Hey Everyone - Dez here from All Things Venture. When I started to work at Cadre in 2019 it wasn’t long before I heard the phrase, “Doing well, while doing good.” It’s such a simple concept and adage, but it’s one that I think a lot of young professionals struggle with. Many of us have checked the box on the doing well part. We have a job that pays the bills, allows us to save, and live the lifestyle that we want. But the doing good? Doing good feels more elusive. I’ll never forget my summer intership on the trading floor at Morgan Stanley because it was the first time I felt like doing good may be out of reach. Pretty early on that summer I had this epiphany where I realized that the entire job of being an equity trader is to help rich people become more rich. As a relatively naive, glass-is-always-half-full 21 year old - it was a bit of a wake up call. At that point in my life I wasn’t really ready to only focus on doing well. Fast forward a few years and I’ve now picked up the work experience, and confidence that in most places you can do well, while doing good. Some jobs are more explicit (i.e working for the Emerson Collective, or the Ford Foundation, or Teach for America), but I generally have the view that where there’s a will there’s a way.
So, with that in mind I want to introduce today’s Startup Spotlight - Levo. Levo was started by Jason Yu, someone who I believe is firmly on the track of doing well, while doing good. Levo is focused on creating better jobs for the nearly ~3.5M home health & personal care aides in the US that take care of nearly 10M Americans every year. Why focus on creating better jobs for home health aides? I’m glad you asked. Over the next decade, the number of Americans 65 and older is expected to increase by 30%. By 2040, it’s an expected 44% increase. On top of that the industry is experiencing a severe shortage of workers. 80% of home based care providers are turning away referrals due to capacity and 75% of home based care providers report an increase in the cost of care due to staffing shortages. Our country is getting older, our citizens are living longer, and consumer preferences are shifting toward wanting to comfortably live in their own homes for as long as possible.
I think the home health care market is fascinating and that building a startup in this industry is the perfect example of being able to do well, while doing good. As always, let’s dive right in.
Jason super excited to be chatting, can you tell us a little bit about Levo, your business and what you're doing?
Thank you, thank you for having me. My name is Jason Yu, I am the founder and CEO of Levo. I help caregivers find work, and better jobs. I am a recent Grad from the Wharton healthcare management MBA Program. I am also a former operator in the healthcare space and I built Levo because, as someone who is a first generation immigrant, as someone who has seen my parents work hourly jobs, I know that the amount of potential that is in these types of jobs, is not very equal to the amount of opportunity that is given to the people who are doing these jobs. What Levo is doing, is helping build a career ladder and be the trusted advisor, like the best friend of these caregivers and what we've seen is that, like these caregivers come from all different walks of life. They're from generations of nurses and nurses aides. They might have been doctors, but emigrated to the United States and simply don't have the right certifications. In any event, what we want to do is - we want to be the easiest way for these caregivers to find the jobs that worked for them.
Can you help the audience better understand the challenges going on in the caregiving market and the fundamental lack of supply in the market?
Yeah so it's a very tough job. To sum it up, it is a very physically and emotionally taxing job where caregivers, especially senior caregivers, they are the ones that work with people towards the end of their life. In most of these cases, these caregivers they are the closest human relationship that the seniors have. Beyond their family members, beyond their friends. And the reason why there's a fundamental imbalance, even though this job is so important and so crucial to healthcare infrastructure, is because it’s just not compensated as such. When I talk to some of my customers, they tell me that their competition is not necessarily another agency. Their competition is the Amazon warehouse or driving for DoorDash. At the end of the day, the unfortunate reality is that home care agencies that staff caregivers, they’re looking for a certain level of professionalism, but not necessarily compensating for the requisite amount.
How do you think about making the home care agencies that you work with today more competitive relative to the Amazon warehouse worker job?
I think about it in terms of making it as easy as possible to get the job, so when you already have someone with the desire to care, when you have someone who wants this type of job, you should not be building barriers or building fences to keep them from getting those jobs. I also think about it in terms of this job should merely be like, the first step in a long healthcare career. That’s something that has been DIY’d in the past when it comes to, people quitting their job with one employer in order to go back to school, or someone saving up money so that they can pay for a certification class, and then from there they move up themselves and go from like starting out as a personal care assistant to being a licensed practical nurse or, even a registered nurse.
When you think about it, what we're doing is, we're building that career path for the caregivers. We're making it easier for caregivers to find these jobs and we're making it easier for the home care agencies to hire them, with the understanding that if the caregivers were ambitious and wanted to move along that career ladder - that that's okay. We’re not going to hold on to workers, because that's not necessarily the right way, because if you try to hold on to people that's when they end up leaving the industry, not necessarily just your company.
Can you help us better understand what that career ladder looks like, and how Levo is upskilling workers at each rung in that ladder?
