Preventing Patient No-Shows

Patient no-shows waste staff time and leave patients without necessary care, but these strategies can help your organization prevent them from happening.
Clinical Operations Patient Experience

Are you struggling with patient no-shows? You’re not alone. The problem affects organizations of all sizes and specialties, and costs the healthcare industry billions of dollars every year. No-show appointments waste staff time and clinic resources and leave patients without necessary care, making it harder for healthcare organizations to achieve their broader goals of improving population health and reducing waste.

Why do patient no-shows happen?

Maybe patients forget about their appointment or they can’t reach your office in time to cancel, or maybe they don’t understand the ramifications of not showing up. Perhaps they lack access to reliable transportation or face other barriers to care related to social determinants of health.

How to prevent no-show appointments

Regardless of the reasons, there are several strategies that can help your organization prevent no-shows from happening:

  1. Schedule Efficiently and Streamline Intake
  2. Analyze Your Data
  3. Send Automated Appointment Reminders
  4. Offer Online Patient Appointments
  5. Communicate Your Patient No-Show Policy

Schedule Efficiently and Streamline Intake

Patients are more likely to forget or miss an appointment if they’re forced to wait several weeks or even months to be seen, according to a study in the journal, Clinical Ophthalmology. Try to schedule patients as soon as possible, especially new ones and those with urgent needs. In addition, keep patient wait times short by encouraging patients to complete medical check-in ahead of time on their computer or mobile device so they won’t need to spend time filling out paperwork in the office. An organized, streamlined patient scheduling system helps build patient loyalty, boost satisfaction and reduces no-show appointments, because when patients see that you value their time, they’re more likely to value yours.

Analyze Your Data

Efficient scheduling starts with looking at your appointment data, including no-show rates and what’s causing them in the first place. Frank Cohen, Director of Analytics and Business Intelligence at Doctors Management LLC, suggests measuring the lead time from scheduling to the actual appointment and examining whether that affects the likelihood of a no-show.

“After three weeks of waiting, a correlation begins to develop,” Cohen says. “The longer a patient has to wait to come in for an appointment, the higher their no-show rate.”

In a recent analysis of no-show rates at a large healthcare organization, Cohen used predictive analytics to estimate the number of patient no-shows, and more specifically, who might be a no-show.

“When you can identify patients who are more than 50% likely to no-show, it gives you the opportunity to reach out ahead of time to remind them about the appointment, and ask if they perceive any problems with showing up for the visit,” Cohen says.

While he uses advanced algorithms in his work, the process doesn’t have to be complicated or costly. He says medical practices can start by analyzing specific patient variables, such as provider, time of day, age group, payer type, etc., and look for correlations between those variables and no-shows.

“You don’t have to use advanced statistics,” Cohen says. “You could look at all of your no-shows from the past month and break them down by payer group. If you find that among all no-shows, 25% of those happen on Wednesday mornings, try scheduling different patient types in that time frame, and see if that affects your no-show rates.”

Send Automated Appointment Reminders

Automated appointment reminders are a quick and friendly way to engage with patients before their visit and prevent no-shows. Sending a text or email appointment reminder offers them a convenient way to confirm, cancel or request to reschedule an appointment, which in turn helps boost patient satisfaction and loyalty. Automated reminders also streamline operations and free up staff time previously spent trying to fill last-minute schedule gaps. According to survey data from MGMA, more than 50% of respondents said that their practice uses multiple communication methods to connect with their patients and prevent no-shows, including email and text messages. And since the majority of Americans now own a smartphone, automated reminders are likely the most reliable way to reach patients and reduce the chances of an appointment no-show.

Offer Online Patient Appointments

Rather than placing patients on hold who call to schedule an appointment (and potentially having them hang up), allow them to request an appointment on your website or through an online portal. According to a study from Accenture, while it can take up to eight minutes to schedule an appointment by phone, it takes less than a minute to book one online. This convenient option offers patients more freedom to choose their preferred appointment time and increases the likelihood they’ll keep the appointment.

According to a 2017 study in the Journal of Medical Internet Research, web-based scheduling tools help reduce no-show rates, save staff time, improve patient satisfaction, boost efficiency and increase revenue. These benefits are driving a growing number of healthcare organizations to make online appointments a central part of their scheduling system. The Accenture study also reported found that two out of three patients will book appointments online by 2019.

Communicate Your Patient No-Show Policy

Patient no-shows leave holes in providers’ schedules, add to staff stress and hurt your bottom line. But do your patients understand that? It’s important to make patients aware of both the consequences that no-shows can have on their care and the business impact they have on your practice. Create a patient no-show policy that patients read and sign before their first appointment that briefly and clearly explains the problems caused by no-shows and how you handle them. Include an explanation of fees charged for missed appointments, the number of no-shows allowed by your organization and your requested notification window for cancellations. Make sure staff also are well-informed about the policy, and encourage them to use it as an opportunity to educate patients.

Learn how Phreesia helps healthcare organizations improve the appointments process.