Why Patients Miss Doctor Appointments & How to Decrease No-ShowsErika Barredo
Given the fact that healthcare systems consumed about 20% of the U.S. Gross Domestic Product (GDP) in 2017, which correlates to hundreds of millions of doctor visits each year, it is inevitable that the occasional no-show appointment will occur. However, a significant number of missed appointments can equate to millions of dollars in lost revenue, especially in a hospital setting. According to a 2016 study, the average yearly no-show rate for primary care and specialty medical appointments is just under 20 percent — an astounding number that could mean significant revenue loss for healthcare systems, both large and small.
The average yearly no-show rate for primary care and specialty medical appointments is just under 20 percent.
In order to improve upon the no-show rate in healthcare facilities, it’s important to first understand why patients miss their appointments, the financial impact that this has on the entire healthcare system, and what can be done to decrease the number of no-shows each year.
What Causes Patients to Skip Medical Appointments?
Generally speaking, younger patients, patients of lower socioeconomic status, and patients who receive government-provided health benefits have the highest no-show rates. According to a research study published in Annals of Family Medicine, there are four primary reasons a patient might skip a medical appointment and fail to provide adequate or any notice at all: 
- Logistical reasons. Some patients reported having missed a doctor’s appointment due to problems taking time off work, childcare, cost, and not having transportation to and from their appointment.
- Emotional barriers. For about 65 percent of study participants, negative emotions surrounding the idea of visiting a doctor’s office kept them from following through with their appointment . In some cases, patients made an appointment while they weren’t feeling well, but then decided not to go a few days later after the initial sense of urgency faded away.
- Perceived disrespect. Forty-four percent of study participants reported a perceived disrespect for their health views, personal beliefs and opinions, and time as reasons for not showing up for an appointment . Long wait times fell into this category.
- Lack of understanding of scheduling system. Finally, another group of people simply didn’t realize how their no-show would affect the medical office and other patients. In fact, many patients mistakenly believe that no-shows actually help doctor’s offices because there is a general belief that these offices are usually always overbooked anyway.
The Cost of No-Show Appointments
It might seem like a missed appointment here and there is harmless – maybe even to be expected – but the fact of the matter is that the average hospital experiences about 62 no-shows per day, which adds up to an estimated $3 million in lost revenue each year . Another consideration specific to hospital settings is the added costs of missed surgeries. When pre-surgical and even surgery appointments themselves are missed, hospitals could potentially lose $500 or more per visit .
The average hospital experiences about 62 no-shows per day, which adds up to an estimated $3 million in lost revenue each year.
Hospital size has also been shown to affect the no-show rates, with larger facilities tending to have significantly higher no-show rates than smaller hospitals and family practices . Still, no matter the size of the health system, missed appointments could account for anywhere from 3 to 80 percent of all scheduled appointments, making this one of the most common reasons for lost revenue across the board .
How to Decrease No-Shows and Increase Revenue
While eliminating no-show appointments altogether may never be possible, there are some proven steps that healthcare systems can take to significantly lower the number of missed medical appointments and therefore increase revenue streams. Administrators at Mount Sinai Medical Center in New York have found that the single-most effective way to do this is to “communicate more readily with patients and make scheduling — or rescheduling — an appointment much easier” .
Studies have shown that the no-show rate drops from 23 percent to around 15 percent when patients are given a reminder call a few days before their appointment.
One important component of effective patient communication is to implement an appointment reminder system into everyday practice. However, making reminder calls can cost time and money if a staff member has to take time out of his or her day to call patients. Studies have shown that the no-show rate drops from about 23 percent to 15 percent when patients are given a reminder call a few days before their appointment. 
This is one of the many reasons why using an automated messaging system such as the Tine Health Patient Relationship Management Platform can be so beneficial when trying to increase patient satisfaction and retention and revenue at the same time. The Tine Health messaging system allows you to schedule automated appointment reminder texts and/or calls, plus gives patients access to video instructions, aftercare guidelines, and follow-up messaging and surveys.
Other ways that you can help to decrease missed appointments and increase patient satisfaction is to lower wait times and shorten the amount of time in between each appointment.
Implementing new and innovative strategies to help decrease the number of no-show appointments that your healthcare system or medical office deals with each year is one key way to increase both revenue and positive patient outcomes. If you’d like more information about how Tine could help, contact us to schedule a demo or take a look at our FAQ page.
 BMC Health Services Research