Zemplee Podcast : Episode 16

Ishanya Anthapur (00:10.54)

Running a home care company is operational chaos. Agencies juggle intake calls, caregiver matching, compliance documentation, scheduling, and constant communication with families, making it one of the most operationally complex sectors in healthcare. Home care agencies are basically doing the work of hospitals, but without half of the infrastructure, funding, technology, or media buzz that hospitals rely on.

So what would happen if we started directing real technology and innovation towards home care? How much could we shift the needle in that industry? Today's guest is here to talk about that. Our guest today is a co-founder of Sage, an AI native CRM and workflow platform designed specifically for home care agencies. Our guest today has previously worked on product at companies like Uber, Blue Apron, and TripAdvisor, all

home names and was the first product hire on Uber direct, helping grow it into a billion dollar global logistics operation. Super impressive guys. Through his experience helping his own father navigate the care system, our guests saw firsthand how fragmented and operationally difficult home care can be. So he's really got a personal connection to this story. He later founded, co-founded Clara, a home care marketplace and compliance platform.

that is scaled across California and other states. That experience ultimately led to SAGE, where our guest today and his team are now using AI to automate intake, communication, and operational workflows for home care agencies. Welcome, John.

Jon Levinson (01:53.806)

great to be here. Thank you so much for having me.

Ishanya Anthapur (01:56.962)

John, you're going to join us today to talk about the intersection of AI, logistics, thinking, and the future of home care and operations. But I wanted to start out by telling us a little bit about what is Sage and who is Sage built for?

Jon Levinson (02:11.118)

Yeah, absolutely happy to. And thank you for that wonderful introduction. I think you nailed it when you described Sage as a CRM and intake workflow automation platform for home care agencies, but that's a lot of jargon. So effectively what Sage does is it helps agencies better manage their client intake workflows and their relationships with other members of the community, whether those are people seeking care, their family members,

or referral sources that they work with to generate more business and ensure that they have a steady stream of clients coming in the door. And what Sage does is build a virtual assistant that uses AI to record every conversation that the intake folks in those agencies have with prospects, with referrers, with their family members, with whomever, and generate intelligent next steps.

for that person to take following those conversations for every step of that intake workflow to manage that relationship from the very first time that they contact them, that they get on the phone or that they receive an inbound form on their website or what have you, all the way through signing a contract, getting a caregiver assigned to that case, getting them into the home and managing that client relationship on an ongoing basis thereafter.

By taking the contents of those conversations, those phone calls, those in-home assessments, real-world meetings, and generating things like email, follow-up emails, care plans, CRM updates on the status of that lead in your pipeline, so that everything is kept up to date automatically and synced back to your agency management system or scheduling software.

that the agency uses as basically their source of truth and their hub for all of their operations.

Ishanya Anthapur (04:07.714)

I love this idea because you I think there's you could someone could say there's already CRMs in place there's already this and that but home care is such a specific intake process there are so many extra details you've got to collect so many things here about who this patient is where they are distance wise like what's going on with their

medical background, what's going on with their insurance, right? Like so many tiny little details and that's just the logistics. And then you've got the personal side of things, right? Like what is their daily blueprint like? When can they expect caregivers? So why are we relying on humans to sit on the phone and try to record everything, whether manually or even on their...

on laptops, it's still it's so much operational work. So I think something that comes in that is specifically designed for home care is is ingenious. It's really, really a great invention. And we're so happy to have you. I'm curious, because you said you had your own personal journey into this space, coming from product at bigger big tech companies or. Yeah.

Jon Levinson (05:06.766)

Yeah, go ahead.

Ishanya Anthapur (05:19.244)

from other companies. can you speak a little bit as to how you got involved in the wonderful world of home care?

