Reduce first-session no-shows for an insurer-referred video therapy service

A company provides counseling over live video: each patient meets a therapist once a week in a video session. Patients are not charged directly. Instead, a health insurance plan pays the company for every session a patient completes. New patients arrive through one funnel. A health plan hands the company a list of prospective patients. The company's call center phones each of them and books an initial counseling session. On that call most people agree to join the service and choose a date for their first session. A large share of these new patients, however, never attend that first session. As the product manager, how would you solve this? ```hint Follow one booked patient Trace what a newly booked patient has to remember, decide and do between hanging up with the call center and joining the first video session. For each step, ask what could stop someone who said yes on the call. ``` ### Clarifying Questions - Did these patients go looking for counseling, or is the health plan suggesting it to them unprompted? Does the plan cover the full cost, or is there a copay? - What must a patient do before the first session: install an app, create an account, fill in intake forms, test a camera? - How many days usually pass between the booking call and the first session, and does the patient know which therapist they will see? - What happens today after a no-show: does anyone follow up, and can the therapist's slot be reused? ### What a Strong Answer Covers - A goal tied to how the company is paid: attended first sessions and the weekly sessions that follow, not the show rate on its own. - The path from the booking call to the first video session, with possible no-show causes sorted into forgetting, practical barriers such as technology or timing, and weak motivation or a weak commitment on the call. - A diagnosis plan: which cuts of the no-show data would confirm or rule out each cause before committing to fixes. - Prioritized fixes across the call center, reminders, onboarding and the therapist, weighed against their cost. - Success metrics and an experiment design, with guardrails for booking volume, cost per attended patient, patient privacy and patient experience. ### Follow-up Questions - If call center agents start booking only people who sound committed, the show rate goes up. How would you tell whether that is a real improvement? - Walking each patient through setup on the booking call adds agent minutes. How would you decide whether that pays off? - Some no-shows may be people in distress rather than people who forgot. How should the follow-up process handle them?