a16zCan AI Fix Housing and Healthcare Affordability?
At a glance
WHAT IT’S REALLY ABOUT
Elise AI targets housing, healthcare costs through autonomous operations automation
- Elise AI argues housing and healthcare dominate household budgets and GDP, so cutting operational waste via AI can meaningfully improve affordability and quality of service.
- In housing, the biggest affordability driver is supply, but AI can also increase utilization of existing stock by improving response rates, speeding leasing cycles, and reducing unit downtime.
- Regulation and zoning constrain new construction, yet capital availability and investment returns also limit supply; Elise claims better operations can raise returns and attract more construction capital.
- The company’s near-term wedge is automating administrative and communications-heavy workflows (leasing, touring, work orders, documentation), moving toward a long-term vision of “fully autonomous buildings.”
- In healthcare, Elise focuses on administrative workflows (intake, scheduling, patient communication), aiming to reduce ballooning non-clinical costs and improve adherence and outcomes through ongoing AI engagement.
IDEAS WORTH REMEMBERING
5 ideasHousing supply is the primary affordability lever, but utilization gains matter now.
They cite a ~5M-unit national shortage and the need to add ~1.8–2.0M units/year, yet note short-term wins like responding to inquiries and reducing leasing friction can turn vacancies into occupancy faster.
Communication failures are a hidden source of “phantom vacancy.”
They claim nearly half of rental inquiries go unanswered, and report buildings using their AI showed ~2% higher occupancy versus market—suggesting better follow-up can measurably raise utilization.
Operational efficiency can attract more capital to housing construction.
Beyond zoning reform, they argue more supply requires better returns; by creating “10X operators” that lower controllable costs (especially labor), housing becomes a more attractive asset class, pulling in investment for new builds.
The path to ‘autonomous buildings’ starts with automating admin, not robots.
They emphasize much on-site work is administrative (leasing Q&A, documentation, work-order logistics) and can be automated today; the hard boundary is physical tasks and legal requirements, though sensors/smart locks push that boundary outward.
Centralization + AI can dramatically change staffing ratios.
They reference outcomes like ~200 units per employee and even specialized centralized roles supporting multiple properties at massive scale (e.g., one employee across 10,000 units) by shifting coordination to AI.
WORDS WORTH SAVING
5 quotesWe wanted to use AI to solve real-world problems, and housing and healthcare are the bus-biggest expenses that people have.
— Minna Song
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 kinda keep that shortage from getting worse, let alone making up for that deficit.
— Minna Song
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.
— Minna Song
It's pretty self-evident that technology makes the experience better for everyone and brings down costs.
— Minna Song
I think our drive always has been cost reduction. Uh, if at some point we get to a place where, like, housing and healthcare are not cost concerns for, for the average person, I, I, I think that'll be, like, amazing.
— Tony Stoyanov
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