The a16z Show - Can AI Fix Housing and Healthcare Affordability?

Episode Date: August 21, 2025

Housing and healthcare make up nearly half of household spending, yet both sectors are riddled with inefficiency and rising costs.In this episode, Erik Torenberg is joined by a16z Growth partner Alex Immerman and Minna Song and Tony Stoyanov, cofounders of EliseAI, to discuss why they’re tackling these critical industries and how AI can transform everything from leasing and maintenance to patient scheduling and compliance.The conversation covers:Why the U.S. is 5 million housing units short — and how technology can help unlock existing supplyHow automation can cut waste, reduce labor costs, and improve affordabilityWhat fully autonomous buildings might look like, and how that model could extend to healthcareThis is about the costs that touch every household, and the role AI might play in finally bringing them down.Timecodes: 0:00 Introduction 0:28 Why Housing and Healthcare?1:17 Technology’s Role in Housing3:39 Housing Affordability & Supply Challenges5:42 Regulatory and Capital Barriers8:30 Improving Efficiency in Real Estate13:05 Automation and the Future of Property Management18:28 The Human Role in an AI-Driven Industry20:35 Financial Engineering & Data Bottlenecks21:51 The Future of Housing: Robotics, Mobility, and Flexibility25:29 R&D and Technology Adoption in Real Estate27:09 Addressing Criticisms of PropTech29:24 Maintenance, Repairs, and AI Solutions31:44 Expanding from Housing to Healthcare32:38 Parallels Between Housing and Healthcare36:41 The Future of Healthcare Operations39:09 Lessons Learned & Ultimate Vision for EliseAI40:55 Closing ThoughtResources: Link to blog: https://a16z.com/announcement/investing-in-eliseai/Find Minna on LinkedIn: https://www.linkedin.com/in/minna-song/Find Tony on LinkedIn: linkedin.com/in/stoyan-tony-stoyanov-07690a53FInd Alex on X: https://x.com/aleximm Stay Updated: Let us know what you think: https://ratethispodcast.com/a16zFind a16z on Twitter: https://twitter.com/a16zFind a16z on LinkedIn: https://www.linkedin.com/company/a16zSubscribe on your favorite podcast app: https://a16z.simplecast.com/Follow our host: https://x.com/eriktorenbergPlease note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. a16z and its affiliates may maintain investments in the companies discussed. For more details please see a16z.com/disclosures. Stay Updated:Find a16z on YouTube: YouTubeFind a16z on XFind a16z on LinkedInListen to the a16z Show on SpotifyListen to the a16z Show on Apple PodcastsFollow our host: https://twitter.com/eriktorenberg Please note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. a16z and its affiliates may maintain investments in the companies discussed. For more details please see a16z.com/disclosures. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

We're about 5 million housing units short of what we actually need in the country. Our goal is to enable fully autonomous buildings. An entire portfolio has the ability to run core operations without requiring human intervention at all. Housing and healthcare are the biggest expenses that people have. It's pretty self-evident that technology makes the experience better for everyone and brings down costs. And more people should be working on it. Elise AI is taking on two of the biggest and most expensive challenges we face, housing and health care. Joining me today are my colleague Alex Imerman from our growth team, along with Elise AI's co-founder's Minna Song and Tony Stoyanov.

We explore why these industries have resisted technological change, how AI can cut costs and inefficiencies, and the vision Minna and Tony are building toward, a future with more affordable, accessible services. Let's get into it. We're honored to announce our latest investment in Elise AI. Minna, Tony, welcome to the podcast. Welcome to the portfolio. Thank you. Well, and you guys give us a brief background or give the audience a brief background on why lease AI, why housing, why health care?