Jon Levinson (05:26.338)

Yeah, I think my story is similar to many others in that home care was an industry and a space that I had paid zero attention to and was barely aware of its existence before my family came into contact with that need ourselves. And it was an eye-opening experience and not necessarily in a good way. without getting into too much of the gory details, unfortunately, my father has been suffering from pretty acute health issues for a number of years and coming

out of COVID, he really needed some additional assistance beyond what our family could provide ourselves while keeping him safe in the home. And my mom, who has done an incredible job of being his primary family caregiver, like millions of others, it goes underappreciated. And my mom is certainly the poster child for the amount of work it takes to care for someone in the home who's in need.

She was looking for.

additional assistance. So our family started looking for local agencies. We started exploring whether there were private duty caregivers, people we could hire directly to care for my father, doing everything that your typical family does when you're exploring the space and doing your research for the first time. And it was challenging. We couldn't differentiate between a high quality agency and a low quality agency, the caregiver that was going to be caring for my father.

Ishanya Anthapur (06:29.869)

Yeah.

Jon Levinson (06:57.522)

wasn't necessarily clear when we tried hiring privately. There were all the logistical issues of managing payroll and taxes and insurance and what happens when that caregiver isn't available or needs to take a break. And I saw my mom struggling under this load while I was working at Uber. And my brain has always been very tech oriented, has always thought about

breaking down problems systemically and think about how we can apply technology to potentially solve some of these issues. And I was looking at the home care space through the naive lens of someone working at a tech marketplace and saying, why does it seem as though this industry has not evolved and adopted tech in the same way? The rideshare industry is, we're not still all riding around in yellow taxi cabs the way we were 20 years ago.

So why are we still purchasing home care in the same fragmented, expensive, and non-transparent way we always have? And so it got me really fixated on that problem. I started doing research in my free time to better understand the dynamics of the industry. And one thing led to another. I eventually decided that.

this was a space I wanted to commit myself to investing in professionally and building to try to build a better solution for my own father and my family and hopefully the millions of others who are in similar positions. So that kind of led to the creation of Clara and the evolution from Clara to Sage is one that we can get into, but it basically came from the...

Ishanya Anthapur (08:25.805)

Yeah.

Jon Levinson (08:36.836)

Collision of Maya and our team's idealistic view of how the home care world should operate and the reality of how it does operate and some of the problems that stand in the way of delivering that high quality, reliable and affordable care and where we can best leverage our talents as technologists to make the biggest impact possible.

Ishanya Anthapur (08:57.902)

That makes a lot of sense. I'm wondering if one of the challenges, could you, did you anticipate the challenge of the home care system being so fragmented? And I'm wondering how that compares to the ride share market and if that had, you know, that helped you at all when you were building Clara.

Jon Levinson (09:23.106)

Yeah, it was a bit of a surprise, I'll be honest with you. I think we underestimated how challenging it is to establish yourself as a brand and grow a sustainable business in the home care space. And it really illustrates why home care continues to be such a hyper local business. People rely on the relationships that they have built in their community.

When you're the agency owner or operator or the provider, you've built relationships with referral sources, the case managers, the social workers, the discharge coordinators at the local skilled nursing facilities who have patients that need to be safely discharged to their home. You're going to build those relationships and maintain them. You're also going to build relationships directly in the community with family members simply by spending years delivering a high quality service, generating Google reviews, generating positive word of mouth.

the way that most families continue to find care.

is by asking their friends, their colleagues, the people they know from church or their kids little league team, Hey, I know your mom or dad had trouble finding, looking for care. and you went with this person. Can you share a recommendation? How did you go about doing this? Do you recommend the agency you went with and so many more of the incumbent agencies in this space, they don't have to spend very much on marketing because they have substantial inbound demand.

from that organic word of mouth because they've been doing this for a long time and they have a reputation. But for those up and coming agencies that are just getting their feet under them, growing their business is their primary concern. It's their number one pain point. How do we get people to be aware of us? How do we get people to know that we are here?

