a16z says the value is in the action layer. Practices already own it.
a16z's State of Longevity report says AI makes health answers cheap, so the value moves to whoever helps people act on them. For DPC, concierge, longevity and primary care practices, acting on the answer is the job. Here is what the report means for a practice, and what to set up first.
Executive read
- On November 3, 2026, a16z published The State of Longevity. Its main point: AI makes health answers cheap, so value moves to the companies that help people act on them. a16z calls this the action layer.
- The report is written for founders, but the action layer it describes is the daily work of a practice: order the test, read the result, book the follow-up, start the treatment, check progress.
- The practices that win are the ones that make that next step easy and keep the patient coming back. That is a question of recall, intake, messaging and membership, more than of any one new drug or test.
What the report says.
The State of Longevity, by Daisy Wolf and Eva Steinman at Andreessen Horowitz (a16z), looks at what U.S. consumers are doing about their health with their own money. It draws on a survey of 500 U.S. consumers and covers six trends: the race to become a person's healthcare home, non-toxic products, peptides, cholesterol, wearables, and brain health.
The line that matters most for a practice is this one: "As AI makes answers and interpretation cheaper, value will migrate to the companies that can figure out the action layer." And, in the authors' words, "Knowing your numbers is the starting point. The opportunity is helping people act on them."
The gap is between knowing and doing.
The report's wearable numbers show the gap clearly. 54% of the people surveyed use a wearable, and 83% of those check it every day. Yet 55% of wearable users say their data has never led them to change a habit or see a doctor.
The authors name the hard part directly: asking an AI a health question is useful, "but arranging the next test, booking the appointment, and making sure the patient gets follow-up care and prescriptions is harder." Patients now arrive with more data and more questions than before. What they lack is someone who turns that into a plan and follows through.
That gap is a practice's work.
a16z sees an opening for "companies that connect testing to personalized treatment, help patients access medications, and track their progress." A practice already does all three. It has clinicians who can order labs, prescribe and follow up. What most practices lack is not clinical skill. It is the operating loop around the visit.
In a typical practice, the follow-up depends on a person remembering. The lab result arrives, the patient gets a portal message, and the next visit is booked only if someone calls. Each of those steps is a place where a patient quietly drops off.
Prescribing will not set you apart. Keeping patients will.
The report makes a point every membership practice should note. "GLP-1s helped many care delivery companies grow, but most of the enterprise value accrued to pharma." The authors expect peptides to follow the same path: "as more companies offer the same drugs, prescribing them could become less of a competitive advantage and more of a service patients expect."
They add that offering a new treatment may matter more for keeping existing patients than for winning new ones. For a DPC, concierge or longevity practice, that is the business model in one sentence. The patient relationship, kept over years, is what holds value.
Patients will bring you what they read.
The report covers topics patients will raise at their next visit. It says U.S. guidelines now recommend testing lipoprotein(a), or Lp(a), at least once in adulthood, and that roughly one in five people have a high level. Only 21% of the people surveyed knew about PCSK9 inhibitors, a class of cholesterol drugs. 62% said they would pay more for products labeled non-toxic.
The authors also warn: "Consumer spending is moving faster than the evidence." That is where a practice earns trust. Patients need a fast, careful answer from a clinician who knows their history, not a sales page. A practice that replies quickly, and is careful in what it says, keeps that patient.
What to set up first.
1. Recall from your own patient list. Pick a group (for example, patients tagged as due for annual labs) and send them a campaign they can book from. In Cara, this is the Grow module.
2. Intake that arrives finished. Forms go out with the booking and are filed to the chart before the visit, so the visit is spent on the plan, not on paperwork. This is the Intake module.
3. One inbox for every patient question. AI reads each message first and flags urgent ones. AI writes reply drafts, and staff approve each one before it is sent. This is the Messaging module.
4. A membership that pays for the follow-up. Offer it after the visit, with your own tiers and prices, billed through Stripe. This is the Memberships module.
5. One funnel to measure it: lead, booked, completed, member, by campaign. If you can see where patients drop off, you can fix that step.
The short version.
The a16z report is about where large companies will be built. But its central idea applies to every independent practice today. Answers are becoming free. The follow-through is not. Practices that make the next step easy, and keep the relationship going, are in the right place.