alzheimer’s Association, “Wandering: Who’s at Risk?”2012. 11 Alzheimer’s Association, “2012 Alzheimer’s Disease Facts and Figures,” Alzheimer’s & Dementia, Vol. 8, Issue 2. 12 According to Parks Associates data, 90% of adults ages 65 and older, who live in a household with broadband Internet access, own at least one mobile phone. Parks Associates, September 2012.
The Need
Population Data
Current Solutions
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mobile phone’s GPS capabilities to determine when a person travels beyond a pre‐set
zone and alert care providers that he or she needs help; LoJack offers a similar service
using a proprietary bracelet design. Wireless door sensors also are available that can
alert a caregiver should a person with wandering issues leave the home unexpectedly.
Solutions to help caregivers of those with dementia are needed. Over 15 million people
provide unpaid care to a person, usually a family member or friend, with Alzheimer’s or
other forms of dementia. On average, caregivers spent 21.9 hours per week providing for
those with Alzheimer’s.13 Top caregiving tasks include helping the person with mobility
issues (getting in and out of bed, dressing, bathing, feeding, etc.), instrumental activities
of daily living (shopping for groceries, preparing meals, providing transportation, doing
laundry, etc.), and performing household chores, among others. 61% of caregivers report
the emotional stress of caregiving is high to very high and the physical stress of caregiving
is high to very high.14 Solutions designed to help caregivers manage these tasks will find
an underserved market.
Managing medications
Managing a prescription medication regimen can be difficult for many older Americans.
Medication non‐compliance is a serious healthcare problem which can render patient
treatment ineffective while drug interactions can cause serious health complications.
According to Parks Associates data15, 70% of people ages 50‐64 and 87% of people ages
65 and older take at least one medication on a regular basis. 57% of those ages 50‐64 and
74% of those ages 65 and older take multiple medications. Among adults ages 55‐64, 19%
report forgetting to take their medications and 11% report running out of medication
because they did not refill their prescriptions. Among people 65 and older, these rates
decline to 11% and 5% respectively. In excess of 2 million serious adverse drug events
and about 100,000 deaths occur annually due to medication problems, according to the
Center for Technology and Aging.16
The most common solution consumers use to manage their medications is a physical
organizer, usually in a pill box format. Pill organizers are cheap and widely available, but
require consumers to correctly organize their medications according to their physician or
pharmacist’s instructions.
13 Alzheimer’s Association, “2012 Alzheimer’s Disease Facts and Figures,” Alzheimer’s & Dementia, Vol. 8, Issue 2. 14 Ibid. 15 Parks Associates, Multiple Medication Management and Smart Pill Boxes, Q1 2012. 16 Center for Technology and Aging, “Technologies for Optimizing Medication Use in Older Adults,” September 2011.
The Need
Population Data
Current Solutions
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Mobile applications address a number of medication management issues, such as
identifying pills, providing information on common side effects, scheduling medication
reminders, and alerting users of potential drug interactions. Applications like GreatCall’s
Jitterbug medication reminder service, Montuna Software’s DoseCast app and Vocel’s
ThePillPhone app also alert users when prescriptions need to be refilled and connect
users to their pharmacies. These applications are cheap and user‐friendly, but many
require the user to own a smartphone and rely on consumers to manually enter accurate
medication and dosage information.
New solutions also track the consumer’s medication compliance. Vitality GlowCaps fit
over standard prescription bottles and detect when a user opens the bottle. Caps flash
and play a ring‐tone if a user skips a dose, in which case Vitality can call the user and
email a report to family members or care providers. OtCM produces RFID labels that,
when applied to a standard medication blister package, detect when pills are removed
from the packaging. The data can be collected by an NFC‐enabled mobile device or the
OtCM EventTaker located at a pharmacy. Like other solutions, OtCM also offers SMS,
phone and email reminders as well as a web‐portal to show users and their care
providers their medication compliance data.
Other solutions attempt to remove the consumer from certain medication management
tasks: InRange’s Emma device is programmed remotely by a health provider to dispense
medication in the user’s home and SentiCare’s PillStation remotely monitors medication
compliance by using pictures of the medications as they are distributed. Proteus Digital
Health has developed perhaps the most innovative solution: sensors that communicate
with a body‐worn patch are incorporated directly into the medication and pass health
data along to the patch when the medication is ingested. Proteus’ ingestible sensors are
FDA approved.
Finally, home monitoring solutions like door sensors can be applied as medication
compliance solutions. Wireless sensors connected to the medicine cabinet, for instance,
could alert a family member if the cabinet was not opened by a certain time of day and
so an older parent has not yet taken his or her pills.
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2.2 Aging with Vitality
Sharpening Memory/Improving Cognition
Studies17 suggest that most people suffer some decline in their cognitive abilities by age
60, with larger declines by age 75. Older adults have more trouble problem solving,
process information more slowly, and have a shorter attention span than younger adults.
Furthermore, process‐based intelligence declines earlier than intelligence based on
accumulated knowledge.
Along with a general decline in cognitive abilities is the general memory loss many older
adults suffer as they age. As discussed in Section 2.1, memory loss is also a serious
symptom associated with Alzheimer’s disease and other dementias. Forgetfulness affects
older adults’ daily lives and can cause serious health emergencies due to in‐home
accidents and wandering away from home.
Intellectual or cognitive decline varies among individuals as they age, and older adults
can better maintain their cognitive abilities if they received high levels of education,
worked intellectually demanding or complex jobs, are physically fit and eat a balanced
diet. Cognitive decline affects those who are socially isolated or relatively inactive more
severely.
According to the New England Journal of Medicine, 10% to 20% of people older than 65
suffer from Mild Cognitive Impairment (MCI).18 MCI is considered to be among the
earliest stages of cognitive decline, experienced before Alzheimer’s disease or other
advanced dementias. A study conducted by physicians at the Mayo Clinic found that 19%
of men and 16% of women ages 70‐89, who were not suffering from dementia, showed
signs of MCI.19
According to a U.K. study published this year in the British Medical Journal, memory
begins to decline as early as age 45.20 Studies show that about 5.4 million, or one‐third,
of people over age 70 suffer from memory loss that disrupts their regular routine.21
17 Kristine Williams, Susan Kemper, “Exploring Interventions to Reduce Cognitive Decline in Aging,” Journal of Psychosocial Nursing and Mental Health Services, Vol. 48, No. 5 (May 2010): pp. 42‐51. 18 Jane E. Brody, “When Passes are Not Just Signs of Aging,” The New York Times, September 5, 2001. 19 Peggy Vaughn, “Mild cognitive impairment more common in older men than older women,” NIH National Institute on Aging Press Release, September 7, 2010. 20Francine Goldstein, “How early can cognitive decline be detected?” British Medical Journal, January 5, 2012. 21 University of Michigan Institute for Social Research, “One in Three People Over 70 Have Memory Impairment.”
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Older consumers seeking intellectual stimulation engage in common activities like
reading books and newspapers, completing puzzles, or attending continuing‐education
classes designed for older adults.
New online services aim to improve the memory and cognition skills of older adults.
These solutions are typically designed as games, puzzles or other cognitive challenges.
Nintendo’s Brain Age is among the top grossing brain health games, selling more than 17
million copies globally since its release in 2005. Lumosity, a subscription‐based online
brain game portal, is also very successful, with an estimated 20 million registered users
generating approximately $80‐$90 million in revenue during 2011. Solutions from Vivity
Labs, Posit Science, Happy Neuron, CogniFit, Dakim and others offer memory games, as
well as games aimed at improving players’ focus, reaction time, hand‐eye coordination,
processing abilities, and language skills.
Rather than attempt to improve older adults’ memory, new solutions also aim to help aid
a consumer’s memory, many of which address prospective memory, or the ability to
“remember to remember”.22 Analog prospective memory aids would include to‐do‐lists,
calendars and reminders jotted down on post‐it notes. New solutions addressing
prospective memory include online and mobile solutions that send email alerts or text
messages to remind an older adult to perform a certain task, like taking medication or
buying eggs at the grocery store. Astrid is an online and mobile app that allows users to
construct to‐do‐lists and cross‐off tasks once they are completed; to‐do‐lists can be
collaborative so other household members or caretakers can add or delete tasks from
the list. Prospective memory aids are incorporated into many other solutions that are not
dedicated as a memory aid: medication management solution Vitality GlowCaps, for
instance, flash and play a sound if the user forgets to take his or her medicine.
Other solutions target retrospective memory, or things learned in the past. Technologies
that address retrospective memory might include pictures or videos of a task performed
at an earlier time that can serve as a “how to” for future action. Cooks Collage is one such
example – it extracts pictures from video taken of a person cooking a particular recipe
and creates a visual summary of the steps required to recreate that dish.
Improving or Aiding Vision
Between the ages of 40 and 60, people commonly experience problems seeing in low
light, problems with glare off of reflective surfaces, reduced tear production, changes in
color perception, and Presbyopia – the loss of the ability to see close objects or small
22 Niamh Caprani, John Greaney, Nicola Porter, “A Review of Memory Aid Devices for an Ageing Population,” PsychNology Journal , Vol. 4, No. 3 (2006), pp. 205‐243.
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print.23 More severe vision problems are likely for adults ages 60 and above, including
Cataracts, Glaucoma, Age‐related Macular Degeneration (AMD), and Diabetic
Retinopathy. Vision difficulties negatively affect an individual’s ability to perform basic
everyday tasks, especially driving. Poor depth and color perception could also increase
the risk of in‐home accidents such as falls, burns and cuts.
Presbyopia affects everyone to some degree after the age of 45. Among Americans age
40 and older, 17% have Cataracts, 7% have AMD and 2% have Glaucoma.24 Among the
same age group, 25% suffer from Myopia (nearsightedness) and 10% suffer from
Hyperopia (farsightedness); 2% have low vision and about 1% are blind.
Solutions to assist people with declining vision include magnifying glasses, large key
stickers for computer keyboards, and “talking” versions of everyday items such as
calculators, clocks, and scales. Smartphones now feature flashlight and magnifying apps
to aid vision and most personal computing device (computers, tablets, e‐readers, etc.,)
feature adjustable font sizes. Many mobile devices also have text‐to‐speech capabilities,
which read emails, messages and other text out loud. New advancements in voice‐
recognition and motion‐sensing technologies can help those who have trouble typing or
seeing small buttons. Apple’s Siri technology, for instance, allows users to set calendar
reminders through voice activation. Instead of using a remote with many small buttons,
Microsoft’s Kinect technology could allow users to change channels or adjust the volume
on the TV using hand gestures.
Improving or Aiding Hearing
Hearing loss is common for many adults and can result as a natural consequence of the
aging process (Presbycusis), or as a result of exposure to loud noises. Hearing loss can
impair a person’s ability to engage others in conversation and to conduct everyday
activities, such as driving, safely. People with hearing loss are less likely than others to
participate in social activities, and are less satisfied with their friendships, family life,
health and financial situation.25
According to the National Institute on Deafness and Other Communication Disorders, 18%
of people 45‐64 years old, 30 percent of those 65‐74 years old and 47% of those over age
23 American Optometric Association, “Adult Vision: 41 to 60 Years of Age.” 24 National Eye Institute, “Prevalence of Blindness Data.” 25 National Academy on an Aging Society, “Hearing Loss: a growing problem that affects quality of life,” December 1999.
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75 experience some hearing loss.26 Two‐thirds of Americans 65 and older with hearing
loss do not use hearing aids, citing costs and image as barriers to use.
In addition to medical‐grade hearing aids, various sound amplifiers on market help the
hearing‐impaired detect and recognize noise. Some amplifiers are designed to increase
the volume of specific devices or noises – such as a telephone ring – while personal
sound amplifiers that fit in a user’s ear amplify and clarify soft sounds while filtering
background noise. Personal devices from cell phones to watches and alarm clocks now
come with vibrating features to alert users of an incoming call or alert. Cell phone
manufacturers that target older populations, such as GreatCall, feature high‐volume
speaker phones and superior call quality. Overseas, mobile phone carriers such as
Deutsche Telekom and Telestra have launched high‐definition voice service, which will be
available from U.S. carriers in the 2013‐2014 timeframe.
Maintaining Muscle Strength
As people age, their bodies gradually lose the ability to maintain skeletal muscle function
and mass – a condition known as “sarcopenia”. The loss of muscle strength associated
with aging can lead to reduced mobility, declining activity, and dependence on others. It
can also result in balance problems, a greater risk of falling, and an increased risk of
osteoporosis. Maintaining muscle function and strength while aging is a great
preventative measure against disability and a proven way to enhance healthy living.
A meta‐analysis of studies on resistance training in adults finds that “there is strong
evidence to indicate that muscle weakness is a treatable cause of disability, and that
aging persons with early‐onset deterioration are probably the most likely to benefit from
strategic interventions.”27 The American College of Sports Medicine (ACSM) also
recommends adults engage in a resistance‐training program to build and maintain
muscle mass and function.28 Older adults should engage in exercise programs under the
supervision of their caregivers and follow programs that are progressive in nature,
individualized and involve all major muscle groups.29
26 National Institute on Deafness and Other Communication Disorders, “Quick Statistics,” http://www.nidcd.nih.gov/health/statistics/Pages/quick.aspx. 27 Mark D. Peterson, Matthew R. Rhea, Anada Sen, Paul M. Gordon, “Resistance exercise for muscular strength in older adults: a meta‐analysis,” Aging Research Reviews 9 (2010) 226‐237. 28Kent J. Adams, “Strength, Power and the Baby Boomer,” ACSM Current Comment, American College of Sports Medicine. 29 Michael G. Bemben, “Physiology of Aging,” ACSM Current Comment, American College of Sports Medicine.
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The U.S. Census Bureau reports that 20% of adults age 45‐64, 13% of those ages 65‐74
and only 12% of those 75 and above engage in regular muscular strength and endurance
exercises.30
The fitness market provides ample solutions to assist consumers in building muscular
strength. These include fitness equipment – such as dumbbells, resistance bands and
large multi‐exercise machines – as well as fitness classes focused on building or
maintaining muscle strength.
New technologies on market are designed to assist, track and motivate consumers of all
ages to engage in physical exercise, though solutions targeting aerobic activities
dominate the market. An overview of new fitness solutions is provided in Section 2.3,
under “Engaging in Age‐Appropriate Exercise.”
30 U.S. Census Bureau, “Table 212. Age‐Adjusted Percentage of Persons Engaging in Physical Activity and Fitness by Selected Characteristics: 2008,” Statistical Abstract of the United States: 2012.
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2.3 Maintaining a Healthy Lifestyle
Eating Healthy A nutritional diet is a fundamental aspect of living and maintaining a healthy lifestyle,
regardless of age. The Academy of Nutrition and Dietetics recommends eating plenty of
fruits and vegetables, varying protein choices, consuming at least three ounces of whole‐
grains daily and at least three servings of low‐fat dairy products. As people age, however,
certain nutrients – such as calcium, vitamin D, vitamin B12, fiber and potassium– become
particularly important to maintaining good health. The Academy also recommends older
adults limit their sodium intake and consumption of saturated fats.
Unfortunately, poor eating habits can leave older adults overweight or malnourished.
Poverty, depression, and social isolation can decrease appetite, as can changes in taste
and smell that are common with age.31 People with certain diseases and those taking
medication may have dietary restrictions that can be confusing and difficult to follow.
In 2010, 43% of men and 45% of women ages 65‐74 were obese; 27% of men and 30% of
women 75 and older were obese.32 Estimates for poor nutrition and malnutrition among
older adults range from 15‐50%. Data from the CDC’s National Health and Nutrition
Examination Survey show only 17% of adults 60 or older consume a good quality diet, 30%
skip at least one meal per day, and 16% consume fewer than 1,000 calories per day.
Basic nutritional and dietary guidelines for older adults are widely available online from
credible sources such as the National Institutes of Health and the USDA.
Weight loss programs such as Weight Watchers and SparkPeople help consumers
understand their nutritional needs and plan their meals accordingly. Some weight loss
programs, like Nutrisystem, ship balanced meals to subscriber’s homes. Online portals
and mobile applications, such as MyNetDiary.com and Livestrong’s Calorie Tracker, serve
as digital food journals that help users track their caloric intake, set goals and monitor
their progress.
Mobile apps such as Meal Snap, the Eatery, and SnapDish Food Camera let users take a
picture of a meal with a smartphone, the app automatically calculates the calories and
nutritional content of the food, and enters the data into the user’s food diary. Many
online and mobile diet aids are positioned as weight‐loss tools and are not designed to
advise or assist a person with specific dietary needs.
31 Donini, Savina and Cannella, “Eating habits and appetite control in the elderly: the anorexia of aging.” International Psyogeriatrics Vol. 15, No. 1 (March 2003): pp. 73‐87. 32 Federal Interagency Forum on Aging‐Related Statistics, Older Americans 2012: Key Indicators of Well‐Being, Washington, D.C.: U.S. Government Printing Office, June 2012
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Engaging in Age-Appropriate Exercise Along with eating a healthy diet, regular exercise forms the foundation of healthy living
for older adults. Consistent exercise can prevent or lessen the impact of many diseases
and can help older adults manage stress and improve cognition. Additionally, group
exercise classes can be a great form of social engagement.
The CDC reports that only 33% of adults ages 65‐74 and 17.5% of those 75 and older
engage in regular leisure‐time physical activity; 32.7% of Americans ages 65 and older
engaged in no leisure‐time physical activity.33 Parks Associates data shows that 45% of
people age 55‐64 exercise indoors or outdoors at least once a week, a rate which
increases to 54% of people 65 and older.34
Solutions assisting older consumers to exercise on their own – in and around the home –
or at a fitness facility are widespread. These include fitness devices as well as fitness
classes and personal training services. Basic information on how to engage in age‐
appropriate or condition‐appropriate exercise is available online from health and
wellness‐related websites, and often from physicians or physical therapists’ offices.
Some traditional fitness equipment manufacturers have started to integrate online
fitness programs with their equipment. iFit.com allows users to insert a Wi‐Fi enabled
memory card into an iFit‐compatible fitness equipment – often from major brands such
as NordicTrack. The card can download, store and update user‐selected fitness programs
from iFit.com.
Smartphone applications such as Fleety provide users with strength training workouts,
including videos showing proper form, and allow users to track their progress towards
fitness goals. Fleety and fitness‐tracking app Endomondo also provide motivation by
allowing users to set up competitions with peers. Endomondo has partnered with
municipalities and employers to launch fitness competitions among employees, a
strategy that could be extended to senior living communities.
Major fitness brands and some new comers also are developing wearable fitness devices
that go beyond the traditional pedometer. Nike, Adidas, Jawbone, Basis and BodyMedia
offer watches, armbands, athletic shoes and bracelets that can monitor, track and
analyze a user’s fitness progress.
33 CDC, “Data Table for Figure 7.2 Percentage of adults aged 18 years and over who engaged in regular leisure‐time physical activity, by age group and sex: United States, January‐September, 2009,” Early Release of Selected Estimates Based on Data From the January‐September 2009 National Health Interview Survey. 34 Parks Associates, Managing Care through ACOs: Consumer Interests & Requirements, December, 2012.
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Finally, game consoles are making headway into the physical fitness market. The top
three game console manufacturers, Nintendo, Sony and Microsoft, all offer gaming titles
that work with motion sensors and other accessories to make physical fitness more fun
and appealing.
Controlling Sodium Intake Excess sodium in a person’s diet can result in high blood pressure (hypertension), which
increases the risk of heart disease and stroke. The CDC recommends no more than 1,500
mg of sodium consumption daily, but the average American consumes more than double
that amount. The sodium content of many foods can be difficult to ascertain, especially
for meals consumed at restaurants, and older adults who are less mobile may rely too
heavily on processed foods that are high in sodium as opposed to fresh foods that expire
more quickly.
The CDC estimates 90% of Americans eat more sodium that is recommended for a
healthy diet.35 According to CDC’s National Health and Nutrition Examination Survey, 64%
of men and 69% of women ages 55‐64 years old suffer from hypertension, as do 72% of
men and 81% of women 75 and older.36
There are few solutions available to help consumers easily understand, track and manage
their sodium intake. Some online food diaries, like those profiled above, provide
estimates of sodium contained in popular food items. Popular online recipe and health
websites also provide ideas for consumers to prepare low‐sodium meals. The Mayo Clinic,
for instance, provides hundreds of recipes with no more than 140 mg of sodium per
serving.
Improving Sleep Quality Insufficient sleep can have serious negative effects on a person’s physical and mental
health, as well as his or her ability to perform daytime activities that require energy and
focus. Common causes of insufficient sleep among older adults include anxiety,
medication side effects, and health problems, like sleep apnea or restless leg syndrome.
Older adults are also more likely to suffer from advanced sleep phase syndrome (ASPS),
which causes the body to want to sleep earlier than normal.
35 CDC Vital Signs, “Where’s the Sodium?” February, 2012. “http://www.cdc.gov/vitalsigns/Sodium/index.html 36 CDC, “Table 70. Hypertension among persons 20 years of age and over, by selected characteristics: United States, selected years 1988‐1994 through 2007‐2010,” Health, United States, 2011, With Special Feature on Socioeconomic Status and Health, 2012.
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According to the U.S. Census Bureau, 27% of adults ages 45‐64 and 15% of adults ages 65
or older did not get enough sleep 14 or more days out of the month.37 ASPS is quite rare,
estimated 1% of the population. According to a study conducted by the CDC38, 39% of
adults ages 45‐54, 34% of adults ages 55‐64, and 24.5% of adults ages 65 and older slept
less than 7 hours in a 24‐hour period. 59% of the 45‐54 age group, 62% of the 55‐64 age
group and 50.5% of those 65 and older reported snoring – a major indicator of sleep
apnea.
A common strategy to promote sleep is to play relaxing music, whether though an alarm
clock, mobile device, or stand‐alone ambient noise player. Top sleep‐aiding mobile
applications instruct users to engage in breathing exercises or medication to relax before
bedtime, or provide sleep diaries to track the user’s length and quality of sleep, based on
data manually inputted by users.
Some sleep tracking apps have automated sleep data collection. Sleep Cycle and Sleep
Bot Tracker, which require the user to place his or her smartphone under the pillow,
monitor sleeping patterns and only sound an alarm to wake the user when he or she is in
a light sleep phase. Wearable devices like the Wakemate wristband, Fitbit Aria, or the
Zeo headband similarly track sleep patterns and relay the data to a smartphone or tablet
app. These apps allow users to manually input relevant data about the environment
(location, light conditions, etc.) in which they slept on any particular day as well as
personal feelings and behaviors (stress, diet, exercise) in order to produce more
meaningful sleep analysis.
Preventing Dehydration Older people are more susceptible to problems caused by dehydration, or the loss of
bodily fluid. Aging tends to make people 50 and older less aware of thirst and also
gradually reduces the body’s ability to regulate its fluid balance. Dehydration can
aggravate symptoms for people suffering from diabetes, heart failure, or COPD, and can
lead to complications such as low blood pressure, convulsion, severe cramping and
muscle contractions, faster breathing, or rapid but weak heart beat. Older adults who are
severely dehydrated may require hospitalization.
37 U.S. Census Bureau, “Table 195. Insufficient Rest or Sleep by Number of Days and Selected Characteristics: 2008.” 38 CDC, “Unhealthy Sleep‐Related Behaviors,” Morbidity and Mortality Weekly Report, Vol. 60 No. 08 (March 2011): pp. 233‐238.
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Researcher Janet Mentes found that 48% of older adults admitted to hospital emergency
departments were dehydrated.39 Another study by A.K. Kant shows that 63% of people
ages 65‐74 and 81% of people 85 and older failed to meet the recommended daily fluid
intake volume from food and beverages40.
The best way to prevent dehydration is to drink adequate water daily. Consumers can
track their daily water intake through a paper journal. New solutions can detect
dehydration and remind consumers to drink water, such as the W+Plus system, acumen
Hydrotrack dehydration monitor, and Oregon Scientific’s heart rate monitor with
dehydration alert. Several smartphone apps help consumers remember to drink enough
water by providing reminder alerts and a log to record the amount of water consumed
daily. Examples include Waterlogged, iHydrate, and Carbodroid. Waterlogged allows
users to input their water consumption using pictures of the glasses of water they are
about to drink.
Boosting Daytime Energy Aging affects older adults’ energy levels. A marked drop in an individual’s daytime
energy level may indicate the onset of illness. Even if not caused by specific health
conditions, low energy will reduce older adults’ levels of activity and engagement with
others.
A Columbia University study of adults ages 65 and older found that 22% of women and
12% of men had a lack of energy (anergia).41
Methods of boosting daytime energy include eating a healthy diet, engaging in exercise,
napping, and reducing stress. Caffeinated drinks, such as tea and coffee, and energy
drinks such as 5‐hour Energy and 6‐Hour Power can serve as short‐term solutions to
boost energy levels. Few solutions exist dedicated to boosting energy; instead, solutions
that could effectively increase older adults’ energy levels address the underlying
problems causing low energy, such as poor sleep and diet, depression or lack of exercise.
39 Janet Mentes, “Oral hydration in older adults”, American Journal of Nursing, Vol. 106, No.6, pp. 40‐49. 40 http://www.h4hinitiative.com/wp‐content/uploads/Monograph‐Danone_The‐elderly_2304_final.pdf 41 Cheng, Gurland and Maurer, “Self‐Reported Lack of Energy (Anergia) Among Elders in a Multiethnic Community”, Journal of Gerontology, Vol. 63, No. 7 (2008); pp. 707‐714.
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Reducing Stress
Chronic stress can result in severe health consequences. Stress can worsen hypertension
and high cholesterol levels, can increase the risk of heart disease, can complicate
recovery from illness and can result in depression.
According to the latest Stress in America42 report conducted by the American
Psychological Association, Boomers (Ages 47‐65) and Mature adults (66 years and older)
report less stress than younger generations, but still experience stress levels higher than
recommended. Money, work and housing costs are top stressors for Boomers, while
health problems and family issues are top sources of stress for Mature adults. 63% of
Mature adults are somewhat or very significantly stress by health problems affecting
their families and 56% are stressed by personal health concerns.
According to the Stress in America survey, 44% of Boomers report laying awake at night
due to stress while 40% overate or ate unhealthy foods due to stress. 42% of Boomers
and 23% of Mature adults experience irritability or anger as a result of stress. Two‐thirds
of Mature adults say managing stress is important but only 46% say they are “very good”
to “excellent” at doing so.
Consumers can manage their stress levels through breathing exercises, exercise and
meditation.
Top stress management mobile applications help users understand and respond to stress.
Stress Tracker allows users to rate and track their stress levels, sources of stress, moods,
feelings and symptoms, and provides action steps users can take to lower their stress
levels. The Cleveland Clinic Stress Management app features meditation exercises read
aloud by a narrator. The Relax Stress & Anxiety Relief app guides users through breathing
exercises with calming music.
New solutions are integrating sensor technology into their stress management systems.
SweetWater Health’s SweetBeat system integrates a heart rate monitor with its mobile
app to identify users’ stress levels through heart rate variability; the system doubles as a
weight loss tool. Samsung’s MyFit MP3 player comes equipped with built‐in stress
sensors. Affectiva’s wearable wireless Q Sensor constantly checks for signs of stress or
anxiety through changes in the user’s skin conductance. The resulting data can help
consumers identify their greatest sources of stress.
42 American Psychological Association, Stress in America: Our Health at Risk, January 11, 2012.
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2.4 Managing Health Risks and Conditions
Reducing Bad Cholesterol High cholesterol is a risk factor of heart diseases such as coronary artery disease (CAD),
heart attack, stroke, and congestive heart failure. For people 50 and older, lowering
overall cholesterol levels, especially the low density lipoprotein (LDL, a.k.a. bad
cholesterol), prevents plague build‐up, thus improving overall heart health.
The CDC reports that 49% of men and 53% of women ages 65‐74 have high cholesterol,
as do 45% of men and 53% of women 75 and older.43 The CDC estimates that 71 million
American adults have high LDL, and only one in three have it under control. People ages
50 and older have a much higher incidence of LDL than younger age groups.
Although consumers typically receive blood test results from their doctor, self‐test kits
from brands such as CholesTrak, Home Access Instant Cholesterol Test, or First Check
Home Cholesterol Test are also available for people to check cholesterol at home. These
kits, however, have various limitations: only total cholesterol level is shown with no
breakout of LDL, HDL and Triglyceride readings. Two advanced test kits (from Cardio
Check and Lifestream Personal Cholesterol Monitor) can test total cholesterol, HDL, and
Triglyceride, but they require three separate blood drops, don’t measure LDL, and are
more expensive (more than $100). As a result, less than 2% of consumers have used the
solution at home.44 If an individual already has abnormally high cholesterol, cholesterol‐
lowering medications or plague‐removal surgery (known as endarterectomy) might be
needed.
Cholesterol control requires a comprehensive approach involving dietary changes, weight
control, regular exercise, and stress reduction. Health portals such as WebMD offer
cholesterol health checks, while MindBloom and Thecarrot.com offer comprehensive
solutions that can help consumers address their dietary, fitness, and mental health needs.
43 CDC, “Table 71. Cholesterol among persons 20 years of age and over, by selected characteristics: United States, selected years 1988‐1994 through 2007‐2010,” Health, United States, 2011, With Special Feature on Socioeconomic Status and Health, 2012. 44 Parks Associates, Personal Care Tools and Application, 2010.
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Keeping Glucose in Range
Blood sugar levels fluctuate daily, but too much or too little glucose in the blood can have
serious consequences. The need to keep glucose level in a controlled range is paramount
for people with Type I or Type II diabetes and very essential for those with pre‐diabetes.
According to the CDC, diabetes affects 25.8 million people in the U.S. 27% of people 65
and older have diabetes, which is more than twice the average of people 20 years and
older.45 More worrisome is the rising number of people suffering pre‐diabetes symptoms
who share the same risk factors as a diabetic. The CDC estimates that 35% of people 20+
are pre‐diabetic. Among people 65+, pre‐diabetes incidence is 50%, or about 50 million
people.
Keeping blood sugar levels in the right range requires a careful diet, exercise and
sometimes medication and insulin injections. Diabetics must monitor their glucose levels
several times a day with the help of a glucose monitor from brands such as Bayer,
OneTouch, FreeStyle, TrueResult and Accu‐Chek.
New glucometers, such as Sanofi’s iBGStar glucometer, make better use of consumers’
health data. By syncing users’ glucose readings with a diabetes management app, these
new devices help users track their glucose levels and share collected data with physicians.
Maintaining a Healthy Weight
Being over or under the recommended weight guidelines is a direct contributor to many
lifestyle‐related illnesses such as high cholesterol, diabetes, and heart problems. Weight
problems can also cause older adults to become inactive, which can worsen many health
problems and lead to social isolation.
In 2010, 43% of men and 45% of women ages 65‐74 were obese; 27% of men and 30% of
women age 75 and older were obese.46
Educational information from health care providers can help consumers understand the
recommended weight range for their age, gender and height. Solutions on market
helping consumers to maintain a healthy weight tend to fall in “diet & nutrition” or
“physical fitness”. Consumers tend to track their weight using a basic scale, though new
45 CDC, “Diagnosed and Undiagnosed Diabetes in the United States, All Ages, 2010,” 2011 National Diabetes Fact Sheet, http://www.cdc.gov/diabetes/pubs/estimates11.htm. 46 Federal Interagency Forum on Aging‐Related Statistics, Older Americans 2012: Key Indicators of Well‐Being, Washington, D.C.: U.S. Government Printing Office, June 2012
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WiFi‐enabled scales now enable users to capture that data daily and watch their weight
levels rise and fall over time.
Keeping Blood Pressure in Range
Abnormal blood pressure—whether too high or too low—is a leading cause of heart
disease and stroke. The need to manage blood pressure is particularly urgent for people
ages 50 and above due to the loss of elasticity in the arteries that results as a byproduct
of aging, and can result in high blood pressure.
According to CDC’s National Health and Nutrition Examination Survey, 64% of men and
69% of women ages 55‐64 years old suffer from high blood pressure (hypertension), as
do 72% of men and 81% of women 75 and older.47
Medication is the most common solution to controlling blood pressure. Care providers
also offer telephone consultation hypertension management services centering on
patient education on the early signs of adverse events and lifestyle risk factors, such as
being overweight, excessive sodium intake, and poor sleep quality.
According to Parks Associates’ data, 60% of consumers in broadband households who
have abnormal blood pressure own a meter to monitor their blood pressure at home.48
Most of these devices simply display readings on the device’s screen with no option to
track and review the collected data.
New blood pressure monitor designs leverage smartphones to offer enhanced functions.
Connected blood pressure cuffs from companies like iHealth and Withings, which sync
with mobile applications, can help users track their blood pressure automatically and
share data with their physicians. These apps can also integrate educational materials
from with trusted third‐parties to help users manage related hypertension risk factors
such as weight, sodium intake and sleep quality. Adoption of these new solutions,
however, is low due to low awareness among the targeted population and increase cost;
the price of a connected blood pressure cuff is 40‐50% higher than an old‐fashioned
monitor. In addition, these new device makers have found it difficult to enter the
traditional retail channels such as drug stores and supermarkets.
47 CDC, “Table 70. Hypertension among persons 20 years of age and over, by selected characteristics: United States, selected years 1988‐1994 through 2007‐2010,” Health, United States, 2011, With Special Feature on Socioeconomic Status and Health, 2012. 48 Parks Associates, Managing Care through ACOs: Consumer Interests & Requirements, 2012.
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Relieve Back Pain
Back pain can be caused by a variety of factors such as arthritis, previous injury, and
certain illnesses or infections. People ages 50 and older suffer back pain
disproportionately because of age‐related illnesses, occupational hazards, and
accumulated impact from bad posture.
According to the U.S. Census Bureau, 33% of people ages 45‐64, 30% of those ages 65‐74,
and 34% of those ages 75 and older suffer from lower back pain.49
Medications and chiropractic services can temporarily relieve back pain symptoms, but
surgery is sometimes required for a longer‐term fix. To prevent back pain, however,
solutions help older adults modify their sitting and standing posture and follow muscle
toning exercises. Back pain apps such as iREHAB Back Pain, exercise apps such as Yoga for
Back Pain Relief, and digital programs such as FPR (Feeling Pretty Remarkable) all address
back pain in older adults.
Detecting Skin Problems
Skin cancer accounts for more than half of all cancers in the U.S. People with pale
complexions, excessive exposure to the sun and exposure to certain occupational
chemicals are more likely to develop skin cancer. Older adults must watch for early signs
of skin problems such as changes in the size, color or shape of an existing mole, or scaly,
itchy, or raised patches on the skin.
According to the American Cancer Society, more than 2 million cases of basal and
squamous cell skin cancer are diagnosed each year, with another 75,000 people
diagnosed with Melanoma, the most dangerous type of skin cancer.50
Regular skin cancer screening is recommended by the medical community, but in many
cases, regular self examination is the first step toward skin problem identification or
prevention. Mobile apps such as SkinVision, SpotCheck, Skin of Mine, or virtual
consultation service from providers such as Direct Dermatology make monitoring one’s
skin for changes more convenient for older adults.
49 U.S. Census Bureau, “Table 199. Persons 18 years of Age and Over with Migraines and Pains in the Neck, Lower Back, Face, or Jaw by Selected Characteristics: 2009,” Statistical Abstract of the United States: 2012. 50 American Cancer Society, “Skin Cancer Facts,” January, 2012. http://www.cancer.org/cancer/cancercauses/sunanduvexposure/skin‐cancer‐facts
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Addressing Calcium Deficiencies Due to calcium loss, older adults have weaker bones that are prone to fracture or break if
they endure a sudden strain, bump, or fall. The need to slow the thinning of bones and
prevent osteoporosis is greatest for women approaching menopause, but is broadly
applicable to all age groups above 50.
According to the National Osteoporosis Foundation, about 10 million U.S. consumers
have osteoporosis and about 34 million are at risk for the disease.51 The NOF estimates
about half of all women older than 50, and up to one fourth of men, will break a bone
because of osteoporosis.
Healthy lifestyle choices can help prevent further bone loss and reduce the risk of
fractures. People 50 and older can choose a calcium‐rich diet and engage in age‐
appropriate exercises to maintain bone density and strength. The first step to prevent
osteoporosis is education and risk assessment. Websites and mobile apps offer plenty of
solutions for people to learn how best to prevent osteoporosis. Mobile application
CalciumTrack works like a food diary and estimates the amount of calcium the user
consumes daily.
Maintaining Good Dental Hygiene
Recent research has shown that good dental health is linked to lower risks of chronic
conditions and dementia. Good dental hygiene helps prevent gum disease, slow tooth
decay, and prolong the life of dentures and implants. Stronger teeth, in turn, help older
adults eat, improve speech, and enhance self‐esteem.
According to the National Health and Nutrition Examination Survey in 2004, 17.2% of
people age 65 and over have periodontal disease and 10.6% have moderate or severe
periodontal disease.52 But recent research from the CDC and the American Academy of
Periodontology (AAP) concluded that “the prevalence of periodontal disease may have
been underestimated by as much as 50%.”53
Prevention is key to maintaining good dental health. Recommended preventive dental
care includes frequent brushing, flossing, and rinsing teeth and regular visits to a dentist
for professional dental care. However, people of all ages skip simple tasks like teeth
51 National Osteoporosis Foundation, “Bone Health Basics: Get the Facts,” http://www.nof.org/learn/basics. 52 National Institute of Dental and Craniofacial Research, “Periodontal Disease in Seniors (Age 65 and Over),” http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/GumDisease/ 53 CDC and the American Academy of Periodontology, “CDC: Half of American Adults have Periodontal Disease,” September, 2012. http://www.perio.org/consumer/cdc‐study.htm
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brushing and dental flossing or perform these tasks improperly. New technology‐
powered dental care products have seen growing adoption over the past ten years.
Electric toothbrushes from brands such as Philips Sonicare or Oral‐B are selling well
(Philips estimates 22 million users of its Sonicare toothbrushes).54 Additionally, new app‐
connected toothbrushes from Beam Technologies and Philips’ Airfloss provide feedback
on users’ brushing habits. Educational mobile apps like Cavity‐Free 3D teach users how to
brush and floss properly, while Brush DJ and Time2Brush remind users when it’s time to
brush and track their brushing time.
Managing Arthritis
Arthritis can cause pain, fatigue, and inflammation such as swelling, stiffness, and
redness. Persistent arthritis pain can affect people both physically and mentally; it can
lead to chronic disability and affect older people’s daily activities, such as walking.
The most common types of arthritis are Osteoarthritis and Rheumatoid Arthritis.
Osteoarthritis affects 27 million people in the U.S., according to CDC estimates, and a
majority of those suffering this condition are 50 years or older. Rheumatoid arthritis
affects an estimated 1.5 million adults.55 Arthritis incidence has been steadily on the rise
over the last 20 years and is still growing.
Although medication can relieve arthritis pain, lifestyle changes – such as getting
adequate sleep, maintaining a healthy weight, and participating in properly designed
exercise programs – helps ease arthritis pain as well. Devices and applications that help
improve sleep quality, reduce excess weight, and keep older people active with exercise
are also beneficial to people living with arthritis.
Technologies and mobile applications that target arthritis specifically fall into the
following four categories. First, apps like ArthritisID and Zimmer Arthritis 411 provide
arthritis information and education. MyPainDiary and Track+React apps enable users to
track their arthritis pain levels. Joy Bauer Food Cures provides a diet plan for people living
with arthritis, and Arthritis Connect helps people connect with others who have the
condition.
54 Philips, Annual Report 2011, http://www.annualreport2011.philips.com/content_ar‐2011/en/proofpoints/global_oral_healthcare_brand.aspx. 55 CDC, “Arthritis‐Related Statistics,” http://www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm.
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2.5 Improving Quality of Life
Staying Connected Socially Older adults appreciate the sense of being able to stay connected with the outside world
and maintain or even expand their social circle after retirement. Social isolation is
particularly relevant to people of older age as decreased mobility and other aging
symptoms significantly limit their ability to meet, communicate, and enjoy
companionship with friends, neighbors, and family members. Reallocation to a new
neighborhood or a new housing type may aggravate a sense of isolation. For some, it can
be an episodic concern as they soon adjust themselves to the new environment. For
many older people, however, the feeling of being shut out of their former social circle or
a sense of a dwindling number of friends can reduce their quality of life.
The Australian Center of Aging Studies reported that “longevity increased by 22% among
people 70 and older with a large circle of friends compared to those with the fewest.”56
A 2008 study from the University of Chicago concluded that “chronic loneliness is a
health risk factor comparable to smoking, obesity and lack of exercise, and contributes to
a suppressed immune system, high blood pressure and increased levels of the stress
hormone cortisol.”57
A tracking survey of 1,064 participants 60 and older, conducted by the University of
California at San Francisco from 2002 to 2008, found that 30% of respondents reported
feeling lonely sometimes and 13% felt lonely very often.58 Extrapolating the data, Parks
Associates estimates that social isolation affects at least 4 million people 65 and above in
a severe way.
Current solutions to older people’s social solitude focus on two aspects: community
gatherings and online social networking. People in their late 60s and 70s rely on senior
community centers, casually organized clubs, and volunteer work to stay connected.
Younger adults, however, also use digital media to stay connected with friends and social
contacts. Parks Associates’ data shows that 56% of adults ages 55‐64 and 44% of those 65
56 Giles, Glonek, Luszcz and Andrews, “Effect of social networks on 10 year survival in very old Australians: the Australian longitudinal study of aging,” Journal of Epidemiology and Community Health¸ Vol. 59 (2005): pp.574‐579. 57 John Cacioppo and William Patrick, Loneliness: Human Nature and the Need for Social Connection, W. W. Norton & Company, 2008 58 Judith Graham, “The High Price of Lonliness,” The New York Times, June 18, 2012, http://newoldage.blogs.nytimes.com/2012/06/18/the‐high‐price‐of‐loneliness/
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and older, who live in a household with broadband internet access, use Facebook on a
weekly or daily basis.59
Keeping Mobilized
Older people treasure the ability to drive, such that giving up the car keys can be a sad
life milestone. The sentiment is understandable since the ability to drive expands
people’s life radius, brings a sense of pride and independence, and helps them meet
many practical, daily needs—shopping, running errands, meeting family and friends,
seeing a doctor, etc. But declining vision, slower reaction times, and a weakened muscle
system force many older people to give up driving and rely instead on public
transportation, family and friends – or to simply become home‐bound. A study
conducted in suburban Maryland in 2006 found that ”those who had given up driving
were nearly five times more likely to end up in long‐term care after eight years than
those who were still driving, even when researchers accounted for various health
problems.”60
An AAA survey conducted in December 2011 found that 88% of people 65 years and
older consider the inability to drive a problem and 57% felt it was a serious problem.61
According to the Insurance Institute for Highway Safety (IIHS), there were 22 million
licensed drivers aged 70 and older as of 2008, representing 78 percent of that
demographic group.62 Inversely, 22% of the people 70 and older, or approximately 3.5
million, are unable to drive.
Transportation support is a common benefit provided by assisted living facilities and
retirement communities; shuttle services typically feature a routine route for basic living
needs like grocery shopping, haircuts, doctor visits, etc. However, these services usually
do not run on nights or weekends, and often require advanced notice. Most elderly who
give up driving and live at home rely on their adult children for a ride or take public
transportation service, where available. Some companies, like SilverRide, as well as non‐
profit organizations, like the Independent Transportation Network of America, are
attempting to fill the transportation gap by providing low‐cost private transportation
services for older adults.
59 Parks Associates, March 2012 Survey, 2012 (see Appendix for associated chart). 60 Kay Lazar, “Off the road,” The Boston Globe, December 21, 2009: http://www.boston.com/news/health/articles/2009/12/21/the_emotional_and_physical_costs_of_giving_up_driving/ 61 AAA, Senior Driver Survey Report, December, 2011. 62 Insurance Institute for Highway, “Q&A: Older Drivers,” September 2012: http://www.iihs.org/research/qanda/older_people.aspx
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For those who are still behind the wheel but are concerned about driving, multiple
technologies are in place to make driving safer and more convenient—lane departure
warning systems, forward collision warnings, and electronic stability control are a few. In
the long term, self‐driving cars (Google) provide hope that one day the older adults who
are no longer able to drive will be able to sit in the car as a passenger and let the car take
them to their destination.
Navigating the Healthcare System
The U.S. healthcare system is complex and confusing to the older adults. The multi‐payer
system, coupled with complex benefit designs, has given rise to confusing coverage terms.
Frustration arises when access to needed care is subject to restrictions based on network
eligibility, pre‐existing conditions, co‐payment requirements, and maximum benefit caps.
For older adults, assistance navigating the U.S. health systems is most needed in the
following two areas:
1. Coverage decisions: Older adults need assistance understanding appropriate
coverage and associated costs, filling out paperwork correctly, following rules for
using health services, and learning what to do in the case of a
coverage/reimbursement dispute.
2. Healthcare service decisions: older adults need assistance choosing the best
available doctors, learning about a growing list of treatment options, making
treatment decisions after physician consultations, and managing health and chronic
conditions under care provider supervision.
