Robert F. Gricius is the Chairman & CEO and founder of DSH Management Solutions, LLC. He holds a Computer Science Degree from the University of California, Berkeley, an M.B.A. in Finance and is a licensed C.P.A in the Commonwealth of Virginia. He founded RFG Associates, Inc. in 1992 after a career as a Hospital Chief Financial Officer and Corporate Director of Managed Care for a $1 billion+ multi-hospital system in the Mid-Atlantic region and DSH Management Solutions, LLC in 2006.

While the principal at RFG Associates, Inc., Mr. Gricius has represented provider clients in disputes with managed care payers comprising over 80% of the covered lives in the Mid-Atlantic region and with several Medicaid States and Medicare.  Based on his professional reputation and experience as a testifying expert witness in healthcare finance, he has opined on the financial fiduciary responsibilities of administrative executives, contract compliance issues between providers and payers, anti-trust issues as they pertain to managed care contracting, Medicare and Medicaid HMO operations and Third Party Administrator performance in claims adjudication and capitation management.  In the course of many of these cases, he developed and implemented custom relational database models that incorporated multiple hospital pricing schemas, population based distribution of select inpatient demographic markets and tracking systems to manage the document flow and relationships among thousands of case-related exhibits.

From 1998 to 2002, RFG Associates, Inc. represented eighteen hospitals in the Commonwealth of Virginia versus the State Title XIX program after uncovering a series of nine separate systemic hospital inpatient reimbursement errors subsequent to a claims payment methodology change (Per Diems to AP-DRG’s). These system errors artificially deflated payments to every hospital in the State over a period of four years. Final settlement was reached over this extended period subsequent to a series of appeals that generated $22 million in supplemental Medicaid claims payments to his clients and stipulations for corrective action on behalf of the contracted vendor.

While Chairman & CEO of DSH Management Solutions, LLC, he has grown the company from a beta-site only in 2007 to over 80 hospitals clients as of the end of 2011.  Revenue growth has increased from $500K/year to $6.8 Million/year from 2008 to 2011 while EBITDA has moved from a negative$500K to $3.1Million in the same time period.  He has lead the development and deployment of the industry’s only fully integrated DSH/340b software suit (MDSS®) and the associated administrative, regulatory and technical electronic data interchange networks between his clients and States that have over 93% of the Medicaid membership and 100% of all Medicare beneficiaries.  Since 2008, DMS has identified and/or recovered over $150 million in Federal DSH reimbursement on behalf of his clients, acquired 70% market share in the State of New Jersey, and been endorsed by four States (TN, MS, FL & VA) as their preferred DSH/340b vendor.  DMS has built a data warehouse populated with over 100 million Title XIX/XVIII eligibility/entitlement records and has over 200 million hospital inpatient and outpatient records that have spawned data related services that are an adjunct of the System and Network developed for MDSS® along with a series of DSH related products and services in conjunction with his strategic partners that will drive continued growth over the next several years.