Jon Levinson (11:15.724)

We have good quality caregivers. We care deeply. Our prices are affordable. We accept your long-term care insurance or Medicaid or whatever program you want. Like getting the word out, that awareness, driving that top of funnel demand is a huge challenge for those relative newcomers to the space. To juxtapose that with Uber, to your question, the network effects of Uber were extraordinary. And they, because of the breakout potential of that product,

were able to leapfrog from market to market. So while Uber needed to seed every individual city independently, the drivers in San Francisco were not going to be the same drivers in Los Angeles. People traveled from one city to another for work, for on vacation, for pleasure. And if I was used to using Uber in San Francisco and I arrive in LA,

I'm going to open the Uber app and try to take a ride. And I'm to tell everyone I run into in LA, Hey, there's this thing called Uber. It's amazing. You should do it. So the network effects for a product like Uber, even though they needed to establish each market individually, we're a lot stronger than network effects in home care, which are hyper local and relationship based for good reason. The risk associated with making a bad decision in home care is really high. The risk associated with trying a new ride share.

It's pretty low. You might have a bad ride. You might have a bad trip. You're not going to wind up having a really devastating health outcome. And so people need that trust when it comes to home care in a way that, you know, an Uber might be able to have a more risk tolerant stance.

Ishanya Anthapur (13:00.334)

Thank you. puts it in frame really well. think you're right that home care is still such a hyperlocal game, but we are seeing the rise of more sort of structured national companies, but they all kind of still operate in that sort of franchise space. They're franchises of that bigger national company.

If someone wanted to install something like Sage, would it be at that franchise level or yeah, how's that working out for you guys right now?

Jon Levinson (13:38.062)

We work directly with franchisees and independent home care agency operators. So our technology is easily deployed at the individual agency level. We can also work with larger organizations, but effectively our software goes into the hands of the people who are on the ground helping families find care. And what it delivers is a higher quality experience for the consumers with significantly less effort.

on the part of the agency operators so they can get through a lot more in their day while giving a better experience to the people that they're trying to sell their product. And it leads to a higher conversion for those agencies as well. Because really when you're a consumer or you're a family caregiver and you're looking for help and you're trying to decide between agency A and agency B or you go online and you go to a placeformom.com and you...

talk to someone and then all of a sudden without knowing why you start getting 17 different calls from home care agencies, which is an experience I'm sure a lot of folks have had. It's really hard to differentiate who is actually going to deliver the experience you want. And many consumers ultimately, they make their decision based on two factors. One is price and the other is responsiveness and the trust that

you can get from working with someone at an agency that really can build that trust quickly and demonstrate that their agency is going to be there to care for you and your loved one over the lifetime of your relationship. so Sage participated in the AgeTech Collaborative Program from AARP just this past fall and through that program we were able to run a number of consumer surveys and

Ishanya Anthapur (15:25.036)

nice.

Jon Levinson (15:32.62)

We asked people who had shopped for home care, we asked hundreds of people who had shopped for home care in the past two years, what was it that caused you to select the provider that you ultimately went with? 30 % of them said responsiveness. And some other stats around that, 81 % of respondents said they expected a response from the agency they contacted within an hour.

90 % said they expected a response within 24 hours. So if your agency isn't able to respond to these leads, you're gonna lose them. And that is really a devastating outcome for these businesses in these competitive markets. And it's a bad experience for the families. Like my family had that experience. My mom got a list of home care agencies to call when my dad was being discharged. She called the whole list. She got a call back from

maybe one out of every four, three out of four never bothered to call her back. And that is just something that we believe should not happen anymore. And Sage can help agencies with that.

Ishanya Anthapur (16:38.978)

Yeah, definitely. mean, do you think that this sort of inbound outreach client acquisition workflow is where you can really see automation in AI coming into play to help?

Jon Levinson (16:52.782)

I think that the home care space is one that is perfectly suited for AI across the board when it comes to a lot of the workflows that have historically been handled by humans. And it's really exciting to think about what that means for these businesses and what it means for the pricing dynamics for families and for caregivers as well.

