Becker’s Healthcare Podcast: Interview with Rick Hundorfean, COO of MUSC Health – Charleston Division

Date: October 17, 2025
Host: Laura Dearda
Guest: Rick Hundorfean, MBA, Chief Operating Officer, MUSC Health – Charleston Division

Episode Overview

This episode features Laura Dearda in conversation with Rick Hundorfean, COO of MUSC Health’s Charleston Division. The discussion spotlights the growth, challenges, and strategic vision of South Carolina’s only comprehensive academic health system. Rick shares organizational successes, current system-wide challenges (from workforce shortages to infrastructure constraints), expansion strategies, workforce development, the role of innovation, and his philosophy on what it takes to lead a thriving healthcare organization in the next five years.

Key Discussion Points & Insights

1. Introduction to MUSC Health & Recent Successes

[01:15]

• Mission & Scale: MUSC, founded in 1824, is the only comprehensive academic health system in South Carolina, covering all 46 counties with 17 hospitals (5 more in development), 2,800+ beds, 3.21 million patient encounters annually, and 950+ care locations.
• Recognition: MUSC’s downtown Charleston campus has been named South Carolina’s #1 hospital for 11 consecutive years, with several nationally ranked specialties.

Recent Successes:

• Comprehensive Cancer Hospital Approval:
  “Earlier this year...our MUSC Board of Trustees approved a resolution to initiate the planning and construction of a state-of-the-art comprehensive cancer hospital, a medical office building, and an outpatient surgery center in Charleston. This really marks a very bold and visionary step in advancing cancer care for us as well as research and prevention throughout South Carolina and beyond.”
  — Rick Hundorfean [02:25]
• Expansion of Emergency and Urgent Care through Intuitive Health Partnership:
  “This strategic collaboration will really allow us to ensure that our patients are receiving exceptional care when they need it, close to home.”
  — Rick Hundorfean [03:29]
• Children’s Hospital National Recognition:
  “Our Shawn Jenkins Children’s Hospital remains South Carolina’s only children’s hospital to make the rankings. We’re super proud of that. We also had six specialties ranked in the top 50 in the nation.”
  — Rick Hundorfean [04:36]

2. Top System Issues: Workforce Shortages & Infrastructure Constraints

[05:40]

• Workforce Shortages & Retention:

  • “One of our biggest issues...is the critical workforce shortages that we’re experiencing across the system tied closely with retention opportunities. It’s important to note that this is not MUSC specific but really a nationwide issue.”
    — Rick Hundorfean [05:44]
  • Severity in rural and underserved areas; expansion success is directly linked to recruiting and retaining staff.
  • MUSC’s six educational colleges train a large segment of the state’s workforce and boast a high in-state retention rate, but supply remains short of demand.

• Infrastructure and Expansion Challenges—Charleston Focus:

  • “Physical location and expansion in downtown Charleston presents multiple complex challenges...especially one positioned on the coastline, we face many challenges...specifically vulnerability to flooding."
    — Rick Hundorfean [07:17]
  • Constraints include storms/hurricane season, complex zoning, parking, and environmental impact (e.g., stormwater management).

• Community Engagement:

  • “We do our very best to partner closely with the community to ensure what we’re doing is the best for Charleston and surrounding communities.”
    — Rick Hundorfean [08:42]

3. Opportunities for Growth Over the Next Few Years

[09:52] Rick outlines four strategic growth areas:

• Geographic Expansion & Integration:

  • Expanding deeper into underserved/rural areas and rapidly growing coastal regions.
  • Acquisition of Thailand's (Tidelands) Health and new facilities in Indianland and through the Kiowa Partners Pavilion.

• Specialized Care Expansion:

  • Major investments in high-demand specialties (e.g., cancer, digestive health, heart/vascular, neurosciences, precision health).

• Innovation:

  • Launch of the $30M 1824 Health Ventures Fund and the South Carolina Health Innovation Fund to seed MUSC-affiliated startups and healthcare innovation in-state.
  • "We continue to stimulate the state’s economy and healthcare ecosystems by translating academic research into commercial ventures..."
    — Rick Hundorfean [12:03]

• Workforce Development:

  • New College of Medicine building to enhance education and retention.
  • Expansion of residency programs beyond Charleston (e.g., Florence, Lancaster).
  • “...development of a new center of excellence within our College of Nursing Behavioral Health Center...helping address recruitment and retain our workforce.”
    — Rick Hundorfean [13:32]

4. What it Takes to Lead a Thriving Organization in the Next Five Years

[14:40] Rick’s framework for future leadership:

• Systemness and Integration:

  • “Our leaders [must continue] to focus on seamless, high reliability integration across our network of clinical sites, regional hospitals, and academic departments.”
    — Rick Hundorfean [14:46]

• Driving Health Transformation & Economic Impact:

  • Growth relies on generating new knowledge and achieving commercial, operational, and clinical excellence.
  • Leveraging venture funds and innovation for progress.
  • Using AI to “support patient volume growth without commensurate staff increases...a core challenge for all academic health systems today and that allows us to drive preeminence in areas like precision health.”
    — Rick Hundorfean [15:57]

• Workforce Engagement & Culture:

  • Prioritizing investments in workforce development, career pathways, residency expansion, well-being plans, and internal leadership pipelines.
  • “We’re promoting from within and building up our workforce.”
    — Rick Hundorfean [16:48]

• Aspirational Long-Term Goals:

  • “MUSC has two really big aspirational long term goals...The first being that we’ll be a top 20 academic health system in the nation and that South Carolina will be top 20 in the nation for health outcomes, and we’ll achieve that through our One MUSC strategy.”
    — Rick Hundorfean [18:36]

Notable Quotes & Memorable Moments

• On Academic Health System Reach:
  “We provide care in each of our 46 counties in South Carolina at over 950 locations...Super proud of our outreach.”
  — Rick Hundorfean [01:58]

• On Addressing State Needs:
  “The success of our expansion into rural communities is directly linked to our ability to recruit and retain staff in those remote locations...our system’s growing demand has necessitated major investments in workforce development initiatives and pipeline programs.”
  — Rick Hundorfean [06:26]

• On Change and Resilience:
  “With storms or hurricane season running a majority of the year...for coastal cities like Charleston, this is a real concern for us.”
  — Rick Hundorfean [07:49]

• On the Importance of System-wide Integration:
  “It’s important that our leaders continue to focus on seamless, high reliability integration across our network of clinical sites, regional Hospitals and academic departments.”
  — Rick Hundorfean [14:46]

Timestamps for Major Segments

| Segment | Timestamp | |---------------------------------------|--------------| | Intro & Guest Background | 00:44–01:15 | | MUSC Overview & Success Stories | 01:15–05:20 | | Key Issues: Workforce & Infrastructure| 05:40–09:13 | | Opportunities for Growth | 09:52–14:19 | | Leading for the Future | 14:40–17:19 | | Closing Reflections | 18:05–18:29 |

Conclusion

This episode offers an in-depth account of MUSC Health’s statewide impact, its ongoing campaigns to address workforce shortages and infrastructure limitations, and the ambitious path set by its leadership toward clinical, operational, and innovative excellence. Rick Hundorfean articulates a vision anchored in system integration, community engagement, workforce advancement, and the translation of academic strengths into actionable improvement for patient care and South Carolina’s overall health outcomes.