An Aug. 11, 2026, MGMA Stat poll found that 32% of medical groups reported higher patient no-show rates year to date compared with 2025, while 58% reported about the same and 10% reported lower rates. The poll had 190 applicable responses. [Note: Percentages don't total 100% due to rounding.]

Medical practices made no-shows their top patient access priority before 2026 began. In our December 2025 poll, 27% chose no-shows, narrowly ahead of online scheduling (24%), phone access (22%) and wait times (21%).¹ This week’s results provide a year-to-date check on whether responding practices are gaining ground as many patients face higher coverage and out-of-pocket costs.

Compared with last year

The results shifted modestly in the wrong direction from a year ago: The share of groups reporting higher no-show rates rose 5 percentage points from our Aug. 12, 2025, poll,² while “about the same” declined 2 points and “decreased” fell 3 points.

The open-ended comments reinforce how difficult the problem can be to diagnose. Practices reporting higher no-show rates described many of the same tactics used by those whose rates held steady or improved: text and phone reminders, automated messages, confirmation calls, no-show fees and pre-check-in outreach.

Among respondents seeing increases, comments pointed to patient costs and broader economic pressure, transportation and gas expenses, work conflicts, weather and seasonal factors. Several leaders simply said they did not know what was pushing their rate higher despite adding more reminders or outreach. Others said they were double-booking or overbooking to absorb expected misses.

Respondents reporting lower rates cited automated and text reminders, no-show fees, transportation support and more same-day appointment availability, among other changes. Because these are unstructured comments from a limited number of respondents, they cannot establish which interventions caused rates to rise or fall. They do suggest that no-shows rarely have a single cause — and that adding another reminder may not solve the problem if cost, transportation, work or long scheduling lead times are what keep the patient away.

What changed around the schedule this year

For some patients, the cost of keeping an appointment rose in 2026 even when the practice did not change its reminder process. Enhanced premium tax credits for Affordable Care Act Marketplace coverage expired at the end of 2025. The number of people who paid their premiums and had active Marketplace coverage fell 13%, from 22.1 million in 2025 to 19.2 million in February 2026, according to KFF.⁴ Among 2026 Marketplace plan selections, the average deductible rose 37% to a record $3,786, up from $2,759 in 2025.⁵

That deductible increase can affect whether a patient keeps, postpones or cancels a visit after learning the expected cost. KFF’s January 2026 tracking poll found that healthcare was the household expense adults worried about most, ahead of housing, food, utilities and transportation. Separately, 2024 federal survey data show that 17% of adults delayed or went without medical care, mental health care or prescription drugs because of cost.⁶

The practical response is to move the cost conversation earlier. Several days before the visit, staff should verify coverage, provide an estimate when possible and explain whom the patient can contact about payment options. Waiting until check-in leaves less time to resolve a cost concern or refill the slot.

Better attendance also creates a capacity trade-off. In MGMA’s July 14 poll on new-patient wait times, one leader reporting longer waits said established patients were returning at higher rates, with fewer no-shows and cancellations.⁷ When more established-patient slots stay full, new-patient access can tighten unless the practice also adds capacity or adjusts its templates.

Add rebooking to the no-show scorecard

Track cancellations and no-shows separately. A cancellation gives the practice notice and a chance to refill the slot. A no-show usually does not. For both, the next question is whether staff rebooked the patient and whether the visit was eventually completed.

The 2025 MGMA DataDive Financials and Operations data report found a 19.95% appointment cancellation rate in its 2024 single-specialty aggregate, and only 27.40% of canceled visits were rescheduled within 30 days.⁸ Do not treat 19.95% as a universal target: The measure includes patient- and practice-initiated cancellations, and the one-year change was unusually large. Use it as a prompt to check your own data. When a slot opens, how often is it refilled, and how often does the patient complete a visit within 30 days?

The same data set shows why access and patient collections should be reviewed together. Practices collected about 72% of copayments at the time of service but only 26.83% of patient-due balances.⁸ When staff rebook a visit, they can also recheck coverage, update the estimate and offer payment options. That step matters more when higher deductibles leave patients responsible for a larger share of the bill.

Start with your own baseline

Published no-show estimates vary widely by definition, specialty, patient population and setting. Rather than chase a blended national figure, find where your own missed visits concentrate — new-patient visits, procedures, behavioral health, one location or one provider template.

Compare each clinic with its own 2025 baseline using the same definition and time period. Start by breaking the rate out by visit type and lead time; add payer, provider, location or referral source if the first cut does not explain the pattern.