We wanted to use AI to solve real world problems. And housing and health care are the biggest expenses that people have. They eat up about 42% of what a typical household makes. And nationally, these sectors, make up about 40% of the entire GDP. So it's pretty obvious that we need to figure out how to cut waste in these industries. It was pretty crazy to us that not enough people were working on these problems. Top technology people, for example, are not asking the hard questions about how can we actually fix it. It's just sort of an accepted tax that we all pay. So we started digging a lot

deeper into how these systems operate. And once you do that, you can see inefficiencies everywhere you look. And those really add up to huge costs to all of us. And it's also not just about the money, but the quality of these services has a really big impact on people's lives. And when they fail, it doesn't just hurt individuals. It actually hurts kind of society as a whole. So really fundamentally important problem for us to solve. Alex, why don't you give the perspective from the growth team in terms of there's been a lot of players in the space over time. What got you excited about this space and why this team? Yeah, I mean, as you think about the space, a lot of it ties with what Minna just said, right? So our partner, Mark, every year, like, clockwork, he sends out this

updated chart and it shows consumer goods and services over time. And if you look at housing and healthcare, as Minna just said, like prices just go up, up, up to the right. And any industry that technology has touched has gone down. So you can see that in computers, TV, video games, and we keep asking ourselves, like, why hasn't software eaten this industry? Why hasn't software touched housing and healthcare?

And right now, it's like such a paradigm shift with AI where the operational, administrative, and communication burden can really change. And so you look at Minna and, Tony, like two incredibly tenacious technical co-founders. And they were early to this problem. They started in 2017. And they have gone deep. First in housing and more recently in health care. And the results just speak for themselves. Customers absolutely are delighted with the product.

You see that qualitatively in the feedback we heard, but then quantitatively the scale, the growth, the efficiency. And we're thrilled to partner with them. Minna, why do you go deeper in terms of what are the unlocks to actually improve housing affordability or when you give some more context on the problem? Well, for housing affordability, housing supply matters most of all. That's the single greatest determinant of housing prices. So one, we know that we need to build way more units. We're about 5 million housing units short of what we actually need in the country.

And we need to add somewhere between 1.8 to 2 million units per year just to, kind of keep that shortage from getting worse, let alone making up for that deficit. We've only developed about one and a half million units last year, so we actually need to increase our delivery by about 50%. And actually, analysts say that the pipeline is shrinking for 2026 and beyond. So they said it's going to drop by about 50%, so we're headed in the completely wrong direction. So housing supply matters, but in the short term, we can actually get more out of our current supply. So I'll give you an example, which is almost half of inquiries that go to a rental apartment building, never get responded to. So you've all experienced this, right? We've all experienced

that we want to look at an apartment, but we get ghosted. No one responds to us. And that apartment's still sitting there available, and you want it, but it's being underutilized just because the process is broken. And so AI is managing all that demand. We can actually turn vacant apartments into occupied way faster. So we have data that proves that this works, actually. Earlier this year, we provided data to an organization called ALN and found that buildings using our AI had 2% higher occupancy compared to market. So we're working on fixing the affordability problem and the supply problem from a bunch of different angles. You mentioned we're going in the wrong direction. Can you share more about why that's happening and what are the sort of biggest regulatory or technological bottlenecks that need to be

addressed for that to change? There's a lot of regulation, a lot of zoning laws that cause parts of this problem, but even relaxing regulation will not solve that problem by itself. We also need more capital flowing into housing construction today. And that's a big thing that we think about internally at Elise AI. Capital flows where there are the highest returns. And right now, housing has lower returns relative to other asset classes. But we're actually enabling.

housing to achieve higher returns because we're creating these 10x better housing operators that return higher profits to investors. If housing is a stable and a higher return investment, how much more capital would be flowing to this most fundamental need for society. So that's really great for everyone because it drives more supply into the market and supplies really king to fixing the housing crisis. On the regulatory side, do you think we'll see full yimbism in our lifetime? Or is your view of there's some structural reason that impedes that in the US relative to, you know, a country like Japan and we just got to work with what we've got. I think we really hope so. I think different cities actually have kind of started making real progress towards this.

