Stats you need to know about patient cancellations and no-shows

Patient cancellations and no-shows are a consistent challenge for private practices. Not only do missed appointments negatively impact the rhythm of a practice’s operations, but they also pose financial and operational hurdles, and research shows that no-shows represent a significant burden on healthcare providers.

To learn more about why patients (and practices) miss appointments or cancel at the last minute, Tebra surveyed over 1,000 patients and 200 providers for our 2023 Patient Experience Survey: Scheduling and Retaining Patients. 

Below are 10 no-show and cancellation stats and actionable recommendations for improving your patient show rate and running operations smoothly.

71% of patients say offering more same-day or next-day appointments would help prevent no-shows, cancellations, and rescheduling. 

Research published in the journal Risk Management and Healthcare Policy shows that the lead time, or the waiting time between the day the appointment is scheduled and the day of the appointment, is positively correlated with an increased chance of a no-show. When the lead time is more than two weeks, the probability of a no-show, cancellation, or rescheduling of appointments rises “significantly.”

Practices can combat the risks of long lead times by offering more same-day or next-day appointments. 

Manually scheduling appointments in a busy practice amounts to a full-time job. Instead of relying on front office staff to handle the tedium of scheduling, practices can significantly improve their operations by adopting more streamlined systems. Practice management software allows practices to maximize scheduling efficiency, release available appointment slots automatically, and reduce the administrative burden on front-office staff to ensure more patients can get booked faster. 

75% of patients say they’d be more likely to show up to their appointment if they could reschedule their appointment online. 

In today's “always-on” environment, patients want convenient ways to manage their healthcare on their own time. In 2023 and beyond, a user-friendly online scheduling platform is essential for a modern practice. 

Patient-powered scheduling confers benefits to both the patients and the practice. Patients benefit from the flexibility to manage their healthcare and busy lives on their own time. Practices can decrease no-shows and cancellations. The best practice management platforms make it easy for patients to reschedule and then release the newly available appointment time to be booked by other patients.

Tebra’s scheduling survey found that more than half (56%) of patients would be willing to do a telehealth session if their provider was unavailable in person. 

No-shows, cancellations, and rescheduling most often result because of scheduling conflicts. Work conflicts, transportation, and not feeling well are the primary reasons patients miss appointments or cancel at the last minute. Telehealth makes it easy for patients to receive the care they need without the logistics of having to travel to the office. 

Additionally, the same survey found that 74% of patients said they’d use a virtual waiting room if available. Virtual waiting rooms create a more efficient telehealth experience by allowing patients and healthcare providers to signal their readiness for a telehealth appointment. Staff monitor the online platform and facilitate entry into the telehealth session when both parties are ready. 

In-person appointments are also a viable use for virtual waiting rooms. Virtual waiting rooms in the office allow patients to check in online via their mobile phones and skip the traditional waiting area experience. 

According to Tebra’s scheduling survey, 68% of providers say they have to cancel or reschedule appointments between 1-10 times per month. 

While some practices may be eyeing no-show or cancellation fees, a vast majority of physicians routinely have to cancel at least once, and up to 10 times per month should also be considered. Tebra’s survey found that no-show fees aren’t effective and may cause patient tension.

According to Tebra’s survey, 68% percent said they’ve never shown up for an appointment they would have canceled because they were afraid of being charged a no-show fee, and more than half (52%) of patients said they don’t believe it’s fair to be charged a fee for a no show or cancellation.  

Additionally, a more understanding no-show policy can prevent hard feelings if and when providers have to cancel. Rather than punitive strategies, practices can reduce no-shows by implementing the other strategies outlined in this article, like more frequent automated messaging reminders and more timely appointment availability.  

While providers and healthcare staff are privy to the challenges of keeping a practice running on time, patients are less sympathetic. It’s no surprise that 1 in 3 patients said they’d look for a new provider if their provider were late to an appointment. Of the respondents who said they'd make a switch, over one-third said they’d look for a new provider after just 2 cancellations. 

