Paul Kusserow on the forces changing healthcare faster than ever
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You're listening to McKinsey on Healthcare, a podcast dedicated to showcasing the latest trends, insights, and innovations shaping the healthcare industry. I'm Anne Kofel, a partner in McKinsey's Boston office and your host for this episode. Today, I'm joined by Paul Kucero. Paul is the chairman and former CEO of Amedisys, a home health and hospice care provider. He's also the executive chairman of Unified Women's Health and the co-founder and chairman of Healthpilot Technologies. Paul recently published a book called Becoming Healthcare Revolution, 10 Forces That Will Cure America's Health Crisis. In it, he and his co-author David Johnson discuss the outside forces that are shaping the U.S. healthcare industry and how healthcare systems will soon transform in ways we've never seen before.
Paul, welcome to the show. We're happy to have you here.
Appreciate your having me.
So, Paul, just to get us started, what inspired you and your co-author David to write this book?
Well, I wrote a book before this called The Anatomy of a Turnaround, and it was about turning around a medicine. It's the company that I ran for 10 years. Dave was my editor then, and he's a healthcare economist. And we started to look through some of the ideas that were coming out of there, and then we... started to talk about where we were in the journey of healthcare in the United States. And we believe that there was something that was going to occur pretty quickly. We spent about six months doing pretty extensive research, and the book started to form quite naturally. So we put it all together, and the thesis came very naturally, which is healthcare is going to change more in the next 10 years than it has in the last 100.
You introduced the healthcare revolution as stemming from complacency in an ever-changing world. What are some examples of this? Why do you say that now is the tipping point?
What came out of the research that was most interesting was we actually went back 100 years, over 100 years, and looked at how we got to where we are now. You know, those that don't learn from history are doomed to repeat it. And so we looked at something called the Flexner Report, which was basically the start of modern healthcare in the United States, which came out in 1910. by a guy named Abraham Flexner. He was doing a project for the Carnegie Foundation, and he was looking at medical schools and hospitals in the United States. And what he saw really appalled him. And he came out with this report suggesting how to reform the U.S. health care system. It basically looked at medical schools and hospitals and started to figure out, you know, what we know today, which is how do we build hospitals around academic centers?
How do we train physicians in the appropriate way so they can drive great care? that's research-based. And what happened was a huge transformation in the 20s of the U.S. healthcare system. There were 150 hospitals slash medical schools, 100 of them closed, and what was left turned out to be the best healthcare system in the world. The interesting thing about that is while we were superior in the 20s, 30s, 40s, 50s, with this methodology, 50 years later, we had already outgrown it in 1970. Another 50 years, and we really haven't progressed that much. And the problem is we're using, it's like if we were driving around Model Ts now, and the rest of the world is driving around all the advances we have.
And there's some forces that are at work now that we believe will append this model once and for all and bring us into a transformative new world.
You structure your book around macro forces like demographics and tech imperatives and market forces like care redesign. Do you see market and macro forces being additive or intention?
The macro forces, I think, are going to be the forces that cause the dissemblement or the destruction or the change, however you want. I mean, you know, the one thing we do talk about is change is very constant in the business world and certainly in the health care world.
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