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Tales from the Front Desk

The Dollars and Cents of “No-Show” Patients

Every health care organization experiences patients who do not arrive for their appointments. While misery may love company, we should not assume that no shows must be accepted as a fact of life. This blog looks at what causes no-shows, just how costly they are – in terms of dollars and patient outcomes – and how prevalent these events are in various health care settings. Then, we’ll look at the solutions that are now available to stop this phenomenon and the financial losses they cause.

Medical Clinics and No Shows

An analysis in 10 medical clinics reported in NCBI found that the mean no-show rate was 18.8 percent of all appointments – approximately one in five. These no-show rates remained at a high level despite an attempt to reduce them by a centralized phone reminder. In fact, the phone reminder initiative only reduced their incidence by less than one percent – from 16.3 percent down to 15.8 percent. A VA center also found that traditional methods of reminders did not significantly reduce no-shows. Phone and mail reminders only decreased them a little over one percent – from 18.17 to 16.96. With the application of a centralized phone system, the rate decreased almost one percent more, from 16.3 percent to 15.2 percent, over the course of a year. Some studies find no difference in no-show rates when reminder systems are used. Meanwhile, the clinics incurred significant losses, with the average cost of each absent patient totaling $196. For a medical clinic seeing 300 patients a day, this means a daily loss of $12,000.

Hospitals and Health Systems

Patients who fail to keep their appointments is also a problem for hospital patient access departments. In a community hospital, the average no-show rate was 62 appointments per day at an estimate annual cost of $3 million. In a training hospital, 25% of appointments were not kept.

Private Practice

In private practices, the no-show rate can be even higher than in medical groups and hospitals.  A large family practice found that no shows and cancellations constituted 31.1 percent of patient appointments, resulting in an estimated total annual revenue shortfall of 3 to 14 percent.

The Story in the Statistics

 What are these statistics telling us?   
  • No shows are expensive, constituting a considerable loss for the provider.
  • Traditional methods of phone and mail aren’t very effective in stopping them.
  • In fact, using current solutions, it may cost as much to try to prevent no shows than just letting them happen.
It’s not an encouraging story. But thanks to advances in technology, there can be a happier ending.

Automate the Patient Appointment Process

What if patients could be engaged to keep their appointments, with two-way communication through an intelligent chatbot, that bypassed the phone system and the busy patient access department – AND reduced the number of no-shows by half or more? What if the valuable data in your electronic records could be tapped to identify when patients were due for check-ups or preventive screenings, and automatically notify patients about them – even making the appointment with two-way texting? What if this automated system could be activated with no big implementation costs, no additional burden on staff, and no IT involvement? That’s the Asparia answer to the “old school” approaches for managing patient adherence to appointments and preventive care. Here’s how the results add up.
  • When patients are notified about regular check-ups and screenings, they are less likely to get sick – and the cost for their care goes down. Health care providers are in a more competitive position for risk-based contracts and pay-for-performance bonuses.
  • When patients keep their appointments, we get the same results – better health care – PLUS the costs lost to these no-shows is reduced by half or more. These are efficiency savings that go directly to the bottom line.
  • When patients get better care, everyone wins – an intangible reward that is the reason why we’re all in health care in the first place.
For more information on changing your no-show story, contact Asparia at

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