Suncoast Ventures · Fund II Care Economy Thesis
The Caregiver Economy
Mispriced, undercounted, and recoverable.
Suncoast Ventures · Ohai.ai
May 2026
Executive Summary
We wrote three papers with one argument.
Paper I reprices caregiving from the ground up. Paper II maps what the headline number misses. Paper III calculates what can be won back if coordination burden is reduced.
Paper I
$1.6T
53.0B hours of unpaid care
Repricing the Caregiver Economy
63.0M Americans provide 53.0B hours of unpaid care annually. Replacement-cost methodology floors the market at $1.01T. Opportunity-cost methodology reaches $1.6T, capturing displaced labor participation and wages foregone.
Paper II
$9,901/year
354 annual hours
The Coordination Economy
Caregiving extends beyond direct support into scheduling, transportation, provider communication, and follow-up across fragmented systems. That coordination burden is unmeasured and unpaid: 354 additional hours and $9,901 in annual opportunity cost per caregiver.
Paper III
$98.6B
3.276B recoverable hours
Recoverable Time & Economic Capacity
Reducing caregiver coordination burden by one hour per week recovers 3.276B hours annually across the caregiving population. At a blended opportunity-cost wage of $30.09/hour, that is $98.6B in economic capacity.
Scale: the $1.6 trillion hiding in plain sightPart I
53 billion caregiving hours, uncounted.
$1.6T at opportunity cost — the size of the global pharmaceutical industry. The gap between that and the prevailing estimate is $952 billion: larger than the entire U.S. defense budget. That’s the equivalent of 25 million full-time workers whose labor has never appeared on a balance sheet.
Minimum Wage
~$384B
Applying the federal minimum wage across 53.0B annual caregiving hours produces a conservative baseline valuation of unpaid care labor.
BLS 2023 · Repricing the Caregiver Economy
Replacement Cost
$1.01T
AARP’s replacement-cost model values caregiving at professional caregiver wage rates: pricing the labor required to replace the work itself.
AARP/NAC 2020
Opportunity Cost
$1.6T
Opportunity-cost methodology measures the economic impact of caregiving, including lost wages and reduced workforce participation. The methodology used in this thesis.
BLS/ATUS 2023 · Repricing the Caregiver Economy
Caregiving Value by Methodology
Three valuation approaches applied to 53.0B unpaid hours · Repricing the Caregiver Economy
Caregiver Workforce
Paper I63M caregivers. 19.2M balancing care with workplace disruption.
Work disruptions include reduced hours, missed shifts, career slowdowns, workforce exits, and the ongoing strain of balancing employment with caregiving responsibilities.
The Caregiver Funnel
63.0M total → 38.4M employed → 19.2M facing work disruptions · AARP/NAC 2020 · Repricing the Caregiver Economy
The Caregiver Toll
Papers I–IICaregiving produces measurable, documented effects on health.
Sleep loss, elevated depression risk, deferred medical care, and chronic stress are not anecdotal. They are consistent findings across a decade of caregiving research.
Sleep Disruption
40%
40% of high-burden caregivers report significant sleep disruption, double the rate of non-caregivers.
AARP/NAC 2020
Depression Risk
2.2×
High-burden caregivers face 2.2× higher depression risk than non-caregivers of comparable age and circumstance.
Schulz & Beach 1999 (JAMA); AARP/NAC 2020
Chronic Stress
2×
High-burden caregivers face twice the chronic disease exposure of non-caregivers, driven by sustained physiological stress.
Schulz & Beach 1999 (JAMA); AARP/NAC 2020
Per-Caregiver Cost
Paper I$21,642 per caregiver, every year. Income loss plus out-of-pocket.
Income Loss
$11,549/yr
Per-caregiver income foregone: reduced hours, career interruptions, and labor force exits valued at opportunity cost.
BLS/ATUS 2023; AARP/NAC 2020 · CPI-adj. 2024$
Out-of-Pocket
$10,093/yr
Direct household spending on care services, supplies, and coordination that insurance does not cover.
AARP/NAC 2020 · CPI-adj. 2024$
Economic Spillover
$6,800/yr
Employer productivity loss per caregiver employee: absenteeism, presenteeism, and unplanned turnover.
AARP/NAC 2020; Repricing the Caregiver Economy
Annual Cost Per Caregiver
Caregiver-borne vs. employer-borne · 2024$, CPI-adj. · AARP/NAC 2020; Repricing the Caregiver Economy
$21,642 per caregiver × 63.0M caregivers = $1.4T annually.
Direct household economic burden across 63.0M caregivers.
Household Burden: $1.4T
$727B income loss + $636B out-of-pocket · per caregiver: $11,549 + $10,093 = $21,642 (2024$, CPI-adj.) · AARP/NAC 2020
Demographic Expansion
Paper I46 million Americans without a caregiver by 2035 — more than the entire population of California.
Economic burden compounds at roughly 7.5% annually. The caregiver base grows at roughly 3%. The gap is structural.
Burden vs. Supply: Indexed Growth 2025–2035
Economic burden ~2.1x · Caregiver base ~1.3x · 54% divergence by 2035 · AARP/NAC 2025; Gannott 2026
Structure: how the burden compoundsPart II
The Coordination Economy
Paper IIWomen spend 102 more hours on coordination than men each year.
