FOLIO 14 · Research
← Back to registerCitations / DOIs / no vendor round-trips
Primary sources behind every figure.
Every statistic on this site linked to a primary source. No vendor-blog round-trips. Reviewed quarterly.
The $150 billion figure
Cost of missed appointments to the US healthcare system (industry estimate)
2024Multiple healthcare-IT industry analyses · Widely cited industry estimate · n = National cost modeling
No single authoritative peer-reviewed origin; the figure circulates across vendor and trade publications
Key finding: $150 billion is the figure most commonly cited for the annual cost of no-shows to the US healthcare system. It is an industry estimate, not a peer-reviewed result, and we flag it as such.
Used on: Homepage, /healthcare
No-show rates in healthcare
No-shows in appointment scheduling: a systematic literature review
2018Dantas LF, Fleck JL, Cyrino Oliveira FL, Hamacher S · Health Policy · n = Systematic review of 105 studies
doi:10.1016/j.healthpol.2018.02.002
Key finding: Average no-show rate of the order of 23% across specialties, with significant variation by setting and specialty (safety-net, behavioral health, and specialty settings run higher).
Used on: All pages, /healthcare, /benchmarks
No-show to primary care appointments: why patients do not come
2013Kaplan-Lewis E, Percac-Lima S · Journal of Primary Care & Community Health · n = 273 patients contacted after a missed appointment
doi:10.1177/2150131913498513
Key finding: Forgetting (35.5%) and miscommunication about the date or time (31.5%) were the two most common patient-cited reasons; both are addressable by reminders and confirmation. The remaining third cited work or family conflicts, transportation, feeling better, and cost.
Used on: /healthcare
Behavioral health no-show rates
Patient non-attendance at out-patient clinics: a systematic review
2018Kruse GR, et al. · BMC Health Services Research · n = Systematic review, 34 studies
doi:10.1186/s12913-018-3038-1
Key finding: Behavioral health no-show rates 28-40% average across settings. PTSD and anxiety highest.
Used on: /behavioral-health, /benchmarks
Why don't patients attend their appointments?
2007Mitchell AJ, Selmes T · Psychiatric Bulletin · n = Literature review
doi:10.1192/pb.bp.107.015479
Key finding: Depression symptoms including low motivation are a primary driver of behavioral health no-shows.
Used on: /behavioral-health
Predictors of no-show behavior at VA PTSD clinics
2013Fortney JC, Pyne JM · Journal of Behavioral Health Services & Research · n = Retrospective cohort, VA PTSD clinics
doi:10.1007/s11414-013-9331-y
Key finding: Avoidance as a symptom of PTSD drives 33% of no-shows in PTSD treatment settings.
Used on: /behavioral-health
SMS and reminder effectiveness
Use of telephone and SMS reminders to improve attendance at hospital appointments: a systematic review
2011Hasvold PE, Wootton R · Journal of Telemedicine and Telecare · n = Systematic review, 29 studies (33 estimates)
doi:10.1258/jtt.2011.110707
Key finding: Reminders cut non-attendance by a weighted mean of 34% of baseline: automated and SMS reminders ~29%, manual phone calls ~39%.
Used on: All pages, /reduce/reminders, /
Mobile phone messaging reminders for attendance at healthcare appointments
2013Gurol-Urganci I, de Jongh T, Vodopivec-Jamsek V, Atun R, Car J · Cochrane Database of Systematic Reviews · n = Cochrane review; text-message comparison pooled 4 RCTs (n=3,547)
doi:10.1002/14651858.CD007458.pub3
Key finding: Text-message reminders increased appointment attendance versus no reminder (risk ratio 1.10, 95% CI 1.03 to 1.17). Text and phone reminders had a similar effect, at lower cost per message.
Used on: /reduce/reminders
Patient outcomes: beyond revenue
Morbidity, mortality and missed appointments in healthcare: a national retrospective data linkage study
2019McQueenie R, Ellis DA, McConnachie A, Wilson P, Williamson AE · BMC Medicine · n = 824,374 Scottish patients, 16-month follow-up
doi:10.1186/s12916-018-1234-0
Key finding: Among patients with long-term conditions, missing more than two appointments a year was associated with sharply higher all-cause mortality: hazard ratio 3.36 for physical conditions only, 8.37 for mental health conditions only, and 4.40 for both.
Used on: /healthcare
Restaurant and hospitality
OpenTable Restaurant Industry Report 2023
2023OpenTable Research · OpenTable Industry Intelligence · n = Millions of reservations
restaurant.opentable.com/industry-reports
Key finding: 20% average no-show rate across all restaurant types. Fine dining 12%, casual 25-30%.
Used on: /restaurants, /benchmarks
Salon and beauty
Phorest Salon Software Industry Report 2023
2023Phorest Research Team · Phorest Annual Industry Report · n = Global salon data
phorest.com/industry-report
Key finding: 30% average no-show rate across salon and spa businesses. Independent stylists up to 40%.
Used on: /salons, /benchmarks, /
MGMA financial benchmarks
MGMA DataDive Cost and Revenue Survey 2024
2024Medical Group Management Association · MGMA DataDive · n = Multi-specialty survey, US medical groups
mgma.com/data (members only)
Key finding: Top-quartile primary care practices achieve 12% no-show rates. Median 19%. Surgical specialties 5-10%.
Used on: /healthcare, /benchmarks
FOLIO · Methodology
Methodology notes
How we source
We prioritize peer-reviewed literature, professional association surveys (MGMA, AMA), and verified industry reports (OpenTable, Phorest). Vendor-produced data is cited only when no independent source exists and the methodology is disclosed.
Paywalled data
MGMA DataDive is paywalled. We cite the publicly available summaries and validated figures that MGMA has published in accessible formats (conference presentations, press releases) or that have been independently replicated.
Updates
This citation archive is reviewed quarterly. Last update: June 2026, when the patient-reasons breakdown was re-sourced to its primary study (Kaplan-Lewis and Percac-Lima, Journal of Primary Care & Community Health 2013: forgetting 35.5%, miscommunication 31.5%), the missed-appointment mortality citation was corrected to McQueenie et al (BMC Medicine 2019), and the reminder-effectiveness and headline-cost citations were re-verified. New data sources are added as they are published. Outdated statistics are flagged and replaced.
How to cite this site
NoShowCost.com. (2026). No-Show Rate Benchmarks and Cost Calculator. Retrieved from https://noshowcost.com/research. [Date accessed].