10 ways to reduce no-show rates and cancellations at your healthcare practice

Learn how you can grow your practice by reducing no-show rates and cancellations.

Treating patients is your passion, but to do that, you need them to show up to appointments. No-shows and cancellations are frustrating — and become expensive fast. According to Tebra’s 2023 survey on appointment scheduling, patient cancellations, and no-shows cost practices as much as $7,500 per month. That translates to a loss of approximately $375 per patient.

Here’s how to improve no-show rates — and the profitability of your practice.

Charging a fee for consultations, cancellations, and no-shows increases the chance of patients taking their appointments seriously. If they know they will pay if they miss their appointment, they are more likely to show up or at least cancel in advance with plenty of time for you to fill their slot. However, this approach also requires careful consideration.

According to the American Medical Association’s Code of Medical Ethics Opinion 11.3.2, it’s important to clearly notify patients in advance of any no-show fees you will charge them for missed appointments or failing to cancel an appointment within a pre-specified time period. 

Include your no-show policy as part of your intake paperwork, and display it in your office and on your website, so patients aren’t caught by surprise.

You will want to consider how you will track no-shows and fee collection. The effort into fee collection may also take more resources away from your practice and become an added expense rather than offsetting no-show losses. You’ll also want to factor in what would happen if patients leave because of the fee.

Booking different patients into the same time slot can be an insurance policy of sorts. It’s likely that someone won’t show up, so this practically guarantees you won’t be stuck with an unused time slot.

But be careful with this practice, because it could cause patients to spend an inordinate amount of time in your waiting room. In Tebra’s survey, 17% of patients said up to 15 minutes and 39% said 16 to 30 minutes was too long to wait in the waiting room before an appointment. It’s important to pay attention to average wait times to avoid impacting patient retention.

Some types of patient appointments require a certain level of privacy, but others do not. Group appointments allow you to spend more time with patients, while essentially eliminating the chance of having a time slot that produces zero revenue.

For example, the Cleveland Clinic offers more than 200 different shared medical appointments. The clinic enables 10 to 15 patients with chronic conditions to see a care team together for 90 minutes, compared to 15 to 30 minutes for an individual appointment.

In addition to reducing no-show rates and cancellations, group appointments can help grow your practice, because you’re able to meet with more patients. They can also benefit patients by creating the chances for community support from others who share their health concerns, which can boost patient retention.

Some patients diligently note appointments on their calendars as soon as they make them, but not everyone is as organized. Many people have the best of intentions, but accidentally miss appointments due to genuine forgetfulness.

Your practice can mitigate this. Of patients surveyed, 40% said doctors should send more appointment reminders to stop them from canceling, rescheduling, or no-showing. By generation, Gen Zers (born 1997 and later) and Millennials (born between 1981 and 1996) were most likely to change their behavior because of appointment reminders. Nearly 50% of Gen Z wanted more reminders, followed by 45% of Millennials. 

Consider sending automated emails, calls, or text messages to patients to inform them of their appointment time. In fact, one study found that telephone reminders reduced the no-show rate from 20.99% to 7.07%.

Ideally, you’ll want to send reminders at least the day before an appointment. Betterhelp, a virtual therapy marketplace, sends patients reminders multiple times: 1 day before, 3 hours before, an hour before, and 5 minutes before an appointment. 

Typically, you would create a reminder workflow that sends a specific message during a set time frame. For example, you may send the first reminder a week before the appointment and another the day before. You may also want to send a follow-up immediately to a day after the appointment.

You could go a step further with automated reminders by requiring a patient to respond to a text, call, or email to confirm the appointment. With this approach, you can fill the time slot for patients who do not confirm.

Sending well-timed appointment confirmations and reminders is an easy way to decrease no-shows and cancellations across all patients, as well as for specific age groups. You can even automate this process and give time back to your busy staff to focus on revenue-generating tasks. 

Another method to better reach patients and reduce no-shows is to personalize all communication. For example, if you send a follow-up text message, it’s often better to include the patient’s name, appointment time, and other essential information. 

You can personalize emails and text messages manually or through an automated platform. For growing practices, the automated solution reduces your workload and the potential for errors — making it ideal for personalized reminders.

Personalization can also refer to communicating via patient preferences. Patient A may prefer emails, Patient B likes text messages, and Patient C could want calls or texts. Using the right channel to contact patients can help ensure they receive your message. 

Patients are much more likely to keep an appointment for which they’ve already paid. Tebra’s survey found that 64% of patients said they would be more likely to show up for an appointment if they were offered a discount for prepayment. Not only does this guarantee you won’t lose money from a no-show or a last-minute cancellation, it also increases the chance you’ll get to treat the person.

Without an incentive, most patients probably won’t be too eager to pay upfront, so offer a discount. The ability to save money will entice some of your budget-savvy patients to prepay. Consider giving it a try, as this practice is becoming increasingly common in both hospitals and doctors’ offices. Just be sure to review your local regulations to make sure your discount is compliant.

Reducing no-show rates and cancellations will increase patient retention and ultimately help grow your practice. Treating a full patient load each day allows your business to remain profitable, while ensuring you’re able to help as many patients as possible.

It’s common for practices to write an appointment date on a physical card to help patients remember. However, these can get lost easily. 

A patient portal, meanwhile, enables patients to easily review the date and time for their next appointment. This solution also provides capabilities for canceling, rescheduling, booking, and potentially reviewing intake and medical record information.

The use of patient portals is growing among all demographics, including the geriatric population. The University of Michigan National Poll on Healthy Aging found that 78% of people aged 50 to 80 have used a patient portal.

Some patients may feel overwhelmed or anxious to keep their appointments. A patient who requires physical therapy for 12 weeks might feel frustrated after week 3 and start skipping sessions. A patient in EMDR therapy may experience an intense breakthrough, but the emotional exhaustion may overwhelm them, and they forget their next appointment. 

Maintaining a positive reminder tone can negate anxiety, foster trust, and help clients keep their appointments.

At some point, you may notice a pattern of chronic no-shows with a few patients. You may want to terminate your relationship with these patients or refer them to another office. Chronic no-shows are unlikely to start attending appointments on time suddenly, so it’s better to cut your losses and make room for new patients.