Martin Army
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FORT BENNING, Ga. (March 6, 2013) -- Meeting the health-care demands of the Fort Benning community is already a challenging job, but officials at Martin Army Community Hospital said patients who miss appointments are adding to that challenge.

One of the primary concerns with missed appointments is that they limit access to care for multiple patients.

"The phrase we use is 'an appointment missed by you is an appointment missed by two,'" said Capt. Kim Decker, chief of MACH's Healthcare Management Division. "What we mean by that is that if you miss the first appointment, you're likely going to need another appointment, and then whoever didn't get an appointment initially is also still needing an appointment."

Tricare, the military's health-care program, has strict access standards that MACH must meet when treating patients. However, when patients fail to appear for appointments, those standards may fall out of reach.

"We have a Tricare access standard where we're supposed to provide you with an acute appointment within 24 hours, but when patients fail to appear for their appointments or they don't call and cancel in advance, it's kind of hard for us to have enough appointments to meet the health-care needs of our patients," said Terry Beckwith, MACH chief of public affairs. "We're really calling out a plea to the community to cancel their appointments if they know they're not going to be able to make it."

Currently, 6 to 7 percent of all appointments made at MACH are eventual no-shows.

At an average cost of $93.41 per appointment, no-shows in January cost the hospital almost $260,000, Decker said.

MACH does not penalize patients financially for missed appointments, something Decker said contributes to the issue.

"Right now, we don't charge patients if they don't come in for an appointment," Decker said. "That's not the way that Tricare does business. A lot of times patients don't really realize what that costs because they don't feel that cost. But, we all feel it when there aren't enough appointments available."

While the cost of missed appointments exceeded $250,000 in January, those costs have steadily declined over the last year.

Costs fell from a high of $411,000 in April 2012 to a low of $208,000 in December before rising again in January.

While the issue of missed appointments is still a problem for MACH, Decker said the decline in revenue lost due to no-shows could be attributed to community support.

"We've experienced a sustained 30 percent reduction in our no-shows since around September, and a lot of that has to do with the amount of effort that the units are putting forth," Decker said. "We make sure there's a list of names of people that have no-showed that goes out to the units, and they have been working diligently to make sure their Soldiers understand why this is a problem. We've gotten a lot of support, and we really appreciate that."

In addition to the revenue lost from the appointment itself, MACH also receives funding based upon the number of patients treated, Beckwith said. If an appointment is missed, that number goes down.

However, there are instances where keeping an appointment simply isn't feasible. In those instances, Decker said canceling appointments in a timely fashion, rather than no-showing, is the key.

"If you can cancel an appointment in a timely hour, we'll have the ability to get another patient in to fill that appointment, and that really helps us out," Decker said.

MACH prefers 24-hours notice for a canceled appointments in most cases, though more or less notice can be needed, depending on the type of appointment being canceled.

"We'll need more time for things like surgeries, but if it's something such as a primary care appointment, we can often fill those in as little as a few hours," Decker said.