A 2011 Deloitte survey showed that 76% of healthcare consumers do not have a strong
understanding of how the health care system works.63 A 2008 Common Wealth Fund
survey found that “8 of 10 respondents agreed that the health system needs either
fundamental change or complete rebuilding,” and it concluded that “adults' health care
experiences underscore the need to organize care systems to ensure timely access,
better coordination, and better flow of information among doctors and patients.” 64
Health concierge services aim to alleviate consumer frustration by devoting dedicated
personnel to guide consumers through the various healthcare decisions needed for each
care episode.
63 Deloitte Center for Health Solutions, 2011 Survey of Health Care Consumers in the United States: Key Findings, Strategic Implications, 2011. 64 Sabrina K. H. How, Anthony Shih, Jennifer Lau, and Cathy Schchoen, Public Views on U.S. Health System Organization: A Call for New Directions, 2008. http://www.commonwealthfund.org
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Companies offering health concierge services include Health Champion, MDVIP,
EliteHealth.com, and SignatureMD, among others. The current user base of these
services is small. A 2009 survey conducted by a congressional agency indicated that there
were only 750 doctors practicing concierge care in 2009, although this is a big jump from
the mere 150 concierge doctors counted in 200565. Using an estimate of 500 patients per
concierge doctor, the user base for this service is only estimated in the 500,000‐700,000
range in 2012.
One big inhibiting factor is price. Most high‐end concierge services charge an annual
membership fee starting from $1,500, making them less affordable to ordinary families.
A few providers are trying to move the service price downward. For instance,
EliteHealth’s basic membership can be as low as $14.95 per month but the services
included in this basic membership are so limited that the lower tier becomes less
appealing to consumers who have a primary care doctor.
Availability of the service is also a concern. Users may desire an option to meet their
concierge doctor face‐to‐face. With a small number of concierge care doctors located in
more affluent locations, such as New York and Florida, the service concept becomes less
appealing to those with no face‐to‐face access to a concierge doctor. Online virtual care
is on the rise as part of concierge services, allaying some of these concerns.
A lighter version of such services offers consumers symptom checking capability, links to
local doctor’s office, and ancillary features such as doctor ratings, online appointment
scheduling capability, and online paperwork preparation prior to a face‐to‐face
appointments. Examples include ZocDoc and, Aetna’s iTriage. ZocDoc has 2.5 million
monthly users and is available in 34 major metropolitan markets. The iTriage app was
downloaded more than 7 million times by users before it was acquired by Aetna in
December 2011.
Managing Healthcare Costs
Healthcare cost burdens on people 50 and older have increased significantly over the last
ten years. Premium increases, rising co‐pays, and a multi‐tiered healthcare benefit
system that shifts many costs to end users have all contributed to rising spending on
medical services for the older population. Additionally, older adults are more prone to
costly chronic conditions. The need to understand the cost implications of healthcare
decisions and to find the most cost effective treatment options is very acute for the 50+
age group.
65 http://vitaadvisors.com/2010/11/29/medpac‐on‐retainer‐medicine/
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According to Aetna’s Empowered Health Index survey in July 2012, 88% of consumers
said that health insurance choices are tough because information is confusing and
complicated. 43% of adults do not track their out‐of‐pocket health costs and 81% have
difficulty in making healthcare decisions because they do not know the costs of tests and
procedures.66
The solutions to this need fall into two categories—services offering cost comparison
information before patients make service decisions and services assisting patients with
medical bill disputes. Companies offering cost comparison services include CastLight,
GoHealth, UnitedHealth’s MyHealthcare Cost Estimator, LowestMeD.com,
ClearHealthCosts.com, FaircareMD, SnapHealth, Anthem Care Comparison, and GoodRX
app. These services, however, face typical start‐up challenges: low consumer awareness,
incomplete cost data, and limited coverage of healthcare facilities and procedures. For
instance, GoodRX and LowestMed.com only offer drug costs while UnitedHealth and
Anthem’s tools only address costs for their subscribers. GoHealth compares only
insurance costs, whereas Castlight is focused on B2B services for employers and insurers,
limiting its ability to build scale quickly.
Evaluating Care Quality
Although care quality varies by provider type and care service categories, the U.S.
healthcare system is far from being transparent. This makes it difficult for patients to
select care providers, set the right expectation for an upcoming care experience, and
provide timely feedback to care providers.
The need to understand care quality of different provider and facility types is growing as
more healthcare dollars are spent by consumers. Anecdotal evidence shows that
consumers are increasingly interested in providing feedback about their care service
experience through digital tools and social media, and they also draw their own
conclusions based on reviews and comments by online peers.
Solutions to help patients understand differences in the quality of care across healthcare
facilities, provider types, and procedures include online sites to rate and evaluate doctors,
and hospital services. Leaders of such solutions include HealthGrades, RateMDs.com,
Vitals.com, Carechex, and Angie’s List. HealthGrades is the largest provider of this kind of
service, boasting more than 200 million visitors. While consumers are generally trusting
about ratings from peer groups, the personal nature of care experience and varied care
66 Aetna, “Decision 2012: Health Care Benefits Second Most Difficult Decision for Consumers,” September 17, 2012. http://newshub.aetna.com/press‐release/decision‐2012‐health‐care‐benefits‐second‐most‐difficult‐decision‐consumers
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quality perceptions keep users wondering whether consumer reviews alone offer
complete information.
Government portals also provide clinical performance data in a report card format but
report card data requires a high‐level of clinical literacy to understand and thus are less
useful to ordinary consumers.
Receiving Divorce/Grief Support The loss of a loved one and the end of a marriage are painful life experiences. These life‐
changing events bring individuals grief and stress and leave survivors with many practical
considerations to resolve. The mental burden can have a dramatic impact on older adults,
affecting their quality of life and personal health. The loss of a loved one can also lead to
a smaller social circle and less frequent social engagement.
The U.S. divorce rate is highest among people 45‐54 (16.6% or men and 20% of women),
according to the 2011 American Community Survey. Divorce rates for people 65 and
older hovers around the national average of 11%.67 By 75, the rate of becoming widowed
reaches 50% for women and 17% for men. By the age of 85 or older, the widow rate hits
73% for women and 35% for men.68
Following the death of a spouse or other loved one, consumers can attend bereavement
support groups at local community centers or places of worship and can call crisis
hotlines in an emergency. Professional counseling services can provide more long‐term
support for any number of issues.
Online support groups also provide social support for people struggling with health
conditions or undergoing dramatic life changes. Websites that provide divorce and grief
support services include Sincemydivorce.com, Daily Strength, GriefShare, HelloGrief.org,
GriefJourney.com. These portals are organized by topic, and information is presented in
either message board/forum format from users or in a curated format. The average
number of daily unique visitors for these portals is in the 10,000‐30,000 range, indicating
monthly unique visitors below the 1‐million mark, an unappealing metric to large brand
advertisers. In addition, designs of these portals are usually more educational than
interactive, and information is cluttered with ads, which further reduces the user
friendliness of these Websites.
67 U.S. Census Bureau, “Marital Status,” American Community Survey, 2011. 68 U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2010.
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Managing Life Phase Transitions There are many types of life events that affect people physically and mentally. For older
adults, these transitions can be physical changes to the body (e.g., menopause), lifestyle
changes (e.g., retirement), or health related (e.g., diagnosis of a major life‐threatening
disease). These events can cause stress and lead to behavioral changes further worsening
the affected person’s physical and mental health.
According to the Pew Research Center, beginning in 2011 – the first year when the oldest
baby boomers hit the retirement age – 10,000 people will hit the retirement age of 65
each day for the next 19 years.69 All women will encounter menopause at some point in
the aging process; the average age of a women’s last menstrual cycle is 51, but the
menopausal transition, or perimenopause can last a full year.70 Additionally, new
diagnosis of chronic conditions and terminal illnesses are in the millions each year.
Self‐education and peer support are the two most important aspects of a support
program helping older people make life phase transitions successfully. Online
educational tools through providers like WebMD, A.D.A.M., MedHelp and online patient
support services such as PatientslikeMe, InspireHealth, CureTogether are designed to
relieve end users’ anxiety, receive peer support, and find comfort and means of
treatment to improve health and wellness during these life stage transitions. These Web
portals generate millions of visits each month but members of specific support groups—
those active users—are still a small portion of the total Web traffic. PatientslikeMe has
an estimated 700,000 members and InspireHealth has about 250,000; both programs
having been running for several years. These programs tend to attract sicker patients or
patients with a unique illness that is not in the mainstream public health domain. For
others, online support group use is light given that the content on these portals is more
health‐related than associated with life transitions.
Online consultation services such as CopeToday and HealthLinkNow provide additional
support for people experiencing life phase changes, but these and others are still in the
start‐up phase.
69 Pew Research Center, “Baby Boomers Retire,” December 29, 2010. http://www.pewresearch.org/daily‐number/baby‐boomers‐retire/. 70 NIH National Institute on Aging, “AgePage: Menopause,” April, 2012. http://www.nia.nih.gov/health/publication/menopause
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Planning for End of Life Care
Planning end of life care is a difficult issue, whether for oneself or for a loved one. People
living with or dying of advanced illness seek physical, mental, and emotional support on a
range of topics : having an open conversation with doctors about end‐of‐life care choices,
advancing directives on care wishes, designating decision‐makers when they are unable
to make their own decisions, evaluating the proper time to start hospice care, and
addressing legal matters after death.
Younger adults, who are more likely to be caregivers, endure physical and emotional
fatigue, stress, depression, and anxiety associated with taking care of an older and very
sick family member. They need education and support on how best to cope with the
physical and mental burden of meeting a family member’s end of life care needs.
MedPac data indicated that more than 500,000 patients used hospice care in 2000. By
2009, Medicare hospice beneficiaries jumped to more than 1.1 million in total number. In
2010, about 44% of Medicare beneficiaries who died that year used hospice care, up
from just under 23% in 2000.71
Online resources such as Compassionandsupport.org, GrowthHouse.org, and WebMD
provide educational information about end of life planning. Most hospitals offer hospice
care as a listed service and home care agencies also offer hospice care in specific
locations or in home. Other than those informational portals and on‐the‐ground services,
there are few entrepreneur activities in this care arena.
71 MedPac, Report to the Congress: Medicare Payment Policy, March, 212. http://www.medpac.gov/chapters/Mar12_Ch11.pdf
The Need
Current Solutions
Population Data
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2.6 Evaluating Needs-Based Challenges
From the evaluation of the more than 30 needs identified in Sections 2.1 through 2.5, certain commonalities
across needs categories emerged. These commonalities represent nine broad healthy living challenges for the
50+ community. Products and services that attempt to solve or remedy one of these nine broad healthy living
challenges also will address, at least in part, multiple more specific needs of older adults. These market
challenges are summarized below, along with the types of specific needs a solution in that space could address.
Examples of solutions currently on market that address the needs within a challenge area are provided.
Figure 2: Thirty‐Two Needs Captured in Nine Healthy Living Challenge Areas
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Healthy Living Challenge
Needs Addressed Current Technology/Solutions
Physical Fitness Improve muscle strength Engage in age‐appropriate exercise Maintain healthy weight Boost daytime energy Reduce Stress Keep mobilized Reduce bad cholesterol Keep blood pressure in range Relieve back pain
Connected fitness tracking devices: Fitbit, Nike Fuelband, Jawbone Up, Basis, Nintendo Wii.
Senior fitness classes and weight loss programs: SilverSneaker, SparkPeople
Smartphone apps/online portal to track exercise progress: Endomondo, DailyBurn, Runkeeper, Nike+
Diet and Nutrition Eat healthy/portion control Maintain healthy weight Control sodium intake Prevent dehydration Boost daytime energy Reduce bad cholesterol Keep blood pressure in range Keep glucose in range Slow bone loss Maintain dental hygiene
Online/mobile diet/nutrition education tools: WebMD,
Diet plans: WeightWatchers, Nutrisystem
Diet/nutrition tracking app/diary: Meal Snap, The Eatery, SparkPeople
Reminder apps: Waterlogged, Carbodroid
Behavioral & Emotional
Health
Reduce stress Improve sleep quality Receive divorce/grief support Manage life phase transitions Plan for end of life care
Online support Group: Daily Strength, SincemyDivorce.com, InspireHealth
Online mental health counseling services: Cope Today, HealthLinkNow
Sensors tracking underlying causes: Zeo, Fitbit Aria
Apps tracking stress level: Relax Stress & Anxiety Relief app
Aging with Vitality Aid memory/cognition Improve or aid vision Improve or aid hearing Manage arthritis Boost daytime energy Prevent osteoporosis Maintain muscle strength
Brain/memory games: Lumosity, Dakim, Posit Science
Digital vision/hearing aid apps: magnifier app, voice recognition
Memory aids/digital reminders: Time2Brush
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Healthy Living Challenge
Needs Addressed Current Technology/Solutions
Vital Sign Monitoring Reduce bad cholesterol
Keep blood pressure in range
Keep glucose in range
Detect skin problems
Improve sleep quality
Maintain dental hygiene
Medical sensors: Glucometer, BPM, connected insulin pump
Education apps: Diabetes Buddy
Self examining tools: Beam Brush app, SkinVision, Sleep Cycle, W+Plus
Teleconsultation services: Direct Dermatology, Alere
Social Engagement Stay connected socially
Keep mobilized
Stimulate intellect
Reduce stress
Social networks and online support groups: Facebook, PatientslikeMe
Transportation support services/ safe driving aid: SilverRide, ITN America
Medication
management
Manage multiple medications Prevent in‐home accidents Sharpen (aid) memory
Medication reminder gadget or service: Glowcap, GreatCall, Independa
Automatic medication dispenser: InRange, Senticare
Emergency Detection
and Response
Detect falls Send alerts when lost Prevent in‐home accidents
Fall detection sensor: Philips AutoAlert, Halo Monitoring, Wellcore
Home activity/ hazard monitoring sensor: WellAware, Grandcare, AFrameDigital, Tunstall
PERS service: Philips Lifeline, AMAC
PERS devices: LogicMark, Visonic
GSP tracking device/service: Healthsense, LoJack
Navigating the
Healthcare System
Manage multiple medications Manage healthcare costs Evaluate quality of care Navigate health system Plan for end of life care
Health Concierge Services: Health Champion, Concierge Health Services
Cost comparison app or service: Castlight, GoHealth, GoodRX
Care quality rating services: HealthGrades, Vitals.com, Carechex
Online support group and resource portal: WebMD, GrowthHouse.org, Compassionandsupport.org
Figure 3: Leading Needs‐Based Healthy Living Opportunities in the 50+ Market
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3.0 Evaluation of Leading Market Opportunities
3.1 Framework for Evaluating Opportunities
To determine the leading opportunities in the 50+ healthy living market, Parks Associates took a two step
approach: first, we evaluated the ability of current solutions to meet market needs, and second, we evaluated
the growth and revenue potential of new or improved solutions in each of the nine challenge areas.
Existing solutions addressing the nine healthy living challenges – such as those listed in the third column of
Figure 3 above – were assessed according to the solution’s ability to meet the needs of the market, the maturity
of the technology used, and the solution’s consumer appeal. The results indicate whether current solutions in a
challenge area are meeting the needs of the market, and if not, whether there is room for new solutions to
differentiate from current ones. The following matrix provides greater detail of this evaluation strategy.
Figure 4: Current Solutions Evaluation Matrix
Evaluation Criteria Rating 1 Rating 3 Rating 5
Access Convenience Offline only Offline + Online Offline + Online + Mobile
Educational MaterialBasic and general
Condition‐specific, credible
sources
Condition‐specific, credible
sources, personalized
Functional Richness Analog functionality
Digital functionality
(Processes, stores, analyzes
data)
Sensor functionality
(Collects data without manual
consumer input)
Motivation/Incentives
Self‐motivation
Incorporate 1 motivator:
‐ Social engagement
‐ Gamification
‐ Physician Rx
‐ Financial Incentive
‐ Other
Incorporate >1 motivator:
‐ Social engagement
‐ Gamification
‐ Physician Rx
‐ Financial Incentive
‐ Other
Action facilitation
Does not provide tools for
action
Partners with solutions for
actionProvides tools for action
Notification, Feedback &
Consultation None
Provides alerts & feedback for
self‐use
Provides data and alerts to
caregivers or care providers for
intervention/consultation
Technology Maturity
Unstable technology, high cost
curve, interoperability issues
Developing technology, costs
declining
Mature technology, scale
efficiencies, high usability
Design/Aesthetics
Poor aesthetic or design
creates barrier to adoption
Aesthic/design neutral. Not a
barrier, not a driver
Superior aesthetic/design
drives solution adoption
Consumer Awareness
Low: needs marketing or new
positioning
Medium: Specific consumer
segments aware of product
High: most 50+ consumers
aware of solution
Affordability
Priced out of most consumers'
budgets
Cost justifiable to those who
need solution
Low out‐of‐pocket costs (may
include 3rd party payor)
Current Solution Evaluation Matrix
Solution Utility
Technology Maturity
Consumer Appeal
Total Possible Scoring range = 10 to 50
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In addition to the ability to differentiate from current solutions on market, each challenge area was also scored
according to its growth potential, revenue potential, and barriers to entry/risk factors. Figure 5 illustrates the
scoring matrix for the market opportunity posed by each challenge area.
Figure 5: Market Opportunity Assessment
Rating 1 Rating 2 Rating 3 Rating 4
Ability to
Differentiate
Ability of existing solutions
to meet market needs
(sub‐rating score)
Market needs
met:
40 to 50
Market needs
largely
addressed:
30 to 39
Market needs
underaddressed:
20 to 29
Substantially
underserved
market needs:
10 to 19 35%
Growth potential
Addressable market
(size of 50+ market,
applicability beyond 50+),
growth potential
Small
market/low
growth
Small
market/high
growth
Large
market/low
growth
Large
market/high
growth 20%
Revenue potential
Business model maturity
and revenue potential
Low revenue
potential/
stable
business model
Medium revenue
potential/less
defined business
model
High revenue
potential/less
defined business
model
High revenue
potential/likely
sustainable
business model 25%
Barriers to entry/
Risk factors
Regulatory/policy risks,
partnership opportunities,
patent/legal issues,
presence of dominant
market forces
High with
barriers
unlikely to
change long
term
Moderately high
with barriers
likely to change
short‐term
Medium with
predictable
risks/barriers
Low with
predictable
risks/barriers 20%
Market
Opportunity Evaluation Summary
Rating BreakdownWeight
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3.2 Comparative Assessment
All nine challenge areas present solid opportunities for investors and entrepreneurs. Due to particularly
favorable market conditions, three challenge areas scored 75 or higher, on an index of 100, representing the
best of these nine opportunities for new investment.
Medication management (84/100): a large addressable market is underserved by current medication
management solutions. There are distinct ways new technologies could help the acute issue of
medication non‐compliance, profitably.
Vital Sign Monitoring (79/100): most vital sign monitoring devices on market fall short of making
collected data meaningful to users. Strong growth in the connected vital sign monitoring market is
expected, thanks in part to health reform incentives.
Aging with Vitality (75/100): there is proven demand from a large market of aging adults for solutions
to help them see, hear and move better. Current solutions are single‐purpose devices or services with
outdated designs, which opens clear avenues for new solutions to differentiate.
Figure 6 reveals the full results of the opportunity evaluations. The table illustrates the opportunity areas’
relative attractiveness before projections of total revenues, revenue variance and adopters are considered. After
constructing market forecasts, Parks Associates’ final ranking of the nine opportunity areas was adjusted slightly,
as illustrated in Figure 12.
The following sections provide detailed information supporting our evaluation of the market opportunities
presented by each challenge area. Ratings highlighted in green indicate the highest score(s) received for that
metric, while red indicates the lowest score(s) received for that metric.
Figure 6: Opportunity Evaluation Results
Opportunity rating
Rating + Weight = Category Sub‐Score Rating WeightSub‐
ScoreRating Weight
Sub‐
ScoreRating Weight
Sub‐
ScoreRating Weight
Sub‐
Score
Medication Management 4 35% 1.4 3 20% 0.6 3 25% 0.75 3 20% 0.6 3.35 84
Vital Sign Monitoring 3 35% 1.05 2.5 20% 0.5 4 25% 1 3 20% 0.6 3.15 79
Aging with Vitality 3 35% 1.05 3 20% 0.6 3 25% 0.75 3 20% 0.6 3 75
Navigating Care 3 35% 1.05 2.5 20% 0.5 3 25% 0.75 3 20% 0.6 2.9 73
Emergency Response 3 35% 1.05 3 20% 0.6 3 25% 0.75 2.5 20% 0.5 2.9 73
Social Engagement 3 35% 1.05 2.5 20% 0.5 2 25% 0.5 3.5 20% 0.7 2.75 69
Physical Fitness 2 35% 0.7 3.5 20% 0.7 2.5 25% 0.625 3 20% 0.6 2.625 66
Diet & Nutrition 2 35% 0.7 3 20% 0.6 2 25% 0.5 3 20% 0.6 2.4 60
Behavioral & Emotional Health 2 35% 0.7 3.5 20% 0.7 1.5 25% 0.375 3 20% 0.6 2.375 59
Total
Raw
Score
Opportunity
Attractiveness
Index
Potential for
DifferentiationGrowth Potential Revenue Potential
Barriers to Entry/
Risk Factors
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3.3 Opportunities Addressing Medication Management
The market for medication management is huge yet underserved. An estimated 80 million
people ages 50 and older take two or more medications, a number which is projected to
rise to 91 million in 2018. Existing solutions are either too casual, focusing only on the
medication reminder side, or too complex (thus costly) in counting and dispensing pills.
Opportunities exist for new ways to track medication usage without the hassle of
owning a bulky piece of hardware or subscribing to an expensive medication tracking
service.
The medication management market is a dynamic one, with a number of new solutions
hitting the market in the past 3‐5 years. Hardware and software innovations attempt to
improve upon the analog solutions that are widely used by older consumers to manage
their medications today. Solutions like pillboxes are cheap and widely available but rely on
the consumer to understand their medication instructions, identify pills accurately,
remember to take their medications at the right time consistently and provide users and
caregivers with little to no feedback on compliance.
Mobile applications address a number of medication management issues, such as
identifying pills, providing information on common side effects, scheduling medication
reminders, and alerting users of potential drug interactions. Some apps also alert users
when prescriptions need to be refilled and connect users to their pharmacies. These
applications are cheap and user‐friendly, but most require the user to own a smartphone
and rely on consumers to manually enter accurate medication and dosage information.
New pill packaging form factors attempt to collect medication compliance information
automatically for greater convenience and accuracy. Smart pill bottle and smart blister
packaging solutions from companies like Vitality GlowCaps and OtCM are expensive and
will have greater success partnering with disease management companies or gaining
reimbursement from insurers than selling direct‐to‐consumer. Solutions that require a
specialized in‐home device that is programmed remotely, such as InRange’s Emma device
and SentiCare’s PillStation, also must seek alternative avenues of generating revenues and
suffer from poor aesthetics.