More reminders are unlikely to help if forgetting is not the main reason patients miss. Tebra’s 2026 survey of 473 providers and 3,196 patients found that 81% of providers viewed forgetting as the leading cause, while patients more often cited work conflicts (31%), weather (30%) and emergencies (27%). The same survey found that 69% of patients wanted to reschedule online without calling.⁹ Ask patients why they missed and check whether they can cancel or reschedule directly from the reminder.

Fees can still be one part of the approach. In January 2025, 42% of practices reported using a no-show fee, and practices with a fee were more likely to report improvement in their no-show rates than those without one (25% versus 16%).³ The finding is self-reported and does not prove the fee caused the improvement. Treat fees as one option, not a stand-alone no-show strategy.

Where to look next

• Separate no-shows from cancellations. A combined “missed visit” rate hides which problem is growing. For each event, calculate the share rebooked within 30 days and the share that ultimately results in a completed visit.
• Check lead time before adding reminders. Use waitlists to pull patients into earlier openings, release held slots on a set schedule and protect same-day or next-day capacity where demand supports it. Measure what changes before adding another message or vendor feature.
• Move cost conversations earlier. Verify coverage, provide an estimate when possible and give the patient a contact for payment questions or options. If cost is the barrier, earlier notice gives the patient and the practice more time to find a workable next step.
• Make cancellation and rebooking easy — and assign an owner. Let patients cancel or choose a new slot from the reminder or portal when the visit type allows it. Define which staff member or team contacts high-priority no-shows, how quickly they act and when the issue is escalated.

Start with the last six months of no-shows and cancellations. Sort them by visit type and lead time, then calculate how many were rebooked within 30 days and completed. Let the weakest segment determine the next change — whether that is an earlier cost estimate, a shorter lead time, a different reminder or clearer staff follow-up. For a deeper look at matching interventions to different kinds of missed visits, see “Beyond reminders: A segmented playbook for the no-shows you still can't fix.”

Join MGMA Stat

Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/mgma-stat. Polls will be sent to your phone via text message.

Additional reading

• “Stable staff-to-physician ratios might conceal real strain in your practice” (MGMA Stat, July 8, 2026)
• “Phones are still a bottleneck costing medical practices time they can’t afford” (MGMA Stat, March 11, 2026)
• “Automatic for the people: AI moves for medical practices to boost the front office and access” (MGMA Stat, Feb. 11, 2026)

Notes

1. Harrop C. “Patient access priorities for 2026: Tackling wait times, phones, no-shows and more.” MGMA. Dec. 10, 2025. https://www.mgma.com/mgma-stat/patient-access-priorities-for-2026

2. Harrop C. “Patient no-shows in 2025: What’s changing and what to do about it.” MGMA. Aug. 14, 2025. https://www.mgma.com/mgma-stat/patient-no-shows-in-2025

3. MGMA Staff Members. “No-show fees in medical practices on the rise to balance bumpy attendance rates.” MGMA. Jan. 8, 2025. https://www.mgma.com/mgma-stat/no-show-fees-in-medical-practices-on-the-rise-to-balance-bumpy-attendance-rates

4. Cox C. “ACA Marketplace enrollment is down by 3 million after big jump in premium payments.” KFF. June 29, 2026. https://www.kff.org/quick-insights/aca-marketplace-enrollment-is-down-by-3-million-after-big-jump-in-premium-payments/

5. McGough M, Ortaliza J, Lo J, Cox C. “What we know so far about 2026 ACA Marketplace enrollment, premiums, and deductibles.” KFF. May 19, 2026. https://www.kff.org/affordable-care-act/what-we-know-so-far-about-2026-aca-marketplace-enrollment-premiums-and-deductibles/

6. Rakshit S, Cotter L, McGough M, Claxton G. “How does cost affect access to healthcare?” Peterson-KFF Health System Tracker. March 10, 2026. https://www.healthsystemtracker.org/chart-collection/cost-affect-access-care/

7. Harrop C. “New-patient wait times largely hold flat in 2026 as some groups add providers in bid to meet demand.” MGMA. July 15, 2026. https://www.mgma.com/mgma-stat/new-patient-wait-times-largely-hold-flat-in-2026-as-some-groups-add-providers-in-bid-to-meet-demand

8. MGMA Staff. Margin in motion: Revenue-cost realities and staffing for yield. 2025 MGMA DataDive Financials and Operations data report. September 2025. https://www.mgma.com/2025-financials-and-operations

9. Tebra. The state of patient no-shows and cancellations in 2026. https://www.tebra.com/ebook/pe-gpid-the-state-of-no-shows-cancellations-2026