‘Social Determinants of Aging’ Startup Exits Stealth with $6M in Funding, Magellan Health’s Support

A new senior care startup has come out of stealth, armed with millions of dollars in seed funding and backing from a major population health provider.

The startup is DUOS, a New York-based company that enables aging in place by deploying expert care coordinators — “Duos” — into the homes of older adults. It unveiled its model on Tuesday while also announcing $6 million in seed funding from investors Redesign Health and Forerunner Ventures.

“At the highest level, Duos — our personal assistants — work with older adults to help them stay at home while also providing their regular caregivers peace of mind,” co-founder and CEO Karl Ulfers told Home Health Care News. “We’re using technology plus that personal assistant to establish relationships with older adults and caregivers, around all those needs they have to be able to age independently in their own home.”


Broadly, DUOS is building its business via two different strategies, Ulfers explained.

On one hand, it works directly with consumers who require help coordinating everything needed to age in place through its technology platform. Those services are already available across the U.S. in a 100% virtual capacity, with DUOS planning to integrate its in-person offering down the road.

On the other, the startup teams up with both payer and provider organizations to help them keep members and patients out of institutional settings. Its enterprise business is currently up and running with one client across Georgia, with particular density in the Savannah area and its surrounding rural communities.


In addition to the Georgia client, which Ulfers isn’t able to reveal quite yet, DUOS will soon launch its enterprise business in Pennsylvania. That expansion into the Keystone State is related to an existing partnership with Magellan Health Inc. (Nasdaq: MGLN), one of the nation’s largest complex care management companies.

“At Magellan, we are committed to transforming the health care experience through high-tech and high-touch solutions that address the health and wellness needs of the whole person – life, mind and body,” Alisa Bahl, the company’s chief strategy and innovation officer, said in a statement. “This collaboration with DUOS will allow us to augment our behavioral health offerings and expand our multidisciplinary care teams through a personal assistant solution for older adults that addresses social determinants of aging.”

The human element

Similar to other senior care startups that address “social determinants of health,” DUOS is focused on “social determinants of aging,” according to co-founder and Chief of Staff Jacques Anderson.

That’s an important mission considering America’s rapidly aging population.

Upwards of 10,000 Americans turn 65 every day, with the vast majority of them looking to stay out of long-term care facilities. By 2031, one of every five U.S. citizens will be of retirement age.

Unlike other senior care-startups that operate with a tech-first mindset, however, DUOS is somewhat unique with its hybrid approach.

“The human element is one of the things that underpins our business model,” Anderson told HHCN. “We’re in a world where there are a growing number of older adults who are living alone. That’s coupled with growing technology and social needs. Oftentimes, these individuals don’t have any additional support, such as an adult child or a caregiver who can potentially help out. Our business model is looking to fill that gap that’s essentially left in the market in our culture.”

In addition to Anderson and Ulfers, the DUOS leadership team includes COO Anne Marie Aponte, previously of Accolade and DispatchHealth, plus Chief Product Officer Kristen Lynch, previously of Onduo and Athenahealth.

For Anderson, co-founding DUOS has been a deeply personal experience, she explained.

Although her parents are still under the age of 65, they both live with chronic health conditions, which Anderson has tried to help manage remotely. On top of that, Anderson’s father recently battled through “a very bad bout of COVID.”

“They both live in St. Louis, while I live in New York,” she said. “They each have chronic conditions, so I manage a multitude of things. And they are individuals who are not quite recognized as senior citizens, … but they’re already facing a tremendous amount of issues.”

A three-pronged approach

As far as reimbursement, DUOS has “three primary channels,” Ulfers noted.

Thanks to the ongoing supplemental benefit expansion in Medicare Advantage (MA), DUOS is able to contract with payers offering social-needs benefits and programs for chronically ill members. DUOS also works with plans coordinating care for dual eligibles.

“We can also sell directly to those risk-bearing providers that service those MA and duals plans,” Ulfers said.

A second channel is long-term care insurance.

“We’ve got a number of conversations going on right now, where long-term care insurers are interested in offering DUOS as a benefit to help people age independently in their home when they go on claim,” Ulfers added.

The last channel is employers with employee-benefits packages that offer respite for workers caring for older loved ones. Starbucks (Nasdaq: SBUX), Best Buy (NYSE: BBY) and TripAdvisor (Nasdaq: TRIP) are just a few of the corporate giants now offering caregiver benefits.

“There is an incredible amounts of stress that working parents go through between taking care of their kids and taking care of their aging parents,” Ulfers said.

As for the Duos, they’re part-time workers — not independent contractors. There’s not one single profile of a Duos, though DUOS has found success in recruiting workers from the “9 a.m. to 3 p.m.” segment.

“The ‘9 a.m. to 3 p.m.’ movement are moms and dads that are stay-at-home moms and dads, people who maybe have time during the day while their kids are at school or at other activities,” Ulfers said. “They have a strong desire to continue to be involved in a mission like ours and have work that’s meaningful.”

DUOS additionally tries to recruit individuals with prior caregiving experience.

“We’ve done a ton of research in this space on who older adults actually want to work with,” Ulfers said. “What we’ve learned is that they really want to work with people who have life experiences and have done caregiving themselves previously.”

Moving forward, DUOS plans on using its $6 million in seed funding to further build out its technology platform for both its direct-to-consumer and enterprise models.

“From a tech perspective, you need to have various modalities to be able to service everyone,” Anderson said. “We need to be able to have in-person [services], so you need to have a mobile app. You need to have a web form that people can interact with. The enterprise side of our business requires us to have security, privacy, HIPAA-compliance — all these different compliance and regulatory overlays.”

Companies featured in this article: