The CEO of a company that cares for 369,000 elderly Americans went to a country facing a ‘demographic time bomb,’ and what he saw could be a lesson for the US

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Paul Kusserow had to see it for himself.

Kusserow’s the CEO of Amedisys, a $3.7 billion company that’s in the home health, hospice and personal care businesses in the US. Amedisys has a front row seat for the challenges of an aging population in the US.

Elsewhere in the world — particularly in Scandinavia and Japan— countries have already started to experience a big shift into an aging population. In Japan, more than a quarter of the country’s population is over 65, making it the world’s oldest country. Some economists refer to the situation Japan is facing as a “demographic time bomb.”

For comparison, 20% of Sweden’s population is over 65, and as of 2015, about 15% of the US population was over 65.

“They’re living with what we’re going to hit in 10, 20 years,” Kusserow said. So to figure out what the US could do to keep itself from being over-extended, Kusserow headed to those countries to see how those countries are managing to take care of the elderly.

As a whole, the elder care market is worth an estimated $350 billion, and home health, hospice and personal care are all in their own right multi-billion-dollar businesses. The field is pretty fragmented: There are an estimated 2.5 million home care workers out there, and about 12,400 home health agencies managing them all.

Amedisys is a relative giant in a field made up of lots of tiny companies. Since the beginning of the year, Amedisys’s stock is up 117%, giving the company a market value of $3.7 billion. The company has 18,400 workers and cares for 369,000 people.

Read more: A VC spoke to 30 founders and investors about the $350 billion elder-care market and found 3 reasons why starting a company in the market is a challenge

Home care is growing as the US gets older. The idea is that having help at home, which can range from cooking and cleaning to bathing and medical care, can let elderly people stay independent for longer, and hopefully out of the hospital or nursing homes.

The problem is that as the number of elderly people increases, there’s a risk of a shortage of home-care workers. The work itself tends to be difficult and poorly paid, too.

One solution is a change in the way at-home care is delivered. That’s something countries like Japan and those in Scandinavia are figuring out through the help of technology, Kusserow said.

“What they’re utilizing is really good technology,” he said.

Here’s how that works: Say there’s a relatively healthy 80-year-old living in Sweden who can still get around on her own. Using sensors — such as a watch with an accelerometer, a smart bathroom mat, or sensors around the kitchen — caregivers can remotely monitor her activity. Should she fall or stop going about her daily routine, those caregivers are alerted and can intervene to help her out.

“They build that pattern analysis. When that’s disrupted, caregivers go in,” Kusserow said.

That way, the 80-year-old can keep living in her home instead of a nursing home or other kind of facility, making care much less expensive.

While the US is using sensor technology for seniors, Kusserow said he hasn’t seen it used effectively yet. That might start to change in the coming years as the US starts to experience what countries like Japan have seen.

Other big players in retail and technology have had their eyes on the aging population as well. In August, Best Buy bought health services company GreatCall for $800 million. The company makes cell phones and connected devices that can alert emergency services for seniors.

Amazon and Walmart both seem to have an interest in the space, with Amazon’s move into the pharmacy business with its acquisition of PillPack, and Walmart’s partnerships with a health insurer focused on Medicare health insurance plans for the elderly..

Amazon hasn’t said much about its healthcare ambitions, but what it has talked about publicly has to do with the aging population. In February, Babak Parviz, a vice president at Amazon, said that the elderly population was something “we deeply care about.”

“We have looked at the older population in the context of health obviously, but we know that this group has a lot of issues, a lot of unmet need, some of them relate to health, but their health and the broader issues that they face are all interrelated,” Parviz said.

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