‘There’s No Undoing This Revolution’: HHS Secretary Alex Azar Touts In-Home Care, Virtual Visits

U.S. Department of Health and Human Services (HHS) Secretary Alex Azar believes that COVID-19 has led to a health care revolution, one that will include a larger focus on care in the home.

Specifically, Azar thinks the increase in telehealth usage and a stronger focus on social determinants of health will be major influences in a more value-based health care system in the U.S moving forward.

“One of the instructive experiences from COVID-19 has been the vastly expanded role of telehealth,” Azar said Thursday at the Medicare Advantage Virtual Summit, hosted by the Better Medicare Alliance. “We went from about 14,000 virtual visits in Medicare fee-for-service each week before the pandemic to nearly 1.7 million virtual visits a week, at the peak. There’s no undoing this revolution.”


Although the ongoing public health emergency has increased the need for home-based care, the federal government has recognized the crucial part it plays in the health care system for years. That recognition is partly reflected by the evolution of Medicare Advantage (MA), Azar said.

“We’ve already worked over the past several years to create permanent flexibilities … in Medicare Advantage, expanding the ability for plans to pay for virtual check-ins and a wider variety of circumstances, allowing patients to receive this care from the convenience of their home rather than a doctor’s office,” the HHS secretary added.

Additionally, through the changes that have occurred to telehealth during the COVID-19 crisis, rural residents will begin experiencing easier access to care, Azar said.


Rural access to care has long been an inequity of the U.S health care system.

The COVID-19 pandemic has also exposed the disparities in care for both underprivileged and chronically ill populations. The expanded MA benefits — both the primarily health-related ones and those under the new Special Supplemental Benefits for the Chronically Ill (SSBCI) program — are a way to address those disparities moving forward, Azar believes.

“We want to support you in addressing these disparities and health challenges in a holistic way,” he said. “And that has informed our efforts to expand the array of supplemental benefits that MA plans can offer.”

Last month, the U.S. Centers for Medicare & Medicaid (CMS) released new data in a 2021 MA preview. It revealed that 738 plans are offering primarily health-related supplemental benefits in 2021, a 46% increase compared to the nearly 500 plans that did so in 2020.

It also showed that 920 plans are offering benefits under SSBCI pathway next year, a nearly 400% increase compared to the 245 plans that did so this year.

“All of you have made it a priority to address social determinants of health,” Azar said. “And that is an area of great interest for us as well. Addressing costly and debilitating chronic conditions can sometimes be impossible without addressing particular non-health needs. And MA allows you to do that in a way that focuses on value outcomes and a patient’s individual needs.”

Zeroing in on social determinants will be easier with more MA plans carrying SSBCI benefits in 2021 and beyond.

In general, the pool of MA beneficiaries is also getting larger, which will help providers reach and care for more individuals.

The actuarial firm Milliman recently examined growth in MA enrollment over recent years; the firm’s results showed an increase of 60% in MA enrollment from 2013 to 2019. Enrollment among beneficiaries in traditional Medicare only increased 5% during the same time frame. 

“This independent report offers an eye-opening look at Medicare Advantage’s explosive growth,” Allyson Schwartz, the president and CEO of the Better Medicare Alliance, said in a press release. “And with dramatic growth in enrollment among dual-eligible beneficiaries, we know that supporting health coverage for our most vulnerable seniors means supporting these individuals’ choice of Medicare Advantage.”

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