The client intake workflow is one where AI can do a massive amount of work under the hood. We still in our product have designed it to keep the agency employees, the owner operators, the intake specialist, the nurses, front and center, because we want them there building trust, but they should not have to spend any amount of time.

taking notes that distract them from the conversation. If we were having this call right now and I had to write down everything you were saying to me, or you had to write down everything I was saying, we would not be paying attention to one another. It would not work. So eliminating that need is a no brainer. Eliminating the need to translate that into formal documentation to share with the rest of your team is also a no brainer.

And being able to cut down all of the duplicative tasks of saying, oh, my notes are in this app or on this piece of paper. And then I need to put them in my CRM over here or a spreadsheet where I track my leads over here. And then the care plan needs to be written in a third system over there. All of that just creates overhead, wastes time, should not have to happen. AI is incredibly good at doing those kinds of tasks. And so Sage automates a hundred percent of that.

The other workflows in home care that are already being automated in really interesting and exciting ways are things like scheduling and staffing. So when we were running Clara, all of these workflows were things that our team experienced and the pain of growing and scaling that operation was something we felt firsthand.

Jon Levinson (18:57.922)

Scheduling and staffing is a constant juggling act for agencies. It's another task that AI can do really well. And there are a number of companies like Care QB, for example, that are working with agencies to solve that scheduling and staffing problem to make sure.

they're assigning the right caregiver to the right case at the right time and ensuring coverage when caregivers call out or there's a change in schedule. That's another great application. There are other applications in the billing and revenue cycle management that are right for automation as well. So it's our vision and our view that

In the future, a small independent home care agency or a franchise should be able to run a business with dozens up to 100 caregivers, dozens of clients active, generating millions of dollars of revenue full with a team of under five people. AI should be able to assist those people, put them in positions where they're doing the work a human has to do and automating the work that humans should not have to do. And the implications of that.

are that an agency with five people today that might have to go hire another two or three people to grow to the next tier doesn't have to make those hires because their existing team can get 50, 60, 100 % more efficient, double their efficiency. And the pricing implications are dramatic. One thing we were trying to do with Clara,

was reduce the sticker price for families and increase the take-home wage for caregivers. And we were able to do that really effectively with the operating software we built for ourselves because unlike agencies, we weren't spending 30 % of our top line revenue on operating expenses. And when you look at the PNL, not to get too in the weeds of the home care business here, but when you look at the PNL of a home care business,

Ishanya Anthapur (20:35.608)

What?

Jon Levinson (20:55.376)

they're spending up to a third or 40 % of every dollar they take in, not on wages to the caregiver, but on operating costs because they're still doing things with pen and paper really inefficiently. And that cost can be eliminated and it can be returned to the caregiver in the form of higher wages, which creates a virtuous cycle where your agency can retain caregivers, retain higher quality caregivers, reward the best caregivers so they stick around. And that will help you grow your business.

Or you can reduce the price that you charge to consumers and make this service that's becoming increasingly unaffordable just a little bit less pricey for people.

Ishanya Anthapur (21:35.023)

Yeah, and you can, you could, have the option, the flexibility to go dynamic too with the pricing and kind of expand into different markets, price, lower price, higher for different like levels of service. So I think it's, it's really wonderful. I mean, the other place I know about automation and AI coming in is also in terms of the marketing.

Jon Levinson (21:48.346)

Totally.

Ishanya Anthapur (21:57.711)

but also in terms of just hiring caregivers and things like that. So sounds like that's exactly, it's like a similar space that Sage and Clara exist in, but they're very innovative and they're gonna go really far. We're really excited about, yeah, we're really excited about this.

Jon Levinson (22:00.643)

Yeah.

Jon Levinson (22:12.592)

That's a great one.

Ishanya Anthapur (22:18.094)

So I wanted to ask how caregiving has showed up in your life and in your teammates lives because thank you for sharing. do know about your story already and has your mom found some relief after all of this?