Minneapolis is a great example. They did a big housing reform. Part of that was actually ending single family zoning rules there. And that happened back in 2019. And I think ever since that, we've seen supplying has grown three times faster than the national. average and rents have stayed actually flat for that whole period compared to everybody else's experienced about 31% increase. So I think we're seeing some early signs there and hopefully other cities and states take that example. And then even if we got sort of Tokyo level zoning

tomorrow, how fast could supply responder? Is it really just the sort of capital balance that is preventing that? I think the data is somewhat clear that obviously would take a few years to see the full impact, but I think if you let people build, they will go and build and the market will take care of itself. And obviously, there will be a lot more innovation as well as it gets much more competitive of the market. When we go deeper into understanding what needs to be true for it to be a more attractive asset class, maybe you can sort of walk us through, explain a little bit how it's made up and what would need to be true to improve the rate of return there. It's very inefficient. That's the reality is that we're dealing with the physical world.

and along the way, real estate has not invested a ton of technology. So it hasn't gotten a lot of the efficiencies that an internet company or SaaS company could achieve. So there's a bunch of headwinds working against this asset class. One is labor. Labor is super expensive. It's only getting worse, particularly after COVID. There's a bunch of other reasons like insurance premiums and just costs and supply chain. disruptions after COVID as well. But all in all, I think the biggest controllable expense that our

customers look at is labor. There's not too much they can do always about, it's not as low hanging as insurance changes. New York and San Francisco are two markets that have really struggled with housing supply. Assuming we don't get more housing supply in these two cities, what do you think can be done to increase the affordability? Yeah, I mean, I think even if we don't build more, more units. S.F. Vacancy rate is at about 3.5% today. So there's definitely room for more efficiency. You can kind of increase that utilization by making units turn faster, by filling units faster. For all of that, better technology can help. You want to cut all the manual inefficiencies. But there are also other ideas around like you can do smaller apartments,

share amenities, more flexible layouts. Better infrastructure in general also helps. You know, If you connect Jersey better to New York, obviously that increases the supply in a way in the whole metro area, and that increases affordability. So I think all of these things can help a lot. To a certain extent, those are band-aids. We do need to build more units, and that will be the main way to consistently drive that affordability.

But I would say there's definitely more room for improvement, even at today's supply. Yeah, I mean, of course, we hope that more supply gets built and more red tape gets cut in San Francisco. I know Eric and I are at least optimistic about permit SF led by Mayor Lurie. But I guess absent that software probably can be an important lever to resolving some of these issues, where do you see that tangibly impacting affordability? I think technology can counter some of the cost inflation and headwinds.

But it's also a sector that historically hasn't invested much in tech compared to other industries. So I think number one, we have to execute really well to get these sort of non-tech adopted. audiences to use what we builds and accept it. But if we do that well, the biggest controllable expense is labor. So AI being used to automate and eliminate a lot of the manual and inefficient workflows can help a lot. So we're already seeing customers reduce some of these expenses and finding other savings as well, like cutting legal fees because your operations are already more compliant from the start or reducing cap-x costs by optimizing preventative maintenance so things don't break as much. So all of these

things add up and, you know, if someone's absorbing those costs and it's you. So yeah, we're creating these sort of 10x operators that... My landlord is not thanking me. So we've seen with many of your clients then be able to centralize a lot of their staff, increase AI as a communication mechanism with their tenants. And the impact has been dramatic. I know with equity or residential, one of your customers, they've gotten up to 200 units per employee. Maybe just walk us through, like, how do you get from half of that, which I think is like baseline expectation to twice as high? And then how do you think about the efficient frontier? Like, where should that be in five years from now? Our goal is to enable fully autonomous buildings.

So that means an entire portfolio has the ability to run core operations without requiring human intervention at all. So when you look at what actually happens on site at a building, you quickly realize how much of that day-to-day work is just administrative in nature and can be automated away. So really when you're thinking about the physical limits, it's just truly the physical work that's left. The maintenance or things that are maybe,

legally required. So those are the parts that I think are a little bit harder and actually put kind of the thresholds on what's possible today. But I think going after full automation is really hard technical challenge that no one has truly figured out yet. So we really have to sort of reimagine our customers' entire operating models to be able to develop products that support this. So I think Equity Residential was a great example. Really early on had take an advantage of a ton of technology to get cost optimization and efficiencies. Brookfield Properties is another one of our customers.

