We quote from a 2008 paper by Ty Ulmer and Cathy Troxler of University of Florida's Community Health Scholars program:
But, there's more, of course. Patients might not appear for a follow-up visit they deem to be unnecessary and simply an additional billing mechanism. Patients who faithfully kept their earlier appointments might resent that they were forced to wait for an hour or more beyond their scheduled appointment time. As such, they concluded that the office in question was quite overbooked, and a no-show would be...no problem.
Since health care is either "free" or substantially paid by a third party in most cases, the patient does not appreciate the value of it. Indeed, we have often said in this column that the most important thing in America about health care is that we shouldn't have to pay for it. Such issues as actual quality of outcomes pale in comparison.
Medical practice management guru Elizabeth Woodcock offers these observations:
She also recommends that cancellation notifications by the patient should be encouraged, and an easy mechanism to do so should be instituted. Overbooking, she argues, should be considered if your no-show rate goes above five percent.
Blogs frequented by doctors offer plenty of juicy comments and anecdotes on the matter of missed appointments, including lively debates over the wisdom of charging patients for such an offense. As most providers know, effective October 1, 2007, CMS allows them to charge Medicare beneficiaries (not Medicare itself) for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge non-Medicare patients for missed appointments.
I have to share one posting with you, the content of which seems dubious...
Regarding SMS (text messaging) as a way to remind patients of their upcoming appointments, a number of studies indicate that this is an excellent approach. In one report, 41% of respondents indicated that they would prefer a text reminder, compared to only 1.3% who wanted a phone call. Likewise, Kaiser Permanente implemented SMS reminders in a one-month pilot project, resulting in 1,837 fewer no-shows.
While a number of such services are available to practitioners, the folks at Los Angeles-based Screenpush International Inc. are about to release Notifly, an automated appointment reminder platform. [http://screenpush.com]
I recently caught up with Joshua Otten, Managing Partner, who detailed some of the new product's advantages.
Current products are usually a small part of a much bigger and more complex and expensive platform, and many customers do not really want or need all the other tools that are included. Cost per reminder on current products ranges from 12.5 cents to 50 cents per reminder. Notifly will be significantly less expensive, as low as 2 to 4 cents per reminder.
Since the most frequently cited reason for missed appointments is that the patient simply forgot, and most people seem to prefer SMS reminders, this looks like an idea whose time has definitely come.
Michael D. Shaw
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