How to Reduce Patient No-Show Rates in Healthcare  

Healthcare practices are all too familiar with patients who fail to show up to their appointments. It can be frustrating for doctors, especially those with busy schedules and long waitlists.

No-shows aren’t just annoying; they’re also expensive. They cost U.S. health systems over $150 billion annually and can result in fragmented care.

Fortunately, there are steps you can take to reduce patient no-shows, and not just by implementing a stricter no-show policy. In this post, we’ll look at how to address common reasons patients miss their appointments using both inbound and outbound strategies.

First, You Need to Understand Your No-Show Rate

Before you work to improve your appointment attendance rates, you need to know how many no-shows you’re getting.

Your no-show rate can be calculated using this formula:

No-show rate = (Number of no-shows or late cancellations) ÷ (Total number of scheduled appointments) x 100

While no-show rates vary based on different factors, there are a few benchmarks to consider:

• Typical no-show rates can be as high as 10%.
• Some specialties have much higher rates.
• Behavioral health practices and public clinics can have no-show rates of 30% or more.

To calculate how much no-shows impact your annual revenue, you can use a no-show cost calculator for a rough estimate.

Common Reasons Patients Miss Appointments

There are a few common reasons why patients miss appointments:

• They forgot about the appointment.
• They didn’t receive a reminder (even if you sent one, they may have missed the voicemail).
• They didn’t understand the importance of the visit, so it wasn’t a priority.
• They booked too far in advance.
• They felt disconnected or anxious about their care and may have gotten too nervous at the last minute.
• They couldn’t get in touch to cancel or reschedule, so they just didn’t show up.

While patients can genuinely be sick, have a flat tire, or get snowed in on the day they’re supposed to come see you, the reality is that most missed appointments happen for the reasons above. Having strategies in place to reduce no-shows can increase appointment attendance, improve the healthcare patient experience, and prevent lost revenue.

Inbound and Outbound Strategies to Reduce No-Shows

There are multiple inbound and outbound strategies healthcare providers can use to boost patient engagement while reducing last-minute cancellations and no-show appointments. Let’s discuss each.

Inbound strategies

Medical practices can use inbound strategies to improve the healthcare experience for patients who are actively trying to reach them. If patients need to reschedule their appointments, you want to make it as easy as possible to prevent no-shows.

1. Streamline appointment booking

Nobody wants to listen to hold music or endure long wait times while they’re trying to reschedule an appointment. If they can’t easily get through to someone on your team, whether due to a high volume of calls or the need to call after hours, you should have other options available.

Allow patients to schedule and confirm their appointments online, through a mobile app, or even using an AI-powered voice system.

Nextiva’s HIPAA-compliant IVR and SMS can automate intake and reduce scheduling friction for patients. In many cases, this can also reduce the workload for your admin team, increasing overall productivity.

2. Offer self-service options

If patients can reschedule or cancel appointments through options like text, email, or portal access, you’ll likely have more engagement. Some patients won’t want to go through the hassle of making a phone call to reschedule or cancel, but a few quick clicks are much more convenient.

3. Provide real-time support

Current healthcare call center best practices recommend offering real-time support. Cloud-based contact center solutions can help your practice handle calls quickly by offering real-time support. This can reduce call abandonment and improve rescheduling rates.

Outbound strategies

Outbound strategies prioritize techniques to get in touch with patients and remind them about upcoming appointments.

1. Automated appointment reminders

Send automated reminders through the patient’s preferred communication channel at multiple touchpoints before the visit.

This might mean sending them a text message, phone call, or email, both 72 hours and 24 hours before the visit. Modern healthcare CX innovation requires multichannel outreach across the patient journey, after all.

Two-way SMS allows patients to instantly respond and confirm their appointment without calling back.

You should include options to confirm, reschedule, or cancel the appointment. Appointment confirmations can help you accurately assess the number of patients who will reliably attend in-office or telehealth visits.

These reminders should be personalized with the following information:

• Patient name
• Doctor name
• Reason for the visit
• Appointment time

For example, your reminder messages might say: “Hi Lisa, you have a visit with Dr. Blake on Tuesday at 2:30 pm. Reply 1 to confirm, 2 to reschedule.”

2. Same-day and short-notice fill-ins

Maintain a waitlist of patients who may be willing to come in on short notice. If there’s a cancellation, you can send a quick mass text to those who may be able to come in for same-day appointments.

For best results, automate outreach using your contact center’s broadcast or batch messaging features.

Patients appreciate getting the option to access early appointment times, and your clinic doesn’t miss out on potential revenue—it’s a win-win.

3. Follow up on missed appointments

When a no-show does happen, reach out to the patient within 24-48 hours with a friendly message. The script should focus on care and support, not blame.

“Sorry we missed you!” texts or emails can invite rescheduling without shame or penalty. Ultimately, this can be essential to prevent fragmented care and ensure the patient’s health comes first.

When possible, include easy booking links and reiterate that you care for their health. To increase efficiency, automate these follow-ups with templated messages triggered by a missed appointment status in your patient management software (PMS).

