Cut Patient No-Show Rates with Better Communication

Reducing Patient No-Show Rates: A Comprehensive Guide

High patient no-show percentage have a negative impact across the healthcare network. They damage provider revenue, and they prevent patients from receiving optimal care – a serious lose-lose.

A central cause of no-show rates is patients lacking a convenient and easy way to communicate with providers. Many providers still force patients to pick up the phone, or wrestle with clunky portals. They fail to meet them in a digital medium that is easy, convenient, and multilingual. When providers improve their overall patient communication, no-shows rates reliably fall.

How can providers implement the right strategies reducing no show rates in primary care? And what results can they expect? Read our guide to find out.

The Cost of Patient No-Show Rates

Staff call out a name in a packed waiting room. Visibly impatient people look up, but no one answers. The staff call out the name again. Silence again. The name is crossed out.

It’s a no-show: A patient has failed to show up for an appointment, having failed to cancel that appointment ahead of time. This happens thousands of times every single day. No-show patients are a headache for almost every single healthcare practice, and it’s been this way for years.

Whenever a patient doesn’t appear for a check-up, surgery, or consultation, it leads to wasted capacity. Personnel, resources, and expertise that have been scheduled for that particular appointment are underutilized, and the slot goes empty.

Unlike a cancellation, where staff could backfill the appointment, a no-show is lost revenue.

No-shows are bad for patients, leading to:

  • Interrupted continuity of care
  • Poorer clinical outcomes
  • Unmonitored medication use
  • Delayed preventive screenings

No-shows are also bad for providers, for a range of reasons:

  • Unspent labor is still paid labor, typically ranging from 50 to 60% of total operating revenue.
  • A shortage of doctors and other medical personnel forces healthcare practices to overstaff. Their ever-increasing salaries, combined with high no-show rates, further drive down revenue.
  • Overstaffing contributes to employee disengagement and turnover. Several healthcare organizations have seen an 18% dive in productivity and as much as 16% loss in profitability.
  • No-shows add more administrative burden to staff who are tasked with scheduling and appointments. As the list of patients to call grows, the operational expenses required for calling patients, making follow-ups and no-show appointments also increase.

For providers, these ill effects translate directly to damaged bottom line.

The overall cost of no-show patients to providers, in dollars and cents?

An average of around $200, per appointment. Across the US healthcare system, this translates to $150 billion every year.

Breaking Down Patient No-Show Costs

The no-show devil is in the details. Patient no-show rates vary greatly across the US healthcare system, ranging from 5.5% to 50%. (The global average for patient no-show rate is 23%, according to the National Library of Medicine).

However, wherever you look, the picture is bleak. Data from the Physicians Foundation revealed that doctors in the US see 20 patients daily. However many of those are failing to show up, significant revenue leakage is the result.

For managed care and services that receive monthly fixed fees from their clients, they can't pass along the additional costs of services and administration. When clients don't show up, the impact of the loss of revenue is intensified because of the extra expenses.

It's critical for healthcare providers to empower no-show patients to show up to their appointments. Not only will it stop the financial bleeding, more patients appearing for their check-ups and procedures can generate millions of revenue. One study shows that reducing the no-show rate to 5% would increase revenue by nearly $51.8 million annually across the US healthcare system.

Poor Provider-Patient Communication Drives No-Shows

Some of the causes of no-shows are hard to mitigate: People are busy and occasionally forgetful. Public transportation and the weather play a role.

However, there is one big area where providers can actively slash patient no-show rates:

US research has shown that up to 31.5% of no-shows fail to show up because of poor provider communication. This is nearly identical in Canada, where 32% of patients cite miscommunication as their primary reason for missing appointments.

Fragmented communication between patients and providers as well as outdated practices for managing patient preferences for reminders are among the leading drivers of no-show rates among providers.

To fix this, healthcare practices need to start making the whole appointment scheduling journey as seamless and friendly as possible. Modern patients want communication with their providers to deliver the same things they expect from consumer products: convenience, value and innovation.

Patients want to connect with providers in a way that is convenient, adds value to their experience, and utilizes innovations they appreciate and use. This means they don’t want to communicate like it’s still 1995:

  • 79% of healthcare consumers expect providers to communicate with them via channels they prefer.
  • 80% of patients now put a premium on convenience factors and would have no difficulty switching to another provider if it’s more convenient.

Strategies on how to stop no show appointments must also consider language barriers and how to address them. According to the National Library of Medicine, among LEP patients who received professional medical treatment, 50% said their inability to understand the local language contributed to errors, 30% struggled to understand medical instructions, and 20% did not pursue healthcare services if they were not readily available.

Patients Want Reminders & Rescheduling – By Text

There are two major things that can immediately cut patient no-show rates:

  1. Texting patients appointment reminders.
  2. Offering them the option of self-rescheduling by text.

Notice the common denominator? Texting.

Texting, while not a new communication platform, is the most widely used messaging medium in the US. Currently, there are over 275 million smartphone users in the US. 98% of users send texts on a regular basis.

