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How to Prevent Patients From Canceling or Missing Appointments

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Guidelines for Both Tracking and Reducing Patient No-Shows

Across all areas of medicine, patient no shows and canceled appointments can affect revenue and efficiency. With high no-show rates, and patients needing services that cater to an on-demand lifestyle, taking a closer look can improve operational efficiency for a medical practice. Take a look at why patients may be missing their appointments, how to deal with no show appointments, and more.

What Is the Average No-Show Rate for Doctor Appointments?

When it comes to the average no show rate, medical practice managers can all have unique numbers to give. No-shows can be higher for certain types of providers. For example, a primary care physician may naturally have a higher rate of patient cancellations or no-shows than a specialist. To offer a general idea of what rates look like for the medical industry, a systematic literature review published in 2018. It found that the average patient no-show rate with all specialties is around 23 percent.

Why Do Patients Miss Their Appointments?

To understand how to prevent no shows, you must first look at why patients miss their appointments to begin with. Not every patient is the same, so every patient may have their own affecting factors. Some general reasons why patients miss scheduled appointments include:

  • Forget the scheduled appointment
  • Lack of transportation
  • Conflicts arise that take priority over the appointment (e.g. sick child, work responsibilities, etc.)
  • Costs associated with care
  • Not having time to dedicate to the appointment process (driving to the office, waiting in the waiting room, and so on)
  • Finding care at another provider before their scheduled appointment

Cost to the Practice for No-Shows or Missed Appointments

The economic effect of missed appointments is quite massive when you look at the larger scale of the industry as a whole. Patient no-shows are actually thought to cost the healthcare industry as a whole a whopping $150 billion every year.

The average cost of a single missed appointment is around $200. However, factors affecting the costs differs from one practice to the other. For example, a general practitioner may lose $200 due to a time slot not being filled. However, they may also incur costs associated with staff time. The time that went into preparing for that patient’s visit and then the time that goes into rescheduling efforts.

Why Track Your Patient No-Show Rate

Tracking your no-show rates can give you valuable insight to use in efforts to improve the problem. Essentially, when you track no-show rates, you can start to see not only which patients are missing appointments, but certain patterns for missed appointments. For example, if you are tracking patient no-shows all year, you may recognize you have more cancellations in the spring than in the fall. With this insight, you will know that your efforts to curb no-shows may need more attention in the spring.

Reliable data on no-show appointments can also be valuable for examining revenue. When you know how many no-shows are happening, you can determine how much money you may be losing within a given time frame. When you see how much revenue is lost, you obviously get a good view of how much making changes could benefit your operation.

Related – Evaluating the Impact of Patient No-Shows on Service Quality

How is the patient no-show rate calculated?

The Institute for Healthcare Improvement offers a basic formula to calculate no-show rates:

Total number of no-show appointments divided by the total number of appointment slots. Multiply the result by 100.

If you have 50 no shows over a 30-day period, and 250 total appointments available, the formula would be: 50/250 × 100 = 20. Therefore, the no-show rate would be 20 percent.

Strategies to Reduce No Show Rates

Adjustments for the purpose of deterring no-shows and canceled appointments don’t necessarily have to be complicated. A few changes may yield a drastic drop in missed appointments. Each practice manager has to examine their own unique reasons as to why patients are missing appointments. Then use that information as a springboard to generate solutions. Reducing no show rates in primary care compared to specialized care, for instance, may require different efforts.

Make care as convenient as possible.

Patients can be missing appointments because healthcare can pose interruptions in their daily lives. Having to work, no childcare, lack of transportation, and being long distance from the provider are reasons why patients cancel and miss their appointments. Offering a care model that allows for basic care and convenience can be one of the biggest advancements toward lowering no-show rates.

Telehealth solutions have a big part to play in making healthcare more convenient for the average patient. Data collected from October 2020 showed that telehealth visits have a no-show rate of just 5 percent.

Top Telehealth Software Comparison

Communicate with patients about their upcoming appointments.

Communication is obviously how to keep patients from canceling appointments or becoming a no show. Most modern patients do expect appointment reminders. A study published by The American Journal of Medicine found that no-show rates among patients were as high as 23 percent with no reminders. No-show rates were reduced to 17.3 percent with automated appointment reminders and 13.6 percent when they spoke to a live staff member.

Communicated reminders about appointments don’t have to require a lot of staff-hours; technology makes it simple to keep in touch with:

  • Automated text messages
  • Emailed alerts via patient portals
  • Pre-recorded, automated phone calls

Implement and follow a cancellation/no-show policy.

Many practitioners go through the process of creating a no-show or cancellation policy, but never actually implement or follow it with their patients. What is a no show policy? Essentially, this policy states how patient no shows and cancellations should be handled. These policies don’t have to be especially punitive for the patient to encourage cancellations over no shows. A policy may cover:

  • How many appointments a patient can miss before they may be dismissed as a patient
  • If a no-show fee will be assessed for no-shows and the precise fee amount
  • How far in advance an appointment should be canceled to avoid being counted as a no-show

Avoid long-lead appointment scheduling.

Patients may be more likely to miss their appointment when there is a longer wait time between appointment-scheduled and appointment-day. If you are seeing a high no-show rate, examine the average wait time with appointments. An analysis of 4.2 million scheduled appointments among 13,000 providers found that a new patient who waits longer than a month is twice as likely to miss their appointment than a new patient who gets an appointment within a week.

How To Deal with No Show Appointments

Regardless of what strategies you implement, no-shows are going to happen. When they do, having a concrete plan in place to accommodate the schedule change and concurrently reschedule the patient is always for the best.

If you are using a good EHR (electronic health record), the rescheduling process can be simplified. Many programs allow you to notify patients of their upcoming appointments through text messages and emails, directly through an interface. Likewise, these digital interfaces allow a look at prior missed appointments to reschedule a new one.

Patient No-Shows Happen, But Convenient Care May Help

With CareTime MD, medical practices gain the advantage of offering incredible convenience to patients. And, the platform falls right in line with an existing EHR for added ease-of-use for practitioners. Taking advantage of this revolutionary medical care technology can do a lot to lower your practice’s no-show rates and canceled appointments alike. To find out more about CareTime MD, reach out to get a quick call for more information.