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|Member Snapshot - Joseph Gruber|
A Passion for Geriatrics
The Consultant Pharmacist publishes occasional snapshots of members who have interesting practices or businesses or are involved in unusual projects or research. All pharmacists were asked to provide answers to several questions. This was originally published in the July 2017 issue of The Consultant Pharmacist.
Joseph Gruber, RPh, CGP, FASCP, is chief clinical officer with ActualMeds, a medication management company. During his career he has concentrated on technology systems and services to meet the growing demand for pharmacist-delivered cognitive services both in the Medicare/Medicaid and commercial environments.
Tell us about yourself and your business/ practice.
Geriatrics and gerontology have always been a passion for me. When I was a senior in pharmacy school, there were no experiential sites available in nursing facility practice. I found one on my own and got it approved. That was my first contact with consulting/senior care pharmacy. Early on during my hospital practice I completed a masters-level certificate program in gerontology. This was an entrée for my assignment to accompany the hospital geriatric multidisciplinary care team. After several years in the hospital setting, the opportunity arose to join a legacy Omnicare long-term care pharmacy operation, which launched my 20-year association with Omnicare. As a regional clinical director I was able to have direct input into Omnicare’s proprietary documentation system for medication regimen review (MRR). As the American Society of Consultant Pharmacists (ASCP) broadened its scope to care for seniors wherever they reside, I too was broadening my practice to work in the health care technology sector and empower pharmacists to go beyond MRR and into the medication therapy management (MTM) world. Since then, first as vice president of clinical products with Mirixa, and currently as chief clinical officer with ActualMeds, a medication management company, I have concentrated on technology systems and services to meet the growing demand for pharmacist-delivered cognitive services, which promote effective drug therapy, in both the Medicare and commercial environments.
What have the highlights and challenges been over the years?
Early on, ramping up technology in the long-term care consultant pharmacy sector was needed to allow consultants efficient and accurate systems to document and perform high-level MRR. With the advent of Medicare Part D, there were many challenges, as the focus of medication reimbursement shifted from individual state Medicaid agencies to Medicare prescription drug and Medicare Advantage plans. Recently, the Centers for Medicare & Medicaid Services has continued to move the requirements for Part D MTM programs toward a more robust patient benefit. In addition, the CMR requirement has been extended to nursing facility beneficiaries, allowing an expansion of the consultant’s scope of services beyond reviewing patient medications to providing CMRs as well. This is challenging in that our technology needs to keep pace with our expanded service offerings. It also highlights the opportunity for consultant and senior care pharmacists to make even greater contributions to patients' care, wherever they reside.
What advice can you offer other consultant pharmacists?
As the value of pharmacist-provided cognitive services grows both with government and commercial payers, consultant and senior care pharmacists will need skills and tools to enable them to participate and compete. Use your ASCP membership to the maximum in making sure you have the clinical skills you need. Differentiate yourself from your colleagues with the Board Certified Geriatric Pharmacist and other board-certified credentials, and use ASCP educational offerings to get credentialed and keep current. Network: Find groups of like-minded pharmacists who will allow you to participate in large business-to-business MTM payer contracts. While we are the experts and team leaders for medication management in all its forms, remember it takes a multidisciplinary team to make a difference for our patients. So, make sure you find and engage team members.
What are your hopes for the future of your business/practice?
Actually, the question is more what are my hopes for the profession at large. My hope is that consultant and senior care pharmacists will achieve true provider status, allowing payment through Medicare. That state pharmacy practice regulations will continue to expand to allow for collaborative practice and advanced practice pharmacist licenses so that pharmacists can manage patients’ medications in a more independent way. That said, while we recognize pharmacists as practitioners, we also need to be team players. I hope that technology will continue to evolve that will allow pharmacists a complete view of patients’ medication use, enable systems that foster efficient and robust documentation of clinical encounters, and an ability to easily communicate findings and recommendations to the rest of the care team.