The Growth Channel

Four lessons on reducing no-show rates with hospital-provided transportation

by Emily Zuehlke Heuser and Anna Yakovenko

Editor's note: This story was updated on November 29, 2018.

When Valley Health's community needs assessment showed patients were having trouble getting to appointments, the strategy team at one of their system hospitals—Page Memorial Hospital in Luray, Virginia—investigated rideshare options as a solution to meet demand and appeal to more consumers.

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But with just two Uber drivers in their rural Virginia market, a partnership with Uber or Lyft—an increasingly popular option in more suburban and urban settings—was unrealistic. And with no nearby taxi companies, a more traditional taxi voucher approach was no more promising.

A low-tech, low-cost solution

Instead, Page Memorial Hospital developed a low-tech, low-cost solution. The hospital's receptionists offer patients at risk for appointment cancellation or no-show a free ride to their visit, and, using a rented van from a community partner, a courier takes the patient to and from his or her visit.

The results are as impressive as the solution is ingenious: The ride option decreased ambulatory no-show rates from 7% to 4% in just eight months. The courier averages 7.5 rides per week, but that number is quickly growing as more patients learn about the program. The strategy team has even heard stories of new patients choosing Page Memorial Hospital because of its transportation support program.

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We sat down with Valley Health leaders to get their advice for other systems facing patient transportation barriers.

  1. Know your market. The Valley Health model works best in rural areas, where patients are spread out, and Uber, Lyft, and taxis aren't options. It may not be scalable or as cost-effective in urban markets with higher volumes and unpredictable traffic patterns.

  2. Set boundaries. Valley Health scopes the program across several parameters. Patients must be located within a 30-minute drive and be able to get into the van with minimal assistance, and parents must provide a car seat, if necessary, and accompany minors. Additionally, to ensure a manageable volume of requests, the system scaled up the program over time and set scheduling parameters. At first, the system offered rides to only primary care appointments—it's since expanded to include outpatient multispecialty clinic, imaging, rehab, lab, and cardiac rehab visits between 9:00 a.m. and 3:00 p.m. on weekdays.

  3. Promote the option through receptionists rather than marketing materials. For legal reasons, Valley Health cannot directly market the service to consumers. Instead, they track patient no-show and cancellation rates and flag these patients as ideal ride candidates to receptionists. Receptionists are prompted to ask patients why they are cancelling their appointment and offer a ride if the reason is transport-related.

  4. Find a sociable employee to staff the vehicle. Although community volunteers have offered to drive patients, Valley Health opted to use their courier, since employees are covered by the system's insurance and already budgeted for. As a result, the only remaining cost—for fuel and the rental—is charged to the department receiving the patient. An added bonus: The courier, Jim, is widely regarded for his friendliness and ability to put people at ease. In fact, by offering an enjoyable service instead of an impersonal taxi ride, many of Valley Health's riders are repeat pick-ups because they like Jim and the service so much.

Thanks to Ben Dolewski, Operations Manager; Travis Clark, VP of Operations; and Steven Levy, Manager of Business Development from Valley Health for sharing their insights with us.

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