Yeah, we can start out even with the variance between different agencies for the same certification level. So, what we're doing at Levo is we are one, making it easy for caregivers to find their jobs, but also advising caregivers on what jobs are the best fit for them in terms of an employer. So, for example, a top-of-the-line home care agency in New York - they're probably paying around like $18 per hour for a home health aide, and then on the opposite side of the ladder, you have companies that are doing more like waiver like Medicaid like support services that, have a more of like a volume based model, and those are the places that don't necessarily require experience, meaning they will train you, and the level of acuity from the patient population is typically lower as well.
So, the ladder that we're already seeing is where, if someone applies to that top-of-the-line private pay home care agency, but doesn't necessarily have the right experience, or isn't quite ready for that jump.
We will be able to send them first to the more volume-based agency to basically cut their teeth in the job,
and to get more reps in, and to understand, like all right, maybe you need some more work with memory loss patients, and we're going to work on that for the next couple of months. So that's simply in the like personal care assistant and home health aide side.
The next step is where you move into certified nursing assistants (CNAs), and this is where you can either work in the home, or you can work in a facility. So, facilities that means like skilled nursing, or assisted living like those type of places. When you move up to becoming a CNA, that's when you start cracking like $20 an hour $25 an hour. And then, after you become a CNA that's when you can start becoming a licensed practical nurse (LPN), and depending on your employer, you can either get between like $35 an hour, or even more if you become a traveling LPN, at like a post-acute facility.
Finally, there are bridge programs that get you from LPN to RN (registered nurse) but traditionally RN is where you need a four-year bachelor's degree and obviously, like we've seen like, especially during the pandemic that, the demand for traveling nurses has also gone up. The earning potential for nurses goes anywhere from like $65 an hour to like over $100, $150 per hour like depending on the place and the type of work that's required.
Wow. That’s incredible, and you know, assuming you can get people from home-health aide up to licensed practical nurse, that could be a 3x improvement in their hourly wage. But I’ll ask a slightly nuanced question, do you view Levo as a network?
I view Levo as a series of opportunities. I think the biggest distinction that I want to make here is that we're not a marketplace. We're not a place where you find a job, and then we kind of clean our hands and like we're good to go. We’re more of a relationship. We build a relationship with each caregiver who comes through our doors, and if that means we're a network then let's go. Let's go ahead and call it a network but, I see it more as, we build relationships with the caregivers, and we build relationships with our customers. What that means is we're able to direct our caregivers to the places that fit both their experience and background, as well as their desires and ambitions.
When you speak with those caregivers what are their ambitions?
Some people are in school to be nurses, and they are working part time as caregivers. Some people have been working as caregivers for the past 12 years, and they consider this their career and they want to find a very stable client who they can then build relationships with. The most common story that we hear is that, a caregiver is typically a working mother, someone who's a first generation immigrant with young children, and they are caregiving in order to provide for their children's education. They see that second generation as their hopes and dreams.
A very common conversation that we have is, you can be a part of that story, you can be part of that growth story. You don't have to stay at like $12.50 an hour you don't have to stay at like $15 an hour.
There are different ways for you to also build up your experiences and work for the employers that value you, for you.
That’s incredible. What's something that you didn’t expect in your journey to become a founder?
That businesses move in step functions. When I first started, I had this like very naive view that, “Okay I'm going to set a goal and every single month we're going to grow by this much, and we're going to hire this many people, and it's going to just go according to plan.” I think you know where the story is going, but what I learned is basically everyone has a plan until you get punched in the face.
And through those growing pains, what I found was that there are times of drought and there are times, where like, it's pouring. The key is to not to let the times, where you feel like everything is going wrong, to really affect how you execute. When things are going right, you should take advantage of as many of these opportunities as possible. Like if you were to tell me this time last year that our business would be where it is today, I probably wouldn't be like that surprised. But, if you told me like the journey that it took to get here and the various peaks and valleys along the way? Yeah, I’d probably be a little more nervous than I was at this time last year.
One question I always ask, and I love asking it because it - I think it captures the ethos of All Things Venture, of sharing and learning in public is, what advice would give to anyone who's thinking about becoming a founder or starting their own business?
Just get started. It doesn't matter how small it is. It's a lot easier to change directions than it is to get started, like inertia is extremely important. I know people from college, from my job, from business school who've always thought about starting a business, who have always had the itch, who have always had that notepad where they would write down the different ideas that came to them.
So my advice would be figure out how you can test your idea. You don't have to quit your job. You don't have to do any of that. If you’re really convicted about something, maybe you should just go ahead and try to get a job in that area, or maybe do something on the weekends, but anything just, just get started.
Because once you get started, you'll realize that it's a lot easier to accelerate and it's a lot easier to change direction.
That’s it for this week everyone. I hope you all have a fantastic weekend AND enjoy Juneteenth. If you enjoyed this post/learned something new - don’t hesitate to share this bad boy with a friend.