An internal float pool is cheaper per hour and better for predictable, recurring gaps. An agency is faster, more elastic, and the only realistic option for credentials you cannot recruit locally. Most facilities that get this right run both — float pool for the baseline, agency for the peaks and the hard credentials. Treating them as an either/or is what produces either chronic overtime or runaway agency spend.
Lower cost per hour, no markup, clinicians who already know your units, EMR and protocols, and no onboarding lag. For predictable recurring gaps across similar units it is straightforwardly the better answer.
Speed, elasticity, and access to credentials that do not exist in your local market. You pay only for the hours worked, carry no FTE, and the employment burden, insurance and credentialing sit with the agency.
The honest trade is cost per hour. You are paying a premium for optionality — which is the correct purchase when the need is genuinely variable, and a poor one when it is not.
Compare your annual agency spend against the fully loaded cost of the FTEs it replaces — wages, burden, benefits, PTO, recruitment and turnover cost. If agency spend on a given unit has been steady for more than a year, that is a permanent role wearing a temporary costume, and the float pool or an FTE is cheaper.
If the spend spikes seasonally and falls away, agency is doing exactly what it should.
We support facilities standing up or refilling internal float pools through permanent and contract-to-hire placement. It reduces your agency spend, which is a strange thing for an agency to offer — but a facility running the right mix stays a client for years, and one bleeding on agency spend eventually cuts us entirely.
Rate detail is published here.
Describe the gap and we will tell you honestly which model fits — including when the answer is neither.