The ingestible sensor system developed by Proteus Digital is extremely innovative and
takes much of the responsibility of tracking medication compliance out of consumers’
hands. Even though this system has attained FDA approval, it is still many years out of
mainstream adoption and will potentially suffer from consumer resistance to the idea of
“digestible electronics.”
Challenge Statement
Limitations of Current Solutions
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Difficulty identifying pills Confusion over care providers’ instructions regarding dosage, interactions, etc. Limitation on the number of pills physical solutions can accommodate
Bulky design for most automatic medication dispensers
High cost of connected medication management devices without insurance coverage
The medication management market is getting crowded, but is still in its early days. The
need to increase medication compliance is acute and incentives to improve care
accountability will likely increase interest in medication management solutions among
care providers and payers. The market is large and the revenue opportunity is high.
Overall Attractiveness Index: 84 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate High, as current solutions fall short of addressing
medication compliance in a cost‐effective way, and no
leader has emerged among the connected management
solutions
Growth potential Large unmet need with high growth potential; applicability
beyond 50+ market
Revenue potential Potentially high revenue opportunity with potentially new
business models to drive greater adoption
Barriers to entry/
risk factors
Potential patents governing automatic dispensing methodology or packaging design of pill dispensers
Retail distribution partnerships may be difficult to forge
Medication reminder apps lack a method of automatically detecting compliance
information and most current pill box solutions lack a comprehensive online/mobile
application. Solutions should be integrated so that a user with a basic mobile phone can
receive simple medication reminder messages and smartphone users can access an app
capable of more complex tasks such as idenfitying pills, viewing dosage information,
displaying instructions to refill the pill box, automatically refilling a prescription when it
is depleted and displaying the user’s medication compliance history.
A subscription service enabling care providers or caregivers to intervene if an individual is non‐compliant; applicable to a smaller user group with high compliance requirements.
Digital medication scanner (2D/3D barcode or NFC) that creates a medication log, which
can be shared with the patient’s pharmacist to assess compliance, to send alerts if
intervention is needed, or to enrich loyalty/reward programs
Summary: Major Pain Points
New Product/ Service Concept
Opportunity Assessment
Opportunities to Improve on Existing Solutions
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3.4 Opportunities to Enable Aging with Vitality
After the age of 50, a majority of people experience common age‐related conditions,
including memory loss, vision and hearing impairment, and arthritis. An estimated 44
million consumers ages 50 and older could benefit from solutions that address or manage
these symptoms in 2013 alone. Current solutions on the market tend to be single‐
purpose devices or services with outdated designs. The market calls for function‐rich
devices with a better design/aesthetic appeal that use emerging input technologies to
improve ease of use.
Current solutions on market addressing the common symptoms of aging tend to be analog
products. Consumers rely on print calendars and to‐do‐lists to remember important dates
or tasks, turn up the volume on TV sets and cell phones to assist their hearing, use
magnifying glasses or enlarge computer fonts to assist their vision, use canes to assist in
walking and claws to grasp onto hard‐to‐reach objects. These products are readily
available and are typically low cost. Still, new solutions on market incorporate new
features and techniques that may be more effective and more valuable.
Technologies addressing memory loss include memory aids as well as solutions to help
improve memory skills. Online and mobile to‐do‐lists send email alerts and text messages
to remind an older adult to perform a certain task, giving the traditional “to‐do‐list”
concept anywhere/anytime availability. Even more valuable is the ability to contribute to
reminder lists collaboratively. Online and mobile app Astrid, for instance, allows other
household members or caretakers to add or delete tasks from the list. Some reminder
apps, such as the iPhone 5’s Reminder app, also integrate geo‐fencing technology so that
users can set reminders according to their location, in addition to date and time. These
reminder apps require smartphone ownership and their complexity may be a barrier for
some older adults
Solutions designed to improve memory skills are typically designed as games, puzzles or
other cognitive challenges. Brain game services like PositScience and Lumosity are well‐
designed and easily accessible solutions to enhance cognitive skills. Subscriptions fees are
relatively low, but more research and marketing needs to be done to convince users of
the credibility of such services.
The market for solutions assisting hearing has seen new entrants as well. Until recently
the personal sound amplifier market has been characterized by relatively cheap, clunky,
unappealing devices. Worse, the marketing for such devices is so elderly‐focused that an
unnecessary stigma may be attached to this category. New entrants from consumer
electronics manufacturers, such as Able Planet and RCA, should improve the design and
Challenge Statement
Limitations of Current Solutions
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image of these devices. Price ranges for personal sound amplifiers vary widely (≈$35 ‐
$899), so some consumers may not be able to afford their desired device.
Developing technologies such as voice recognition, gesture recognition and text‐to‐speech
could serve as the foundation for solutions to assist those with vision impairment and
those struggling with fine motor skills. Using these technologies, developers and
manufacturers have a great opportunity to create solutions for easier device control and
data input than current methods (e.g., pushing small hard‐to‐see buttons on a remote
control, typing a text‐message on a small virtual keyboard). Because common digital
devices are typically designed for and marketed to younger generations, solution
providers can differentiate themselves by incorporating these technologies to make
device interaction as friendly as possible for older adults.
Benefits of most cognitive improvement services/brain games need more scientific
research
Advanced memory aid solutions require smartphone ownership and advanced digital
literacy
Emerging technologies like voice and gesture recognition are still developing
There is proven demand for products and services that help consumers 50 and older
compensate for certain side‐effects of aging. Well designed, aesthetically appealing
solutions that are moderately priced could easily differentiate from current solutions.
Overall Attractiveness Index: 75 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate High: a broad range of needs can be addressed through
improved technology and solutions
Growth potential Large market with relatively large growth potential
Revenue potential High revenue potential with likely sustainable business
models
Barriers to entry/
risk factors
Technology/patent licensing from potential partners
Sales and marketing investment required to raise awareness of new solutions’ benefits over older options
Technology reliability and accuracy
In some instances, clinical benefits need to be obtained through well designed trials
Summary: Major Pain Points
Opportunity Assessment
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Brain game services should allow users to track their cognitive skills over time to detect
not only if their skills are improving, but also if they are deteriorating. While a decline in
cognitive skill cannot diagnose a clinical problem, it may serve as a red flag or early
warning system for the onset of dementia. An opportunity exists to explore the clinical
uses of longitudinal cognitive skills tracking.
There is a need for solutions that remind older adults “how” to perform a process‐based
task, such as cooking, in addition to simply reminding consumers “when” to perform a
task. A video diary solution that helps users or caregivers record, organize and access
videos in a very simple way could be a great resource for older adults
Invest in companies producing the underlying technologies rather than specific
solutions: High‐Definition (HD) voice, Location‐Based Services (LBS), voice recognition,
gesture recognition, text‐to‐speech functionality.
Augmented reality‐based solutions that show users the effects of aging and how
behavior changes could impact the aging process, with the goal of encouraging healthy
behaviors through fun and informative engagement.
New Product/ Service Concept
Opportunities to Improve on Existing Solutions
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3.5 Opportunities in Vital Sign Monitoring
An estimated 79 million consumers ages 50 and older live with at least one severe chronic
condition. Proper interpretation of vital sign data followed by an actionable plan is critical
to older adults’ ability to self‐manage their conditions and for general healthy living. Most
vital sign monitoring devices on the market fall short of making collected data meaningful
to end users. The high cost of new connected solutions, along with the use of different
networking standards for data transfer, further inhibits market adoption. The market calls
for an interoperable ecosystem of devices that will allow users to monitor multiple vital
signs and receive feedback through one central application.
Basic analog and digital scales are the most common vital sign monitoring devices, but
Parks Associates data also indicates that as many as 2 in 5 consumers ages 50 and older
living in broadband households owns a blood pressure meter and nearly 1 in 5 owns a
glucometer.72 These devices are widely available and some are covered by health
insurance at low or no cost to the consumer. Yet, data is trapped in the device with little
to no feedback and no analysis of progress over time is provided. Few solutions send data
to care providers or caregivers to intervene if vital signs are abnormal.
New solutions in this market are helping consumers make more meaningful use of the
data collected by vital sign monitoring devices. Using a variety of communication
technologies – wired and wireless – scales, blood pressure meters, glucometers, and even
toothbrushes monitor health data, transfer that data to a mobile application and provide
feedback to the user. Some solutions also give users the ability to share that data with
physicians. However, connected vital sign tracking devices are priced higher than
traditional solutions and many require smartphone ownership for data collection and
analysis purposes.
Vital sign tracking solutions that can appeal to a broader market than one particular
disease condition will be more successful. WiThings is perhaps the best example of a
company creating an ecosystem of connected health tracking devices: it offers consumers
a connected scale and blood pressure meter and partners with manufacturers of sleep
monitoring and physical activity monitoring devices. Users can set goals, track their
progress and receive motivational messages from the WiThings app or they can export
their data to one of WiThings’ health and wellness partners. WiThings’ products can be
used by multiple householders, with a dashboard that can handle up to 8 users. Users also
can export health data collected by WiThings into their personal health record with
72 Parks Associates, Managing Care through ACOs: Consumer Interests and Requirements, December 2012.
Challenge Statement
Limitations of Current Solutions
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Microsoft Health Vault. Still, connected vital sign tracking devices are quite expensive and
their high‐tech nature may be intimidating to older consumers.
Another approach is to offer consumers the ability to perform self‐examinations as a
prevention technique for certain conditions like skin and breast cancer. Existing mobile
apps and web solutions instruct users on how to conduct a self‐exam, remind them to
perform self‐exams regularly and provide tools to track any changes or concerns. Some
also provide consultation services from dermatologists who review users’ photos of their
skin. These new solutions make monitoring one’s breasts and skin for changes more
convenient for older adults and are moderately priced. However, these services rely on
users’ self‐motivation to consistently engage in these preventative measures. Uptake and
revenue potential may be marginally better for services that respond quickly and credibly
to users’ concerns about suspected problems (e.g. suspicious moles), than for those
providing a largely educational or preventative service.
Finally, teleconsultation services are available that help consumers struggling with
particular conditions, such as diabetes, manage their health and wellness. Services like
Alere work with consumers to help them understand how to best manage their condition
and provide personalized interventions if the subscriber is off track. Teleconsultation
services are not directly or completely reimbursable under Medicare and most state
Medicaid programs. Clinical benefits are not well communicated to target users resulting
in low compliance.
Low awareness of the benefit of self‐monitoring
Lack of feedback on progress for users of standard vital sign monitoring devices
Lack of data integration between various health monitoring solutions
Lack of data integration with care providers for medical intervention if necessary
High cost of devices if uninsured or not reimbursed by insurer
Adding connectivity to standard vital sign tracking devices increases their usability, but
connected health monitoring devices are still costly. Adoption wil grow significantly as the
technology matures; reimbursement of connected trackers should expand as they prove
their ability to improve care outcomes or reduce care costs. Reimbursement for
teleconsultation services will also increase under the ACO model, which provides more
incentives for preventative care.
Summary: Major Pain Points
Opportunity Assessment
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Overall Attractiveness Index: 79 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate High for a complete chronic care solution: more affordable
solutions with improved ease of use and concrete health
benefits as an incentive are needed
Growth potential Large market with moderate growth potential
Revenue potential High revenue potential with likely sustainable business
models
Barriers to entry/
risk factors
Difficulty getting into retail distribution channel Multiple networking protocols compound interoperability
complexity
Medical liability risk associated with the use of a monitored
service
Investment in service capability can be costly
Competition from existing providers, like Alere
The market needs an ecosystem of moderately‐priced interoperable devices that can
monitor multiple vital signs and report all data back to one application for feedback and
analysis. The solution should offer the ability to share data with a user’s PHR, care
providers and caregivers. The solution should incorporate reminders as well as a rewards
system to encourage users to monitor their health regularly.
Wearable sensors built into commonly used products that are less intrusive to use, such
as a pillow, chair, watch or clothes, to reduce the need to wire up or use specialized tools.
New Product/ Service Concept
Opportunities to Improve on Existing Solutions
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3.6 Opportunities in Care Navigation
The U.S. healthcare system is exceedingly complex and consumers have difficulty
understanding their options regarding care access, quality, and cost. Innovations that aim
to streamline the experience for consumers face systematic resistance to transparency.
Current solutions suffer from a siloed approach to sharing health data with consumers,
and fall short on interpreting data to consumers in a meaningful way. The market needs
well‐organized information and customizable assistance programs to meet healthcare
consumers’ needs. A conservatively estimated 35 million consumers ages 50 and older
would be strongly interested in receiving such a service immediately.
A few solutions on market are designed to ease the many pain points of navigating the U.S.
healthcare system, but all have very low uptake currently. Many of these services require
high Internet literacy as many of the online portals can be confusing for older consumers
to navigate.
Health concierge services guide consumers through some of the decisions needed for a
care episode, such as understanding symptoms they are experiencing, deciding when and
if to see a doctor, and choosing the right doctor to address the condition. Some services
also act as patient advocates for obtaining second opinions and dealing with insurance
coverage issues. Currently, few doctors practice concierge care and most high‐end
concierge services charge an annual membership fee starting from $1,500, making them
less affordable to ordinary families. The market for online concierge services is growing,
but must overcome consumers’ desire to meet their concierge doctor face‐to‐face.
New web portals and mobile applications offer symptom‐checking, links to local doctors’
offices, doctor ratings, online appointment scheduling capability, and online paperwork
preparation prior to a face‐to‐face appointment. These services are growing and major
health insurers, like Aetna and Humana, have been investing and acquiring companies in
this space. Cost comparison services are also hot, but face typical start‐up challenges: low
consumer awareness, incomplete cost data, and limited coverage of healthcare facilities
and procedures. Additionally, current solutions serve only certain parts of the market (e.g.,
a certain insurer’s subscriber base, employer‐based healthcare), and as such their scale is
limited.
New online sites offer consumers the ability to rate and evaluate doctors and healthcare
facilities. While consumers generally trust ratings from peer groups, the personal nature
of care experience and varied care quality perceptions keep users wondering whether
consumer reviews alone offer complete information. Government portals also provide
clinical performance data in a report card format, but the evaluation metrics require a
Challenge Statement
Limitations of Current Solutions
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high‐level of clinical literacy to understand, making these solutions less useful to ordinary
consumers.
Finally, online resources such as Compassionandsupport.org, GrowthHouse.org, and
WebMD provide educational information about end of life planning. Most hospitals offer
hospice care as a listed service and home care agencies also offer hospice care in specific
locations or via home visits. Other than those informational portals and on‐the‐ground
services, there are few entrepreneur activities in this care arena.
Paid concierge service remains a novel concept; consumer awareness and willingness to
pay are low
Portal and tool usability needs improvement; health data and care evaluation data
sometimes provided in unclear terms
Insurers and health care providers are not inclined to share cost and quality data, fearing regulation non‐compliance and loss of competitiveness
Revenue/business models are still in an early stage of development
Many solutions solve just one aspect of the care navigation problem, meaning consumers
must reference multiple sources to navigate just one episode of care
Impending health care changes means there will be more transparency throughout the
health care system. With more information available to consumers, care providers and
insurers will need solutions that differentiate their services, reduce churn and control costs.
In these early days, many solutions provide the answer to just one question, but more
comprehensive solutions are needed.
Overall Attractiveness Index: 73 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate Medium High: current solutions lack sufficient data of health
system performance for public use; business models still
evolving for health concierge services, cost comparison
portals, and provider ratings sites
Growth potential Could affect a large market, but growth rate dependent on
uptake of emerging technologies and ability to overcome
significant obstacles
Revenue potential Medium revenue potential with less defined business models
Summary: Major Pain Points
Opportunity Assessment
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Barriers to entry/
risk factors
Ability to scale nationally limited by lack of quality metrics for comparison sites and qualified providers for concierge services
High marketing costs to raise awareness
Outdated regulations that constrain business expansion or service innovations
Competition from a few early movers in this market
An online portal and service, with accompanying mobile application, that acts as a
comprehensive care navigator through an entire care episode. It would help consumers
evaluate their medical issues, determine if and when to see a doctor, and provide insight
into the cost and quality of services offered by care providers. It should also (natively or
through partnerships) store a consumer’s personal health records, evaluate his or her
insurance benefits coverage, and assist in filing insurance claims. This portal should allow
users to set flexible permissions so caregivers can see some or all of their health activities,
especially regarding end‐of‐life planning.
A digital medical care planner app that offers interactive, step‐by‐step instructions to find
resources for patients’ needs.
New Product/ Service Concept
Opportunities to Improve Existing Solutions
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3.7 Opportunities Enabling Emergency Detection & Response
Over 5 million older consumers fall annually and over 7 million older consumers pose a
wandering risk. Solutions that can detect and initiate a response to emergencies –and in
the future can potentially prevent adverse incidents– will see consistent demand. Current
solutions suffer from an image problem with consumers. Vendors have not moved fast
enough to incorporate the latest mobile technology, and fail to make self‐installation easy
and convenient. Opportunities are abundant to improve current emergency detection
and response solutions for a better user experience and higher adoption rate.
The most prevalent technological approach on market today for responding to falls – the
leading cause of injury among older consumers – is a monitored Personal Emergency
Response System (PERS) with a wearable panic button. The PERS device market has been
relatively static, and faces a number of barriers to growth. First, past marketing efforts
have emphasized the frailty of the user, which has attached a stigma to device use;
consumers rarely view themselves as “sick enough” to justify using the device and many
consumers are wary of being branded as frail. This image issue is compounded by the
unattractive designs of most wearable panic buttons. Traditional PERS devices are also
limited by their ability to work only within the home and only if the user is mobile enough
to press the panic button.
Recently, OEMs have introduced new features, such as emergency response outside of
the home and automatic fall detection, to push beyond some of these limitations. These
benefits are not well known and devices with automatic fall detection are generally more
expensive. Some OEMs, like Lifecomm, are also taking steps to improve design, though
they are currently the minority. Notably, technologies addressing in‐home falls typically
focus on the need to initiate a medical response to the emergency, with few solutions
designed to prevent falls. Solutions that help older consumers improve their strength and
balance could be positioned as fall prevention technologies.
Solutions also exist to address other in‐home emergencies and accidents that may result
from an older consumers’ mobility issues or forgetfulness. Standard smoke and carbon
monoxide detectors are cheap, ubiquitous and serve the basic purpose of alerting
householders of an emergency situation. Some wireless smoke and carbon monoxide
detectors now offer an additional layer of functionality: sending alerts to family members
or emergency responders if a concentration of either is detected. Home monitoring
sensors from companies like Wellaware also alert caregivers of an emergency if those
sensors detect that the person being monitored has exhibited an unusual pattern. Finally,
safety devices are available that can automatically turn off the stove and oven if left on for
too long. These advanced emergency detection sensors and devices are relatively
Challenge Statement
Limitations of Current Solutions
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unknown and suffer from very industrial design. Home monitoring sensors and services
are still a niche product and priced out of the range of many older consumers.
Finally, current solutions to assist people who are lost or who wander from home are
available from both the private sector and government programs. Twenty‐nine states
have some form of recovery program targeting missing seniors, often referred to as “Silver
Alerts.” There is movement at the federal level as well to provide similar support and
funding for recovery assistance for older people who are lost. Of course, these programs
should be used as a last resort when wandering prevention techniques have failed or
when caregivers are unaware that the person is missing.
From the private sector, mobile phones enable people who are lost or confused to call
relatives or friends for help – provided the wandering person is aware he or she is lost. For
those caring for an older adults suffering with dementia, wireless door sensors can alert a
caregiver should a person with wandering issues leave the home unexpectedly. Solutions
using the GPS on a cell phone or a wearable device provide even greater functionality:
geo‐fencing technology determines when a person travels beyond a pre‐set zone, alerts
caregivers that he or she needs help, and directs the caregiver to the current location of
the wandering person.
Stigma related to PERS for fear of being labeled as fragile and weak
Aesthetic and design issues inhibit PERS wearability Low awareness of home and hazard‐monitoring sensors
Reliability of sensor technology, potential for problems with false alarms
Cost of whole‐home sensor deployment is still too prohibitive
Alternatives “safety nets” available: family members, mobile phone
The PERS market is a low‐growth mature market, but significant opportunities exist to
attract slightly younger, image‐conscious consumers. The growth projections for dementia
in the near term reveal a solid opportunity to address wandering. Data suggests that
caregivers find emergency detection and response services and devices much more
appealing than potential users, but few existing solution providers prioritize care givers.
Summary: Major Pain Points
Opportunity Assessment
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Overall Attractiveness Index: 73 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate High: opportunities to improve on function and design. Most
solutions on the market are reactive services; ability for
proactive services to differentiate.
Growth potential Limited size of addressable market with low growth for
current solutions; new innovations may trigger dormant
demand to spur higher growth
Revenue potential Large revenue potential with likely sustainable business
models
Barriers to entry/
risk factors
Competition from existing solution providers
Installation of sensors and monitoring systems can be costly for start‐up companies
Potential liability risks associated with a missed event or slow response
Patents on certain features such as two‐way voice communications may not be licensed or licensed on unfavorable terms
Consumer stigma toward PERS
Emergency prevention technology is still in development
A moderately‐priced, sleek‐looking solution that works outside of the home and can
detect falls automatically: design options should be available to appeal to consumers of
different ages and genders. Marketing to caregivers should be prioritized and online
portals or mobile phone applications must incorporate caregiver notification.
A combined PERS/wandering detection/medication management service that
incorporates caregiving responsibilities: a comprehensive solution that provides
emergency detection and response for a number of use cases and allows
users/caregivers to select one or a bundle of services. This centralizes multiple
caregiving tasks and can provide more functionality at lower cost than would stand‐
alone solutions.
Technologies addressing in‐home falls typically focus on the need to initiate a medical response to the emergency, with few solutions designed to prevent falls. Solutions that help older consumers improve their strength and balance could be positioned as fall prevention technologies. There could be opportunities for partnerships between PERS service providers and fitness equipment manufacturers or gaming console providers to engage older consumers in balance‐improving exercises.
New Product/ Service Concept
Opportunities to Improve Existing Solutions
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3.8 Opportunities Addressing Physical Fitness
Physical fitness is fundamental to older adults’ ability to live a satisfying and independent
lifestyle, thus representing an attractive business opportunity. Yet, 38 million consumers
ages 50 and older are obese and a third of Americans 65 and older engage in no leisure‐
time physical activity. Most solutions on market today either fall short on interactive and
self‐motivation features, or are designed and priced for younger demographics without
careful consideration of the 50+ population’s needs, habits, or purchasing power. The
market calls for a more affordable solution with a basic set of interactive features that
older consumers feel are comfortable to use and valuable to their lives.
