How to Reduce the Number of Patient No-Shows

Published: February 24, 2023, Last Updated: February 2, 2024

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Writer: Martha Pierson
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Patient no-shows can be a costly and frustrating problem for healthcare clinics. In fact, patient no-shows are estimated to cost health facilities about $150 billion annually. Fortunately, there are various ways for healthcare providers to reduce patient no-shows, eliminating delays in patient care and increasing productivity.

From utilizing appointment reminders to offering incentives to patients, providers can use several strategies to ensure that patients show up for their appointments. In this blog, we deep-dive into the importance of measuring the patient no-show rate and give several ideas for reducing this rate.

Why Do Patients Miss or Cancel a Doctor’s Appointment?

Patients may miss or cancel their visits for various reasons, from personal issues to dissatisfaction with the clinic. In some cases, the provider can incorporate actionable patient retention strategies to reduce no-shows.

Close up on calendar with doctor's appointment reminder

Here are some reasons why your clinic’s no-show rate may be high:

  • Forgetfulness – a patient may simply forget about an appointment made weeks prior. Therefore, a simple reminder the day before can help you avoid these scenarios.
  • Scheduling inconvenience – patients may have something else come up at the time of their appointment. To avoid last-minute no-shows, your clinic can allow online rescheduling services through the patient portal. As a result, the patient can change appointment dates and times.
  • Fear – some patients may have anxiety over going to the doctor. This can be reduced through educating and informing the patient about the procedures. Dedicate more time to answer any questions the patient may have to help calm their anxiety.
  • Language barrier – some patients may cancel their appointment if they cannot communicate in English. Having providers fluent in other commonly spoken foreign languages can help.
  • Fear of high costs – in some cases, the patient’s insurance policy may not cover the full cost of medical services. In turn, the patient may choose to forgo treatment if they don’t have enough to pay out-of-pocket. Installment loans, guarantee programs, or personal loans can give patients an opportunity to reduce the financial burden of getting treated.

Defining No-Show Patients

No-show patients are individuals who scheduled an appointment with a clinic but did not appear and provided no prior notice. Additionally, patients who cancel their appointment last minute may also be considered no-shows.

Of course, the rate of no-show patients differs from one health center to another. However, the national average rate is approximately 18%. This number almost doubled during the COVID-19 pandemic, causing healthcare providers significant financial hardship.

Why Do You Need to Measure the Patient No-Show Rate?

Knowing the percentage of patients who do not show up for their appointments can provide insight into how well your practice is running and help you make informed decisions about improving it.

First, by tracking no-show rates, it is possible to identify any underlying trends in patient behavior, such as those who are more likely to skip appointments or areas where there may be a need for better communication between patients and providers. This information can be used to send reminders or call these patients to avoid missed appointments in the future.

patient retention in healthcare

In addition, measuring no-show rates can allow healthcare providers to better plan staff and resources. If there is an unusually high rate of no-shows, it could signify that you need to change something in your daily operations. For instance, this data can help determine whether certain services are being underutilized or if particular patient populations may be more at risk for missing appointments.

Finally, measuring the patient no-show rate can help ensure that practices remain financially sustainable. The no-show rate also represents the amount of lost revenue. Recapturing that revenue can improve the financial health of your facility. For example, if a single provider experiences two no-shows daily, you can calculate the yearly revenue loss of those missed appointments. Let’s say the total yearly missed revenue is around $100,000. This cost could be equivalent to hiring additional staff members to improve customer service.

How Do You Calculate the Patient No-Show Rate?

Calculating the exact patient no-show rate depends on who you consider a no-show patient. For instance, you can count only patients who scheduled an appointment and didn’t show up or those who called and canceled at the last minute. In either case, divide the total number of no-shows by scheduled appointments.

Here’s a representative example to showcase it better. Suppose the total number of appointments made in a given period was 600. The number of no-shows during the same period was 50. Therefore,

Patient No-Show Rate = 50 / 600 = 8.33%

6 Strategies For Reducing Patient No-Show Rates

Now that you know about the impact of no-show appointments, here are six ways to reduce patient no-shows in your healthcare facility.

Send Automated Reminders

According to a study by Huron Learning Lab, 23% of patients forget about an appointment unless they are reminded of it beforehand. However, the introduction of automated email reminders has decreased no-shows by 25%. Similarly, the rate decreased by 40% when a staff member called the patient to remind them of the upcoming appointment.

Patient viewing doctor's appointment reminder on cellphone

Set up a draft message to send to every patient 24 to 48 hours before their appointment, confirming their availability for the indicated time. For example, you can send a message as simple as: “Hello! We want to remind you that you have an appointment tomorrow at 4 p.m. at our clinic. Does this time still work for you?” You can also include the following information in the email to remind them about other details of the appointment:

  • The purpose of the visit
  • List of the documents the patient needs to bring
  • Address of the facility and parking instructions
  • Contact information for further inquiries

Note: Be sure to get your patients’ consent to receive messages via email, text, call or however you plan to contact them. Otherwise, you could be in violation of laws like CAN-SPAM and TCAP, which have very expensive penalties.

