Strategies | Practice Productivity Improvement

Patient no-shows can be one of the main sources of uncertainty for a medical practice, affecting physician productivity, financial stability and practice efficiency. To minimize this uncertainty, a number of different strategies have been employed or suggested by professional organizations, consultants and other practices to achieve optimum practice productivity. A few scheduling, financial, technological and patient management strategies are discussed below.

Scheduling strategies

Medical Group Management Association (MGMA) suggests medical practices schedule accurately to avoid long wait times for patients. Patients who consistently have extended wait times are more likely to miss their appointments. Other successful scheduling strategies:

  • Cancel appointments if a patient doesn’t confirm their appointment. Keep a waiting list or list of patients who are available for short-notice appointments who can be contacted to fill the empty slot.
  • Minimize the delay between scheduling the appointment and the visit date. Studies have shown a long delay can be a cause of missed appointments.
  • Designate one or two open slots per day for same-day appointments.
  • If most no-shows occur on a specific day of the week or time of day, add more timeslots or shorten waiting time between visits to help offset lost revenue.

Note: Some practices have used overbooking as a scheduling strategy, with varying degrees of success. When the number of patients who show up exceeds normal system capacity, it can cost the practice in patient wait time and length of a clinical day—which results in overtime pay. If the patient experiences long wait times, it can reflect poorly on the medical practice. In the long run, problems created by overbooking may outweigh any benefits.

Financial strategies

Whether or not a medical practice uses financial strategies to help minimize no-shows depends on many factors including whether or not the practice has the resources to implement these strategies, your patient population, payer policies and other factors. Some financial strategies to consider include:

  • Charge for no-shows/same-day cancellations (unless it’s an emergency). It’s important to check with your payer policies first to ensure they allow you to charge your patients for missed appointments. • Allow patients to pre-pay for appointments.
  • Reward patients who show up on time with discounts on their bill.
  • Ask for a deposit that will be applied toward their appointment if they show up or will forfeit if they don’t show up.

Technological strategies

Technology can now expand the capabilities of your staff improve communication with your patients and help you keep more updated records of patient interactions. Some suggestions and considerations include:

  • Automate appointment reminders and confirmations, using voice messaging, text and email.
  • Use effective automation strategies and develop a robust reminder process and workflow to attain the greatest reductions in no-show rates.
  • Evaluate your practice management system to see if it tracks no-shows and cancellations and consider upgrading to one that does.
  • Consider an advanced scheduling system that integrates with your practice management system and allows for same-day appointment booking and re-arranging.

Patient management strategies

Get your patients actively involved in the process of remembering their appointments and keeping you updated by implementing some simple strategies:

  • Confirm contact information with patient at check in. Remove or update invalid phone numbers and email addresses.
  • Allow patients to pre-register for appointments through patient portals. Studies have shown that patients who are engaged in the process will keep their appointments.
  • Have the patient repeat the date and time of their next appointment (whether in person or on the phone). It’s amazing how this simple act can help them remember their appointment.
  • Make it easy for people to let you know they can’t make it to their appointment. An easy way to do this is through an automated appointment/confirmation system that allows patients to respond via different methods like text messaging or email.

Medical practices can help improve their productivity by integrating into their processes specific scheduling, financial, technological or patient management strategies. Which combination of these strategies will work best for your medical practice depends on the resources you have available, current technologies, existing processes or workflows, budget for new investments, the demographics of your patients and many other factors. However, medical practices can achieve significant benefits by investing the time to analyze their operations and applying appropriate strategies.

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