Why patients miss appointments and how practices can help

Missed appointments are an unavoidable challenge for many private practices, affecting patient retention, provider efficiency, and revenue cycle management. Implementing technology-driven solutions, such as automated patient reminders and EHR-integrated scheduling, can significantly reduce no-show rates and enhance practice performance. No-shows often throw off schedules, leave gaps in care, and add up to thousands in lost revenue each year. At the same time, patients face real obstacles — long commutes, work conflicts, and transportation issues can make it difficult to show up, even when they intend to. To better understand these challenges, Tebra surveyed 750 Americans and 250 healthcare professionals, uncovering the biggest barriers to appointment attendance and how they impact both patients and practices.

Missed appointments create financial strain on healthcare practices, disrupting schedules and reducing efficiency, ultimately impacting revenue. By implementing EHR-integrated scheduling systems with automated appointment reminders and patient self-scheduling, private practices can improve attendance rates and minimize financial losses, ensuring sustainable operations.

More than a quarter (27%) of healthcare professionals reported revenue losses due to appointment cancellations and no-shows, with practices losing an average of $22,872 per year. These gaps in care impact patient access and provider productivity, emphasizing the need for streamlined practice management solutions such as EHR-integrated patient scheduling and automated reminders. On average, providers experienced 14 missed appointments per month, with primary care seeing the highest cancellation rate (43%), followed by mental health (20%) and specialist care (14%).

To offset these losses, 34% of practices said they charge a no-show fee. While these fees can help recover some revenue, they don't fully address the underlying issues. Private practices looking to implement a structured billing approach should follow best practices on properly billing patients for missed appointments, which covers CPT codes, compliance considerations, and best practices for reducing revenue loss." Implementing electronic health record (EHR) systems with features like automated appointment reminders, patient self-scheduling, and telehealth integration and no-show policies can help reduce no-shows and improve practice efficiency.

Getting to a medical appointment isn't always easy, and for many patients, the time and distance required can create significant challenges. Long commutes can lead to missed work, financial strain, and even skipped routine care.

We discovered that 20% of patients have traveled more than 50 miles for an appointment, with many spending an average of 9 hours per year commuting to medical visits. For those with jobs, this travel time often comes at a cost — 1 in 5 people reported missing work or losing wages due to the time it takes to see a doctor.

Financial concerns also influence preventive care. More than half of respondents (57%) said they would be more likely to schedule routine visits if they had access to paid sick leave. Without this flexibility, many patients may delay necessary care, increasing the risk of more serious health issues down the line.

Private practices can help reduce these barriers by leveraging digital solutions such as telehealth and automated scheduling through an integrated EHR platform. Offering flexible appointment times, coupled with virtual visit options, enables patients to receive necessary care without the added burden of travel or work conflicts Telehealth options and local partnerships with pharmacies or community health centers may also provide alternatives that minimize travel time.

When patients can't make an appointment, they don't always cancel in advance. Work conflicts, transportation barriers, and financial concerns all contribute to missed visits, making it harder for people to access the care they need.

No-shows were a common issue, with 15% of patients admitting to skipping an appointment without canceling. Patients were most likely to miss a visit due to work obligations or scheduling conflicts (33%). Transportation barriers also impacted healthcare access, with 14% of patients missing appointments because they had no way to get there.

For some, missing a visit comes with an added financial burden: 1 in 6 patients (16%) were charged a cancellation fee after failing to show up. Understanding the medical billing process for no-shows, including CPT codes for missed appointments and best practices for charging fees, is crucial for private practices to maintain financial stability." These costs, combined with scheduling difficulties, can discourage patients from rescheduling, ultimately delaying necessary care.

Private practices can reduce no-shows by using EHR-driven appointment reminders via text, email, or phone. These systems also enable patient self-scheduling, telehealth visits, and extended hours, providing greater flexibility and reducing scheduling conflicts that often lead to missed appointments.. Clear cancellation policies and waitlist systems can also help ensure that open slots are filled, improving efficiency and patient access.

Missed appointments remain a persistent challenge, but private practices can mitigate their impact by leveraging technology such as cloud-based EHR systems, digital patient engagement tools, and AI-driven scheduling solutions. These innovations streamline workflows, enhance patient access, and improve practice efficiency.By offering flexible scheduling, leveraging telehealth, and using automated reminders, practices can make it easier for patients to keep their appointments. Tools like EHR-integrated scheduling and waitlist systems can also help fill last-minute gaps, minimizing revenue loss.

Understanding why patients miss visits is the first step to addressing the problem. One effective strategy is to track and analyze no-show trends using standardized calculations. Private practices can use this no-show rate calculation guide to benchmark their patient attendance rates and implement data-driven strategies to reduce missed appointments, strengthen patient relationships, and create a more financially stable practice.

Tebra surveyed 750 Americans and 250 healthcare professionals to explore the costs and challenges of commuting to medical appointments.

Tebra, headquartered in Southern California, empowers independent healthcare practices with cutting-edge AI and automation to drive growth, streamline care, and boost efficiency. Our all-in-one EHR software and billing platform delivers everything you need to attract and engage your patients, including online scheduling, reputation management, and digital communications. 

Inspired by "vertebrae," our name embodies our mission to be the backbone of healthcare success. With over 165,000 providers and 190 million patient records, Tebra is redefining healthcare through innovation and a commitment to customer success. We're not just optimizing operations — we're ensuring private practices thrive.

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