The current market for physical fitness solutions is quite robust, but with a catch—
solutions are either designed for people with high digital literacy (younger demographics)
or are offered in traditional form factors that lack interactivity and personalized feedback.
The priority for consumers 50 and older is to understand how regular exercise leads to
better health and to engage in age‐appropriate exercises. Traditional solutions (e.g.,
fitness equipment or gym classes), do not offer fitness education through interactive
programs and personalized data that show what type of exercise for how long is
appropriate based on people’s age and health conditions – with the exception of personal
trainers, who are often priced out of the typical 50+ consumers’ budget.
Fitness classes along the model of Silver Sneakers provide people ages 50 and older a
socially engaging and age‐appropriate way to engage in physical exercise. Class instructors
provide personal health and fitness consultations and consumers are largely aware of
fitness classes at their local gym or YMCA, where such programs take place. Silver
Sneakers is offered as a benefit of many Medicare plans so cost is not a barrier to use. The
program has a website for users to track manually their fitness goals and activities and to
request advice from experts in nutrition, fitness and managing stress. Silver Sneakers is
innovative in its approach and business model, rather than in its use of technology. Fitness
classes for older consumers have the best marketing and outreach programs, but uptake
is still low.
Some emerging technology solutions on market offer innovative features but do not focus
on consumers 50 and older as target users. Connected fitness equipment, like iFit‐
enabled treadmills, and wearable fitness devices, like Jawbone Up, make it easy for
consumers to make goals, collect their fitness data, and track their progress. Yet these
devices are cost‐prohibitive for many older consumers and typically lack motivational and
educational elements that are unique to the 50+ population.
Challenge Statement
Limitations of Current Solutions
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
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Online and mobile exercise trackers also help consumers track their fitness progress, but
often rely on the user to accurately and consistently input their fitness data. Solutions like
Endomondo and Runkeeper include integration with social networks and include
gamification elements (like entering into fitness “competitions” with friends) to keep
users motivated. The solutions themselves are low cost, but are most useful to
smartphone owners, which limits their reach. Like connected fitness devices, these
solutions are marketed at younger demographics so most consumers ages 50 and older
are likely unaware such solutions are available to them.
Low or inconsistent motivation to exercise
High cost of some fitness devices, gym memberships and personal trainer services
Lack of personalized instructions on how best to engage in age‐appropriate exercise Lack of feedback on performance
Product design sometimes deviates too far from common fitness device form factors,
which undermines adoption among people 50+
Lack of marketing efforts targeting 50+ to raise awareness and stimulate purchase
interest
While physical fitness tools are abundantly available, opportunities exist for solutions that
can motivate new consumer segments to exercise and market specifically to the 50+
population. New connected solutions offer exciting engagement tools, using instant
feedback, goal‐setting applications, social networking and gamification elements to
motivate users to maintain an exercise program. However, current solutions are too
cutting‐edge and high cost for most mainstream older adults.
Overall Attractiveness Index: 66 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate Medium: crowded market, but the 50+ population’s needs are
overlooked
Growth potential An underserved market with potential high growth
Revenue potential Medium sized revenue potential with less defined revenue
models
Barriers to entry/
risk factors
Brand loyalty to existing solutions Awareness among consumers 50+
Patents on algorithms for sensor data interpretation and data communications methods between host and peripheral applications
Application integration and partnership challenges
Summary: Major Pain Points
Opportunity Assessment Opportunity Assessment
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Current fitness tracking devices need to come down in price for mainstream adoption.
Stand‐alone sensors that are not integrated into expensive wearable devices (like
sneakers), but instead could be simply clipped to a user’s clothing, may be an option to
reduce costs. To expand beyond smartphone users, solutions could pair sensors with a
USB‐based receiver to wirelessly send data to a computer.
The market for physical fitness solutions could be enlarged tremendously if better
motivational tools are provided to attract new consumers, in addition to those who are
already engaged in fitness activities. Parks Associates research reveals that bringing
consumers’ care providers into a health and wellness program is a top motivational
factor for those who do not exercise regularly. Doctors are consumers’ most trusted
source for health and wellness information and consulting with doctors is by far the
most common activity consumers take to manage various health conditions.
Furthermore, 27% of consumers ages 50 and older who rarely exercise report they
would be motivated to better manage their health conditions if they could receive a
personalized action plan from a care provider that they could follow on their own.73
Beyond providing a role for care providers, fitness solutions should include other motivational factors, such as allowing users to post fitness goals and progress on social
networks (accountability), involving family members and friends in the fitness process
(encouragement), launching group contests to reach individual or common goals
(competition). Additionally, online and mobile fitness tracking applications should offer
daily feedback, recommend more or less intensive routines based on age, display fitness
history and health condition, and provide video demonstrations of correct form when
exercising.
A partnership between offline adult fitness class operators (e.g. SilverSneakers, Curve) and fitness tracking device manufacturers to provide age‐appropriate exercise
instruction with advanced tracking and feedback capabilities; offered as a service.
Longer‐term, a solution that links vital sign tracking, dietary tracking and fitness tracking
functionality with physician input/feedback
Digital fitness trainer solution that offers personalized/interactive fitness classes through a streaming video service to the users’ preferred device.
73 Parks Associates, Managing Care through ACOs: Consumer Interest & Requirements. 2012
New Product/ Service Concepts
Opportunities to Improve Existing Solutions
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3.9 Opportunities Supporting Social Engagement
Staying engaged with family, friends and the community is vital to healthy aging, with
multiple physical, behavioral and emotional health benefits. There are ample free
opportunities for older adults to engage with others in the community but mobility and
transportation barriers prevent some seniors from taking advantage of these services.
There is an opportunity for solutions to help as many as 64 million consumers age 50
and older to overcome mobility barriers and for simple, easy‐to‐use technologies to
bring more compelling engagement from the comfort of home.
The current market addressing social engagement for older adults prioritizes face‐to‐face
contact. Local senior centers, places of worship, residential communities for older adults,
and social & veterans clubs provide plenty of low‐cost or free social gatherings and events.
Part‐time work, volunteering, attending religious functions and playing a role in caretaking
for grandchildren can help older adults retain a sense of purpose. Still, these more
traditional means of social engagement are unable to reach many older adults or are
insufficient for solving some social engagement problems.
The basic barrier of transportation for older consumers who can no longer drive, or drive
in a limited fashion (e.g., only in the daytime, only in good weather), is addressed in some
communities by public transportation. To supplement public transportation, companies,
like SilverRide, and non‐profit organizations drive older consumers on an as‐needed basis.
ITNAmerica, a non‐profit organization, provides door‐to‐door transportation in private
vehicles for a yearly membership fee and a per‐ride fee that is roughly half the cost of taxi
services. SilverRide is a private company providing similar services, but limited to the San
Francisco area; it is unclear whether the SilverRide model would be sustainable in other
markets or in markets competing with non‐profit organizations like iTNAmerica.
Other solutions on market address older consumers’ in‐home communication and social
engagement needs. While landline phones are still widely used by older Americans, cell
phone penetration has surpassed two‐thirds of the 65+ population and more than half of
the same age group uses the Internet or email.74 Of those consumers ages 65 and older
who use the Internet, one‐third use social networking sites like Facebook ‐ a 150%
increase since 2009, according to Pew. Consumers ages 50 to 64 are even more connected,
which means engagement with online, mobile and social solutions by older adults will
continue to grow.
Opportunities for leveraging the Internet and mobile platforms as social engagement
platforms are plentiful. Older adults can stay in the loop with other family members
74 Pew Internet & American Life Project, Older Adults and Internet Use, June 6, 2012.
Challenge Statement
Limitations of Current Solutions
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through family calendar applications, can easily receive and view pictures of grandkids
through picture sharing websites and social networks, and can engage with family
members living far away through video‐calling applications like Skype or Apple’s Facetime.
Because device manufacturers and app developers prioritize younger tech‐savvy
demographics, however, there is a dearth of simple apps that are developed for and
marketed to older consumers, creating a clear market opportunity. Apps leveraging social
networks in a simple way can help older consumers reconnect with old friends and
enlarge their social circle by making new ones.
Limited ability to leave the home due to physical mobility issues and a lack of
transportation options
Sharply reduced social circle due to moving or the passing of older friends and family
members
Unproven scalable business models for low‐cost private transportation services
Low, but growing, awareness of how social networks could be beneficial to older adults
Overall Attractiveness Index: 69 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate High: Current social engagement tools are similar and largely
overlook older adults’ needs
Growth potential Large addressable market with moderate growth opportunity
depending on business models
Revenue potential Low‐to medium revenue opportunities due to less defined
business models
Barriers to entry/
risk factors
Marketing cost could be high to build awareness of new solutions
Business/revenue models less defined
Older adults’ conservative stance on user data privacy
A social network geared towards older adults is unlikely to succeed as a stand‐alone effort, since a primary benefit of social networking for older adults is engaging with family
members in younger generations. An opportunity exists to create an application or
interface built on top of Facebook to provide older users a clean, simple user experience
with fewer moving parts. The solution must provide a simple profile set‐up process, easy
access to family and friends, and simple picture viewing.
Transportation support services can be improved through the use of online scheduling
software to offer riders and their caregivers convenient tools to schedule pick‐up/drop‐
off. Safety assurance can be enhanced through the use of GPS/geo‐fencing technology to
ensure timely arrival at the correct destination.
Summary: Major Pain Points
New Product/ Service Concept
Opportunity Assessment
Opportunities to Improve Existing Solutions
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
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3.10 Opportunities Addressing Diet & Nutrition
Proper diet and nutrition is fundamental to keeping older adults healthy and independent.
There is abundant information on healthy eating, tools to track food consumption are
widely available, and weight loss programs are moderately priced and heavily marketed.
Still, 38 million consumers ages 50 and older are obese and 42 million suffer from
hypertension and need to limit their sodium intake – these consumers need better, more
relevant, more accessible, and more personalized diet guidance. While this need is
currently served by dietitians or nutritionists within a chronic care program, the market
calls for a lighter, less expensive, self‐manageable, and personalized dietary solution.
The current market for diet and nutrition solutions is dominated by weight loss services.
Weightwatchers, Nutrisystem and Jenny Craig provide subscribers with the materials,
motivation, tools and sometimes even food items to lose weight. Consumers can track
their daily food intake manually using print, online or mobile food journals. Low‐fat and
low‐calorie recipes are available in cook books, magazines and recipe websites. Even with
these solutions available, many consumers have difficulty eating a proper diet consistently
and the nutritional needs of those 50 and older taking medication or suffering from
certain chronic conditions are much more complex than the need to simply drop pounds.
New dietary tracking apps and web portals have limitations as well. Although they help
users set diet goals, track their progress and provide feedback on the nutritional value of
users’ eating behaviors, effective diet tracking on these new device platforms also require
a high level of digital literacy, which many older consumers lack. At the same time, these
solutions do not advise on the type of food or diet based on users’ unique dietary
requirements. Meal Snap’s use of a smartphone camera to input meal data is a first step
towards removing that friction, though the technology is still unreliable and its database is
not yet comprehensive. Another application, Foodcalc, provides nutritional guidance for
consumers eating out, promising to take into account each user’s specific medical
conditions and dietary needs, but its algorithms can only analyze restaurant menu items
and its validity has yet to be market tested.
Low or inconsistent motivation to eat healthy and control portions
Lack of personalized dietary guidance or feedback based on health conditions and other dietary/nutritional goals
Limited access to healthy foods, due to mobility issues or limited options in certain
residential areas
Moderately high cost of weight loss systems
Incomplete and inaccurate nutritional information when dining out or doing grocery
shopping
Challenge Statement
Limitations of Current Solutions
Summary: Major Pain Points
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While weight loss tools are abundantly available, opportunities exist for solutions that can
drill down to an individual level taking into account specific medical needs. Few
educational and consultation services exist to help users change their food planning,
shopping, and preparation habits. Current solutions are also too focused on consumers
eating habits as a set of choices made by an individual rather than a communal, emotional
activity based on input from multiple household members.
Overall Attractiveness Index: 60 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate Solutions meet general consumer needs but opportunity
exists to differentiate solutions for people 50+ with
specific dietary needs
Growth potential Large addressable market, medium growth potential
Revenue potential Medium‐sized revenue potential with business models less
defined
Barriers to entry/
risk factors
Competition from existing weight loss services and specialized diet plan providers
Technologies and algorithms are still evolving
Low consumer awareness of new diet services and confidence in benefits
Business models remain immature
Need to form partnerships to access to food databases
Partner across device/service categories: dietary tracing devices should partner with fitness solution providers to make their services more comprehensive (e.g., Jenny Craig
with Body Media, or Spark People with Fitbit).
A healthy‐eating grocery delivery service targeting the older adult population, those with certain dietary needs, those with mobility issues or those without easy access to
nutritional food (e.g. modifcations on the Greenling.com model).
A grocery shopping guidance service or application: an in‐store dietitian (e.g. Hy‐Vee grocery store) or a digital diet assistance program on a computer or mobile phone (e.g.
FoodCalc) provides recommended food/meal options and grocery shopping lists based
on shopper’s chronic condition management needs. The digital program may offer a
dietian counciling service as a premium feature.
An augmented reality app to show fitness progress based on daily calorie intake
Opportunity Assessment
New Product/ Service Concept
Opportunities to Improve Existing Solutions
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
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3.11 Opportunities Addressing Behavioral & Emotional Health
Aging in a healthy and happy way goes beyond treating our bodies well, to improving our
behavioral and emotional health as well. An estimated 26 million consumers ages 50 and
older could benefit from a behavioral/emotional health assistance program. However,
most prevalent market solutions are inconvenient and expensive. An opportunity exists
to provide older adults a service, a venue, or a solution that helps users connect with
people with a similar background in a convenient and secured way.
Current solutions on market typically address consumers’ behavioral and emotional health
needs in condition‐specific or episodic way. Consumers can attend bereavement support
groups at local community centers or places of worship or call crisis hotlines in an
emergency. Online support groups provide an easily accessible and anonymous form of
social support for people struggling with health conditions or undergoing dramatic life
changes. Professional counseling services, which could provide more long‐term support
for any number of issues, may be inaccessible for many older consumers due to high costs.
The anonymity of receiving assistance online or over the phone helps to remove the fear
and stigma of seeking help for emotional issues. Beyond traditional peer‐based online
support groups, new online counseling services provide consumers with clinical mental
health treatment that is more convenient and possibly less intimidating than in‐office
counseling sessions. CopeToday, for instance, links users and credentialed counselors
through secure messaging, online chat, telephone and videoconference. CopeToday, and
similar services from eTherapy, HealthLinkNow.com and Breakthrough, also provide users
with counselor profiles and allow users to pick which counselor to engage with. Online
and tele‐therapy business models are immature, however, and many insurers do not yet
cover services.
New solutions are also helping consumers understand the underlying causes of behavioral
and emotional problems that can lead to poor sleep quality and high levels of stress.
Sleep trackers, such as the Zeo sleep monitor or Fitbit’s Aria product, are high tech
gadgets that can help users understand and address poor sleep quality. However, the
technology is still developing, costs are high, and older consumers may be intimidated by
this high‐tech approach.
Stress tracking and management apps – such as the StressTracker app, Cleveland Clinic’s
Stress Management app, and the Relax Stress & Anxiety Relief app – provide consumers
with an immediate means to lower stress levels, through such activities as guided
breathing exercises and meditation. Users can manually track their daily moods and stress
levels to help determine their common stress triggers. SweetWater’s SweetBeat and
Challenge Statement
Limitations of Current Solutions
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
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Affectiva’s wearable wireless Q sensors take the next step by incorporating sensor‐
technology for automatic data collection. Stress tracking apps are a cost‐effective and
always‐available solution to lowering stress, but are limited to smartphone owners and
have low revenue potential.
Social isolation prevents older adults from feeling connected, having a purpose
Unaddressed underlying problems or symptoms (e.g., poor sleep quality, high stress)
aggravate behavioral & emotional health issues
Lack of awareness of support groups Stigma associated with receiving help for emotional health
New online and phone‐based consultation services not reimbursed by payers and
awareness of these new services remains low
Overall the need for behavioral & emotional health has been addressed by current
solutions on the market but there is room for improvement, particularly regarding
convenient access and differentiated service experiences. The science behind stress
tracking algorithms can be improved as well.
Overall Attractiveness Index: 59 (out of 100)
Assessment Criteria Opportunity Assessment
Ability to differentiate Needs broadly addressed with other alternatives but current
solutions are so similar that opportunities to differentiate
from the norm exist
Growth potential Smaller market with potentially high growth due to low base
level
Revenue potential Smaller revenue potential with predictable business models
Barriers to entry/
risk factors
Competition from existing services at high and low price points: professional service providers and free online support groups
Low awareness of self‐care tools Sensors for stress tracking are still an immature technology
An online support group service that connects participants with similar backgrounds
and underlying causes, to increase users’ comfort level engaging in emotional health
discussions. Should offer the ability for people to communicate online in a group setting
using multiple communication tools, such as live chat, IM, video conferencing, and
should include an option to consult with credentialed therapists.
Summary: Major Pain Points
Opportunity Assessment
Opportunities to Improve Existing Solutions
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4.0 Market Forecasts, Investment Implications and Recommendations
4.1 Forecast Methodology and Key Assumptions
Parks Associates developed a scenario‐based revenue forecast model for market opportunities in each of the
nine challenge areas. The forecast work was conducted independently using the best available market data
from the public domain (e.g. Census/CDC data) and Parks Associates’ own research data (e.g. consumer survey
work and industry research).
These forecasts are built upon two major groups of assumptions centered on: 1) identifying the most
likely/targetable users, and 2) identifying the most likely revenue models and associated demand elasticity.
Together, these assumptions create high and low scenarios for the revenue opportunities for each challenge
area.
Step 1: Indentify the most likely/targetable users
The user assumptions start with a broadly defined addressable market metric—Affected
Population. This metric is used to quantify the size of the market where users may have
potential needs but are not necessarily actively searching for a solution. This metric is
necessarily broad and captures the entire population among consumers ages 50 and older
who may be affected by the challenge area.
The next user metric –Targeted Users—identifies users with more acute/urgent needs or
users who are actively searching for a solution. Targeted Users are a subset of the
Affected Population but a more qualified subgroup for the solutions and services targeting
each market opportunity area. Care navigation provides a good illustration of how an
Affected Population is narrowed to a Targeted Population. All consumers ages 50 and
older may have the need for a solution that helps navigate the U.S. healthcare system,
hence the Affected Population in the Care Navigation market is the entire population of
people 50+. The Targeted Users are either those who show strong frustration towards the
current healthcare system, or those who desire to improve their healthcare experience by
actively searching for tools and services.
To determine the size of Targeted Users, Parks Associates built high/low scenarios to
account for different levels of potential interest in products and services marketed directly
to consumers. The high/low interest scenarios are then weighted using a probability scale
relative to the acuteness of the need and the market gap between demand and supply (as
discussed in Section 3). In general, the more acute the need and the bigger the gap,
Affected Population
Targeted Users w/ Qualified Condition or Shown Interest
Projected Users
Weighted High/ Low Probability
Interest to Buy at High/Low Prices
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the greater the weight assigned to the high interest scenario. The final targeted user metric is the weighted
average of the high/low interest scenarios.
Finally, Projected Users are those consumers Parks Associates’ estimates will constitute the actual user base of
solutions in each opportunity area. Projected Users are calculated after applying various pricing schemes to
each market opportunity area (Step Two, discussed below).
Step Two: Determine the most likely revenue models and associated demand elasticity
For revenue models and demand elasticity, the scenario development process is more complex. Any particular
solution brought to market in any of the nine challenge areas could choose to employ any number of business
models. The forecasts provided, however, are not revenue forecasts for particular solutions but, rather, are
forecasts of the potential revenue opportunities in each of the nine broad market challenge areas.
As a result, Parks Associates selected the two most likely or best applicable revenue models for each of the
nine areas (summarized in Figure 7). Our selections are based on our own research of industry practices and
outlook on business model development trends in the digital health industry.
Investment Opportunities
Product Sales
Subscription Service
Technology/ Software Fee
Advertising Sales
Medication Management
Aging with Vitality
Vital Sign Monitoring
Care Navigation
Emergency Detection & Response
Physical Fitness
Social Engagement
Diet & Nutrition
Behavioral & Emotional Health
Figure 7: Dominant Revenue Models for Market Opportunity Forecasts
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The possibility that the two non‐chosen revenue models could be viable and sustainable for particular
solutions in each market opportunity area should not be ruled out. However, it is Parks Associates’ belief that
within the forecast period (2013‐2018), the two selected revenue models are most likely to dominate their
respective markets.
For each revenue model, Parks Associates built high/low scenarios based on different pricing strategies and
associated demand curves. Revenue models of product sales and subscription services are built on demand
elasticity curves derived directly from consumer survey data or indirectly from using analogous
product/services already on market. Revenue models for technology/software fees and advertising are built
on high/low usage assumptions using comparable software pricing ranges and advertising rates.
Unlike the scenarios applied to targeted users, the high/low scenarios for revenue models are not weighted by
probability. Instead, they result in a high/low range of revenue estimates for each model.
Figure 8 summarizes the entire forecast methodology. Section 4.2 provides detailed explanations of the
assumptions and results of the revenue forecasts in each market opportunity area.
Figure 8: Forecast Methodology
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4.2 Market Forecasts and Investment Implications
4.2.1 Medication Management
The entire market of consumers ages 50+ is composed of nearly 100 million people, but
Parks Associates defines the Affected Population of medication management as people
taking two or more medications. Data from Parks Associates’ health survey75 show that:
70% of people ages 50‐64 take at least two medications
87% of people 65 and older take at least two medications
As a result, the affected population of medication management solutions stood at 77.7
million at the end of 2012, and Parks Associates projects that total affected users will
reach 91 million in 2018 as the population ages.
Interest in a medication management solution could be as high as 75% for a smart pill box
solution or as low as 15% for a medication tracking service, as suggested by Parks
Associates’ survey data.76 As a result, the weighted average number of the targeted users
is estimated to hit 45 million in 2013 and 53 million in 2018.
Parks Associates expects that product sales and a medication tracking subscription service
will be the two dominant revenue models for the medication management market. Our
conclusion is based on the fact that consumers are already using products such as pill
boxes with voice reminders, automatic pill dispensers, and Web/mobile phone‐based
medication reminder services. Future product and service innovations will largely follow
the same revenue models to take advantage of consumer awareness and expectation.
