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Providers aim to cut missed appointments

Cleveland-area healthcare providers are taking a crack at reducing the number of patients who are no-shows for appointments, as an absent patient often means absent revenue.

Though it might seem like a minor inconvenience, missed appointments can cost hospitals and doctors' offices big bucks — and in an era of tightening budgets and declining reimbursements from government and commercial payers, every dollar counts.

Officials at Akron General Health System say missed appointments accounted for roughly $18,000 in lost revenue each month for just its cancer program.“Our drugs are so expensive and the volume of patients is increasing so much that it was really putting a crunch on us,” said Connie Bollin, executive director of oncology services at Akron General.

From reminder phone calls, emails and text messages to sending vans to pick up patients, Northeast Ohio's healthcare providers are looking for new ways to ensure their patients stick to their schedules. Healthcare officials say while it's good for their bottom lines, it's also good for their patients' health.

Such efforts include a mailed reminder and a phone call—not an automated message but rather a conversation between a Summa staffer and the patient about the pending visit and whether he or she needs to bring any additional information.

“When somebody misses an appointment, those dollars are not going to show,” Dr. Dumpe said. “Then you've got an awful lot of expertise and infrastructure just sitting on the shelf not being paid for.”

Some health care providers say readmissions are due in large part to patients who skip out on their follow-up appointments.

University Hospitals is installing a new billing and scheduling system throughout its regional network of 1,500 physicians that will include new ways to communicate with patients that should help mitigate no-shows, according to Dr. Michael Nochomovitz, president of University Hospitals Physician Services. The new system has a secure online interface where physicians can send patients reminders. Inversely, patients will be able to send their physicians messages with any questions they might have about their care.

Also, Ms. Curran said the Clinic's same-day appointment campaign, which launched earlier this year with an ad that aired during the Super Bowl, is designed to fill empty slots created by those patients who make last-minute cancellations.

Hospitals and physician groups that mainly serve low-income patients often struggle with the highest no-show rates. The MetroHealth System, which is subsidized by Cuyahoga County, sees a no-show rate of as high as 25% in some of its service lines, according to Dr. Alice Stollenwerk Petrulis, its medical director of managed care.

To combat that problem, MetroHealth is employing care coordinators to act as concierges of sorts in setting up patients' care. MetroHealth also has a van service that transports patients to its main campus — a service it hopes to expand to its community health centers in the coming months.

St. Vincent Charity Medical Center in downtown Cleveland faces similar troubles, according to Nan Woldin, its director of revenue cycle. The hospital, for one, is looking to cut down on the number of patients who cancel pre-admission testing appointments — the important step before a patient is cleared for surgery.

Ms. Woldin said surgeries are a revenue driver, and canceled pre-admission tests often set back surgeries. She said it's harder to fill an empty surgery slot than a diagnostic procedure such as an X-ray because a surgical procedure often requires specialized staffing.
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