Jon Levinson (22:34.704)

Yes, thank you for asking. Our family was fortunate enough a couple years back to find an incredibly dedicated and wonderful caregiver who's been with our family now for, I believe over two years. And that's been a major load off of our entire family.

Ishanya Anthapur (22:47.17)

That's awesome.

Jon Levinson (22:54.722)

made everyone's immensely better. The rest of our team have similar stories. I don't want to overstep my bounds and share some personal details of their lives, but we do really believe that one of the things that's so exciting about working in

the home care space and in age tech is that you can recruit really talented mission driven people. And I know being mission driven is a bit of a cliche that there's a backlash to and I understand it. workedat companies like Uber, transparently. I don't think many people join Uber for the mission. There are interesting problems to solve. There's a really like incredible culture of people who are working hard and solving problems.

Ishanya Anthapur (23:27.758)

you

Ishanya Anthapur (23:32.353)

You

Jon Levinson (23:41.206)

But you're not joining Uber because you're really passionate about changing the world and making delivery and ride sharing of like more accessible people. In the age tech space, you find people who are motivated because they've had experiences that have opened their eyes to this increasing societal problem of our aging population and they want to do something about it.

And I'm lucky because I get to have conversations with folks like you and folks who are just starting their journey in home care. had coffee with someone last week who was basically she quit her tech job and is now doing what I did a couple of years ago, which is figuring out what she wants to do next. All she knows is, hey, this is a big problem. This is a space where I think there's an opportunity for me to make a difference. And I'm going to figure out the best way for me to bring my talents to bear to help.

the American aging population age a little more safely and a little more affordably in their homes.

Ishanya Anthapur (24:37.228)

Yeah, think caregiving is a very interesting space. Can I quickly ask what age did, like, were you when this started to creep into your life?

Jon Levinson (24:48.014)

I was pretty young. I was a sophomore in college when my dad first got sick. And it's been a long journey since then, but this is something that has always been in the background for my family. And it'smade me a lot more empathetic.

Ishanya Anthapur (24:50.062)

Yeah.

Ishanya Anthapur (24:54.06)

Wow, yeah, yeah.

Jon Levinson (25:05.805)

and understand that not everyone's family has someone who's necessarily like truly ill in this way, but everyone's family is struggling with an aging loved one in some capacity or another.

Ishanya Anthapur (25:20.544)

Of course, that's what our journey has shown us too, that everybody is a caregiver or will be a caregiver or will need care. And it's just kind of crazy to us that

Jon Levinson (25:28.176)

Yup.

Ishanya Anthapur (25:32.889)

There, you know, things like health, like there's so much in the medical world that's getting all this attention about AI automation, improving it. but there's tons of space to grow within the home care industry as well. Senior living at large. and I agree completely everyone we've met here. So mission driven, come check out our other podcasts to see all the cool stuff people are doing from things like. Mention care to Sage and Clara. I have a.

Jon Levinson (25:56.728)

Okay.

Ishanya Anthapur (26:02.842)

I want to ask one more last question about, I noticed on your website something called Home Care GPT, which was a HIPAA compliant AI tool for generating care plans and documentation. Can you tell us a little bit about that and how I would possibly use that if I was a caregiver?

Jon Levinson (26:09.858)

Yes.

Yes.

Jon Levinson (26:23.472)

Absolutely. Well, it's super easy to use. You can just go to our website, sagecare.ai and click on the Home Care GPT button in the top navigation menu. And it basically functions just like a chatbot you'refamiliar with, like a chat GPT or a Claude, but it is 100 % HIPAA compliant. So we were inspired to build this.

because we were having conversations with agency employees as well as family caregivers who were very open about the fact that they were using ChatGPT frequently in their day-to-day lives for either professional tasks or personal caregiving tasks that touched on sensitive personal health information that really should not be getting shared to open AIs, just like generic ChatGPT data repositories.

