State by State Cancellation Rate Patterns Amidst COVID-19 Resurgence

As several states in the US experience a second wave of COVID-19 cases, we’ve decided to examine appointment cancellation rates among our patients to see how — if at all — this resurgence has affected medical practices and patients’ abilities to see their providers.

In case you missed it, we’ve created a regularly updated map to reflect which of the 5 stages of the pandemic management each state is currently in. Our map reflects that a number of states have recently had to either pause their plans to re-open or move backwards in phases altogether. However, none seem to be returning to the same level of lockdown that was enforced in the spring.

This trend is consistent with what we see in our data nationwide, in that patients and providers both seem to be upholding their medical appointments through this resurgence. According to the CDC’s case tracker, the most dramatic increases in recent cases are seen in California, Texas, and Florida. All three states have reverted from Stage 4 to Stage 3 (read more about our pandemic management stages here and here) for more effective crisis management.

Yet despite the rising number of cases, California, Texas, and Florida are not experiencing proportional surges in cancellations. In the graph below, you can see that all three had sharp spikes in weekly appointment cancellation rates at the peak of the pandemic beginning in late March, rising from approximately 20% to anywhere between 35% to almost 50%. Since then, rates have steadily decreased and plateaued to be similar to those seen pre-pandemic.

Perhaps surprisingly, this pattern is comparable to that seen in states that suffered even higher cancellation rates back in March. The peak cancellation rates of Massachusetts and New York were both over 60%; as of now, both of these states have transitioned to Stage 4, or the de-escalation stages of pandemic management. As expected, their cancellation rates have since fallen to more closely reflect what they were like in February.

In fact, our data show that no states are experiencing a significant uptick in cancellation rates. Even among states that have moved all the way back to Stage 2 — as they are now seeing their highest number of cases since March — there is no indication in our data that providers have stopped seeing their patients in response. Taking Georgia and Oklahoma as specific examples, we again see a curve strongly resembling those of the Stage 3 and 4 states.

Despite the challenges that these states face, these findings tell a consistent narrative: medical providers are remaining open for business. This could suggest that providers nationwide have adopted safer alternative methods to facilitate healthcare access among their patients, such as through telehealth or zero-contact solutions, both of which are solutions that can work across care models.

Regardless of how severe their spikes in cancellations were in March, elective care, mental and behavioral health, physical therapy, primary care, and specialty clinics have all found ways to continue delivering healthcare amidst a pandemic.

We’ll continue to monitor patient engagement rates and update our map as the landscape changes. For now, however, it seems that patients and providers, alike, are determined to regain a sense of normalcy.