FOLIO 03 · Healthcare

23% / Dantas et al / Health Policy 2018

Medical practice register.

Primary care, specialist, internal medicine, OB/GYN, surgery. Six segments with MGMA 2024 benchmarks pre-filled. Patient-reasons data (J Prim Care Community Health 2013), BMC Medicine 2019 outcomes evidence.

23%

avg rate, Dantas et al 2018

$150B

US annual loss

Medical practice register

Pick a specialty. Rates and revenue are pre-filled from MGMA 2024 data.

Live entry

Slot inputs

Appointment slots per day20

460

No-show rate (Primary Care avg: 19%)19%

1%55%

Revenue per appointment$200

$80$1,200

Daily reading

3.8 no-shows per day average. Your 19% rate is near median for Primary Care.

Annual totals

Annual no-show entry

$350,550

Direct + staff + opportunity

$190,000

Revenue

$42,750

Staff

$117,800

Opportunity

SMS reminder ROI

33% rate reduction saves$62,700/yr

Typical reminder platform-$4,800/yr

FOLIO 04 · Causes

Why patients no-show (J Prim Care Community Health 2013)

35.5%

Forgot the appointment

SMS + email reminders, 48hr + 2hr

31.5%

Miscommunication: wrong date or time, did not know

Confirmation with full details, EHR sync

33%

All other reasons: work or family conflict, transport, felt better, cost

Telehealth option, flexible scheduling, waitlist

Source: Kaplan-Lewis E, Percac-Lima S. No-show to primary care appointments: why patients do not come. Journal of Primary Care & Community Health, 2013 (doi:10.1177/2150131913498513). Among 273 patients contacted after a missed appointment; forgetting and miscommunication were the two most common reasons, with the remaining third spread across work or family conflicts, transport, feeling better, and cost.

FOLIO 05 · Outcomes

The cost beyond dollars

Among patients with a long-term physical condition, missing more than two appointments a year was associated with more than three times the all-cause mortality of those who missed none. For patients with a long-term mental health condition, the risk was more than eight times higher.
BMC Medicine 2019 (McQueenie et al), data-linkage study, n = 824,374 Scottish patients

For patients with chronic conditions, a missed appointment is a missed medication review, a missed lab result, a missed care-gap intervention. Health Affairs literature on access equity documents that no-shows compound health disparities, with transportation-barrier patients disproportionately represented.

Full citation archive →

FOLIO 06 · MGMA 2024

Benchmarks by specialty

Specialty	Avg rate	Top quartile	Revenue / visit
Family Medicine / Primary Care	19%	12%	$185 to $220
Internal Medicine	21%	13%	$200 to $240
Pediatrics	17%	11%	$160 to $190
OB/GYN	18%	12%	$220 to $280
Cardiology	11%	7%	$280 to $350
Dermatology	12%	8%	$250 to $320
Orthopedics	10%	6%	$300 to $420
Surgery	8%	5%	$500 to $900

Sources: MGMA 2024 DataDive Cost and Revenue Survey. Revenue per visit from Medscape Physician Compensation 2024 and CMS fee schedule. Full benchmark folio →

FOLIO 07 · Reduction

Strategies for medical practices

Two-stage SMS reminder

28 to 38% reduction

48hr + 2hr. Require confirmation. Hasvold and Wootton 2011 systematic review of 29 studies.

Strategic overbooking (6 to 10%)

Fills 60 to 70% of slots

Overbook by 60 to 70% of your rate, not 100%. At 19%, that is 11 to 13%.

Active cancellation waitlist

Fills 30 to 45% of slots

MGMA practices with active waitlists recover 35% of cancelled and no-show slots same-day.

Patient portal nudges

10 to 15% additional

Automated portal messages at 7 days and 3 days for established patients.

Full reduction folio →

FOLIO 08 · Related

Margin notes

What is the average no-show rate in healthcare?+

Dantas et al (Health Policy 2018), a systematic review of 105 studies, found an average healthcare no-show rate of about 23%. By segment: primary care 19%, behavioral health 30 to 40%, dental 15 to 25%, specialist 10 to 12%.

How much does a no-show cost a medical practice?+

A primary care practice with 20 slots/day at $200/visit and a 23% no-show rate loses $230,000 in direct revenue annually. Adding wasted staff time and opportunity cost brings the total to $280,000 to $350,000.

Why do patients no-show?+

In a primary-care study of patients contacted after a missed appointment (Kaplan-Lewis and Percac-Lima, Journal of Primary Care & Community Health 2013), the two most common reasons were forgetting (35.5%) and miscommunication about the date or time (31.5%). The remainder cited work or family conflicts, transportation, feeling better, or cost. Because forgetting and miscommunication together account for roughly two-thirds of cited reasons and both are reminder-addressable, SMS plus confirmation is the highest-ROI intervention.

What is the MGMA benchmark for no-show rates?+

MGMA 2024 data shows top-quartile primary care practices achieve no-show rates below 12%. The median is approximately 19% for primary care. For surgical specialties, medians are 8 to 10%.