With increased patient no-show rates in healthcare, the impact of these on a medical practitioner is quite negative. It prevents patients from receiving enough care and decreases the revenue of healthcare professionals. Across the US healthcare system, patient no-show rates vary from 5.5% to 50%. A factor that contributed to this rate is the Covid-19 pandemic. It prompted hospitals and healthcare practices to use and take advantage of internet technology for telemedicine as a work-around in light of implemented lockdowns. Despite the convenience of telemedicine, many patients still miss their telehealth appointments because of various challenges.
Research shows that 80% of patient no-show rates are caused by certain problems and factors. Patients have several reasons that drive them to miss their appointments.
- Emotional barriers
- Logistics
- Forgetting appointments
Among the patients who don’t show up for telehealth appointments include:
- Younger aged patients
- Patients with psychological problems
- Those with lower socioeconomic status
- Individuals on government-provided health beneficiary
How To Calculate Your Patient No-Show Rate
Determine the number of no-shows and divide it by the total number of appointments per week. An example is a 20 percent no-show rate out of 100 patients per week because of 20 no-shows (20 divided by 100).
Everyone has different results on their no-show rate calculation. Data shows that around 18 percent is the national average rate. The Covid-19 pandemic caused an increase in patient no-shows across the US healthcare network with figures in some clinics peaking up to a high of 36.1%.
Patient No-Shows Cost Healthcare Billions
The cost in the healthcare system is an ultimate opportunity and dreaded at the same time because of wasted energy, time, and resources. Healthcare systems find no-shows costly. According to one stat, a single provider spends more than $150,000 annually on about one out of five no-show patients. Healthcare systems with a large setup typically have higher numbers.
According to a particular study, the healthcare system has a setback of around $7 million in 67,000 instances of patients who won’t show up. In a $3.5 trillion industry, every missed appointment costs an average of $200 in lost revenue for healthcare systems. This translates to $150 billion yearly.
A no-show is different from a cancellation where virtual staff could give the canceled slot to another patient and backfill the appointment. It is lost revenue. Some patients think that a doctor’s schedule will be free because of a patient skipping an appointment. But this is not the case since the virtual staff has to do more administrative work. It also hinders the care needed by other patients.
The correlation between diminished healthcare outcomes and no-shows makes matters worse in patients that need utmost care. This year, it is crucial that providers regain the loyalty of patients and lost revenue. In the last couple of years, non-essential procedures made a significant rating drop.
That said, some trends are promising on the horizon. The rise in telehealth may be slowing patient no-show rates. Published in Telemedicine and e-Health, a recent study was conducted in a primary and specialty care clinic. It showed a decreased no-show rate of 7.5% in telehealth compared to in-office appointments at a 36.1% rate.
Why Do Patients Miss Appointments?
Several studies commonly cited many reasons for no-shows. The difference matter in sample size, some conclusions, and methodology. The following are the two suggested reasons that account for almost half of no-shows:
- Forgetfulness
- Scheduling logistics
In the scheduling of logistics, it could be the appointment schedule did not show on the patient’s calendar, or there are double bookings or a conflict with other appointments. The healthcare systems make the right action to prevent these potential no-shows. Providers find it hard to influence or control such as other factors like transportation, fear, and costs that account for the remaining no-shows.
Reminding patients is a way to ensure progress. But a communication approach made to fit all patients would not ensure maximum engagement. It is crucial to have a reminder strategy with automated capabilities.
Each patient is different and each individual has a preferred channel like landline phones, mobile phones, pagers, paper, text, and email. Technology like artificial intelligence, data science, and machine learning helps identify no-show patients and can communicate in a prompt way to make them take action. Decision-makers in the healthcare system should put into consideration additional costs in labor and postage. The healthcare system leadership should decide to implement an automated, omnichannel strategy customized according to patient preferences. This medium will make each patient happy, leading to fewer no-shows and creating a patient-centric approach. It will further close the gap between telehealth and patient no-shows.