They're building this centralized model that enables a single employee to serve as multiple properties and they're actually finding that they can get a single employee to work across 10,000 units using AI in a specialized role. And so think about that. One person managing what used to require dozens of people

that were decentralized, across multiple properties, it's a big difference, but you need a huge amount of automation to be able to achieve those numbers. Even the boundaries of what's actually physical are changing fast. I think something like door access wasn't, I think, 10 years ago.

And today we see more and more physical keys are being replaced by smart logs and now you connect your AI to that system. You can do key provisioning online. And I think we'll see more sensors in the buildings, more decisions being driven and more planning being done by the AI. Of course, there's still some physical boundaries.

The AI is not going to fix the sink, but I think we can push that boundary quite a lot in the next few years. Why don't you talk through where we are today in terms of what's been automated, what's not yet automated, and then we can get to what is the full vision. And in that full vision, what do humans do? A lot has been automated. I mean, maintenance, you'd have physical boards with covered in Post-it notes with people trying to keep track of what needs to be done.

and now that can be automated, triaged by AI, prioritized based on urgency of those issues, routed to the right technician, tracked everything automatically. And we see that some operators with this new, these workflows have cut average work order completion times from four to five days down to under 48 hours. So that's really meaningful for residents.

Leasing was maybe one of the worst. It was people just spending entire days answering emails, the same 50 questions, over and over and over all day long and just the same basic information and now AI can obviously handle that and complete those tasks with all the knowledge of a building

or all the knowledge of a portfolio. Touring was another area of automation, so you'd have to go meet a broker or go meet a leasing agent and be physically escorted to every single showing, but now AI can give you access or you can get access through

smart hardware, smart locks, lockboxes, and the AI can still be there to engage and answer all those questions and do the selling. So that gives you a ton of benefits and efficiencies where you're not just having, you're paying a whole human just to unlock a single door and actually cuts down average time for our customers from about 30 days from listing an apartment

to leasing it to under 14 days because it gives you so much more flexibility to tour around the clock. Documentation was a big area of automation, to lots of people just copying and pasting fields just an industry that was super ripe for technology that just didn't get it for a very long time yeah and I think this is only even the first order automation we can do I think there's a whole second order because Omino is talking about today is like on that single community level single building there's this whole question about like

how do you kind of organize the entire ecosystem, how can you share resources, whether it's people, parts, tools, between many buildings. Obviously, that increases the complexity. But for something like maintenance, we expect to see a lot more dramatic gains once you go on the ecosystem level.

And how about the second part of the question in terms of, okay, your vision comes true in terms of, you know, fully autonomous or fully automated housing. Right now there's a lot of people doing a lot of those activities or some of them. What do they go do? I think as AI takes over a lot of the communication and logistics, human roles don't all disappear. They just, these sort of AI enabled career paths start to emerge.

And I think you're seeing this in other industries as well. I think expectations are higher. People like you mentioned earlier expect that renting an appointment. apartment is super easy, super frictionless, and it doesn't require extensive human contact for basic stuff. And that's a great opportunity for AI. So I think you'll see that these career paths are in the short term, menial parts of the job go away. And people are spending time focusing on building relationships with residents, creating communities. I think people are spending more time at home, right? They're working at home. Their home is their office. Like, you still need

this human connection. And a lot of our customers we see that are creating roles like community engagement and helping people socialize. I think people will specialize tracks. So you might become, instead of this sort of generalist on site doing everything menial and complex, you'll actually see a lot more specialization.

And you might become a renewal specialist who handles the trickiest retention cases or a resident experience specialist that resolves conflicts. But I think in the long run, people will be managing big workforces of AI and sort of overseeing these automated systems that are mainly running most of the work. Yeah, and I'll add up to that that on the maintenance side, obviously I think that physical aspect is never going to fully go away.

I think it will be a lot more efficient. which I think is really needed because there's just huge shortages from labor perspective. And all of the maintenance technicians today are actually over 50 years old. So you can see that in the next few years it's only going to get worse and worse if there's, if there are no more efficiency gains. Going back to just the future of housing for a second. So let's say, you know, 10 years from now, we have robotics. You know, we've made some major advances in longevity research.

