The No-Show: A Top Challenge in Patient Access
As the trend toward consumer-driven health care becomes the norm, many aspects of the provider-patient relationship are likely to be affected. To gain deeper insight into how today’s healthcare consumers are searching for and scheduling care, we collected and analyzed relevant scheduling data from online appointments made online through DocASAP in the last year. In a new Ebook entitled Top Digital Consumer Trends Shaping Patient Access, DocASAP shares insights on how consumers search for and access care. Today we focus on a challenge that many providers face: the “no-show patient.”
The No-Show Problem
Patients who don’t appear for a scheduled appointment, or cancel their appointment at the last minute, pose significant healthcare and cost consequences for medical providers at every level from primary care providers, to diagnostic imaging services and outpatient surgery facilities. In some settings, up to 18% of booked appointments can result in no-shows.
Patients Who are a No-Show Hurt Themselves First
Patients who don’t keep their appointments risk negative effects on the quality of their own health. They miss important screenings, delay necessary diagnostic or pre-surgical testing, and postpone treatment or therapy they need.
Patient Flow Consequences
In any practice that aims to improve efficiency – which is pretty much every practice – the no-show problem is disruptive, and places unnecessary strain on patient flow and staff resources. It’s frustrating and time consuming for staffers to try and re-book late cancellations; when a re-shuffle causes a waiting room delay, patient satisfaction can plummet.
No-Shows Hurt the Bottom Line
The financial consequences of no-show patients are significant. The American Osteopathic Association estimates that in physician practices, the cost of missed appointments can be up to 14% of projected daily revenue.
To summarize, no-show patients present health challenges, as well as administrative problems and financial challenges for providers.
Which Remedies Work, and Which Do Not
Providers and their practice managers utilize a variety of tools to reduce the no-show rate, although not all these are equally effective. A report titled Maximizing Patient Access and Scheduling by MGMA discusses these remedies in depth:
- Staff reminder calls can be costly and time consuming. Although a person-to-person conversation can be compelling, it’s not always possible to reach the patient, resulting in either less-effective voice mail, or repeated attempts to speak in person.
- Automated “robocall” reminders yield minimal improvement, perhaps because they’re easier for patients to screen or ignore.
- Fines or penalties for no-show or late cancellations are not necessarily effective. Many people who miss an appointment tell they simply forgot to come in or cancel.
- Others say they weren’t aware of a no-show or late cancellation penalty, which highlights a dilemma: an unpublicized penalty is not a deterrent, but overemphasizing penalties can be off-putting, even insulting, for patients who reliably keep their appointments.
- Overbooking and walk-in patients can mitigate the effects of no-shows, but this approach can lead to disruption in patient flow, with the downside of waiting room delays and patient dissatisfaction.
One remedy that shows positive results: carefully crafted phone, email or text message follow-up campaigns. In surveys, four of five patients who didn’t keep their appointments report that a timely reminder would have helped.
Other useful approaches include:
- Shorter Lead Time. DocASAP’s own survey shows that shorter lead time on appointments can help reduce no-shows. This matches up with the preference of Millennial-aged patients for quick turnaround, including same-day appointments when offered.
- Online Self-scheduling. According to Hanover Research’s “2019 Health Care Consumer Annual Benchmark Study”, 43% of healthcare consumers now look to schedule care appointments through their health plan’s member portal or mobile app. This finding is reinforced by our survey of appointments booked through DocASAP, which reduced no-show rates to just 6%.
- Pre-appointment assessments. Contact before the appointment can help focus the provider on the patient’s needs, and help to direct the patient’s attention to their upcoming interaction with the provider.