Introduce No-Show Fees

Having a no-show policy in place can incentivize patients to avoid missing their scheduled visits. If you experience a high number of no-shows, one of your last resort options can be to include a no-show fee in your policy and communicate it with your patients. This can be done by attaching the policy to the appointment confirmation email or text and emphasizing the no-show fee when scheduling an appointment.

A no-show fee can also be applied when the patient cancels the appointment after a certain time. For instance, if you have a patient portal, you can place a hold on the patient’s account if they cancel their visit less than one hour before the scheduled time. Even a 10% cancellation fee can help recoup the cost for the lost opportunity to provide a service.

Establish a Patient Portal

Every clinic should also have its own virtual patient portal. An online portal can help your clinic with:

  • Scheduling, rescheduling, and canceling appointments
  • Sending and receiving messages to and from the patient about payments, appointments, medications, and treatments
  • Tracking the patient’s medical history
  • Completing pre-appointment paperwork
  • Collecting payment from patients

Most importantly, a patient portal accelerates communication between the patient and the provider. Therefore, when patients need to cancel or reschedule their visit, they can easily do so with just a few clicks by logging into their account. Similarly, the provider will immediately receive a notification about the rescheduled appointment.

If you opt to include a cancellation fee, be sure to include a disclaimer on your online portal that notifies patients they will be charged a fee for canceling on short notice. Should your patients cancel at the last minute, the online portal can also automatically add the charge, notify your employees, and put a hold on their accounts.

Optimize Scheduling and Reduce Wait Times

Many patients know that they may end up spending time in the waiting room. While some patients may anticipate and plan for extended waiting times, others may not have a flexible schedule. As such, they may cancel if office wait times become excessive.

To remedy long wait times, start by calculating the average time different types of appointments take. For instance, a physical exam may take twice as long as a preoperative consultation. Once you have timed 50 to 100 appointments, your clinic will have a better idea of how long it usually takes to complete the appointment. As a result, the next time a patient schedules a specific type of appointment, your administrators can refer to the averages and schedule accordingly.

Patients sitting at the doctor's waiting room

Nevertheless, some appointments may still run over the allotted time. As a result, it can cut into another patient’s scheduled time. If this occurs in the morning, it can create a chain reaction that delays appointments for the entire day. To avoid this scenario, make sure to include buffers between appointments.

Finally, offer flexible scheduling, such as early mornings, evenings, and weekends. Often, patients make appointments anticipating that they will have time off. However, in some cases, they have to cancel a weekday appointment due to work or other obligations. Offering evening appointments after 6 p.m. or weekend appointments between 9 a.m. and 2 p.m. can help lessen cancellations and improve the patient experience.

Leverage Multiple Communication Methods

While automated email reminders are the most convenient way to reduce patient no-shows, utilizing other communication methods can be more convenient for your patients. Emails may end up in spam or go unopened. Therefore, these are other communication channels that can help your clinic stay in touch with your patients:

  • Text messages
  • Phone calls
  • Messages through the patient portal

Use these communication methods at different times to increase their effectiveness. For example, you can schedule an email the day before the appointment, a text message on the day of the visit, and a phone call for patients running late.

Offer Alternative Financing Options

Finally, offering your patients the flexibility to pay for your services in monthly installments can improve the patient’s financial experience and reduce no-shows.

As mentioned previously, one reason patients cancel their appointment or fail to show up is because of a lack of funding. While insurance covers most treatments and services, it doesn’t always cover the full cost, let alone specialty care. As such, some patients are put in the difficult position of paying the cost of medical treatment out-of-pocket. Often, this financial burden is too much, which causes patients to forgo treatment.

With alternative financing options, your patients no longer have to make that decision. Instead, if they are approved, they can receive the medical care they need with the flexibility to pay in small installments over time. This budget-friendly option may also be available to lower-credit patients, as some lenders may be willing to work with them.

Moreover, financing offers plenty of benefits to the clinic as well. First, it will reduce patient cancellations and no-shows for individuals who struggle with affording care. Second, the provider may receive the money upfront, leaving the patient to repay the loan directly to the lender. And finally, it can provide a competitive edge to your clinic as you better cater to your patients’ financial and medical needs.


While no-shows are a reality for many clinics, calculating and tracking this rate can help assess your clinic’s productivity. Clinics with a high no-show rate can indicate that there is a need to do more to encourage patients to attend their appointments. For instance, your clinic can improve patient attendance rates by implementing measures like automated reminders and flexible payment options.

Martha Pierson

Content CreatorMartha Pierson is a marketing strategist and business development expert based in Glendale, California. As a content creator for the Finturf blog, Martha shares her vast knowledge and experience with readers to help them build and sustain successful businesses. Her articles offer practical tips and actionable advice that entrepreneurs can implement immediately to achieve their goals. Martha also provides insightful analysis of current trends across different industries and offers expert guidance on how businesses can adapt to changing market conditions.

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