A Holistic Approach to Making Appointments
The entire patient care experience elevates with a thoughtful communication strategy before the patient visits the doctor. When a consumer experiences a patient-centric pre-visit, it becomes a norm, and their high expectations will continue to evolve. In a patient’s journey, providers optimize this step, which will lead to the following:
- Improving patient loyalty
- Increasing and accelerating collections
- Lessening administrative burden
Patient Communication is Key to Improving Patient No-Show Rates
Improving patient-provider communications is an area that the healthcare system can control for no-show rates to reduce actively. Another main cause of no-shows is the patient’s lack of convenient and easy means of communicating with the provider. According to U.S. research, poor provider communication is the reason for 31.5% of patient no-shows. Patients forcibly need to use clunky portals or pick up their phones to contact several healthcare providers. Providers fail to meet their patients in a digital medium that offers the following:
- Convenience
- Easy to use
- Multilingual
But studies cited that improving the doctor’s communication methods with the patient does decrease no-shows. Nearly $51.8 million in revenue per year increases across the US healthcare system no-show rate reduce even by a mere 5%.
Strategies To Reduce Patient No-Show Rates
- Use Automated Patient Appointment Reminders
This strategy is perhaps the most effective and simplest to reduce patient no-show rates. Making appointment reminders automated can boost appointment confirmations.
Automated text reminders also serve as leverage to increase patients’ attendance resulting in the usage of slots and better scheduling. Conducting outreach through emails and texts will give you a huge potential to lessen missing appointments.
When text appointment reminders are bidirectional, it means patients have the opportunity to text you back with the following information:
- Ask questions
- Confirm appointment
- Prepare well for their scheduled appointment
- Get directions
Appointment reminders are critical to reducing no-shows. A study showed a drop of more than 14% no shows when parents of pediatric patients received a text message after a phone call reminder. But it can be a burden among virtual healthcare staff who manually message or call patients.
Automated appointment reminders ensure that patients receive consistent outreach and free up more complex tasks for your virtual assistants. Through text messages or email, patients get reminders about their upcoming appointments. It also helps tech-enabled healthcare services meet their growing expectations. The efficiency of your organization improves, and patients enjoy this added benefit.
- Use the Patient’s Preferred Method of Contact
Patients from all age groups utilize technology as part of their lives. Their expectation is lesser from the providers on one-way email and text systems but more on robo-dialers. Because of convenience, they choose to communicate on the following channels:
- Text messaging
- Phone
It is best to ask your patients what contact method they prefer for their appointment reminders.
- Text Patients to Re-Schedule
Be proactive. Reach out and send a rescheduling invitation to your patients who missed their appointments. Motivate them to reply to the text messages and contact the in-house employee or virtual healthcare staff to reschedule medical appointments at their convenience.
- Offer Digital Check-In and Updates on Scheduling Issues
Consumers of healthcare belong to busy people. They turn into no-shows if you ask them to repeatedly wait for long periods before they have a doctor’s appointment. Eventually, these patients become lost because they encounter another healthcare provider who values more of their time.
Many doctors used virtual waiting rooms that started during the Covid pandemic and will continue using them in the future in their medical practice to save administrative time. When you offer patients a digital and touchless check-in process, they can pre-register and complete any necessary paperwork needed before the booked appointment.
Patients and medical staff can quickly communicate with each other through bidirectional texting. It ensures that information is up-to-date and answers scheduling and time issues.
- Reduce the Time Between Scheduling an Appointment and the Actual Appointment
Your patients won’t hesitate to get an appointment by cutting down their waiting time. It will improve no-shows in primary care or specialized practice. It’s because patients prefer their accessibility to information, doctors, and medical services faster. Their experience becomes frustrating when they have to spend waiting time too long to get an appointment and see their doctor.
Healthcare providers can reduce no-show appointments by keeping the waiting time short. When the time between the appointment scheduling and the actual one takes longer, the more the patient turns into a no-show.
This problem is like the scenario of a chicken and an egg. The no-show rates increase when there are long wait times to see a doctor. And other patients experience longer wait times because of the contributions from more no-shows.
Reducing the time can identify delays and optimize the scheduling process for the entire practice. According to a study by Lahey Hospital and Medical Center conducted in Burlington, Massachusetts, a significant margin lessened the outpatient waiting time. After identifying these delays, Lahey Hospital proceeded to optimize its process. The hospital’s average waiting time of 53 minutes is a 23% managed cut down after a substantial change.
Reducing wait times will have a positive result on patients’ experience. Because of this, patient no-show rates reduce. Allow habitual no-show patients to choose appointments between the same day and the next.
