The national average no-show rate is roughly 18 percent. In a $3.5 trillion industry, that adds up to a significant amount of lost revenue for healthcare systems.
At an average cost of $265 per missed appointment, every appointment counts. And despite what some patients think, skipping an appointment doesn’t free up time in a provider’s schedule — it creates more administrative work for staff and prevents other patients from getting the care they need.
Patients who no-show tend to be younger, of lower socioeconomic status, have psychosocial problems, and receive government-provided health benefits. However, those realities don’t cause them to miss appointments. Plus, they’re not something a healthcare system can address.
Patients no-show appointments for a variety of reasons — logistics, emotional barriers, and sometimes simply forgetting. These five strategies address some of the underlying reasons patients no-show and offer both immediate and long-term solutions you can implement to reduce your no-show rate.
Help patients understand why they’re seeing you
One reason patients no-show appointments is that they don’t understand the purpose of the visit. Only 12 percent of US adults have proficient health literacy, and a staggering 77 million adults have basic or below basic health literacy. This results in patients not adhering to treatment plans — including attending their scheduled visits.
Research published in the journal Medscape General Medicine recommended five steps for changing patient beliefs and behavior as they relate to following treatment plans and attending appointments. Ensure patients:
- Recognize the risk of not adopting a healthy behavior
- Perceive their condition as serious
- Believe in the positive effects of the suggested treatment
- Can address their fears and concerns
- Believe they have the ability to complete the treatment plan
Another reason patients miss their appointments is that they’re afraid. They may fear scary test results, getting on the scale, or uncomfortable procedures. Whatever the reason, it keeps them from following through with their scheduled appointments.
“Many people feel anxious because they fear the unknown, and they let their imagination run wild,” said psychologist Dr. Barbara Cox in an interview with NBC’s health site Better. “They may imagine a worst-case scenario, when in fact going for, say, an annual check-up is the best prevention.”
Cox recommends patients acknowledge their anxiety before a visit. Providers can initiate this conversation by asking patients how they feel about an upcoming test or visit and reinforcing their role as not only a provider but also an advocate and an ally.
Reduce the time between scheduling an appointment and the actual appointment
The longer the time in between scheduling an appointment and the actual appointment, the more likely the patient is to no-show. A 2017 study found that wait times to see a doctor rose to 24 days, an increase of 30 percent over the previous three years.
Unfortunately, the problem is a bit of a chicken and egg scenario. Long wait times to see a provider increase no-shows, and no-shows contribute to longer wait times for other patients.
It’s not always possible to reduce the time between scheduling and appointments for an entire practice. However, it might be a good strategy to offer patients who habitually no-show only same day or next day appointments.
Use interactive patient appointment reminders
Perhaps the most effective strategy, and arguably the simplest, for reducing your no-show rate is implementing appointment reminders.
Text appointment reminders that are bidirectional — meaning patients can text you back — give patients a chance to confirm their appointment, get directions, ask questions, and adequately prepare for their appointment.
Eisenhower Health in southern California’s Coachella Valley implemented WELL and saw its no-show rate drop by 40 percent. Additionally, staff time on the phone went down by 88 percent, meaning those patients who did call in were more likely to reach a staff person quickly.
Provide a ride
Not having a ride causes as many as 28 percent of missed appointments, a problem easily tackled with Uber Health or another ride program. For healthcare systems using WELL, when patients respond to an appointment reminder with keywords such as “ride” or “car”, sophisticated Keyword Actions will trigger a chatbot to ask the patient if they need a ride and coordinate all of the details.
WELL is the leader in patient communication and our clients consistently reduce their no-show rates. Download one of our case studies to learn more. ♥
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Pamela Ellgen is WELL’s Health Editor. She began her career in community journalism and is the author of more than a dozen published books. She is a graduate of Washington State University.