Medication management software licensed for smartphone and tablet use could be a
third revenue model but its potential is currently limited by the fact that people 50 and
older have lower smartphone and tablet ownership than younger consumers and are less
enthusiastic app users.
Pricing of medication monitoring devices and services was calculated at half the current
pricing for medication products on the market as we strongly believe that lower pricing
will generate sustained demand. We also used consumer data from Parks Associate’s 2010
survey showing price expectations for a medication service.77
75 Parks Associates, Market Focus: Multiple Medication Management, 2012. 76 Ibid. 77 Parks Associates, Personal Health Tools and Applications, 2010; data showed a consumer demand curve (adjusted for people 50+) based on best‐value price perceptions and an optimal pricing range based on Van Westendorp pricing analysis.
Affected Population
Targeted Population
Projected Revenue Models
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Medication Management Forecast Summary
The following tables highlight the main assumptions forming the medication management solution forecasts.
Parks Associates estimates that pursuing either a product sales or a subscription service strategy could yield five‐
year total revenues as high as $3.1 billion or as low as $2 billion.
Revenue Model 1: Product Sales
2013 2018
High Price Scenario
Pricing $129 $76
Demand 5% 21%
Units Sold Annually* 2.3 million 7.9 million
Annual Revenues $293 million $601 million
5‐Year Cumulative Revenues $2.85 billion
*New/Replacement Purchase Assumption: 4‐year replacement
cycle with 25%‐35% of existing users replacing product
annually after year 4
Low Price Scenario
Pricing $89 $65
Demand 10% 31%
Units Sold Annually** 4.5 million 9.9 million
Annual Revenues $404 million $639 million
5‐Year Cumulative Revenues $3.02 billion
**New/Replacement Purchase Assumption: 4‐year
replacement cycle with 25%‐40% of existing users replacing
product annually after year 4
Revenue Model 2: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $15 $11.60
Demand 3% 6%
Annual subscribers 1.4 million 3.1 million
Annual revenues $245 million $437 million
5‐Year Cumulative Revenues $1.99 billion
Low Price Scenario
Monthly Service Fee $7 $5.40
Demand 10% 23.4%
Annual subscribers 4.5 million 12.2 million
Annual revenues $381 million $792 million
5‐Year Cumulative Revenues $3.28 billion
$293
$360
$434
$564 $595 $601
$404 $426
$442
$535 $572
$639
$0
$100
$200
$300
$400
$500
$600
$700
2013 2014 2015 2016 2017 2018
Reven
ues $Millions
High Price Point Low Price Point
Medication Management Product Sales Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
$245 $275
$308 $346
$389 $437
$381 $427
$479
$552
$647
$792
$0
$100
$200
$300
$400
$500
$600
$700
$800
$900
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Medication Management Service Fee Revenue Forecast2013‐2018
©Parks Associates for AARP, 2013
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Medication management solutions’ potential for success will be strengthened if:
Health insurers and care providers continue to provide education emphasizing
medication adherence as a means to prevent adverse events
Manufacturers and service providers ad functionality to product/service designs beyond
counting pills and sending reminders; they need to demonstrate to users the benefit of
good drug adherence and offer additional value‐added features
Technology and software innvoators make product features easy to use
Solution providers offer competitive product/service pricing that brings more value to
consumers than existing ones on the market
Investors should be aware that a hardware‐centric approach would yield a sizable
revenue opportunity comparable to revenues from a service‐centric approach, but with
much lower variablity/risks.
If investors take a service‐centric approach, a lower entry price for services is preferred
as consumers are more price sensitive to service prices than to product prices.
Our demand assumptions are conservative which project only 31% of the targeted
population will purchase a medication management product and only 23% will subscribe
to a medication managmeent service by 2018. If entrepreneurs find ways to improve
consumer perception of medication management by making more compelling products
at more competitive price points, the end user demand could be much higher.
If entrepreneurs succeed in involving insurers or health providers in their business
plan – offering either marketing support or financial incentives/subsidies – end user
demand could be much higher.
Factors Impacting Success
Implications for Investors
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4.2.2 Aging with Vitality
The desire to age in a comfortable and symptom‐free way is universal among people 50
and older; the Affected Population of this market is therefore the entire population of
people 50+. The affected population hit 101 million at the end of 2012, and Parks
Associates projects that the total number of people 50+ will reach 113 million in 2018,
based on U.S. Census data of aging trends.
Interest in solutions to enable people 50+ to age with vitality is broad but varies by age
groups. Parks Associates modeled higher interest among people 65 and older – for whom
the symptoms such as vision loss, hearing loss and arthritis tend to be more acute – and
lower interest among people 50‐64. As a result, the weighted average number of the
Targeted Population is estimated to be 44 million in 2013 and 49 million in 2018.
Parks Associates expects that two revenue models will prevail: one focusing on products
that address physical deterioration due to aging (such as vision/hearing aids); the other
centering on services that aim to sharpen mental skills, such as memory improvement and
cognitive training. Therefore product sales and subscription service that tap directly into
end user demand will be more likely adopted revenue model than the other two—
software/technology fee and advertising.
Parks Associates modeled the demand curve for aging with vitality products after
medication management solutions. Product unit pricing starts as high as $99 and as low
as $49 because these are the key psychological price points for technology products. For
services that help users improve cognitive skills, Parks Associates used our own estimates
of the annual paid‐user growth of Lumosity.com as a proxy to model demand elasticity.
For subscription service pricing, Parks Associates used prevailing industry pricing
practices—between $5‐15 per month.
Affected Population
Targeted Population
Projected Revenue Models
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Aging with Vitality Forecast Summary
The following tables highlight the main assumptions forming the aging with vitality solution forecasts. Parks
Associates estimates that pursuing either a product sales or a subscription service strategy could yield five‐year
total revenues as high as $2.9 billion or as low as $1.2 billion.
Revenue Model 1: Product Sales
2013 2018
High Price Scenario
Pricing $99 $58
Demand 5% 17%
Units Sold Annually* 2.2 million 7.5 million
Annual Revenues $218 million $441 million
5‐Year Cumulative Revenues $1.74 billion
*New/Replacement Purchase Assumption: 5‐year replacement
cycle with 25% of existing users replacing product annually
after year 5
Low Price Scenario
Pricing $49 $29
Demand 8% 33%
Units Sold Annually** 3.5 million 12.9 million
Annual Revenues $172 million $372 million
5‐Year Cumulative Revenues $1.39 billion
**New/Replacement Purchase Assumption: 5‐year
replacement cycle with 25%‐40% of existing users replacing
product annually after year 5
Revenue Model 2: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $25 $19.3
Demand 3% 6%
Annual subscribers 1.3 million 2.9 million
Annual revenues $237 million $410 million
5‐Year Cumulative Revenues $1.90 billion
Low Price Scenario
Monthly Service Fee $15 $11.6
Demand 5% 12.4%
Annual subscribers 2.2 million 6.1 million
Annual revenues $132 million $282 million
5‐Year Cumulative Revenues $1.19 billion
$218 $218 $236
$263
$363
$441
$172 $167 $175
$225
$284
$372
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
$500
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Price Point Low Price Point
Aging with Vitality Product Sales Revenue Forecast2013‐2018
©Parks Associates for AARP, 2013
$237 $264
$294
$328
$367
$410
$132 $153
$178
$207
$241
$282
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Aging with Vitality Service Fee Revenue Forecast2013‐2018
©Parks Associates for AARP, 2013
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Solutions enabling a better aging experience will have a stronger potential for success if:
Marketing messages stress fun in aging to drive user interest in aging‐mitigating
solutions
New solutions become more affordable and designs differentiate from convention to
give consumers a new experience
Aging‐mitigation features and underlying technologies (text‐to‐speech, gesture and
voice recognition input technoogy) are integrated into existing products that the
target population is already familiar with, reducing the need to purchase a dedicated
device or service
Investors should be aware that purchase behaviors of people 50+ might slow down
product revenue growth on an annual basis. Parks Associates modeled relatively low
elasticity of demand for products that address aging needs due to this age group’s low
impulse‐driven purchase habits and longer replacement cycle for products in this
category. Investors could improve product features to increase demand and/or speed
up the product replacement cycle. Despite slower annual product sales revenues, this
model still represents an attractive opportunity in this market because cumulative
revenues over the forecast period are substantial.
Cumulative service revenues are as high as product revenues in this market, but service
revenue growth is steady and positive. The recurring revenue stream from a service‐
centric business model also helps stablize margin and reduce business volatility caused
by shifting demand and rising competition.
Our demand assumptions are conservative across the board in this market, which
project only 33% of the targeted population will purchase a product addressing their
anti‐aging needs, and only 12% will use a direct‐to‐consumer service to improve age‐
induced cognitive wellness challenges. As this market is completely driven by retail
product and service innovations, a breakthrough product/service concept could
signficantly raise demand above our assumptions, resulting in upside surprises on
estimated buyers and revenues. In other words, entrepreneurs could unlock dormant
demand by focusing on non‐conventional product designs and smart marketing
campaigns to achieve higher revenue growth than our models imply.
Factors Impacting Success
Implications for Investors
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4.2.3 Vital Sign Monitoring
An estimated 78 million consumers ages 50 and older have at least one chronic condition.
Incidences of people 50+ suffering from the following chronic conditions are based on CDC
data and Parks Associates’ estimates:
Diabetes or pre‐diabetes: 44% (people between 50‐64)‐60% (people 65+)
Hypertension: 48% (2013)‐51% (2018)
COPD: 5% (2013‐2018)
Heart Failure: 1.7% (2013‐2018)
Other types of more severe chronic conditions: 6% (2013‐2018)
Parks Associates estimates that up to 30% of the 50+ population suffers from more than
one severe chronic condition. After accounting for co‐morbidity, the Affected Population
figures are estimated at 79 million in 2013 and increase to 86 million in 2018.
Interest in a vital sign monitoring solution could be as high as 75% for people suffering
severe chronic illnesses like COPD and heart failure, but could be as low as 15% for those
with less severe conditions, based on Parks Associates’ survey data78. As a result, the
weighted average number of Targeted Users is estimated at 45 million in 2013 and 49
million in 2018.
Parks Associates expects that product sales and vital sign monitoring subscription services
will be the two dominant revenue models for this market. Software/technology to assist
vital sign monitoring solutions may generate additional revenues through a licensing
arrangement but it will be a small amount relative to product sales and service revenues,
which have been the staples for this industry.
For product sales, Parks Associates estimates that a high‐end vital sign monitoring device
could cost $300 in 2013 whereas a low‐end solution using smartphones or tablets as host
gateways could lower product prices substantially to $99 in 2013. These prices are slightly
lower than current solutions on the market. Assuming a gradual price decline of 5‐10%,
which is common in the consumer electronics industry, consumer demand would follow a
typical demand curve model and rise in the double digits (22‐24%).
For a subscription service, the demand elasticity was modeled on Parks Associates’
consumer survey data in 2010. The high/low‐end prices are two ends of an optimal pricing
range obtained through a Van Westendorp79 model for a vital sign monitoring service.
78 Parks Associates, Personal Health Tools and Applications, 2010 79 Van Westendorp model is a pricing sensitivity analysis technique widely used in market research. See Appendix C
Targeted Population
Projected Revenue Models
Affected Population
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Vital Sign Monitoring Forecast Summary
The following tables highlight the main assumptions forming the vital sign monitoring solution forecasts. Parks
Associates estimates that pursuing either a product sales or a subscription service strategy could yield five‐year
total revenues as high as $4.8 billion or as low as $2.3 billion.
Revenue Model 1: Product Sales
2013 2018
High Price Scenario
Pricing $300 $177
Demand 5% 15%
Units Sold Annually* 2.2 million 5.8 million
Annual Revenues $675 million $1.03 billion
5‐Year Cumulative Revenues $4.82 billion
*New/Replacement Purchase Assumption: 5‐year replacement
cycle with 25%‐30% of existing users replacing product
annually after year 5
Low Price Scenario
Pricing $99 $58
Demand 8% 22%
Units Sold Annually** 3.6 million 7.7 million
Annual Revenues $356 million $453 million
5‐Year Cumulative Revenues $2.33 billion
**New/Replacement Purchase Assumption: 5‐year
replacement cycle with 35%‐40% of existing users replacing
product annually after year 5
Revenue Model 2: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $25 $19.3
Demand 3% 6%
Annual subscribers 1.3 million 3.0 million
Annual revenues $405 million $687 million
5‐Year Cumulative Revenues $3.21 billion
Low Price Scenario
Monthly Service Fee $15 $11.6
Demand 4% 9.9%
Annual subscribers 1.8 million 4.8 million
Annual revenues $324 million $673 million
5‐Year Cumulative Revenues $2.71 billion
$675 $703 $727 $744
$943
$1,030
$356 $360 $358 $350
$455 $453
$0
$200
$400
$600
$800
$1,000
$1,200
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Price Point Low Price Point
Vital Sign Monitoring Product Sales Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
$405 $449
$499
$554
$617
$687
$324 $359
$399 $443
$515
$673
$0
$100
$200
$300
$400
$500
$600
$700
$800
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Vital Sign Monitoring Service Fee Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
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Vital sign monitoring solutions’ potential for success will be strengthened if:
Device manufacturers continue to enhance connectivity and interactivity through
software innovation and make hardware easy to carry and simple to operate
Physicians become more involved in patient’s day‐to‐day management of chronic
conditions, encouraging patients to track vital sign changes and report back results
Device pricing becomes more affordable or functions become more integrated to
reduce purchases of individual devices
Monitored service subscription fees become more affordable as payers provide
incentives to encourage home use of vital sign monitoring services
Investors should be aware that although a hardware‐centric approach could generate a
bigger revenue opportunity than a service‐centric approach, demand for hardware is
subject to a higher level of price sensitivity. For a low‐price entry strategy, sales margins
in the early years of investment would come under pressure, resulting in a longer
payback time.
Both revenue models assume a direct‐to‐consumer strategy. Entrepreneurs may face
competition from payers and providers offering their own‐branded vital sign monitoring
devices or services as part of a chronic care management service without directly
charging end users hardware or service fees.
Our demand assumptions are conservative, which project only 22% of the targeted
population will purchase a vital sign monitoring solution and only 10% will use a direct‐
to‐consumer vital sign monitoring service in 2018. If entrepreneurs find ways to
convince consumers to approach vital sign monitoring as a self‐help tool instead of
waiting for health insurers to offer a chronic care management service, the end user
demand could be much higher.
If health insurers or providers change their current practice of directly funding vital
sign monitoring devices/services to a strategy of incentivizing retail adoption of vital
sign monitoring solutions/services, this market will grow at much higher rate.
Implications for Investors
Factors Impacting Success
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4.2.4 Care Navigation
All American consumers ages 50 and older would benefit from solutions that could help
navigate the extraordinarily complex healthcare market. Parks Associates therefore
defines the Affected Population for care navigation solutions as people ages 50+,
including 61 million people 50‐64 and 42 million people 65+ in 2013. By 2018, these
populations will increase to 66 million and 48 million respectively
Parks Associates narrowed the affected population according to estimates of users’
interest in a care navigation service. Parks Associates estimated 50% of the 50+ population
would be interested in a care navigation solution under a strong interest scenario and 10%
would be interested under a weak interest scenario.
As a result, the weighted average number of the targeted population is estimated at 34.9
million in 2013 and 38.5 million in 2018.
Parks Associates expects that a fee‐based care assistance service and advertising sales will
be the two dominant revenue models for the care navigation market.
We modeled the fee‐based care assistance opportunity on current care concierge services,
but with a much lower average monthly fee. Demand is based on consumer interest
expressed in Parks Associates’ latest survey.80 To calculate the revenue opportunity, the
following scenarios and assumptions were applied:
1) Parks Associates believes that a monthly rate of $50 is a reasonable high price point,
because a health concierge service is typically priced between $30‐$250 per user.
Overtime, the price will drop not because care delivery costs decrease, but because
the competitive nature of this consumer market will force vendors to cut prices.
2) Alternatively, a lower price point of $25 per month could open up bigger
opportunities. We expect a naturally declining price from the $25 level will help care
navigation services recruit more than 3.7 million people in 2018.
3) Finally, if a paid care navigation service fails to rally adequate demand, an ad
supported model could be employed. Ad revenue would be much lower, due to a low
CPM rate.
80 Parks Associates: Managing Care through ACOs: Consumer interest and requirements, 2012.
Projected Revenue Models
Affected Population
Targeted Population
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Care Navigation Forecast Summary
The following tables highlight the main assumptions forming the care navigation solution forecasts. Parks
Associates estimates that pursuing either a service fee or advertising sales strategy could yield five‐year total
revenues as high as $3.3 billion or as low as $360 million.
Revenue Model 2: Advertising Sales
2013 2018
High User Scenario
User Base 24.4 million 32.7 million
Ad Impressions (per user/month)
50 63.8
Avg. CPM $5 $5
Total ad revenues $73 million $125 million
5‐Year Cumulative Revenues $567 million
Low User Scenario
User Base 10.5 million 23.1 million
Ad Impressions (per user/month)
60 76.6
Avg. CPM $5 $5
Total ad revenues $38 million $106 million
5‐Year Cumulative Revenues $400 million
Revenue Model 1: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $50 $38.70
Demand 2% 4%
Annual subscribers 0.7 million 1.5 million
Annual revenues $419 million $719 million
5‐Year Cumulative Revenues $3.34 billion
Low Price Scenario
Monthly Service Fee $25 $15.60
Demand 3% 9.5%
Annual subscribers 1 million 3.7 million
Annual revenues $314 million $684 million
5‐Year Cumulative Revenues $2.73 billion
$419 $466
$518
$577
$644
$719
$314 $345
$396
$454
$542
$684
$0
$100
$200
$300
$400
$500
$600
$700
$800
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Care Navigation Service Fee Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
$73 $78
$84
$96
$110
$125
$38
$47
$57
$69
$82
$106
$0
$20
$40
$60
$80
$100
$120
$140
2013 2014 2015 2016 2017 2018
Revenues $Millions
High User Scenario Low User Scenario
Care Navigation Advertising Sales Revenue Forecast
2013‐2018
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Care navigation solutions will have a stronger potential for success if:
Future solutions are comprehensive, personalized, and bring real value to customers
Solutions are feature‐rich and provide immediate benefits (e.g. medical savings, better
health service choices) to overcome overcome consumer’s price resistance
Solutions offer more affordable service pricing to drive service volume; alternative
revenue models could subsidize service costs
A care assistance service model generates 6x more revenues over the forecast period
than does an advertising‐driven business model. Although the attractiveness of the two
models is evident from a revenue perspective, we caution that service revenues are
highly dependent on target users’ value perception. The ability to offer a personalized
care assistance service will justify an average monthly service fee of $38 from an
adopter perspective and will support the long‐term viability of this model to solve the
care navigation challenge in the U.S.
Ad targetability heavily influences ad pricing. A major risk to our advertising revenue
forecast in this market is the contraction of display ad pricing on Websites and print
media. Our assumption of $5 CPM is a mid‐range figure and could face pricing pressure
from advertisers that are less interesting in the older demographics. If investors and
entrepreneurs could incorprate ad targeting technology into their solutions, they can
preserve their ad rates and protect them from negative pricing trends seen in the online
display ad market. On the other hand, if their targeting algorithms are robust enough,
they can offer performance‐based ad inventory to brands and advertisers that want to
engage with people 50+ with unique products and services. This scenario could increase
advertising revenue opportunity currently not reflected in our forecast model.
Implications for Investors
Factors Impacting Success
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4.2.5 Emergency Detection & Response
Parks Associates defines the Affected Population for emergency detection and response
solutions as people ages 50+, including 84 million people 50‐74 and 19 million people 75+
in 2013. By 2018, they will increase to 92 million and 21 million respectively.
Parks Associates narrowed the affected population according to estimates of users’
interest in an emergency detection or response service. Because consumers ages 75 and
older are much more likely to need and use an emergency service, Parks Associates
weighted the potential interest of this age group higher than other age groups.
Under a strong interest scenario, we estimated 75% of the 75+ population and 30% of the
50‐74 population would be interested in an emergency detection or response service.
Under a weak interest scenario, we estimated 40% of 75+ consumers and 10% of those
50‐74 would be interested in such a solution.
The weighted average number of the Targeted Population is estimated at 25.7 million in
2013 and 28.3 million in 2018.
Parks Associates expects that product sales and emergency monitoring service fees will be
the two dominant revenue models for the emergency detection and response market,
because they are the most prominent and successful ones on the market today, and we
continue to expect them to do well in the future.
We also used consumer price expectations ($15‐$25/month) for a personal emergency
response service (PERS) from Parks Associates’ 2010 survey data.81 Parks Associates
modeled moderate growth of the underlying user base of the emergency detection
service as well as potential hardware sales for the next six years if price is at the high end
of the range. Demand will be more elastic if price drops below $20 per month. This
assumption is built on the fact that the age sweet spot for emergency detection and
response service is 70+ and also our own research showing that these consumers are
more price sensitive than people in younger age groups.
81 Parks Associates, Personal Health Tools and Applications, 2010; Data showed a consumer demand curve (adjusted for people 50+) based on best‐value price perceptions and an optimal pricing range based on Van Westendorp pricing analysis
Projected Revenue Models
Affected Population
Targeted Population
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Emergency Detection & Response Forecast Summary
The following tables highlight the main assumptions forming the emergency detection and response solution
forecasts. Parks Associates estimates that pursuing either a product sales or service fee strategy could yield five‐
year total revenues as high as $2.3 billion or as low as $1.3 billion.
Revenue Model 1: Product Sales
2013 2018
High Price Scenario
Pricing $229 $135
Demand 3% 10%
Units Sold Annually* 0.8 million 2.9 million
Annual Revenues $176 million $391 million
5‐Year Cumulative Revenues $1.47 billion
Low Price Scenario
Pricing $129 $76
Demand 6% 23%
Units Sold Annually* 1.5 million 5.3 million
Annual Revenues $199 million $402 million
5‐Year Cumulative Revenues $1.62 billion
*New/Replacement Purchase Assumption: 4‐year replacement
cycle with 15%‐25% of existing users replacing product
annually after year 4
Revenue Model 2: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $25 $19.30
Demand 3% 6%
Annual subscribers 0.8 million 1.7 million
Annual revenues $231 million $397 million
5‐Year Cumulative Revenues $1.84 billion
Low Price Scenario
Monthly Service Fee $15 $11.60
Demand 5% 17.7%
Annual subscribers 1.3 million 5 million
Annual revenues $231 million $699 million
5‐Year Cumulative Revenues $2.43 billion
$176 $180 $192
$231
$299
$391
$199 $206 $219
$270
$329
$402
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Price Point Low Price Point
Emergency Detection/Response Product Sales Revenue Forecast2013‐2018
©Parks Associates for AARP, 2013
$231 $257
$286 $319
$355 $397
$231 $268
$324
$393
$514
$699
$0
$100
$200
$300
$400
$500
$600
$700
$800
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Emergency Detection/Response Service Fee Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
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Solutions enabling emergency detection and response will have a stronger potential for
success if:
Technology advances continue to make this product category more portable, wider in
range, less error‐prone and more affordable
Better product design removes the stigma associated with this product category, making
people 50 and older more willing to use such a product in and outside of the home
Channel strategies are diversified; expanded retail availability and business referral
programs would reduce distribution costs and extend user reach
For investors and entrepreneurs, people 75 and older are easier targets than people
50‐74, but this market’s long‐term revenue opportunity lies with vendors’ ability to
boost interest among younger demographics. Adding this new marketsegment to
existing demand could potentially jumpstart the total addressable market and
increase revneue over time.
