What is evaluated to determine the necessity of treatments and reduce medical costs in workers' compensation?

The correct choice, medical utilization review, refers to the systematic evaluation of medical treatments and services to ascertain their necessity and effectiveness in relation to a workers' compensation claim. This process plays a crucial role in managing medical costs and ensuring that only appropriate and necessary treatments are provided to injured workers. By assessing whether the recommended healthcare services align with established guidelines, utilization review helps prevent unnecessary expenditures and promotes the delivery of effective care.

While medical cost management and claim assessment are relevant concepts in workers' compensation, they do not specifically focus on the evaluation of treatment necessity in the same structured manner as utilization review. Medical cost management encompasses broader strategies to control overall expenses but does not directly assess the individual treatments. Claim assessment involves reviewing the entire claim for its validity and completeness, which includes various factors but does not specifically target the necessity of medical treatments. The benefit determination process addresses the types of benefits an injured worker may receive but does not directly evaluate treatments and their appropriateness.

Thus, utilization review is fundamentally aimed at reducing unnecessary medical costs while ensuring that injured employees receive the right care aligned with their injuries, making it the most relevant answer to the question.