November 12, 2019

Convert Your No-Show Problem Into a Patient-Friendly Opportunity

Rebecca Haymaker

The physician scans her schedule for the day and sees a name she recognizes – Ms. X, the “Chronic No Show-er”. Every clinic has them. Names and patients they know by heart due to the number of times these patients have missed their appointments. It’s easy to become frustrated or even numb to the issue, dubbing these patients “problems.”

However, it’s important to step back to fully analyze the impact of this issue:

  • Unused slots
  • Lost revenue opportunity
  • Administrative overhead
  • Lost opportunity for other waiting patients

With this perspective, it’s easy to see how this issue can become a source of negativity. However, the item missing from the list, and in my mind the most important impact – patients are not getting the care they need. Upon further investigation you might just find that these are often the most vulnerable patients with significant barriers to care. They may have issues with transportation, childcare, inflexible work schedules, limited financial resources, etc… They are likely used to being treated differently and with less kindness than other patients due to their history with the clinic. Historically much of the response to this issue has been punitive in nature.

But what if there was another way? An option that would allow you to connect these no-show patients to care and relieve the financial burden for your organization? Epic recently added a feature to allow you to identify chronic no show patients at the point of scheduling. The system will look at the patient’s history with the department and prompt the scheduler to place the patient in an overbook slot. While this solution helps alleviate the financial impact of this issue, it doesn’t address the root cause.

One community health center decided to take things a step further and develop a workflow to assess patient barriers to care and develop a personalized care plan to get them connected to the care they need. Rather than using the term “chronic no-show” they use the term “CareConnect” to better define the intent of this process. When schedulers receive the alternative scheduling warning, they transfer the patients in real time to Nurse Triage. Nurses can then complete a brief assessment to better understand the patient’s needs, expectations, and opportunities for intervention. Patients are scheduled into CareConnect slots and are guaranteed to be seen by a provider if they present for their appointment. Nurses will identify other health maintenance and preventative care measures that may be overdue for the patient and build that into the plan for the visit.

Taking this compassionate approach to care is helping to overcome healthcare barriers and saving the organization precious lost revenue – close to $250,000 annually!

If you are struggling with a chronic no-show, are looking to improve your patient experience, or simply want to revive your clinic workflows, call The Wilshire Group. We have seasoned experts with operations and Epic IT backgrounds who can help you solve your most challenging problems. Contact me at for more information.

Rebecca Haymaker

Vice President, Revenue Cycle Services

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