Longtime Workers' Comp Veteran Greg Krohm Shares Insights

For more than 10 years, Greg Krohm has been the executive director of the International Association of Industrial Accident Boards and Commissions. Since 1988, he has served in senior-level positions in the workers' comp system, including the administrator for the Wisconsin Division of Workers' Compensation. In that time, he's seen significant changes.

Recently, Krohm announced he would leave the IAIABC at the end of 2011 and shared his thoughts on the IAIABC and the workers' comp system.

Accomplishments of IAIABC. "I am extremely pleased to see how the IAIABC has developed into a reliable and valuable force for improving workers' comp," Krohm said. "We are engaged with many partner organizations in many positive projects."

Incentivizing medical providers is key to improving comp system (01/17/11)

Costs, ex-mods, Medicare among the topics of breakout sessions (11/01/12)
Opioids, physician dispensing continue to concern practitioners (02/25/13)
Opt-out proponents seek to expand support through education (09/10/12)
Veteran stakeholders add their expertise to comp advisory board (01/30/12)

One organization is the American College of Occupational and Environmental Medicine. The two recently published The Guide to High-Value Physician Services in Workers' Compensation, a topic near and dear to Krohm's heart.

"The greatest near term challenge to the workers' comp system is in improving the quality and cost effectiveness of medical care," Krohm said. "Medical delivery is in disarray due to the complete lack of positive financial and administrative incentives to providers."

Another area of collaboration for the IAIABC has been electronic data interchange. In 1990, the IAIABC embarked on a project to develop standards for communicating data electronically between providers, payers, and state administrators.

While the pace of development has been slow, Krohm said it has paid off. "We have a host of members that deliver countless time to develop EDI standards that are taking off," he said. "More states are interested. New states are signing on all the time. More and more states want to use medical reporting and other EDI documents."

Krohm says the IAIABC has also developed partnerships with a variety of other organizations, such as the National Council on Compensation Insurance, the Workers Compensation Research Institute, and the Association of Workers' Compensation Boards of Canada. International issues have become a particular focus for Krohm and the IAIABC of late.

"The IAIABC's much greater commitment to international themes and collaboration with workers' comp entities outside North America is a positive development," he said."Jurisdictions have a lot to learn from each other in such things as medical care delivery, benefit structures, and enforcement."

Overall, the association is one Krohm says is very open, very transparent. "Anyone can come and talk to their regulator. The open networking and communication between CEOs and workers' comp regulators is gratifying," he said. "That's a major part of the educational process."

Changes. Krohm believes the IAIABC has had a significant impact on disability management. He says there's been a dramatic and positive change because of it.

"We have a long way to go, but I think system administrators, employers, and insurers are finally getting the message that proactive return to work should be at the core of the claims process, not just sending out indemnity checks until the physician declares maximum medical improvement."

What may present a challenge to that thinking is what Krohm refers to as the current "jobless economic recovery." Although workers' comp participants have come to see the wisdom of returning injured workers to the workplace as soon as possible, economics are thwarting that.

Challenges ahead. The current economic environment is one of several challenges Krohm sees for the system. He believes collaboration among participants is key to overcoming them.

"My greatest concern for the long-term success of workers' comp is the lack of state interest or ability to harmonize laws and procedures to eliminate differences that only serve to increase costs for everyone," he said. "There is some greater interest in states learning from each other, but it is moving at a glacial pace."

Short of federal intervention, Krohm sees only small, incremental changes in terms of states learning from each other. However, he does not see a federalization of workers' comp.

"The key for workers' comp is, can it continue to show it's producing more benefit than harm," he said. "Despite its warts and imperfections, the state system sees to it that the vast majority of claims are paid with reasonable speed and efficiency. The greatest indictment is the laws might not be as worker-friendly as people would like. They're too stingy in terms of wage replacement for permanent injury. But you can't say the workers' comp system doesn't pay claims quickly. As a general rule, the system pays within what the laws require."

Despite his impending departure from the IAIABC, Krohm does not expect to be too far away. "I'll work on research and special projects, I hope. Certainly, I'm not going to withdraw my services."

Read more at the WorkersComp Forum homepage.

January 17, 2011

Newsletter Sign-up