Patient access is being treated as a core operational risk for medical practices, shaping patient experience and increasing pressure on front-line teams. An MGMA Stat poll fielded on December 9, 2025, with 236 applicable responses, ranked access priorities across several pinch points. No-shows led at 27%, followed by online scheduling at 24%. Phone access was selected by 22% and wait times by 21%, with 5% choosing other approaches. The spread suggests that access challenges vary by organisation, but the shared objective is consistent execution that keeps schedules usable, improves contact pathways and reduces avoidable loss of capacity.
No-Show Reduction Shifts Towards Targeted Outreach
Leaders prioritising no-shows describe a renewed emphasis on automated reminders and confirmation texts, including same-day reminders and messages sent weeks in advance. These communications are being paired with operational countermeasures such as overbooking or waitlists and tougher cancellation policies or fees. Some respondents also describe ending relationships with patients who repeatedly miss appointments, while others note the continuing need for human outreach supported by vendor tools alongside automation.
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MGMA tracking suggests stabilisation after disruption during the COVID-19 pandemic. By August 2025, 73% of practices reported no-show rates that were the same as, or lower than, the year before, although more than a quarter still reported increases. The operational and financial stakes remain material, with industry analyses estimating that no-shows and last-minute cancellations can consume roughly 14% of a medical group’s revenue on a given day, and some models citing revenue losses around $150,000 (around €138,000) annually per physician.
The source also highlights a shift from uniform tactics towards more targeted interventions. Research indicates that predictive analytics models using factors such as prior attendance, appointment type, lead time and social determinants can identify higher-risk patients, supporting focused outreach and, in some settings, overbooking strategies. Dynamic outreach is described, with live calls or two-way texting reserved for higher-risk visits while lower-risk visits receive automated texts. When likely missed appointments are identified in advance, practices can aim to refill future openings with waitlisted patients or same-day demand to reduce idle capacity.
Online Scheduling and Phone Access Define Entry Points
Respondents selecting online scheduling describe plans to increase use through text and email links, website and portal prompts, on-hold messages and front-desk scripting reinforced through in-visit education. Several report using multiple promotional routes at once, while others note that the technical foundation is still under development, including buildout in Epic or other electronic health record (EHR) systems. Capacity constraints and scheduling templates that limit available options are also described as barriers that can prevent patients from finding suitable appointments online.
Adoption remains uneven. A July 2025 MGMA poll found that 71% of medical groups had fewer than one in four patients using digital tools to schedule appointments. The source links this gap to practices that have tools but have not enabled patients to choose appointments directly, positioning online scheduling as a practical operational focus for 2026. Changes described include more flexible scheduling rules that allow different appointment types to be offered to different patients, times or locations while protecting complex visits that still require staff judgement. Scheduling data is also described as feeding access analytics, supporting monitoring of fill rate, lead time and cancellation patterns. The caution raised is that online scheduling added without careful design can create mismatched visit types, double-booking and disruption on high-demand days.
Phone access is framed as equally central because it often determines whether patients can convert intent into an appointment. Groups targeting phone access describe investment in artificial intelligence (AI)-enabled tools for triage, answering and monitoring call performance, sometimes alongside virtual staffing support. Other approaches include adopting or expanding call centres, centralising phone operations and deploying Voice over Internet Protocol (VOIP) systems with better analytics, callback and queueing options, interactive voice response (IVR), texting and added staffing during peak times to reduce hold times and dropped calls. The source emphasises pacing changes around measurement, with performance tracked through operational metrics such as speed to answer, abandonment and transfers, and with frontline staff involved in evaluating tools that may add friction.
Wait-Time Improvement Blends Capacity and Workflow Redesign
For practices focused on wait times, respondents most often describe hiring more providers to add capacity, sometimes paired with expanding support staff. Leaders also report redesigning schedule templates to favour higher-demand visit types, adding same-day or urgent slots and tackling workflow delays in rooming, check-in and referral response times. Selective use of technology and communication is described as a way to support change and keep patients informed.
New-patient access remains under sustained pressure. A July 2025 MGMA Stat poll found that about two-thirds of medical groups reported new-patient appointment wait times that were flat or shorter than the year prior, while nearly a third reported increases. The source connects this mixed picture to the continued focus on time to third-next-available appointment as a key access metric, and to why wait times remain a leading priority for 2026.
Operational levers are characterised as straightforward but difficult to execute consistently. Template redesign and holds for same-day or urgent access can reduce delays without adding providers, but require discipline from schedulers and clinicians. Simplifying pre-visit paperwork and standardising rooming processes are described as routes to fewer bottlenecks and smoother provider days. Matching visit length and panel size to demand is positioned as another way to reduce chronic overruns that extend waiting and erode schedule reliability.
The polls show that access pressure spans missed appointments, digital uptake, phone capacity and new-patient availability. No-show reduction is moving from blanket reminders towards targeted outreach informed by predictive analytics and supported by proactive refilling. Online scheduling efforts focus on enablement, promotion and rule design that aligns appointment types with capacity, while phone access strategies concentrate on modernising systems, monitoring performance and using AI where it reduces friction. Wait-time initiatives combine capacity expansion with workflow and template discipline, with progress judged through consistent metrics rather than isolated interventions.
Source: Medical Group Management Association
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