5 Ways to Reduce Patient No-Show Rates in a Post-COVID World

April 20, 2021 - by WELL Staff

How to deal with no-show appointments? Given the COVID-19 pandemic still poses a risk to us all, it is completely understandable that many patients fail to show up to their appointments. Anxiety, uncertainty, stress. These are all contributors.

However, despite the disrupted times, high patient no-show rates still need to be addressed. They are a major burden for providers, and optimizing operations means implementing strategies to lower no-shows.

How to calculate your no-show rate? Simply take your total appointment slots and see how many were booked but the patient didn’t show. No-show rate calculation results will differ for everyone but the national average no-show rate is roughly 18 percent. During the pandemic, patient no-show rates soared across the U.S. healthcare network. In some clinics, the figure rose to 36.1%.

Constant no-show rate calculation and monitoring are imperative among providers, especially in areas where patient no-show rates are high. According to research, patient no-show rates can reach as high as 80% in problematic areas where multiple factors that drive patients to miss appointments are present.

If you know how to calculate a no-show rate, then you might have an idea how much a single missed appointment costs a provider. A particular study revealed that 67,000 instances of no-show patients can set back the healthcare system around $7 million.

In a $3.5 trillion industry, every missed appointment represents 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.

And even as hospitals and practices embraced telemedicine to provide care during the pandemic, patient no-show rates remain significantly high in many places. Patients still found themselves missing telehealth appointments due to a number of challenges.

Patients who tend not to show are often younger, of lower socioeconomic status, have psychosocial problems, and receive government-provided health benefits. Patient no-show rates soar for a variety of reasons — logistics, emotional barriers, and sometimes simply forgetting.

The below five strategies to reduce no-show rates address some of the underlying reasons that drive patient no-show rates up and offer both immediate and long-term solutions you can implement to reduce your no-show rate.

1) Help patients understand why they are seeing you

How to prevent no-shows effectively? One reason patient no-show rates remain high is that patients 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.

One of the effective strategies to reduce no-show rates is to make information and health education accessible to patients, particularly in complex medical situations. In addition, providers can also communicate instructions and information prior to a visit or procedure to help patients prepare and empower them to show up to their doctor’s office.

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.

Educate your patients so they:

  • 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

2) Calm fears

How to deal with no-show appointments? Calm your patients and address their fears. Fear fuels patient no-show rates across the world.  Patients may fear scary test results, getting on the scale, or uncomfortable procedures. Whatever the reason, fear keeps patients from following through with their scheduled appointments.

Even as vaccination efforts are currently underway, the Society for Cardiovascular Angiography and Interventions (SCAI) reported that 40% of Americans said they won’t see their doctor as long as the risk of COVID-19 persists.

“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 an annual check-up is the best prevention.”

Addressing the fear factor is a big step in reducing no-show appointments. 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.

3) Reduce the time between scheduling an appointment and the actual appointment

How to prevent no-shows? Cut down the waiting times. Whether it’s reducing no-show rates in primary care or in specialized practice, patients want faster access to doctors, information, and medical services.

Spending a significant amount of time waiting to see their doctor can be a frustrating experience for patients. Reducing no-show appointments means providers need to keep the waiting time short for their patients. The longer the time in between scheduling an appointment and the actual appointment, the more likely the patient is to no-show. 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 is possible to reduce the time between scheduling and appointments for an entire practice if delays are identified and the scheduling process is optimized.

A 2021 study by Lahey Hospital and Medical Center in Burlington, Mass., managed to cut down their outpatient waiting time by a significant margin. After pinpointing causes of delays, Lahey Hospital proceeded to optimize their appointment and scheduling process. After a substantial revamping of their scheduling procedure, Lahey Hospital managed to cut down their average waiting time of 53 minutes by 23%.

If waiting times are significantly reduced, it will result in a positive experience for patients and significantly contribute to reducing hospitals’ patient no-show rates. Consider offering habitual no-show patients same-day or next-day appointments.

4) Use interactive patient appointment reminders

Perhaps the most effective strategy and arguably the simplest for reducing your no-show rate is implementing appointment reminders.

Automated appointment reminders help bring down patient no-show rates and boost appointment confirmations. Leveraging automated text reminders will ultimately increase patient attendance via better scheduling and slot utilization.

Conducting outreach through text and email has a huge potential in reducing missed appointments. This approach has shown to lower Federally Qualified Health Centers (FQHCs) no-show rates across the U.S. during the pandemic. In one study, 43 FQHCs conducted outreach and managed to bring down their no-show rates and convert them into visits via audio calls (49%).

Text appointment reminders that are bi-directional — meaning patients can text you back — give patients a chance to confirm their appointment, get directions, ask questions, and adequately prepare for their appointment.

For example, Eisenhower Health in southern California’s Coachella Valley implemented the WELL™ platform and found it effective in reducing missed appointments which dropped by 40 percent. They also experienced a 23 percent growth in appointment confirmations.

5) Provide a ride

Providing patient transportation is also effective in reducing no-show rates in primary care. Not having a ride causes as many as 28 percent of missed appointments, a problem easily tackled with Uber Health or another ride-share service. 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 the details.

Moreover, it’s important that vehicles used to transport patients are regularly disinfected to prevent any risk of COVID infection. Not only will this keep patients and staff safe but it also encourages patients to show up to their appointments.

Clearly, effective patient communication is key to reducing no-shows. Download one of our case studies and our guide to reducing no-show rates to learn more about how WELL™ can effectively help you significantly decrease your no-show rates and in turn, raise your revenue. ♥

Get Started

Find out how the WELL enterprise communication hub can make it easy to engage patients for a world-class clinical and administrative experience.