- Help Patients Understand the Need for Appointments
If the patients don’t understand the purpose of visiting the doctor, this reason contributes to increased no-shows. US adults having proficient health literacy are only 12%. Meanwhile, those with basic or below basic literacy on health are 77 million. As a result, patients won’t adhere to treatment plans. Few to none will attend their scheduled visits.
An effective strategy is to make information and health education accessible to patients, particularly in complex medical situations. Providers should allow their patients to prepare before showing up in their office by communicating their instructions and giving information in advance.
The Medscape General journal published research that recommends the following five steps to change the behaviors and beliefs of a patient concerning attending appointments and following treatment plans:
- Recognize the risk of not adopting a healthy behavior
- Can address their fears and concerns
- Perceive the seriousness of their condition
- Comply with the treatment plan
- Believe in the positive effects of the suggested treatment
- Calm Patient Fears
Do you know that the patients’ fear fuels the urge for a no-show? Yes, it does! So address their fears like wrong test results, uncomfortable procedures, or getting on the weighing scale. Fear is the unknown. Whatever their reason, it hinders them from attending their scheduled appointments. Their imagination runs wild and could lead to a worst-case scenario of not having an annual check-up even if they know it’s the best prevention.
According to psychologist Dr. Barbara Cox, before the patient visits the doctor, acknowledging the anxiety helps the patient. Doctors should initiate the conversation and act as an ally and an advocate for the patient. Ask their patients how they feel about their upcoming visit and procedure.
- Send Follow-Up Messages
Build patient loyalty. Display your appreciation to your patients by sending automated thank you messages to keep their appointments. It indicates how much you value their time. Your thank-you message post-appointment can include the following information:
- Medications
- Referrals
- Other types of follow-up
- Empower Patients by Letting Them Schedule Their Appointments
Many healthcare organizations still use the phone to schedule all their patient appointments. This process is overwhelming for appointment call centers. It leads to longer hold times and poorer patient experience.
An alternative technology that is easy and convenient for booking an appointment is online self-scheduling. Patients can self-schedule to minimize no-shows and reduce the burden on the virtual administrative staff. It means less time for putting patients on hold if they need to call their doctor’s office. Ultimately, the overall patient satisfaction improves.
- Convert Upcoming Visits to Telehealth to Prevent Missed Appointments
Virtual visits get relief from high no-shows for in-person care affecting your bottom line and patient outcomes. According to a 2020 study in Telemedicine and e-Health, the no-show rate of telehealth visits is just 7.5%, which is four times lower than the average in-office no-show rate before the pandemic. During the pandemic, there was a remarkable difference in the increase.
When sending appointment reminders to a patient and response to cancellations, offer a telehealth visit if they can’t make it to the doctor’s office. Provide a virtual-appointment alternative. It helps patients get needed healthcare and ensures you’ll retain revenue for that particular patient visit.
- Automate the Waitlist Process to Quickly Backfill Canceled Appointments
Although all no-shows or last-minute cancellations cannot be preventable, you can still efficiently respond to them. Stop your staff from spending hours each day just calling patients about their cancellations. Use automation to accomplish this task in a few minutes without the need for any staff effort.
Turn cancellations into opportunities using an automated schedule-management tool. This tool detects a visit cancellation and sends a text message to other clinically relevant patients with upcoming appointments. It offers the reopened appointment slot that was earlier closed and got canceled. There is no need for waitlist sign-ups, portals, apps, or staff work since the patient who will first reply to that text message will get that appointment.
- Keep Patients Engaged With Prompt Follow-Up After They Cancel or Fail to Show for an Appointment
Follow up with your patient after they do a cancellation or no-show. It helps patient retention and addresses essential medical needs before it worsens. Do follow-ups within 24 hours of a missed appointment to keep your patients engaged in their care.
Automate this process using technology and templated messaging. Patients receive prompt messages to reschedule promptly. Offer upcoming timeslots to allow them to self-schedule. You can also allow them to click a link for an appointment request.
Final Thoughts
Reducing no-shows is possible. Empower your patients with the right tools and the right offshore outsourcing provider, like Phoenix Virtual Solutions. HIPAA-certified Phoenix virtual assistants help you maximize profitability while providing the best care for your patients–before, during, and after their visit–so that you can take an active role in their care and treatment. Contact Phoenix today to help you streamline the appointment process and avoid empty timeslots!
