When your patients miss appointments, it can be costly for both them and you. Each 60-minute scheduled appointment slot that goes unused can cost an average of $200 for doctors. When you consider that no-show rates can exceed 30% in the United States, it’s no surprise that the total cost of missed healthcare appointments is around $150 billion annually.
In addition, missed appointments perpetuate poor health outcomes for patients because they’re unable to receive the care they need and deserve. No-shows can be particularly risky when the missed visits are related to chronic disease management or preventative screenings, as patient health can worsen over time when illness is left untreated. Not only do no-shows threaten the continuity of care, they increase chances that high-risk patients will return with more serious and costly conditions that could have been addressed sooner—or even prevented.
Federally qualified health centers (FQHCs) and other clinics who work primarily with underserved populations often experience higher-than-average no-shows. From language barriers to limited access to resources, underserved populations are faced with additional challenges that prevent them from receiving scheduled care.
Below are three reasons underserved patients miss healthcare appointments, as well as strategies for using appointment reminders to ensure they don’t.
Those of us will reliable and consistent transportation take for granted the flexibility and freedom we have to travel where we need to, when we need to. However, for nearly 3.6 million individuals in the United States, transportation is a barrier preventing access to healthcare. This is particularly true for underserved populations who may not have steady access to a working vehicle. While your patient may confirm their appointment when they receive the appointment reminder via text, if they don’t have a ride, they likely won’t show up.
Transportation challenges affect a variety of underserved patient populations, including the elderly and those with low income or less educational resources. Transportation challenges may include:
- Living geographically distant from healthcare services
- Not possessing a driver’s license
- Not having access to a working vehicle
- Being unable to drive due to a physical, cognitive, or mental limitation
There are many ways to address transportation barriers for underserved patient populations. First, it is the responsibility of the health organization to identify and screen at-risk patients who may not have access to reliable transportation as it is unlikely patients will reach out to ask for help. Once you have identified which patients are eligible for a ride, there’s a variety of ways to offer transportation.
From ride-sharing partnerships with Uber or Lyft to door-to-door shuttles, you can use appointment reminders to proactively ask patients if they need a ride when reminding them of an upcoming appointment. When they respond ‘yes’ to the appointment reminder, EHR-integrated solutions can automatically generate a ride offer via text message, letting the patient know when their ride will arrive so they can promptly attend their appointment. Following their appointment, returning home can be just as easy with automated communications systematically scheduling patients a ride based on when is convenient for them. In either direction, patients receive real-time ride updates and reminders directly to their smartphone.
In addition to transportation barriers, patients often cite scheduling conflicts as a primary reason they were unable to attend their scheduled healthcare visit. Traditional clinical office hours often overlap with working hours. For patients who have multiple jobs or limited flexibility in time off, they may have no choice but to skip their appointment in order to remain in good standing at their job.
For others, it’s family commitments that take priority over their own personal health. Some parents may elect to skip preventative care appointments because they are busy tending to their family’s activities. Many healthcare offices send appointment reminders for this very reason—hoping a simple reminder will do the trick in getting the patient to attend. However, many neglect to offer an alternative option in the appointment reminder text, in the event the scheduled date and time no longer works for the patient.
A simple courtesy appointment reminder sent via text gives patients the opportunity to confirm if the date and time still works, but you should also offer an option to reschedule, in case something unexpected comes up. Proactively reaching out before the appointment is missed gives patients the ability to find a better day or time that does work with their schedule, which will ensure there is no lapse in their care.
Finally, some patients just dread going to the doctor. Whether it’s uncertainty about a scheduled procedure or reluctance to hear medical advice that contradicts their habits, some patients worry about the experience. Healthcare exams can be intimidating, and the sterile and stiff atmosphere may not be the most comfortable or welcoming. An appointment reminder on its own may be enough to stir up jitters. And, when patients don’t know what to expect, the response may be to skip the appointment altogether.
Address misinformation or fear proactively by building an ongoing relationship with your patients outside of the clinic. Using appointment reminders and other automated text messages allows you to send educational information at various intervals in between appointments. In addition, you can send specific information or instructions before an upcoming appointment, preparing them with information that is designed with them in mind.
Keep in mind that if English is not their first language, offering additional resources in their native language can go a long way in relieving fear. Addressing your patients fears before their scheduled appointment will reduce the likelihood that they’ll skip out on the appointment.
Most frequently, underserved patients aren’t missing their appointments because they want to. They’re missing appointments because they don’t feel like they have any other option. Consistent and helpful communication via automated communication outreach can help to address barriers that prevent them from attending their visit. In addition, regular appointment reminders and customized patient outreach also increases the likelihood that patients will proactively seek regular care and maintain better health.
Understanding why your patient population misses appointments is the first step to finding solutions that may help minimize no-shows—and the cost and risk associated with them. Once you are able to identify what is keeping your patient from attending their appointment, you can take informed action to remove barriers. Using targeted appointment reminders and patient outreach can help you track why your patients are missing appointments, allowing you to tailor solutions that will best meet their needs and improve your clinic’s bottom line.