How to Reduce Scheduling Barriers

Scheduling barriers can prevent patients from calling to reschedule or cancel. If it’s easier to just not show up than to go through the hassle, that’s what they’ll do.

The following methods can help your practice reduce or eliminate scheduling barriers for your patients.

Minimize the time between booking and the visit

Appointments booked months in advance are more likely to be forgotten or deprioritized.

This makes sense. If you’ve booked an annual check-up four months ago and you become swamped with work and have to worry about your child’s bake sale that day, the appointment just doesn’t feel urgent.

When possible, try implementing practice management tools so patients can close the gap between scheduling and their visits. If at all possible, offer same-week, next-day, or same-day appointments for more urgent issues.

Offer extended hours

If most patients work from nine to five o’clock and your office is only open during that period, Monday through Friday, your rate of no-shows may increase.

You can use call centers to handle calls, including rescheduling and cancellation calls, even if your office isn’t open.

You can also consider accommodating patients with work or family obligations by opening early, staying late, or offering weekend appointments.

Enable self-scheduling

Studies show that 67% of patients prefer self-scheduling options, which are both easy and fast, and can help reduce patient no-shows. You can use a secure, mobile-friendly portal like MyChart to increase accessibility, appointment booking, and healthcare compliance.

Provide multilingual support

Language can be a barrier for many patients. Offering multilingual support can eliminate this obstacle.

Make sure you offer language prompts throughout the booking process, and send reminders in each patient’s preferred language to boost engagement and increase confirmation rates.

How to Reduce Anxiety Around Appointments

Anxiety sometimes gets the best of patients, who may feel it’s easier to avoid an appointment than show up. There are steps you can take to lessen this anxiety and ensure patients get the care they need.

Send educational content

Information can help soothe some patients’ anxiety.

Educational content that includes brief explanations of why their visit matters, what to expect, and what to bring can help put them at ease.

If they’re visiting a cardiologist for the first time, for example, that can be intimidating. Let them know that you’ll perform an EKG, explain what it is, and remind them to wear a loose-fitting top for the test.

Use AI-powered engagement

Even in healthcare settings, AI is here.

Tools like Nextiva’s conversational AI can address frequently asked questions in advance, putting patients at ease. You can also use these features to personalize outreach with empathy while ensuring fast response times.

Keep wait times low

If you’ve ever had a nerve-wracking appointment, you know that waiting around just makes the anxiety worse.

Long wait times in the office can reduce future attendance rates. Prevent this by digitizing intake, allowing remote check-in, and using real-time updates to reduce bottlenecks and keep patients informed of any delays.

Smart Scheduling Techniques for Patients

To prevent revenue loss from no-shows, practices can use smart scheduling techniques to keep their appointment slots booked.

Identify no-show trends

Use your PMS or contact center analytics to monitor no-show patterns based on factors like:

• Day of the week or time of the day
• Specific provider
• Visit types
• Demographics
• Insurance types

For example, you may notice that patients are more likely to skip six-month check-in visits scheduled for Friday afternoons. This can help you plan appropriately.

Strategic overbooking

If your data shows that early-morning Monday visits have a 30% no-show rate, consider double-booking those slots. The odds of at least one patient not showing up are relatively high, and you can plan on having a slightly shorter lunch if needed (or hand off an appointment to another provider) to prevent significant lost revenue.

Build smart workflows

Smart workflows can make a huge difference for your practice. This may include automating follow-up tasks, appointment status changes, and reminder triggers through your contact center software.

Make sure that you’re choosing a HIPAA-compliant contact center solution like Nextiva to protect patient data and avoid potential liability concerns.

How to Avoid No-Show Fees (Focus on Prevention!)

While many practices have no-show policies that include charged fees if the patient doesn’t show up or fails to cancel 24 hours before an appointment, this has some downsides.

These fees may create resentment, decrease trust, and cause patient attrition, especially since emergencies do happen and patients with chronic conditions may struggle to make it to scheduled appointments.

To help, you can consider the following:

• Educate patients on your policies at check-in, and let them know how to cancel or reschedule.
• Use automated policy acknowledgments, such as “By scheduling, you agree to give a 24-hour notice for cancellations.”
• Consider reserving fees or stricter policies (like dropping a patient) for patients with repeat no-shows.

How Nextiva Helps Practices Reduce Patient No-Shows

Nextiva’s contact center solution can help healthcare practices do the following:

• Automate appointment reminders via SMS, email, and voice
• Track patient interactions in one unified platform
• Enable AI-powered IVR and virtual agents for 24/7 scheduling and follow-ups
• Route calls and texts to the right staff instantly
• Analyze no-show trends with real-time contact center analytics

Whether you run a single-location practice or a multisite network, Nextiva gives your team the visibility, automation, and engagement tools they need to lower your patient no-show rates.

Ontrak Health, for example, used Nextiva’s automated multichannel campaigns, smart routing, and SMS analysis to reduce patient no-shows, increase patient enrollment, identify patients at risk for self-harm, and optimize patient workloads across over 300 different clinicians.

If you’re ready to reduce no-shows while improving the patient experience, we’re ready to help. Check out Nextiva’s healthcare solutions today.