Demand in this market is more sensitive to price decreases than in adjacent markets.
Although Parks Associates employed very conservative estimates (up to 23% interested
in a product and up to 18% interested in a service), more portable product designs with
integrated lifestyle functions could appeal to a greater portion of the targeted users and
raise our revenue projections.
A risk factor to our service revenue forecast is the churn rate. Younger demographic
users are more likely to drop existing services and try something new, driving the churn
rate higher and the service revenues lower over time. Service providers could offer
customer appreciation programs or loyalty memberships to reduce this risk factor to
service revenues.
Implications for Investors
Factors Impacting Success
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4.2.6 Physical Fitness
The need to engage in regular, age‐appropriate physical fitness is universal among people
50 and older; the Affected Population of this market is therefore the entire population of
people 50+. The affected population hit 101 million at the end of 2012, and Parks
Associates projects that the total number of people 50+ will reach 113 million in 2018,
based on U.S. Census data of aging trends.
Parks Associates narrowed the affected population according to estimates of users’
interest in a physical fitness solution. Under a strong interest scenario, we estimated 60%
of the 50‐64 population and 50% of the 75+ population would be interested in a physical
fitness solution. Under a weak interest scenario, we estimated 25% of 50‐64 and 15% of
the 65+ population would be interested in such a solution. We assumed the strong
interest scenario would be more likely for the 50‐64 year old group and the weak scenario
more likely for the 65+ population.
As a result, the weighted average number of the Targeted Population is estimated at 38.1
million in 2013 and 42.1 million in 2018.
Parks Associates expects that product sales and fitness service fees will be the two
dominant revenue models for the physical fitness market. However, technology/software
licensing and advertising‐based models are likely to be supplementary in nature to the
two dominant business models in physical fitness.
To assess the revenue opportunity in the physical fitness market, the following scenarios
and assumptions are applied:
1. Parks Associates modeled demand for fitness products based on our tracking of the
connected fitness industry growth. For people 50 and older, demand is less sensitive
to price decline. As a result, our model assumes that
‐ At a higher price point ($129), a 10% price decline can generate, on average, a 25%
increase in demand.
‐ At a lower price point ($89), a 10% price decline can generate, on average, a 33%
increase in demand
2. Parks Associates modeled demand for fitness services based on its tracking of fitness
app usage growth. However, we tempered service user growth for the 50+ market
because slower changes in purchase behaviors of this age group moderates demand.
Projected Revenue Models
Affected Population
Targeted Population
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Physical Fitness Forecast Summary
The following tables highlight the main assumptions forming the physical fitness solution forecasts. Parks
Associates estimates that Pursuing either a product sales or service fee strategy could yield five‐year total
revenues as high as $1.7 billion or as low as $1.1 billion.
Revenue Model 1: Product Sales
2013 2018
High Price Scenario
Pricing $129 $76
Demand 5% 15%
Units Sold Annually* 1.9 million 6 million
Annual Revenues $246 million $460 million
5‐Year Cumulative Revenues $1.88 billion
Low Price Scenario
Pricing $89 $53
Demand 6% 25%
Units Sold Annually* 2.3 million 8.4 million
Annual Revenues $204 million $442 million
5‐Year Cumulative Revenues $1.70 billion
*New/Replacement Purchase Assumption: 4‐year replacement
cycle with 15%‐25% of existing users replacing product
annually after year 4
Revenue Model 2: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $15 $11.6
Demand 3% 6%
Annual subscribers 1.1 million $2.5 million
Annual revenues $206 million $354 million
5‐Year Cumulative Revenues $1.64 billion
Low Price Scenario
Monthly Service Fee $5 $4
Demand 5% 15.8%
Annual subscribers 1.9 million 6.7 million
Annual revenues $114 million $316 million
5‐Year Cumulative Revenues $1.16 billion
$246 $246 $256
$301
$370
$460
$204 $211 $216
$277
$347
$442
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
$500
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Price Point Low Price Point
Physical Fitness Product Sales Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
$206 $229
$255
$284
$317
$354
$114 $133
$161
$194
$245
$316
$0
$50
$100
$150
$200
$250
$300
$350
$400
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Physical Fitness Service Fee Revenue Forecast2013‐2018
©Parks Associates for AARP, 2013
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Physical fitness solutions will have a stronger potential for success if:
Vendors are able to integrate multiple sources of data to give users a richer and more
comprehensive view of their physical fitness activity and outcomes
Payers incentivize consumers to track their fitness/wellness progress
Technological advances result in a dramatic reduction in form factor and price
Technology savvyness of consumers 50 and older continues to rise
End‐user demand is likely most robust among people 50‐64 but current fitness products
and services have done little to cater to this age group’s needs and technology
savvyness. We recommend entrepreneurs to target this age group aggressively before
considering the older 65+ group to maximize near term revenue opportunities.
Our demand assumptions are conservative in this market, which project only 25% of the
targeted population will purchase a physical fitness product and only up tp 16% will use
a direct‐to‐consumer fitness service in 2018. Demand may become more elastic if
device makers/service providers can associate their product user experience with
proven health benefits that matter most to people 50 and older. Smart marketing
messages and innovative designs may unlock demand to be much higher than our
model suggests.
A hardware‐centric strategy not only offers a greater cumulative revenue opportunity,
but also assumes lower risk as reflected in a narrower revenue range for hardware sales
than for service revenues. In other words, the hardware sales model is a safer bet than
the service revenue model.
Product designs in this competitive industry are essential in driving consumer demand,
especially given the fact that this market has attracted large brands like Nike as well as
many start‐up companies. A differentiated product design is not only a competitive
advantage but also a brand asset to drive sustainable market demand.
Factors Impacting Success
Implications for Investors
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4.2.7 Social Engagement
Parks Associates defines the Affected Population for social engagement solutions as the
entire consumer population ages 50 and above, including 61 million people ages 50‐64
and 42 million people 65 and older, in 2013. By 2018, these age groups will increase to 66
million and 48 million respectively.
Parks Associates narrowed the affected population according to estimates of users’
interest in a social engagement service, and assumed higher interest among users ages 50‐
64 than for those ages 65 and older. Parks Associates estimated 80% of the 50‐64
population and 70% of the 65+ population would be interested in a social engagement
solution under a strong interest scenario. We estimated 40% of consumers 50‐64 and 30%
of consumers 65+ would be interested under a weak interest scenario.
As a result, the weighted average number of the Targeted Population is estimated at 63.9
million in 2013 and 70.3 million in 2018.
Parks Associates expects that technology/software licensing and advertising sales will be
the two dominant revenue models for the social engagement market. We expect that
vendors could build social engagement software into existing services that target people
50 and older. For instance, social networking software can be built into a transportation
service to help older adults get more easily connected. Alternatively, an online network
aiming to connect people 50 and older can monetize its visitor traffic through targeted
advertising and sponsorships. Both revenue models depend on the user base of the
services. To assess revenue potential for the social engagement market, the following
scenarios and assumptions are applied:
1. For software/technology fee, Parks Associates assumes 20% of target users would
adopt the underlying software in 2013, growing to 40‐44% of target users in 2018. We
also assume standard software licensing terms based on per‐user per‐year usage. A
price range of $2‐$5 is used to quantify the high and low‐end of the
software/technology fee revenue potential for the social engagement market.
2. For advertising revenues, Parks Associates assumes high/low adoption of the
underlying social engagement service at 70%/40% in 2013, increasing to 85%/65% in
2018. A conservative ad rate of $5 CPM is used to reflect the average ad rate for this
demographic group from advertisers.
Pursuing either a technology/software license fee or advertising sales strategy could yield
five‐year total revenues as high as $959 million or as low as $236 million.
Targeted Population
Projected Revenue Models
Affected Population
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Social Engagement Forecast Summary
The following tables highlight the main assumptions forming the social engagement solution forecasts. Parks
Associates estimates that pursuing either a technology/software license fee or advertising sales strategy could
yield five‐year total revenues as high as $959 million or as low as $236 million.
Revenue Model 1: Software License Fee
2013 2018
High Fee Scenario
Pricing $5 $5
Usage Growth 20% 40%
Tech/Software Users 12.8 million 28.3 million
Annual Revenues $64 million $141 million
5‐Year Cumulative Revenues $591 million
Low Fee Scenario
Pricing $2 $2
Usage Growth 20% 44%
Tech/Software Users 12.8 million 30.8 million
Annual Revenues $26 million $62 million
5‐Year Cumulative Revenues $243 million
Revenue Model 2: Advertising Sales
2013 2018
High User Scenario
User Base 44.7 million 59.8 million
Ad Impressions (per user/month)
50 63.8
Avg. CPM $5 $5
Total ad revenues $134 million $229 million
5‐Year Cumulative Revenues $1.04 billion
Low User Scenario
User Base 19.2 million 42.2 million
Ad Impressions (per user/month)
60 76.6
Avg. CPM $5 $5
Total ad revenues $69 million $194 million
5‐Year Cumulative Revenues $731 million
$64
$75
$88
$103
$120
$141
$26 $30
$35 $41
$50
$62
$0
$20
$40
$60
$80
$100
$120
$140
$160
2013 2014 2015 2016 2017 2018
Revenues $Millions
High License Fee Low License Fee
Social Engagement Technology/Software License Fee Revenue Forecast, 2013‐2018
©Parks Associates for AARP, 2013
$134 $143
$153
$176
$201
$229
$69
$86
$105
$126
$151
$194
$0
$50
$100
$150
$200
$250
2013 2014 2015 2016 2017 2018
Revenues $Millions
High User Scenario Low User Scenario
Social Engagement Advertising Sales Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
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Solutions enabling social engagement will have a stronger potential for success if:
Designs are tailored to the needs of consumers 50 and older to help them solve real‐
world challenges through better social connectivity
There is a continued increase in awareness of and comfort using social
engagement/connectivity tools on PC/mobile among people 50+
Solutions incorporate the ability to target users with ads that bring value to selected
marketers interested in engaging 50+ consumers
Solutions integrate with other popular social networks and services that people 50+
frequently use
Revenue varianace is mainly driven by assumed user growth of related products and
services that use social engagement technologies or solutions. It is important for
investors and entrepreneuers to make such solutions broadly applicable so that user
exposure is maximized. Clearly, partnerships are very important, as is the ability to offer
open/customized APIs to have the technology/solution easily integratable with existing
products and services.
Our ad impression assumptions are conservative; we project only 50 ad impressions per
user per month for services attracting a large percentage of targeted users and 60 ad
impressions for services with a smaller audience size. Technologies that can increase the
target population’s interactivity with social engagement services will boost ad
impression levels and lead to higher advertising revenues than our models suggest.
Ad targetability heavily influences ad pricing. A major risk to our advertising revenue
forecast in this market is the contraction of display ad pricing on Websites and print
media. Our assumption of $5 CPM is a mid‐range figure and could face pricing pressure
from advertisers that are less interesting in older demographics. If investors and
entrepreneurs could incorprate ad targeting technology into their solutions, they can
preserve their ad rates and pretect them from negative pricing trends seen in the
online display ad market.
Implications for Investors
Factors Impacting Success
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4.2.8 Diet & Nutrition
A nutritious diet is essential to the healthy living of all consumers ages 50 and older. Parks
Associates therefore defines the Affected Population for diet and nutrition solutions as
people ages 50+, including 61 million people 50‐64 and 42 million people 65+ in 2013. By
2018, these populations will increase to 66 million and 48 million respectively.
Parks Associates narrowed the affected population according to estimates of users’
interest in a diet and nutrition service. Under a strong interest scenario, we estimated 60%
of the 50‐64 population and 70% of the 65+ population would be interested in a diet or
nutrition service. Under a weak interest scenario, we estimated 30% of both 50‐64 and
65+ populations would be interested in such a service.
As a result, the weighted average number of the Targeted Population is estimated at 53.6
million in 2013 and 59.2 million in 2018.
Parks Associates expects that a fee‐based diet and nutrition management service and
technology/software licensing fees will be the two dominant revenue models for the diet
and nutrition market. A diet management service has gained significant consumer
awareness during the last decade due to wellness initiatives and weight loss programs.
Diet/nutrition related software and technology have appeared more recently in the online
and mobile market.
To calculate the revenue opportunity, the following scenarios and assumptions were
applied:
1. We expect moderate growth of user‐paid dietary/nutrition management service if
offered at a premium rate of $15 per month. At $5 per month, however, growth will
accelerate particularly among consumers in the younger age group (50‐64). Our
demand curve was modeled after vital sign monitoring services but at a higher
sensitivity because users of these services are likely younger and price of
diet/nutritional service in general is substantially lower than a vital sign monitoring
service.
2. Parks Associates assumes that software that enables dietary/ nutritional education
and coaching will be subject to the same licensing term as in the social engagement
technology market. Underlying software user growth is also similar to that from social
engagement market due to strong similarity of user profiles between these two
markets.
Targeted Population
Projected Revenue Models
Affected Population
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Diet & Nutrition Forecast Summary
The following tables highlight the main assumptions forming the diet and nutrition solution forecasts. Parks
Associates estimates that pursuing either a service fee or technology/software license fee strategy could yield
five‐year total revenues as high as $1.6 billion or as low as $199 million.
Revenue Model 1: Subscription Service
2013 2018
High Price Scenario
Monthly Service Fee $15 $11.6
Demand 3% 6.3%
Annual subscribers 0.9 million 2.1 million
Annual revenues $167 million $293 million
5‐Year Cumulative Revenues $1.33 billion
Low Price Scenario
Monthly Service Fee $10 $6.2
Demand 5% 15.8%
Annual subscribers 1.5 million 5.3 million
Annual revenues $185 million $396 million
5‐Year Cumulative Revenues $1.59 billion
Revenue Model 2: Software License Fee
2013 2018
High Fee Scenario
Pricing $5 $5
Usage Growth 20% 40%
Tech/Software Users 10.7 million 23.8 million
Annual Revenues $54 million $119 million
5‐Year Cumulative Revenues $496 million
Low Fee Scenario
Pricing $2 $2
Usage Growth 20% 44%
Tech/Software Users 10.7 million 26.2 million
Annual Revenues $21 million $52 million
5‐Year Cumulative Revenues $210 million
$167 $185
$205 $228
$253
$293
$185 $203
$232
$265
$315
$396
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
2013 2014 2015 2016 2017 2018
Revenues $Millions
High Service Fee Low Service Fee
Diet & Nutrition Service Fee Revenue Forecast
2013‐2018
©Parks Associates for AARP, 2013
$54
$63
$74
$86
$101
$119
$21 $25
$31 $37
$43
$52
$0
$20
$40
$60
$80
$100
$120
$140
2013 2014 2015 2016 2017 2018
Revenues $Millions
High License Fee Low License Fee
Diet & Nutrition Technology/Software License Fee
Revenue Forecast, 2013‐2018
©Parks Associates for AARP, 2013
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Diet and nutrition solutions will have a stronger potential for success if:
Chronic care management programs feature the ability to add diet and nutrition
management functionality to their services
Broader wellness services integration diet and nutrition data, expanding the market for
diet and nutrition software licencing
Diet and nutrition features are subsidized through new innovative service models
Diet and nutrition management services generate 3x more revenue than does the model
of charging a technology/software fee based on user counts. But a risk factor to the
service model is the churn rate, which is influenced by competing solutions in the diet
and nutrition service business; some competing services are totally free as a component
of a comprehensive disease management program. As a result, investors and
entrepreneurs must create a differentiated experience with documented results to keep
users from defecting too soon.
Our demand assumptions are conservative for both the technology/software fee model
and the service revenue model, which project only 40% of the targeted population will
use a diet/nutrition related service and only 16% will use a direct‐to‐consumer diet and
nutrition service in 2018. Technologies with unique algorithms and open architechture
to be embedded in a broad array of online services could experience much higher user
adoption. Services with unique features could also garner higher adoption rates than
our models suggest.
Diet and nutritional service demand becomes more elastic once the monthly service
price drops below $10. Investors and entrepreneurs must weigh the impact of lower
pricing on the program’s gross margin against the potential increase in demand before
taking aggressive price cuts.
Implications for Investors
Factors Impacting Success
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4.2.9 Behavioral & Emotional Health
Parks Associates defines the Affected Population for behavioral and emotional health
solutions as people ages 50+, including 61 million people 50‐64 and 42 million people 65+
in 2013. By 2018, they will increase to 66 million and 48 million respectively. This category
includes divorce and grief support, which most consumers would benefit from as they lose
parents (50‐64 year old group), or spouses and other close peers (65+ group).
Parks Associates narrowed the affected population according to estimates of users’
interest in a behavioral and emotional health service. Parks Associates estimated 30% of
the 50+ population would be interested in a behavioral or emotional health solution
under a strong interest scenario and 10% would be interested under a weak interest
scenario. Our assumptions exclude health insurance‐covered cases in which users seek
clinical help to deal with most severe cases of behavioral/emotional health problems.
As a result, the weighted average number of the Targeted Population is estimated to hit
26.3 million in 2013 and 29.1 million in 2018.
Parks Associates expects that technology/software licensing and advertising sales will be
the two dominant revenue models for the behavioral and emotional health market. The
need for behavioral and emotional health can be directly addressed by a professional
healthcare service paid for by a health insurer. Our forecasts in this category, however,
factor in only those products and services paid for by consumers or that include a usage
decision that is heavily influenced by consumers themselves.
To assess revenue potential for the social engagement market, the following scenarios
and assumptions were applied:
1. For a software/technology fee model, Parks Associates assumes 30% of target users
would adopt the underlying software in 2013, growing to 60% of target users in 2018.
We also assume standard software licensing terms based on per‐user per year usage.
A price range of $2‐$4 is used to quantify the high and low‐ends of the
software/technology fee revenue potential for the behavioral & emotional health
market.
2. For advertising revenues, Parks Associates assumes high/low adoption of the
underlying behavioral/emotional service at 70%/30% in 2013, increasing to 85%/60%
in 2018. A conservative ad rate of $5 CPM is used to reflect the average ad rate for
this demographic group from advertisers.
Affected Population
Targeted Population
Projected Revenue Models
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Behavioral & Emotional Health Forecast Summary
The following tables highlight the main assumptions forming the behavioral and emotional health solution
forecasts. Parks Associates estimates that pursuing either a technology/software license fee or advertising sales
strategy could yield five‐year total revenues as high as $428 million or as low as $145 million.
Revenue Model 1: Software License Fee
2013 2018
High Fee Scenario
Pricing $4 $4
Usage Growth 30% 60%
Tech/Software Users 7.9 million $17.5 million
Annual Revenues $32 million $70 million
5‐Year Cumulative Revenues $290 million
Low Fee Scenario
Pricing $2 $2
Usage Growth 30% 60%
Tech/Software Users 7.9 million 17.5 million
Annual Revenues $16 million $35 million
5‐Year Cumulative Revenues $145 million
Revenue Model 2: Advertising Sales
2013 2018
High User Scenario
User Base 18.4 million 24.7 million
Ad Impressions (per user/month)
50 63.8
Avg. CPM $5 $5
Total ad revenues $55 million $95 million
5‐Year Cumulative Revenues $428 million
Low User Scenario
User Base 7.9 million 17.5 million
Ad Impressions (per user/month)
60 99
Avg. CPM $5 $5
Total ad revenues $28 million $104 million
5‐Year Cumulative Revenues $342 million
$32
$38
$44
$50
$57
$70
$16 $19
$22 $25
$28
$35
$0
$10
$20
$30
$40
$50
$60
$70
$80
2013 2014 2015 2016 2017 2018
Revenues $Millions
High License Fee Low License Fee
Behavioral & Emotional Health Technology/Software License Fee Revenue Forecast, 2013‐2018
©Parks Associates for AARP, 2013
$55 $59
$63
$73
$83
$95
$28 $35
$45
$56
$73
$104
$0
$20
$40
$60
$80
$100
$120
2013 2014 2015 2016 2017 2018
Revenues $Millions
High User Scenario Low User Scenario
Behavioral & Emotional Health Advertising Sales Revenue Forecast2013‐2018
©Parks Associates for AARP, 2013
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Emotional and behavioral health solutions will have a stronger potential for success if:
Better education efforts are undertaken to make services available and accessible to
people 50 and older
Solutions determine methods to target users with ads without triggering their privacy
concerns
Technology advances generate better insights about consumer behavioral/emotional
needs
Vendors integrate behavioral/emotional health solutions into a broader service and
deliver a fun experience for users
Behavioral and emotional health for people 50+ represents a small market for
entrepreneurs and investors despite its targeted user base being similar to that of the
market for emergency detection and response solutions. To excel in this relatively
“niche” market segment, investors and entrepreneurs must clearly communicate their
offering’s value proposition to target users and increase engagement levels through
personalized service features. The main monetization methods—technology fees and
advertising revenues – rely heavily on user loyalty and frequency of interaction with the
service.
Investors and entrepreneurs also need to make behavioral and emotional health a
supplementary component of a broader health/wellness solution in order to increase
end user exposure and drive service/feature utilization. Effective content and
distribution partners and open/customizable APIs for easy integration are key to
overcoming user acquisition barriers and to maintaining healthy advertising CPM rates
Advertising offers greater revenue opportunity but competition is also likely to be
intense. Technology fee revenues depend heavily on the software’s performance in
driving usage volume, and therefore a solution employing the latter business model is
easier to differentiate from the competition.
Implications for Investors
Factors Impacting Success
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5.0 Summary and Conclusions
The healthy living market for consumers 50 and older presents both short‐term and long‐term investment
opportunities. After analyzing the 32 different healthy living needs of people 50+ with these critical business
model questions in mind, Parks Associates concludes that nine areas of the healthy living market represent the
best investment opportunities for break‐through technologies, innovative products, and disruptive services.
Figure 9 summarizes these opportunities.
When evaluating these nine areas to formulate an investment strategy, investors and entrepreneurs must
take into consideration not only the upside revenue potential, but also underlying target user growth trends,
variability of revenue estimates, and unique market factors that could aid or hurt investment/business growth.