We have AGI. But when you paint, what's sort of the experience going to look like? Or how are those impacts, the ones that I mentioned, at least robotics and longevity, going to impact the market and asset class? I think the population is going to change a lot with AI. Why I kind of talk about longevity is, I think a lot of AI research is and should be going to extending human life. but obviously if you're living longer,

there are more people around staying around longer. And, you know, we talk about cost of living a lot. Cost of living is actually one of the, it is the number one reason that people don't have more children. So if AI creates a lot more wealth in the world and it brings, and, you know, it does things like bring the cost of living because of the efficiency is similar to what we work on in housing and health care, people have more kids, again, you have more population. So all these things I think will really affect

the housing market because all those people, this is a fundamental need for all those people. So yeah, we have to find efficiencies kind of as I mentioned before. It is more housing supply, and that's where sort of robotics can come in and play a huge role, which is can we use robots, you know, manufacturing, can we do, you know, modular housing? can we build faster with robots? Can we bring down the cost of construction? And I actually think this is an incredibly, that's one area that we've never touched.

We're not a hardware company yet. But it is sort of this big kind of piece of the puzzle in the long-term vision that really needs to be solved by somebody. And I think you also want to leverage a technology to increase mobility in general. I think today people are stuck in these 12-month, 24-month leases. I think in the future you want to have flexibility to just move in tomorrow and that will be very cheap.

And you can have much, much greater degree of flexibility. Yeah, I think mobility in the market is incredibly important and productive for society. So if you think about it, we are signing these 12-month leases and locked into these contracts as consumers. And that's a big commitment. A lot of people don't want to sign these leases, but it's really laborious to turn over every apartment, not just the maintenance turnover,

but finding somebody, answering all these same 50 questions over and over again, touring. There's so much labor that it makes it really difficult for an operator, like a housing operator, to find a new resident or a new tenant. AI doesn't really care if it's signing shorter term leases. It's just doing, you know, it's doing that over and over and it scales. Then you kind of get the benefit for the, both for the landlord and for the consumer that they can be more, they can do it at a cheaper cost

and people can be more mobile. I think that opens up a ton of opportunity. That's, you know, people can move for jobs easier. People can move for their children's schools. They can increase, improve their quality of life. So I think there's a bunch of different benefits of of mobility. We've been talking about technology as a lever here and the need for it in real estate. And yet real estate spends the least on R&D of any other industry. Why is that and what could be done about it? I think solving housing operations is incredibly hard. The search space is massive. There's just a ton of different edge cases. We face this every day. Every single building is different. it's a really large expense for people.

So it makes all these things make these interactions with an apartment, like leasing. It makes these interactions really complex. So in the past, you've really just needed a person because traditional software couldn't handle the variability that was required. So if you needed a person anyway, there wasn't really a motivation to buy technology. You just leaned on that person, you leaned on people to do absolutely everything.

Of course, those people got really overburdened, but also in the meantime, a lot of that critical data was never collected because it just lived in people's heads. So now AI has changed what's feasible, and it can handle these really large search bases. It can handle these really complex operations. So, I mean, in addition, real estate is so far behind on tech,

it actually has the most to benefit from AI. So it maybe is going from the lowest R&D spending to potentially one of the highest spenders on AI because AI has sort of finally unlocked automation that was possible that really they couldn't take advantage or they couldn't optimize it before. How do you respond to critics of PropTech who just say, you know,

PropTech is here to help residential real estate companies extract more value from their tenants? That's honestly a pretty silly argument. I get it. I think housing is really an emotionally charged subject. People apply these irrational expectations to landlords that they never apply to other types of business owners. So think about other industries.

You wouldn't want airlines to stick to paper ticketing processes so that they extract more value, so that they don't extract more value from tech efficiencies. Or you wouldn't, you know, if a supermarket didn't use scanners or barcodes, it's pretty self-evident that technology makes the experience better for everyone and brings down costs.