Women’s Burden
296 hrs/yr
Women absorb 296 unpaid coordination hours annually at $8,907 in opportunity cost.
BLS ATUS 2023; Repricing the Caregiver Economy
Men’s Burden
194 hrs/yr
Men absorb 194 unpaid coordination hours annually at $5,837 in opportunity cost.
BLS ATUS 2023; Repricing the Caregiver Economy
Annual Gap
102 hrs
102 extra hours annually — linked to higher rates of depression, sleep disruption, and deferred preventative care. Women caregivers face 2.2× the depression risk of non-caregivers.
BLS ATUS 2023; Repricing the Caregiver Economy
The Uneven Hidden Multiplier
Women $8,907/yr vs. men $5,837/yr · gap: 102 hrs (13 workdays) = $3,070/yr · BLS ATUS 2023 (USDL-24-1208) · blended $30.09/hr
The Infrastructure Gap
Papers I–IIIFederal funding covers only 0.015% of unpaid care value.
$244.8M against a $1.6T economy — less than one-tenth of one percent. The infrastructure gap is not a rounding error.
Federal Funding vs. Unpaid Care Value
Federal caregiver grant: $244.8M = 0.015% of $1.6T opportunity-cost value · Repricing the Caregiver Economy
Why Infrastructure Forms NowPart III
Federal Momentum
Papers I–IIIThe government is starting to pay for this.
Federal models, state expansions, and municipal leadership are converging. NYC Mayor Zohran Mamdani has made caregiver infrastructure a central policy commitment. New Mexico Governor Michelle Lujan Grisham has expanded access to home and community-based care statewide. Federal momentum is no longer hypothetical.
Federal Dementia Care Program
Medicare · 2024
$735M–$1.47B
The first federal program paying providers to coordinate dementia care at home, across roughly 400 organizations nationwide.
Federal Caregiver Grant
Older Americans Act Title III-E · Est. 2000
$244.8M
The federal government’s primary caregiver grant, channeled through state aging agencies to local respite, training, and counseling programs.
Older Americans Act
Older Americans Act + RAISE Family Caregivers Act · 2018–present
$2.5B+/yr
Older Americans Act total appropriation. Funds delivery networks, mandates a national caregiving strategy, and finances state-level support infrastructure.
Federal Investment vs. Market Size
Annual appropriation / median market size ($ billions) · CMS; HHS ACL; Repricing the Caregiver Economy
Caregiver support delivers a 5.3x workforce return.
Where the 5.3x Return Comes From
Return components per $1 invested in caregiver support · Repricing the Caregiver Economy (2026)
Venture Categories
Here is what the market needs.
Six infrastructure layers. Each is underbuilt relative to the operational complexity already in market.
Care Coordination Platforms
$15B
Scheduling, transportation logistics, provider communication, medication management, and continuity management across fragmented systems. The operating layer households lack. Example: Ohai.ai
AI Navigation & Continuity
$8B
Adaptive AI systems that manage longitudinal care plans, surface follow-through gaps, escalate proactively, and reduce administrative switching costs across household, clinical, and insurance contexts.
Employer Caregiver Benefits
$10B
EAP upgrades, caregiver leave infrastructure, backup care networks, and productivity stabilization tools. The 87% of employers not yet offering dedicated caregiver benefits represent the whitespace.
Payer & Value-Based Care
$5B
GUIDE-adjacent models, HCBS navigation, dementia care management, and care coordination tools that generate reimbursable value under CMS value-based frameworks.
Care Worker Supply & Training
$4B
Recruitment, credentialing, retention, and upskilling platforms for the direct care workforce. The sector will need 8.9M job openings filled in the next decade.
Caregiver Financial Tools
$3B
Benefits navigation, insurance gap products, savings vehicles, and financial planning tools built around the caregiver economic profile — including the $353,782 lifetime earnings penalty this thesis quantifies.
The team behind the thesisPart V
Suncoast Ventures
We invest in billion-dollar solutions hiding in plain sight.
Suncoast is the healthcare integration layer, backing companies that solve access, affordability, and systemic bottlenecks early. We source through a proprietary ecosystem of operators, payers, and health system leaders.
Healthcare Access
3 Channels
Payer, provider, and policy: operational access across all three channels before categories mature.
Deal Selection
2,000+ Companies
Reviewed · 21 invested. A proprietary priority risk matrix filters for structural healthcare gaps across access, affordability, and systemic bottlenecks.
Ecosystem
57%
Of investments sourced inbound or invite-only, driven by ecosystem relationships with operators, payers, and health system leaders.
Ohai.ai
Sheila Marcelo built the category, twice.
Care.com defined the first generation: marketplace, scale, demand proof. Ohai.ai is the second: AI-native coordination and continuity infrastructure built for the operational complexity of managing ongoing care.
Care.com
Generation 1
Marketplace generation. NYSE IPO 2014. Defined the category and proved large-scale demand.
Ohai.ai
Generation 2
Coordination generation. AI continuity platform for scheduling, reminders, and provider communication.
Built It Twice
Same Founder
As caregiving complexity increases, households need systems that reduce coordination burden. Ohai.ai is being built around that operational layer.