Parks Associates strongly recommends that investors and entrepreneurs focus on areas that serve a large
and/or fast‐growing target user base, offer high revenue opportunity with low variance, feature lower‐than
aveage business risks and a strong opportunity for differentiation.
Revenue opportunity variance, measured by the ratio of Parks Associates’ high‐end to low‐end revenue
estimates in Figure 10, reflects our assessment of the business risks and entry barriers in each of the nine
areas. A low ratio of maximum to minimum revenue estimates (low revenue variance) is an indicator of higher
visibility of revenue streams, more mature revenue models, and lower probability of unknown business risks.
A high revenue variance points to just the opposite. Although a low‐business‐risk/low‐entry‐barrier market
Figure 9: Summary of Nine Market Opportunities
High‐end
Estimates
Low‐end
Estimates
Revenue
Variance
Highest
5‐Yr CAGR
Product
Sales
Monthly
Service
Technology/
Software
Ad
Sales
Medication Management 1 52M Up to 34M $3.3B $2.0B 1.64 16%
Aging with Vitality 2 49M Up to 42M $1.9B $1.2B 1.59 17%
Vital Sign Monitoring 3 49M Up to 28M $4.8B $2.3B 2.07 16%
Care Navigation 4 39M Up to 27M $3.3B $400M 8.36 23%
Emergency Detection & Response 5 28M Up to 15M $2.4B $1.5B 1.65 25%
Physical Fitness 6 42M Up to 22M $1.8B $1.2B 1.61 23%
Social Engagement 7 70M Up to 49M $1.0B $243M 4.26 23%
Diet & Nutrition 8 59M Up to 24M $1.6B $210B 7.61 20%
Behavioral & Emotional Health 9 29M Up to 24M $428M $145M 2.95 30%
Dominant Revenue Models
Opportunity AreaOverall
Ranking
Targeted
Users
(2018)
Projected
Users
(2018)
2013‐2018 Cumulative Revenues
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usually means more intense competition and sometimes a lower likelihood of differentiation, these
opportunities remain very attractive as long as the user base is large and revenue growth is satisfactory (>10%
CAGR).
Figure 10: Projected Revenue Ranges: Low/High‐end Market Opportunities
For instance, the medication management market has a low revenue forecast range (between $2 billion to
$3.3 billion), and thus a low variance of 1.64. By contrast, Care Navigation has a much wider revenue forecast
range (between $400 million and $3.3 billion) and a variance of 8.36. This contrast reflects our belief that the
medication management market has lower investment risks than the care navigation market, even though the
revenue potential of the latter is larger.
To be more specific, the downside risk is more significant for care navigation’s main revenue models:
subscription services and advertising sales. A subscription service to help consumers navigate through the
complex U.S. health system is still an embryonic concept and could face stiff resistance from targeted users,
especially if required to pay out of pocket. The advertising model, on the other hand, faces uncertainties
regarding whether such a service can attract advertising dollars with a sufficient amount of visitor traffic.
$428
$1,036
$1,597
$1,879
$1,901
$2,430
$3,278
$3,342
$4,822
$145
$243
$210
$1,163
$1,194
$1,470
$1,999
$400
$2,333
$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000
Emotional Health
Social Engagement
Diet & Nutrition
Physical Fitness
Aging with Vitality
Emergency Detection
Medication Management
Care Navigation
Vital Sign Monitoring
$Millions
Minimum Revenue
Maximum Revenue
Market Opportunities: Cumulative Revenue Forecasts2013‐2018
©Parks Associates for AARP, 2013
RevenueOpportunity Variance*
2.07
1.61
1.59
1.64
1.65
8.36
2.95
4.26
7.61
*Revenue opportunity variance is measured as a ratio of maximum revenue to minimum revenue projections, and is one measure of investment risk. The higher the ratio, the higher the revenue forecast uncertainty.
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Growth rate, measured by 5‐year CAGR, is an important measure, but must be considered along with other
evalutation factors. For instance, although the behavioral and emotional health market has the highest 5‐Year
CAGR in our foreasts, this is mainly due to our low 2013 revenue estimates. Nonetheless, a high CAGR usually
indicates an underserved market with low competition. Entrepreneurs with briliant business ideas may launch
a niche solution in this fast‐growing market, and end up maintaining substantial market shares and generating
impressive returns on investment.
Parks Associates contends that total revenue potential, revenue estimate variance, and the potential
number of adopters are the best indicators of an area’s investment attractiveness, thus carrying a higher
weight in our final rankings of the nine areas. A visual illustration of the relative market attractiveness among
the nine areas along these three criteria is presented in Figure 11.
Market Opportunity Comparison The maximum six‐year cumulative revenue opportunity is especially pronounced for vital sign monitoring,
med management & care navigation, while social engagement & aging with vitality are projected to have the
greatest user adoption in 2018. After revenue uncertainties are factored in, the model forecasts a sweet spot
for vital sign monitoring, med management and aging with vitality.
Figure 11: Market Opportunity Comparison
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In our final ranking of the nine market opportunities, the size of targeted users and 5‐year CAGR are also taken
into consideration. The results are shown in Figure 12. Our rankings are for comparison purposes, and Parks
Associates strongly recommends investors and entrepreneurs consider all nine opportunities along with
their particular business strengths. Lower ranked opportunities may offer compelling returns if investors
match unique market requirements with their strengths and execute their business plans with speed and
precision.
Figure 12: Market Opportunity Ranking
Market Opportunity Rankings
The target market is that portion of the consumer population that would have an acute need or show strong interest in a particular solution. Adopters are those members of the target market that actually purchase/use the solution.
©Parks Associates for AARP, 2013
Opportunity Area RevenueRevenue
Variance
5‐Year
CAGR
Target
Market
Number of
Adopters
Overall
Ranking
Medication Management #3 #3 16% #3 #3 1
Aging with Vitality #5 #1 17% #5 #2 2
Vital Sign Monitoring #1 #5 16% #4 #4 3
Care Navigation Solutions #2 #9 23% #7 #5 4
Emergency Detection & Response #4 #4 25% #9 #9 5
Physical Fitness Solutions #6 #2 23% #6 #8 6
Social Engagement Solutions #8 #7 23% #1 #1 7
Diet & Nutrition Solutions #7 #8 20% #2 #6 8
Behavioral & Emotional Health #9 #6 30% #8 #6 9
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6.0 References
6.1 Selected Works Cited
Alzheimer’s Association. 2012 Alzheimer’s Disease Facts and Figures, 2012.
American Psychological Association. Stress in America: Our Health at Risk. January, 2012.
Cacioppo and Patrick. Loneliness: Human Nature and the Need for Social Connection. W. W. Norton &
Company, 2008.
Caprani, Greaney, and Porter. “A Review of Memory Aid Devices for an Ageing Population.” PsychNology
Journal , Vol. 4, No. 3 (2006), pp. 205‐243.
Center for Technology and Aging. “Technologies for Optimizing Medication Use in Older Adults.”
September 2011.
Cheng, Gurland and Maurer. “Self‐Reported Lack of Energy (Anergia) Among Elders in a Multiethnic
Community.” Journal of Gerontology. Vol. 63, No. 7 (2008): pp. 707‐714.
Donini, Savina and Cannella. “Eating habits and appetite control in the elderly: the anorexia of aging.”
International Psyogeriatrics. Vol. 15, No. 1 (March 2003): pp. 73‐87.
Federal Interagency Forum on Aging‐Related Statistics. Older Americans 2012: Key Indicators of Well‐Being.
Washington, D.C.: U.S. Government Printing Office, June 2012.
How, Shih, Lau, and Schchoen. Public Views on U.S. Health System Organization: A Call for New Directions.
2008.
Giles, Glonek, Luszcz and Andrews. “Effect of social networks on 10 year survival in very old Australians:
the Australian longitudinal study of aging.” Journal of Epidemiology and Community Health. Vol. 59 (2005):
pp.574‐579.
Medic Alert Foundation and Alzheimer’s Association. Wandering: Who’s at Risk? 2012.
Peterson, Rhea, Sen, and Gordon. “Resistance exercise for muscular strength in older adults: a meta‐
analysis.” Aging Research Reviews. Vol. 9 (2010): pp. 226‐237.
Pew Internet & American Life Project. Older Adults and Internet Use. June 6, 2012.
Williams and Kemper. “Exploring Interventions to Reduce Cognitive Decline in Aging.” Journal of
Psychosocial Nursing and Mental Health Services. Vol. 48, No. 5 (May 2010): pp. 42‐51.
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6.2 Selected Statistical Sources
Centers for Disease Control:
Early Release of Selected Estimates Based on Data from the January‐September 2009 National Health
Interview Survey, March, 2011.
“Diagnosed and Undiagnosed Diabetes in the United States, All Ages, 2010,” 2011 National Diabetes Fact
Sheet, http://www.cdc.gov/diabetes/pubs/estimates11.htm
Health, United States, 2011: With Special Feature on Socioeconomic Status and Health, 2012.
“Injury Episodes and Circumstances: National Health Interview Survey, 1997‐2007.” Vital and Health
Statistics. Series 10, No. 241 (September 2009).
“Nonfatal Bathroom Injuries Among Persons Ages ≥ 15 Years, United States, 2008.” Morbidity and
Mortality Weekly Report. Vol. 60, No. 22 (June 2011); pp. 729‐733.
“Unhealthy Sleep‐Related Behaviors,” Morbidity and Mortality Weekly Report. Vol. 60, No. 08 (March
2011): pp. 233‐238.
Parks Associates:
Managing Care through ACOs: Consumer Interests & Requirements. December, 2012.
Digital Health: Q2 Market Focus, Online Health Service. 2012.
Digital Health: Q1 Market Focus, Multiple Medication Management and Smart Pill Boxes. 2012.
IP‐Based Health Solutions: Home Care & Beyond, November, 2011.
Personal Health Tools and Applications. 2010.
U.S. Census Bureau:
Statistical Abstract of the United States. 2012.
American Community Survey. 2011.
Current Population Survey: Annual Social and Economic Supplement. 2010.
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Appendix A: Population Data
Figure 13: U.S. Population by Age and Sex, 2010
Figure 14: U.S. 50+ Population Forecast, 2011‐ 2018
Total Population Male Female
All Ages 308,745,538 151,781,326 156,964,212
Under 5 years 20,201,362 10,319,427 9,881,935
5 to 9 years 20,348,657 10,389,638 9,959,019
10 to 14 years 20,677,194 10,579,862 10,097,332
15 to 19 years 22,040,343 11,303,666 10,736,677
20 to 24 years 21,585,999 11,014,176 10,571,823
25 to 29 years 21,101,849 10,635,591 10,466,258
30 to 34 years 19,962,099 9,996,500 9,965,599
35 to 39 years 20,179,642 10,042,022 10,137,620
40 to 44 years 20,890,964 10,393,977 10,496,987
45 to 49 years 22,708,591 11,209,085 11,499,506
50 to 54 years 22,298,125 10,933,274 11,364,851
55 to 59 years 19,664,805 9,523,648 10,141,157
60 to 64 years 16,817,924 8,077,500 8,740,424
65 to 69 years 12,435,263 5,852,547 6,582,716
70 to 74 years 9,278,166 4,243,972 5,034,194
75 to 79 years 7,317,795 3,182,388 4,135,407
80 to 84 years 5,743,327 2,294,374 3,448,953
85 to 89 years 3,620,459 1,273,867 2,346,592
90 to 94 years 1,448,366 424,387 1,023,979
95 to 99 years 371,244 82,263 288,981
100 years+ 53,364 9,162 44,202
U.S. Population by Age and Sex, 2010
Source: U.S. Census Bureau, "Table 2. Population by Age and Sex: 2000 and
2010", 2010 Census Briefs, Age and Sex Composition: 2010 (May 2011)
Unit 2011 2012 2013 2014 2015 2016 2017 2018
People 50‐64 #M 59.0 59.7 60.6 61.4 62.4 63.4 64.4 65.5
Growth % 1.3% 1.4% 1.5% 1.6% 1.6% 1.7% 1.7%
People 65+ #M 40.4 41.2 42.1 43.0 44.0 45.1 46.3 47.7
Growth % 2.0% 2.1% 2.2% 2.3% 2.5% 2.7% 3.1%
Total People 50+ #M 99.4 100.9 102.6 104.4 106.4 108.5 110.7 113.2
Growth % 1.6% 1.7% 1.8% 1.9% 2.0% 2.1% 2.3%
U.S. 50+ Population Forecast, 2011 ‐ 2018
Source: Parks Associates, 2012.
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Appendix B: Parks Associates’ Data Highlighting 50+ Market
Technology Attitudes and Adoption
Figure 15: Mobile Phone Ownership, by Age
5%
5%
6%
10%
13%
10%
20%
19%
32%
41%
50%
62%
74%
76%
62%
49%
37%
29%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
18‐24 (n=386, ±4.99%)
25‐34
(n=531, ±4.25%)
35‐44
(n=542, ±4.21%)
45‐54(n=508, ±4.35%)
55‐64
(n=330, ±5.39%)
65 and Older
(n=203, ±6.88%)
% Indicating Phone Ownership
Do not own phone Own basic/feature phone Own smartphone
Mobile Phone Ownership, by Age (Q4/12)"Q2033. Which type of mobile phone do you personally use?"
(Among U.S. Broadband Households, by Age)
Source: Managing Care ThroughACOs: Consumers Interests & Requirements© Parks Associates, 2012.
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Figure 16: Attitudes Towards Technology, by Age
26%
35%
47%
31%
40%
47%
24%
32%
35%
21%
29%28%
14%
17%
22%
13%11%
19%
0%
10%
20%
30%
40%
50%
I value technology, which makes our life/work easier, but I personally don’t
like technology
I truly enjoy technology and would like to purchase the latest technology
products, even though they are always expensive
I heavily use apps on the smartphone for daily information and entertainment purposes
(Among Smartphone Owners)
% Highly Agree with Statement
(i.e., Rating 6‐7 on a 7‐pt. Scale)
18‐24 (n=386, ±4.99%)
25‐34(n=531, ±4.25%)
35‐44(n=542, ±4.21%)
45‐54(n=508, ±4.35%)
55‐64(n=330, ±5.39%)
65 and Older(n=203, ±6.88%)
Attitudes Towards Technology, by Age(Q4/12)"DT1001. Please indicate your level of agreement with the following statement about your attitudes to technology."
(Among U.S. Broadband Households, by Age)
Source: Managing Care ThroughACOs: Consumers Interests & Requirements © Parks Associates, 2012.
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Figure 17: Consumer Use of Top Web Services, by Age
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
18‐24
(n=352, ±5.22%)
25‐34
(n=461, ±4.56%)
35‐44
(n=543, ±4.21%)
45‐54
(n=568, ±4.11%)
55‐64
(n=384, ±5%)
65+
(n=209, ±6.78%)
% Using W
ebsite W
eekly or Daily
Yahoo
YouTube
Use of Top Web Services, by Age (Q4/12)"Q9005. How often do you use the following websites?"
(Among Consumers Ages 50 and Older Living in Broadband Households )
Source: March 2012 Survey© Parks Associates, 2012.
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Diet & Exercise
Figure 18: Healthy Living Behaviors Among 50+
11%
16%
26%
26%
27%
33%
34%
42%
53%
71%
79%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Buy organic food
When eating out, check calories of the foods ordered
Eat fast food
Drink alcohol
Use tobacco products
Exercise indoors (aerobics, yoga, pilates, etc.)
Exercise outdoors (jogging, biking, hiking, etc.)
Weigh yourself
When shopping, check food labels for ingredients and calories
Take vitamins or supplements
Eat fresh fruits/vegetables
% Engaging in Activity Weekly or Daily
Healthy Living Behaviors Among 50+ (Q4/12)"Q4035. How frequently do you...?"
(Among Consumers Ages 50 and Older Living in Broadband Households, n=819, ±3.42%)
Source: Managing Care ThroughACOs: Consumers Interests & Requirements© Parks Associates, 2012.
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Medication Management
Figure 19: Number of Prescribed Medication Taken, by Age
22% 20% 17% 18%13% 13%
8% 10%12% 13%
15% 14%
6% 8%15%
26%
42%
60%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
18‐24
(n=1400, ±2.62%)
25‐34
(n=2140, ±2.12%)
35‐44
(n=2240, ±2.07%)
45‐54
(n=2040, ±2.17%)
55‐64
(n=1240, ±2.78%)
65 and older
(n=840, ±3.38%)
% Taking Specifying Number of Medications
3 or more
2
1
Number of Prescribed Medications Taken by Age (Q1/12)"Q4010. How many prescription medications do you currently take on a regular basis?"
"Q1000. In what year were you born?"(Among Specified Age Groups)
Source: Multiple Medication Management and Smart Pill Boxes© Parks Associates, 2012.
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Figure 20: Challenges Taking Multiple Medications
0%
2%
4%
6%
8%
10%
12%
18‐24
(n=1400, ±2.62%)
25‐34
(n=2140, ±2.12%)
35‐44
(n=2240, ±2.07%)
45‐54
(n=2040, ±2.17%)
55‐64
(n=1240, ±2.78%)
65 and older
(n=840, ±3.38%)
% Specifying Challenges
(As % of A
ll Households)
Forget to take the medications
Run out of medications because you forgot to refill the prescriptionRefilling prescriptions is complicated
Uncertain about the medication’s side‐effects
Challenges with Taking Multiple Medications as % of All Households (Q1/12)"Q4011.Which of the following challenges have you had with your medications?"
"Q1000. In what year were you born?"(Among Specified Age Groups)
Source: Multiple Medication Management and Smart Pill Boxes© Parks Associates, 2012.
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Medical Conditions and Vital Sign Monitoring
Figure 21: Prevalence of Health Conditions, Among 50+
28%
1%
5%
7%
7%
9%
12%
12%
13%
16%
18%
36%
40%
0% 10% 20% 30% 40% 50%
None of the above
Type I Diabetes
Arrhythmia (irregular heart beat)
Heart disease (excluding Arrhythmia)
COPD (Chronic Obstructive Pulmonary Disease)
Asthma
Obesity (BMI over 30)
Clinical depression (on depression medication)
Sleep disorder (Sleep Apnea, Chronic insomnia, etc.)
Type II Diabetes
Overweight (BMI over 25 but below 30)
Abnormal blood pressure (too high or too low)
High cholesterol level
% With Specified Condition
Prevelance of Health Conditions Among 50+ (Q4/12)"Q4025. Do you have any of the following conditions?"
(Among Consumers Ages 50 and Older Living in Broadband Households, n=819, ±3.42%)
Source: Managing Care ThroughACOs: Consumers Interests & Requirements© Parks Associates, 2012.
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Figure 22: Health Device Ownership, Among 50+
1%
2%
3%
3%
13%
17%
16%
35%
35%
1%
1%
3%
13%
11%
20%
23%
33%
61%
0% 10% 20% 30% 40% 50% 60% 70%
A digital pill box with reminder function
Medical alert button/pendant
Heart rate watch
Digital hearing aid
Digital pedometer
Large fitness equipment
Glucometer
Digital weight scale
Blood Pressure Meter
% Using Specified Device
65 and Older (n=203, ±6.88%)
Ages 50‐64 (n=616, ±3.95%)
Health Device Ownership, Among 50+ (Q4/12)"Q4005. Which of the following healthcare products do you or any family member in your household use?"
(Among Consumers Ages 50 and Older Living in Broadband Households)
Source: Managing Care ThroughACOs: Consumers Interests & Requirements© Parks Associates, 2012.
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Figure 23: Van Westendorp Pricing Analysis for Fall Detection Program
$1 $5 $10 $15 $20 $25 $30 $35 $40 $45 $500%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% specifying price point
Good value
Too cheap
Getting expensive
Too expensive
A Fall Detection Program Price Point: Van Westendorp Model (Q2/10)(Among Respondents Interested in Paying for Service for Seniors, n=156, ±7.85%)
OPP: $23
PMC: $17
PME: $30
The model suggests that a good price range for a fall detection service is
between $17 and $30.
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
Health Innovation Frontiers for the 50+ | 29 March 2013 | © Parks Associates AARP Confidential – Not for distribution 117
For more information: Keith Epstein [email protected] 50+ | 30
Figure 24: Van Westendorp Pricing Analysis for Medication Management Program
$0 $5 $10 $15 $20 $25 $30 $35 $40 $45 $500%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% specifying price point
Good value
Too cheap
Getting expensive
Too expensive
A Medication Management/Reminder Service Price Point: Van Westendorp Model (Q2/10)
(Among Respondents Interested in Paying for Service for Seniors, n=113, ±9.22%)
OPP: $23
PMC: $17PME: $30
The model suggests that a good price range for a medication
management/reminder service is also
between $17 and $30.
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
Health Innovation Frontiers for the 50+ | 29 March 2013 | © Parks Associates AARP Confidential – Not for distribution 118
For more information: Keith Epstein [email protected] 50+ | 30
Figure 25: Van Westendorp Pricing Analysis for Home Health Monitoring Program
$0 $5 $10 $15 $20 $25 $30 $35 $40 $45 $50 $55 $60 $650%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% specifying price point
Good Value Too Cheap
Getting Expensive Too Expensive
Home Health Monitoring Service Price Point: Van Westendorp Model (Q2/10)
(Among Respondents Likely to Pay for Service, n=610)
OPP: $17
PMC: $14
PME: $26
Using the Van Westendorp Model, the optimal price is around $17/month and a good price range is between $14 and $26.
Health Innovation Frontiers: Untapped Market Opportunities for the 50+
Health Innovation Frontiers for the 50+ | 29 March 2013 | © Parks Associates AARP Confidential – Not for distribution 119
For more information: Keith Epstein [email protected] 50+ | 30
Navigating the Care Experience
Figure 26: Satisfaction with Hospital Experience, Among 50+
53%
53%
56%
57%
57%
61%
59%
59%
63%
62%
64%
67%
68%
72%
0% 20% 40% 60% 80%
Follow‐up service after patient was discharged
Hospital admission process
Communication with your primary care doctor(about your treatment)
Communication with doctors and nurses from hospital
Overall patient experience of the transitionfrom hospital to home
Information/instructions provided at discharge
Responsiveness of hospital staff
% Very Satisfied with Experience (i.e., Rating 6‐7 on a 7‐pt. Scale)
65 and Older
Ages 50‐64
Satisfactionwith Hospital Experience, Among 50+ (Q4/12)"Q4205. How satisfied were you with the following aspects of most recent hospital service visit?"
(Among Consumers Ages 50 and Older Living in Broadband Households Who Were Recently Hospitalized)
Source: Managing Care ThroughACOs: Consumers Interests & Requirements© Parks Associates, 2012.