It's not merely about the wait time but the broader implication — timely healthcare is synonymous with reliability, and patients, more than ever, seek providers who prioritize and respect their time as much as their well-being. To keep wait times low, practices must take steps like schedule optimization, online check-in, and telemedicine with virtual waiting rooms. 

According to Tebra’s scheduling survey, 91% of physicians said bringing up a concerning matter at the end of an appointment is the top reason appointments run over.

Good patient-provider communication allows providers to better understand and address patient concerns and helps the patient feel heard. Rather than expect patients to know how best to utilize their appointment time, physicians must examine how they facilitate productive patient-provider communication. 

A 2018 study published in the Journal of General Internal Medicine found that physicians, on average, interrupt patients after just 11 seconds.  Physicians are almost always pressed for time when seeing patients. However, it’s possible that patients would share their chief concern initially if allowed to speak for longer uninterrupted. 

Physicians can prevent this by allowing patients to speak uninterrupted for as long as is reasonably needed before chiming in with questions. Practicing active listening can also help patients feel at ease and relaxed to share their concerns.

According to Tebra’s scheduling survey, 54% of providers surveyed said they have systems in place to mitigate no-shows, with 79% saying they use digital appointment reminders. 

Automatic patient reminders produce excellent outcomes for practices. When patients receive reminders, they’re more likely to show up for appointments or reschedule in advance. 

Some practices still prefer to remind patients about upcoming appointments by phone, but one survey shows that 86% of Americans try to only answer the phone if they recognize the caller. . Practices should consider adopting automated patient reminders to lessen the manual workload on staff and circumvent the issue of patients not picking up. 

Despite some providers using reminders, 40% of patient respondents believe more reminders would help, according to Tebra’s scheduling survey.

While most providers already utilize digital reminders, patient responses suggest that more reminders would be helpful. At a minimum, practices should send patients a reminder at least a week or so before an upcoming appointment. 

Phone calls, emails, and text auto-reminders each have their benefits and detractors. Automated reminder calls are more resource-efficient than manual calls but lack the option for patients to reschedule through them. Practices can include a self-service link that allows patients to reschedule via text and email reminders. 

Tebra’s 2023 Patients Perspectives report found that text messaging remains patients’ preferred communication medium, with 67.3% of patients saying they’d like to receive text messages for appointment reminders.

Cancellations and no-shows are not only frustrating and inefficient but costly. According to Tebra’s scheduling survey, 47% of respondents say patient cancellations cost up to $2,500 in lost revenue per month, but some practices say cancellations cost up to $7,500. 

Practices need a multi-pronged approach to preventing no-shows and cancellations, with strategies like automated appointment reminders, more efficient scheduling practices, and offering telehealth appointments. 

Another way to reduce no-shows and cancellations is to allow patients to see other providers at the practice. Since lead time significantly increases the chance of a no-show, providers can mitigate the period between scheduling and the actual appointment by booking across providers. 76% of patients say they’d be comfortable seeing another provider, and doing so would allow practices more flexibility in scheduling to reduce lead time and increase show rate.

Almost one-third (31%) of providers said a predominant reason patients choose to leave their practices is because of a lack of access to timely appointments. 

Our recent patient cancellation and no-show survey revealed that poor appointment availability creates considerable challenges for practices. Not only can a lack of timely appointment availability reduce patient show rate, but practices also say it’s a top reason why patients leave their practice.

A possible solution to avoiding unnecessary barriers to care, may be to only see new patients on certain days, to cut down on access issues for established patients. The practice should also implement automated appointment confirmation messages to help boost show rates, as well as, consider offering telemedicine appointments if you don’t already employ that solution. 

In the realm of private practice healthcare, patient cancellations and no-shows remain persistent hurdles. Our recent survey data underscores the disruptive impact of these issues on practice operations and financial performance. 

To combat these challenges, practices should adopt streamlined scheduling systems, leverage digital communication for automated appointment reminders, and prioritize patient access to timely appointments. 

Understanding the complexities of the patient-practice relationship and implementing proactive measures to improve show rates can not only reduce the financial impact of cancellations but also enhance the overall patient experience at your practice.