Ishanya Anthapur (27:18.574)

you

Jon Levinson (27:19.564)

So we, with HIPAA compliance built into our core DNA and with the relationships with those large language model providers like OpenAI and Anthropic to ensure that all of the requests we send them are HIPAA compliant and secure. We said, hey, we should allow this to be used for folks who want to ask questions of a large language model or

take care of translating some notes into a structured care plan and do it in a fully HIPAA compliant way. So anyone can go to our website, paste in whatever you want, ask whatever questions you wantand chat with this AI and it will generate whatever you're looking for. All of your data is stored securely and there's no risk of PHI leakage or any other sort of...

nasty outcomes that you might find from using ChachiBT with your client's data, which you should not be doing as a home care agency.

Ishanya Anthapur (28:24.928)

It's an amazing tool. It's an amazing tool. I highly recommend you check it out. I put in like a sample of notes from a client called a fake sample and it did spit out a care plan and some follow ups and I thought it was pretty accurate, pretty on point. So it's an amazing tool for caregivers and it's free everyone. So definitely go check it out. And they can find it at www.sage.

Jon Levinson (28:47.972)

Definitely.

Jon Levinson (28:54.372)

sagecare.ai, so S-A-G-E-C-A-R-E.ai.

Ishanya Anthapur (28:54.455)

A.I.

Ishanya Anthapur (29:00.212)

Awesome. That brings us close to the end of the show, but John, I've got a few fun questions. What is a book that you recommend to others? Something you're reading or something you recently finished or even something you read a long time ago.

Jon Levinson (29:14.32)

I'll share a book I recently finished which really blew me away. It has nothing to do with home care, but it really does speak to the human condition. So I recently finished reading The God of Small Things by R.N. Dottie Roy, which really blew me away. It's fantastic, just like literary fiction and...

If you're into that sort of thing, it is unbelievably powerful. I also want to shout out, I know this is cheating, an upcoming book that I have not had a chance to read yet, but a good friend of ours, Becky Real of Real Home Care Consulting is releasing her book called Borrowed Time about her journey in the home care space. And for this audience, I'm really super excited to get my hands on a copy. I'llbe out in Chicago with her at her book launch party next month.

So really excited about that. And Becky's had an incredible journey building a really successful home care agency from scratch, learning a lot of lessons along the way. And she's captured them all in a memoir here, which I encourage everyone to check out. It's, I think, available on Amazon. It's called Borrowed Time. Check that one out,

Ishanya Anthapur (30:31.466)

that's got that sounds great they're both sound like amazing books good stories good lessons from both though and what's something great that you've watched on TV or in a movie recently

Jon Levinson (30:34.733)

Very different.

Jon Levinson (30:40.794)

Totally.

Jon Levinson (30:46.768)

I don't get to go to the movies nearly as much as I'd like to at this point, but I did see a movie last week, which was really fun. It's Nirvana, the band, the show, the movie, a wacky name for a wacky movie. It's a really like heartwarming, small buddy comedy of these two.

fiercely Canadian guys who get into a bunch of hijinks. I recommend it. It's really light and funny, but like surprisingly heartwarming and endearing. Check that one out.

Ishanya Anthapur (31:25.678)

That sounds awesome. And it's not about Nirvana, the band.

Jon Levinson (31:29.168)

It is not about Nirvana the band you're thinking of. If you're Googling it Nirvana with two N's, well three N's technically, N-I-R-V-A-N-N-A the bands. So not about Kurt Cobain. If you're going in looking for Kurt Cobain and Courtney Love Content, you're gonna be disappointed.

Ishanya Anthapur (31:33.55)

you

Ishanya Anthapur (31:45.262)

That sounds awesome. We like to ask those questions because, you know, everyone's human. We've all got our stories and our interests. Thank you so much, John, and best of luck. We're so excited to see where Sage grows to and really, really honored that you could join us today.

Jon Levinson (32:08.62)

Of course, thanks for showing up. Have a great day.