Do you know your practice's no-show rate? For many practices the answer is no, even though no-shows create access issues, reduce revenues, and negatively affect patient care. Before we can treat the problem of no-shows, we must begin with the diagnosis. It starts with tracking no-shows for trends and repeat offenders. Understanding the reasons patients miss their appointments is key to creating a successful and proactive strategy. The most common causes of no-shows are:
- Patients do not feel an established relationship with their doctor or with the practice staff. New patients, or those who see multiple providers in the practice, are more likely to no-show.
- Long wait times for appointments can cause patients to forget, seek care elsewhere, or simply start to feel better.
- Patients do not understand or appreciate the need for the services they will receive during the appointment.
- Personal issues such as transportation, copay or out of pocket expenses, and scheduling conflicts.
Eliminating no-shows may not be possible, however there are ways to reduce them and the impact they have on the practice. A study conducted in 2007 at the Robert Wood Johnson University Medical Group, an outpatient multispecialty clinic, indicated that approximately 23.1% of patients who received no reminder call missed their appointments. The number went down to 17.3% if patients were contacted by an automated appointment reminder system. But the no-show figure went down further to almost 13.6% if an actual staff member made the call. The data shows that patients are more likely to keep an appointment if we remind them that they have one.
We recommend utilizing a personal pre-visit call system with formatted questions and talking points, such as Studer Group’s Patient Call Manager℠, which is proven to impact both no-shows and late arrivals. The calls require a commitment of staff time and accountability, but the personal touch makes a connection with the patient. Key elements of this pre-visit call include:
- Confirming the appointment 48 hours prior to visit using key words, “Does this time still work for you?” The question invites the patient to engage in conversation with the staff and begin building that relationship.
- Reaffirm purpose of the visit and/or testing.
- Review any instructions, paperwork or test nuances.
- Provide directions to the medical practice and parking instructions.
The personal confirmation provides the opportunity to reschedule the appointment if the time no longer works for the patient. It also affords staff the chance to fill the vacated spot with a patient from a wait list, or one that has agreed to be available for short notice appointments. The practice is then able to recapture what would have been lost revenue.
For the inevitable no-shows that remain, it is critical to call patients and reschedule the missed appointment. The practice cannot afford to wait for patients to call back to reschedule. As a rule of thumb, patients should be called within 24 hours of their missed appointment. Using key words, such as, “In order to assure the best care for you, we really need you to come in for your appointment,” can demonstrate the urgency of rescheduling and shows that the practice cares about the patient. The outreach and advocacy on the patients behalf is the kind of personal touch they will respond to and appreciate.
Technology continues to change and improve the treatment options for no-shows. Additional ideas for pre-visit reminders include postcards/mailers that can be sent out, automated calls, email reminders and text messages. Allowing patients to choose their communication preference is a personal touch that communicates the practice’s desire to set the patient and the practice up for success.
Additional Resources:
- Studer Group’s Patient Call Manager: The Clinical Call System (PCM), is one of our most important tools for making patients an integral part of the collaborative care team. Learn how it’s the next generation of care designed to provide touch points as a patient navigates your healthcare system at www.studergroup.com/pcm.
- “7 Ways to Improve Access and Reduce No-Shows” from Studer Group’s Hardwired Results® Issue 14 magazine shares JPS Health Network’s journey and best practices for improving access and reducing no-shows. Access the article at www.studergroup.com/hardwiredresults14.
- Getting timely appointments, care and information is measured in the CG CAHPS survey. Learn about the questions and tactics that can positively impact CG CAHPS results by visiting www.studergroup.com/cgcahps.