Dr. Steven C. Fox Warns of Medicare Insolvency
September 23, 2025 | Medicare
Medicare insolvency, government shutdown threats, and the urgent need for reform are pushing U.S. healthcare toward a crisis. Steven C. Fox, D.O., a leading voice in geriatric and disability medicine, spoke at the 2025 Healthcare Innovation Summit in Nashville. There, he delivered a bold call for systemic change. His warning came against the backdrop of ongoing government funding battles and the projected insolvency of the Medicare Trust Fund by 2032.
Why Medicare Insolvency Government Shutdown Reform Cannot Wait
“The Medicare system is not aligned with the needs of older adults,” said Dr. Fox. “Healthcare outcomes are poor and costs are rising fast. Moreover, the insolvency of Medicare gets closer every day.”
He also stressed that using the functional age of Medicare beneficiaries could improve health outcomes. In addition, it has the potential to save $300 billion in Medicare costs over the next decade.
Key Points from Dr. Fox’s Presentation
Crisis of Alignment
Medicare currently pays based on diagnosis codes and procedures. However, it does not consider functional status. Yet functional status is the strongest predictor of patient need and care utilization.
Poor Outcomes and Rising Costs
U.S. older adults have lower health-adjusted life expectancy than peers in the EU, U.K., and Japan. Furthermore, hospitalization rates and costs keep rising unsustainably.
Functional Age as a Reform Tool
Adding functional age to risk adjustment allows earlier intervention. As a result, it also improves independence and targets cost-saving care models. These include CGA, hospital-at-home, and community-based services.
Massive Savings Potential
Modeling shows a potential $300 billion reduction in Medicare costs over the next decade. However, this is only possible if functional ability becomes part of policy and reimbursement decisions.
Medicare Insolvency Government Shutdown Reform Requires Urgent Action
Dr. Fox urged policymakers, industry leaders, and healthcare innovators to act without delay. “We cannot continue to delay,” he warned. “Therefore, the Medicare Trust Fund faces insolvency by 2032 without bold reform.”
He closed with a clear and direct message. “Aligning care with functional ability is the clearest path to better health outcomes and fiscal stability. Ultimately, the choice is not whether to act. It is how quickly we act to safeguard the future of American healthcare.”