For healthcare providers and practices, this indicates a need to include texting as an integral part of their patient communication options on how to prevent no shows. Here’s why:

  • 70% of American healthcare consumers prefer texting to schedule their appointments.
  • 91% want to be informed about the status of their ill loved ones via text.
  • 83% like to receive reminders from physicians for prescriptions, schedule confirmations, follow-up appointments, and more.
  • In one consumer survey, 55% of respondents said they would reply to text reminders to confirm or cancel their appointments as well as ask for additional details from their physicians.

Texting also enables providers to quickly fill in cancelled slots, ensuring revenue is still generated and patients are still serviced.

The Ongoing Importance of an Omnichannel Approach

Catering to what consumers, and reducing no-show appointments, want means staying flexible. Text is king, but in patient-provider communication, a holistic approach is required:

  • Around 10% of patients still heavily prefer patient portals.
  • Consumers aged over 45 prefer to communicate through email over text.
  • A study published in the Journal of the American Medical Informatics Association revealed that 90% of patients now want live video chats with physicians.

These and other factors mean that broad-ranging strategies on how to prevent no shows are required to reach every segment of the patient base. For this, providers need:

A centralized communication hub capable of unifying all patient communication in one place, and providing patients with convenient communication options that are automated, dynamic, bi-directional, and conversational.


How WELL Improves Patient-Provider Communication

The WELL hub reliably cuts patient no-show rates by equipping healthcare providers with a sophisticated and centralized communication hub that simplifies patient-provider communication. From a unified platform, providers can engage patients in one-on-one, back-and-forth text conversations at scale

The WELL platform eliminates communication issues stemming from outdated and rigid phone systems and other one-way communication tools. Providers can tailor their messages based on their patient’s profile, previous interactions, and current treatment plan. Personalized messaging empowers patients to become more engaged and involved with their health, thus contributing to the reduction of patient no-show rates.

Two-Way Patient-Provider Texting Functionality

Two-Way Patient-Provider Texting Functionality

Patients can get in touch and exchange text messages with their providers through the device that is central to their life: their cellphone. Bi-directional text messaging also allows healthcare providers to see incoming messages from patients which previously went unnoticed.

Fully-Automated Appointment Scheduling & Reminders

Fully-Automated Appointment Scheduling & Reminders

Patients can schedule and reschedule their appointments by sending quick and easy texts. There’s no need to call the doctor’s office, or download an app.

They will be automatically reminded of their upcoming appointments, and invited to confirm, reschedule, or cancel.

Pre-Appointment Instructions

Pre-Appointment Instructions

Patients receive a set of instructions prior to their appointments, empowering them to come to their appointment fully prepared.

Broadcast Messaging

Broadcast Messaging

To help fill slots when patients do cancel, WELL empowers healthcare providers to send customized messages to up to 1,000 patients, informing them of available slots and ensuring all slots are utilized.

Multilingual Support

Multilingual Support

Language issues, a key cause of no-show patients, are heavily mitigated with WELL. The hub is designed to support over 19 different languages, including Spanish, German, Japanese, and Chinese. WELL automatically translates messages to patients’ preferred languages, helping providers build rapport.

Secure Messaging

Secure Messaging

WELL Health not only addresses patients’ communication needs. The system is also designed to protect patient information through secure messaging protocols. All messages are secured and require patients to verify their identity prior to viewing the content of their messages.

The WELL Health Impact (Case Studies)

Vista Community Clinic

Operating out of southern California, the Vista Community Clinic (VCC) was struggling to cut their patient no-show rates. After several failed attempts to reduce their rate via email and one-way text messaging platforms, VCC’s average patient no-show rate was at 23%. In other departments, it was over 30%.

After implementing WELL, VCC’s patient no-show rates dropped to 19 percent in just six months.

“We keep finding more use cases!” said Michelle Monroe, Chief Operations Officer at VCC.

Tiburcio Vazquez Health Center

The Tiburcio Vazquez Health Center (TVHC) caters to 115,000 patients, a large proportion of which are Hispanic. The language barrier was making it difficult for TVHC physicians to connect with such a large volume of patients, resulting in high patient no-show rates and lost revenue.

By implementing WELL Health, TVHC overcame the language barrier issue.

TVHC saw its no-show rate drop by 20%. Confirmed bookings skyrocketed from 25% to 80%.

“They’ve given us a better way to talk to our patients, an easier, more efficient way to reach out to patients, and a better way to handle scheduling,” said Caleb Sandford, TVHC Chief Operations Officer.

Tandem Health

Tandem Health was using a legacy communication system that patients found to be unintuitive and difficult. Cancelling or confirming appointments was difficult, over both the phone and the patient portal. As a result, Tandem Health’s patient no-show rates averaged above 20%.

After onboarding WELL Health, the no-show rate dropped by 25%.

Patients are now able to confirm or cancel their appointments with ease and confidence. “Just walk into any waiting room. Everyone is on their phones, texting,”  said Marty Martin, Director of Clinical Informatics. “With WELL, we are meeting them where they already are.”

For more information on the no-show policy and reducing no-shows, connect with a Communication Specialist


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