What must be established to assure ongoing and proposed treatment is appropriate under a managed health care plan?

To ensure that ongoing and proposed treatment under a managed health care plan is appropriate, it is essential to conduct periodic reviews for treatment necessity. This process involves regularly assessing whether the treatment being provided is still needed based on the patient's current condition, progress, and any changes in medical guidelines or standards of care.

Regular evaluations help to determine if the treatment is effective, if the patient is making progress, or if modifications are required for better outcomes. This approach prevents unnecessary procedures and promotes the efficient use of healthcare resources, aligning treatment plans with the individuals' actual health needs.

Patient surveys can provide valuable insights into satisfaction but do not directly assess the medical necessity of treatments. Constructing a mechanism for annual renewals may not adequately address the dynamic nature of healthcare needs, while a fixed treatment duration may overlook the need for flexibility based on patient response and evolving health status. Therefore, ongoing necessity reviews are fundamental to maintaining an appropriate and effective treatment regimen.