The ZIRP Legacy: How Excess Hospital Infrastructure Creates New Opportunities for Home Infusion

Home-based care for routine medicine is gaining momentum because it’s cheaper for payers, simpler for healthcare workers, and better for patient well-being than constant hospital visits. We’ve unpacked these benefits in previous blogs on home infusion with Float, but zooming out, there’s another dynamic at play here: what created these conditions in the hospital setting?

While there’s no one way to explain the transition away from routine hospital care, at Float, we see a clear line between Zero Interest Rate Policies (ZIRP) and the present state of America’s hospital infrastructure and operations.

Here’s why we believe 15+ years of ZIRP has inadvertently created new and exciting opportunities for home-based specialty pharmaceuticals.

The ZIRP Era and Hospital Expansion

The Zero Interest Rate Policy (ZIRP) era first began in 2008 as a response to the global financial crisis and was extended through 2015. ZIRP does exactly what it sounds like: it sets the central bank’s target interest rate at or near 0%, creating unprecedented access to cheap capital.

The policy was reintroduced in 2020, this time to stimulate growth during the COVID-19 pandemic. During both ZIRP periods, healthcare systems seized the opportunity to expand their physical footprints aggressively. From 2008 to late 2021, hospitals borrowed approximately $144 billion through public bond issues—often for construction.

This building boom led to a dramatic expansion of hospital infrastructure across the United States, making multi-billion-dollar projects commonplace. Ambitious construction endeavours included Mass General Brigham’s $2.3 billion expansion plan, the University of Chicago Medical Center’s $633 million cancer hospital, and Penn Medicine’s $1.6 billion expansion project, to name a few!

The Perfect Storm: Increasing Labor Costs and Shifting Patient Preferences

Fast forward to today, and healthcare systems face a new and challenging reality: the era of cheap capital has ended, with interest rates at 20-year highs in most places. Combined with high labor costs, staffing shortages, and inflation woes, hospitals find it increasingly difficult to operate their newly expanded facilities.

Compounding these financial pressures, patient preferences have also shifted dramatically post-pandemic. People with chronic illnesses are more reluctant than ever to visit facilities that could expose them to infectious diseases, especially when staffing shortages result in longer wait times.

These converging factors have created a “perfect storm” for hospitals: vast physical infrastructure that’s becoming increasingly expensive to operate and maintain, alongside a decline in inpatient volumes as care shifts to outpatient and home settings.

Home Infusion: A Winner in the Shift to Home-Based Care

As hospitals grapple with these post-ZIRP challenges, specialty pharmacies offering home infusion have helped alleviate the burden for routine medicine delivery. Even before the pandemic ZIRP era, the National Home Infusion Association reported that home infusion providers served 310% more patients in 2019 than in 2010.

This growth isn’t surprising when you consider the dramatic operational and cost advantages across the board. For hospital systems, having more available beds helps ensure every minute and square foot counts. For nurses, offloading routine care allows them to focus their time and attention on more critically ill patients.

For payers, home infusion can be 12-24x less expensive than hospital-based care for the same treatments. Per UnitedHealth Group, administering specialty drugs (specifically for the top five most expensive conditions) outside of the hospital setting saves $16,000 to $37,000 per privately-insured patient per year.

Why Float is Positioned for Post-ZIRP Success

Even when the advantages of moving all care that doesn’t need to be in a hospital to the home are clear, specialty pharmacies may need to adjust their operational processes to rise to the occasion. That’s where Float’s AI-powered marketplace model comes into play. We focus on:

1. Technology innovation: Our AI-driven specialty pharmacy portal streamlines coordination between patients, nurses, and pharmacies, eliminating the administrative burdens associated with outdated systems, expediting reimbursements, and reducing chart bounceback.
2. Staffing solutions: Our platform connects specialty pharmacies with qualified nurses, addressing the critical staffing challenges that many healthcare providers face. These nurses benefit from flexible scheduling, higher pay than hospital shifts, and straightforward, rewarding work.
3. Patient-focused care: We help people stay healthy at home instead of spending time and money traveling to overcrowded hospitals. With our 97% staffing rate and 55,000+ completed visits, we bring consistency to routine care at home.

As the legacy of ZIRP-era expansion and pandemic-driven labor issues transform care delivery models, we help specialty pharmacies, patients, and nurses navigate this new chapter successfully.

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The future of healthcare delivery isn’t just about where care happens—it’s about creating more efficient, patient-centered systems that deliver better outcomes at lower costs. Home infusion is a key piece of puzzle, and Float is proud to lead the way.

To become a Float SuperNurse or join our network of specialty pharmacies across California, Arizona, and Texas (and soon Florida, Washington, and Nevada!), visit www.FloatHealth.com. See you there!