So we actually want landlords to use as much technology as possible because when they're slow to innovate, that's really actually bad for consumers. Yeah, and we think that the barriers to entry are already quite high. The operations are very complex. Everything you have to do is multimolo, so much stuff is manual. So I think that limits the amount of people

that can get into that business in the first place. And I think that actually gives a lot more pricing power to the existing landlords. So you can kind of make the argument that actually all of this inefficiency is really bad for the consumer. And I think at the end of the day, we believe that competitive markets

take care of themselves. And I cannot think of a single example where technology was banned. and then costs went down. I think that just never happens. Yeah, it's exactly the opposite, right? So generally when technology is introduced, you see a surplus,

and most of that typically goes back to the consumer. The criticism of ProctTech would be, is it all going to the property managers and the owner-operators? And hopefully as more and more AI is adopted, it's going to address this affordability crisis. Yeah, you need mass adoption. that's where the competitive markets take care of themselves.

So there's rising repairs, maintenance costs, these keep vacancies longer, apartments aren't occupied. This leads to higher housing costs as well. What is the lease doing to address this? What can be done over the next five years? Yeah, I mean, obviously there's a very physical component that needs to be taken care of. but actually where we think AI and technology more broadly can help all of these problems are actually very complex planning problems

that are quite difficult to solve with the current level of technology there's so much computation that you need to do around like how do you get smarter at scheduling technicians how do you get smarter at routing how do you kind of embed a lot of these common sense things that everybody on the ground knows but if you're fixing a dishwasher at the same time somebody can go and fix the holes on the wall

but if you actually want to paint the wall first you need to fix the holes you can just paint over the holes so kind of like there's a lot of technology there that we believe we can build that we'll make all of these planning, purchasing, scheduling orchestration decisions so much more efficient

and we're not even touching like what we think can be another big needle around that preventative aspect of like, how do you track what's going on in a property? How do you know when appliances come near their end of life and replace them in smart and cheap ways? And we feel like all of these problems can have a really, really big impact because today we see our clients waste days and days without,

because some piece of information got lost. Yeah, every day you shave off from the average unit turn time nationwide unlocks billions of dollars in value. So there's a ton of value just by moving the needle a little bit. The cause of those delays is completely avoidable stuff. So like this part wasn't delivered or the data wasn't input into the system. So the next person wasn't scheduled for that job. And it's totally addressable through automation.

And those are the problems that I think are really exciting. So when I met Midna in 2021, she and Tony were building a relatively narrow tool for leasing. We were catching up a bit over a year ago in 2024. Leasing had gone to broader residential ops, so maintenance that we've talked a lot about, billing, delinquencies, et cetera. And then she dropped, we're launching in health care. We launched in health care. And I thought to myself, like, you know, Minna, Tony, that's insane. What are those two industries have in common?

And I kind of just dismissed it, kept in the back of my head. And then, you know, catching up a couple months ago. And the healthcare business is humming. Maybe share what is similar in the workflows, what is different? What's been the most exciting there? Yeah. Yeah, we've been mostly, like, I agree with you, like, those two fields look very different. But we've been mostly touching the admin piece of the healthcare.

And we found, like, those problems sets are quite similar. You kind of see, like, these very bloated cost structures that, you know, have so many inefficiencies. They're all struggling with staffing. All of these total costs, you know, gets pushed to the end consumer. And we think a lot of the causes of that is, like, The very similar dynamics we see between these complex digital physical interactions that are full with regulations. And we believe AI can help quite a lot, both of them. We see so much commonality around how they approach things like intake.

You have to collect very structured information around names, preferences, budgets, insurances. And you keep dealing with this really high volume of repetitive. inquiries, you get the same questions again and again and again. And it's all done over the phone, over conversations. We've been able to adopt quite a lot of our technology pretty seamlessly. We developed our voice technology over the housing space, and that has translated really, really well in the healthcare space. And the same thing with a lot of the scheduling optimizations we've been doing,

have translated quite quite well. So they kind of feel very, very different, but from admin organizational operations perspective, we've barely been surprised by anything by transitioning to healthcare. We spent a bunch of time earlier talking about why housing costs are so high. It seems like no matter what healthcare costs

remain at a sixth or a fifth of the economy, is it that we're just getting a better product for that cost because our is healthcare good that we just keep wanting more of it and so no matter what we just we get something better and we're just going to keep spending it's inelastic that way or is it that some morass of regulatory challenges prevent technology from really you know bending that that that price curve what's happening there where our costs staying the same i think it's boulder actually true i i think it's healthcare is definitely a very elastic need where people are getting

better healthcare, people are getting more healthcare, I think if costs go down, people would want even more healthcare. So I definitely and that's a good thing, right? I think that makes people live longer and happier lives and I think that's super important. And that's all true, but

