Becker’s Healthcare Podcast: Navigating the Future of Infusion Therapy with Tim Affeldt

Date: August 17, 2025
Guest: Tim Affeldt, Health System Leader, Fairview Health System
Host: Scott Becker

Episode Overview

This episode features Scott Becker in conversation with Tim Affeldt, a leading figure in ambulatory pharmacy at Fairview Health System in Minnesota. The discussion centers on current trends and future directions in infusion therapy, the shift toward home-based care, the complexities of reimbursement and cost, as well as leadership insights from Tim’s notable career.

Key Discussion Points and Insights

1. Introduction to Tim Affeldt and His Role (00:21)

• Tim’s Position: Oversees ambulatory and specialty pharmacy operations, including all pharmacy-related infusion initiatives at Fairview Health System.
• Focus Area: Ambulatory pharmacy and infusion therapy management.

2. Major Trends in Infusion Therapy (00:49)

• Integrated Infusion Strategy: Emphasis on comprehensive approaches that account for all patient care sites, reflecting payer and patient preferences.

• Shift in Therapy Modalities: Growth in subcutaneous (sub Q) therapies, many of which replace or supplement traditional IV therapies.

• Expansion of Home-based Therapies: Significant industry movement toward delivering infusion therapies to the home, driven by advances in specialty therapeutics and preferences of payers and patients.

  “The trends really are around a lot more therapies that are becoming sub Q that are healthcare administered… and lots of movement towards treating patients in the home.”
  — Tim Affeldt (00:56)

3. Cost, Reimbursement, and Site-of-Care Implications (02:03)

• Home Infusion as Cost-Saver: Home administration is often the lowest-cost option for payers, increasingly favored for both economic and patient satisfaction reasons.

• Infrastructure Considerations: Building and operating physical infusion centers is capital-intensive; steering patients to home care reduces overhead.

• Strategic Shifts: Moving more therapies and patients into the home is both a clinical and financial priority.

  “Instead of building a bunch of infusion centers and tying up a bunch of capital, a good strategy again is to just move more and more of those patients to the home.”
  — Tim Affeldt (02:39)

4. Patient Experience and Clinical Complexity in Home Infusion (03:04)

• Two Patient Categories:

  • Acute Therapies: Often post-hospital discharge; patients/caregivers trained to self-administer, with periodic nursing visits.
  • Chronic or Specialty Therapies: Higher risk of adverse events; generally require a nurse present for every dose.

• Balancing Independence and Safety: Efforts focus on maximizing patient autonomy while ensuring clinical oversight for safety.

  “For a lot of acute therapies, we can teach the patient or patient’s caregiver to dose on their own…if you get into some of the specialty infusions...it’s usually best practice...to have a nurse in the home for every dose.”
  — Tim Affeldt (03:17 & 03:45)

5. Looking Ahead: 2025 Priorities and Opportunities (04:04)

• Regulatory Environment: Monitoring policy changes, such as those resulting from the Inflation Reduction Act.

• Growth in Specialty Pharmacy: Rising importance of health system-based specialty pharmacies, recognized by payers, pharmaceuticals, and providers as pivotal to successful patient outcomes.

  “Really what we’re probably most excited about is just the continued trend...when it comes to specialty therapies and specialty care…patients can do the best…if they can use the pharmacy that is part of the health system.”
  — Tim Affeldt (04:27)

6. Leadership Advice for Healthcare Professionals (05:09)

• Cultivating a Broad Perspective: Emphasizes networking, interdisciplinary understanding, and curiosity beyond one’s immediate role.

• Holistic Decision-Making: Understanding the motivations of payers, pharma, and providers is key to impactful leadership.

  “Just focus on your network...try to get outside of just what you know…if you have that type of an approach and understanding, it really helps you be a better leader.”
  — Tim Affeldt (05:16 & 05:45)

7. Personal Moments & Lighter Conversation (06:07)

• College Sports Fandom: Tim shares the quirks of being a Golden Gophers fan.

• Host camaraderie: Exchange about sports allegiances and the communal joys and struggles of being dedicated fans.

  “I love my Gophers, but it hasn’t always been the easiest to be a Gopher fan.”
  — Tim Affeldt (06:18)

Notable Quotes

• “There’s been really a trend towards home infusion — that is one of the lowest, if not the lowest, places to treat patients.” (Tim Affeldt, 02:12)
• “For a lot of acute therapies, we can teach the patient or patient’s caregiver to dose on their own.” (Tim Affeldt, 03:17)
• “We really are realizing that patients can...have the most successful journey with their disease state if they can use the pharmacy that is part of the health system.” (Tim Affeldt, 04:38)
• “If you have that type of an approach and understanding, it really helps you be a better leader.” (Tim Affeldt, 05:45)
• “I love my Gophers, but it hasn’t always been the easiest to be a Gopher fan.” (Tim Affeldt, 06:18)

Important Timestamps

• [00:21] – Tim Affeldt’s role and scope at Fairview Health System
• [00:49] – Key trends in infusion therapy
• [02:03] – Cost trends and the economics of infusion therapy
• [03:04] – Complexity and patient experience with home infusion
• [04:04] – Priorities for 2025 and specialty pharmacy growth
• [05:09] – Leadership insight and career advice
• [06:07] – Personal reflections, sports, and lighter moments

Summary

This concise yet insightful episode offers an overview of how infusion therapy is rapidly evolving—driven by payer pressures, patient preferences, and regulatory changes—to favor home-based care and health system specialty pharmacies. Tim Affeldt underscores the operational, financial, and clinical factors influencing these shifts, all while providing actionable advice for emerging healthcare leaders. A must-listen for anyone interested in infusion therapy, pharmacy operations, or strategic health system leadership.