Why Do Actuarial Risk Horizons Really Matter for Anybody Trying to Improve Patient Outcomes? With Keith Passwater and JR Clark—Summer Shorts 7

A listener wrote in asking Stacey to explain something she'd mentioned on a previous episode without unpacking it: actuarial risk horizons, and how the different timelines actuaries and physicians work on affect patient care. So in this Summer Short, instead of answering it herself, Stacey brought in two actual actuaries — Keith Passwater, former chief actuary at Anthem (Elevance) and founder of Havarti Risk Services, and JR Clark, SVP of health plan product and strategy at Paytient Technologies and a former Anthem actuary — to explain risk horizons directly, and to dig into a bigger problem: most actuarial models don't treat the patient as a stakeholder at all.

WHAT YOU'LL LEARN

✅ What a "risk horizon" actually means to an actuary, and why the time interval over which a plan hopes to affect healthcare costs shapes nearly every downstream decision

✅ Why most actuarial models leave the patient or member out of the equation entirely — despite clear evidence that copays and coinsurance above a certain threshold cause patients to abandon care

✅ Why ignoring the patient as a stakeholder isn't just a moral problem but arguably a math problem: care abandonment has real, sometimes fast-arriving financial consequences for plans

✅ What counts as a "risky investment" from an actuary's point of view, and how keeping premiums down looks different depending on whether the time horizon is short or long

✅ How the length of a risk horizon changes what options are actually on the table for benefit design

WHY THIS MATTERS

Every healthcare transformation effort eventually runs into an actuary's math, whether anyone in the room realizes it or not. When that math treats the patient as an afterthought instead of a stakeholder, the result isn't just worse for patients — it may genuinely be the wrong answer, since abandoned care and delayed diagnoses carry real financial consequences that a patient-blind model simply doesn't see coming. Understanding risk horizons is a starting point for anyone trying to build a better benefit design, and it means getting comfortable working hip to hip with the actuaries setting the timelines.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction

02:39 Why is it a problem for actuaries to ignore the patient as stakeholders in benefit design plans?

04:37 What is a risk horizon for actuaries?

05:38 "What's the time interval over which we hope to impact healthcare costs?"

07:25 What is a risky investment from an actuary's point of view?

08:05 How do you keep premiums down when the time horizon is short in an actuary's point of view?

10:31 How do actuaries assess risk horizons or health insurance, and why do they choose those risk horizons?

14:05 What options are on the table when the risk horizon is longer?

16:06 How does the length of risk horizon affect benefit design?