Dr. Steven C. Fox Warns of Medicare Insolvency
September 23, 2025 | Medicare
Against the backdrop of a looming government shutdown over healthcare funding and the projected insolvency of Medicare in 2032, Steven C. Fox, D.O., a leading voice in geriatric and disability medicine, addressed the 2025 Healthcare Innovation Summit in Nashville with a bold call for systemic reform.
“The Medicare system is not aligned with the needs of older adults,” said Dr. Fox. “Healthcare outcomes are poor and costs are rising rapidly. The insolvency of Medicare gets closer every day. Determining and incorporating the functional age of Medicare beneficiaries will not only improve health and quality of life and has the potential to save $300 billion.”
Key points from Dr. Fox’s presentation
- Crisis of alignment: Medicare continues to reimburse based on diagnosis codes and procedures rather than functional status, missing the strongest predictor of utilization and need.
- Poor outcomes, rising costs: U.S. older adults face lower health-adjusted life expectancy and higher hospitalization rates than peers in the EU, U.K., and Japan, while costs escalate unsustainably.
- Functional age as reform: Incorporating functional age into risk adjustment and care planning allows earlier intervention, improved independence, and targeted use of cost-saving care models (CGA, hospital-at-home, and home- and community-based services).
- Massive savings potential: Modeling suggests a potential $300 billion reduction in Medicare costs over the coming decade if functional ability is systematically integrated into policy and reimbursement.
Dr. Fox urged policymakers, industry leaders, and healthcare innovators to act with urgency. “We cannot continue to delay,” he warned. “The Medicare Trust Fund faces insolvency by 2032.
“Aligning care with functional ability is the clearest path to better health outcomes and fiscal stability. The choice is not whether to act, it is how quickly we act to safeguard the future of American healthcare.”