I would say like on the admin side, I don't think we're getting a better admin experience and I think the costs on the admin side have really skyrocketed way faster than anything on the clinical side. And I think partially people have invested in technology, but

it just hasn't been quite good enough again because so much is happening over the phone in these unstructured interactions. But we think with the current level of technology, you can actually make a really big dent into the admin aspect.

I don't think in healthcare there's been this huge boom of technology adoption that has, were surprised we haven't been it hasn't flowed to consumers' pockets yet. I think we'll see that with AI, but I don't think the cycle has given its feedback yet.

So I am still hopeful. But yeah, I think it can arise in either lower costs or better outcomes or a combination of both of those things. In housing, you guys have really gone from leasing to broader resident ops. You've started with scheduling on the healthcare side. Where do you think the platform goes from here?

We think for us, healthcare is much earlier. We think there's so much more that's happening on the admin backend side of things, that we feel like there's so much inefficiencies that needs to be addressed. And I think that's going to take a bit to actually cover all of that. ground, but I think anything from, you know, that first interaction to the billing cycle and, and more importantly, towards like, how do you kind of keep the communication post-appointment with the patient? Because I think today, you know, you go in, spend 10 minutes with the doctor. They're definitely very helpful. But then you get a piece of paper and it's like, good luck

from there onwards. I think AI can help quite a lot with engagement on the patient side. And I think there's a lot to be done there. Yeah, you go home from your appointment. You have like four things that you're supposed to do every night for the next week. And what is adherence to that? Pretty low. But if you got an OEAS message every night, you'd probably do a better job.

Yeah, I think AI plays a great role in education and leaving the outcome on the patient. If AI can scale and achieve better, treatment planned, you know, fulfillment, that's going to be better for everybody. It's certainly going to save us a lot of costs. You know, it's one of the government's largest expenses. And so we're all paying for that, those outcomes being poor as well. Yeah, and this adherence is not easy at all because, like, again, patients are very stressed when they go to a doctor.

It's not an easy thing to do. And I think AI can help them give them more. more time after the appointment to ask questions. Obviously, there's things like language barriers that AI can help quite a lot with. So I think there's all these benefits and that we'll be able to. Yeah, and involve family members who probably weren't able to attend the appointment or the procedure. Yeah, you have to think about all your questions, right, in the moment when you have that time with a doctor. And then if you think of something, your SOL, if you think of something too late.

in this episode we've been talking about housing we've been talking about health care these are two extremely complex markets i'm curious if you can go back in time knowing what you know now what might have you done differently i probably would have started with affordable housing actually affordable housing has kind of every problem that the rest of the industry has plus maximal complexity because of all the dense compliance and paperwork, all the additional requirements, and they are the most underserved. They have the biggest administrative drag, and they are also some of the slowest adopters.

So it just shows that there's this huge, clear opportunity for them to take advantage of AI, and it just takes longer to get there. So that's, I think, one big thing I would change, we're actually kind of approaching healthcare in a similar way, which is start with what is the most underserved, because that's where we can have the largest impact. The most underserved and the most complex, because if you sort of solve those problems,

then the rest of it is sort of easier downstream. Perhaps let's close on the ultimate vision for Elise AI. If you achieve everything you're setting out to do, and obviously you've achieved a ton to date, what more can you say about what that looks like at scale? I think our drive always has been cost reduction. If at some point, and obviously it's not just one company's effort, but if at some point we get to a place where like housing and healthcare

are not cost concerns for the average person, I think that will be like amazing. I think if we can take this 42% of what a household spends on housing and healthcare and bring that down to, you know, 20-something percent, that is I think one of the large most important problems we can solve and more people should be working on it. That's a great note to wrap. Minat Tony, thanks so much for coming on the podcast and being part of the portfolio. Thanks for listening to the A16Z podcast.

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