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        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>173254</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32947</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>EMILY NELSON</PersonNm>
        <TitleTxt>VP HEALTHCARE TRANSFORMATION</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>178625</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>49053</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KARL STEBBINS</PersonNm>
        <TitleTxt>DIRECTOR OF INFO. TECH</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>179867</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>39491</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1439180</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>316160</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>20</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MYERS AND STAUFFER</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>800 EAST 96TH STREET SUITE 200</AddressLine1Txt>
            <CityNm>INDIANAPOLIS</CityNm>
            <StateAbbreviationCd>IN</StateAbbreviationCd>
            <ZIPCd>46240</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>EQR SUBCONTRACTOR</ServicesDesc>
        <CompensationAmt>444876</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SAUK COUNTY PUBLIC HEALTH</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>505 BROADWAY ST NO 372</AddressLine1Txt>
            <CityNm>BARABOO</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53913</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HRSA CONSULTANTS</ServicesDesc>
        <CompensationAmt>273658</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>STEVEN BRISKI LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5251 SNAPDRAGON TRAIL</AddressLine1Txt>
            <CityNm>FITCHBURG</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53711</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT CONSULTING</ServicesDesc>
        <CompensationAmt>187970</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BRIGHT HEALTH SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>102 LOCUST STREET</AddressLine1Txt>
            <CityNm>RIO</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53960</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PERFORMANCE MEASUREMENT SUBCONTRACTOR</ServicesDesc>
        <CompensationAmt>158750</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ROSS SEGEL</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>731 LAKE RIDGE DRIVE</AddressLine1Txt>
            <CityNm>SOUTH ELGIN</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60177</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEDIS, DV AND MEDICAID CONSULTING</ServicesDesc>
        <CompensationAmt>158250</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>8</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>LONG TERM CARE CONTRACT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>4846413</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4846413</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PERFORMANCE MEASUREMENT REVIEWS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>3016460</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3016460</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>FEDERAL MEDICARE CONTRACT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>2627282</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2627282</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER GRANTS</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>2440567</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2440567</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>WIS MEDICAID CONTRACT</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>1060922</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1060922</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>13991644</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>204670</TotalRevenueColumnAmt>
        <ExclusionAmt>204670</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>312397</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>274486</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>37911</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>37911</TotalRevenueColumnAmt>
        <ExclusionAmt>37911</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>ADMINISTRATIVE - SHQA</Desc>
        <BusinessCd>900001</BusinessCd>
        <TotalRevenueColumnAmt>335262</TotalRevenueColumnAmt>
        <ExclusionAmt>335262</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>335262</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>14569487</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>13991644</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>577843</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>662807</TotalAmt>
        <ProgramServicesAmt>80809</ProgramServicesAmt>
        <ManagementAndGeneralAmt>581998</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6716909</TotalAmt>
        <ProgramServicesAmt>5031043</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1685866</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>713249</TotalAmt>
        <ProgramServicesAmt>501731</ProgramServicesAmt>
        <ManagementAndGeneralAmt>211518</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1515884</TotalAmt>
        <ProgramServicesAmt>1066341</ProgramServicesAmt>
        <ManagementAndGeneralAmt>449543</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>530371</TotalAmt>
        <ProgramServicesAmt>373087</ProgramServicesAmt>
        <ManagementAndGeneralAmt>157284</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>3806</TotalAmt>
        <ManagementAndGeneralAmt>3806</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>56736</TotalAmt>
        <ManagementAndGeneralAmt>56736</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>239020</TotalAmt>
        <ProgramServicesAmt>24999</ProgramServicesAmt>
        <ManagementAndGeneralAmt>214021</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>73858</TotalAmt>
        <ProgramServicesAmt>16111</ProgramServicesAmt>
        <ManagementAndGeneralAmt>57747</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>208550</TotalAmt>
        <ProgramServicesAmt>53207</ProgramServicesAmt>
        <ManagementAndGeneralAmt>155343</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>119536</TotalAmt>
        <ProgramServicesAmt>69760</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49776</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>56423</TotalAmt>
        <ProgramServicesAmt>15540</ProgramServicesAmt>
        <ManagementAndGeneralAmt>40883</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>30756</TotalAmt>
        <ManagementAndGeneralAmt>30756</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>73609</TotalAmt>
        <ManagementAndGeneralAmt>73609</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUBCONTRACTORS</Desc>
        <TotalAmt>2171761</TotalAmt>
        <ProgramServicesAmt>2104871</ProgramServicesAmt>
        <ManagementAndGeneralAmt>66890</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER COSTS</Desc>
        <TotalAmt>279869</TotalAmt>
        <ProgramServicesAmt>93823</ProgramServicesAmt>
        <ManagementAndGeneralAmt>186046</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>LICENSE &amp; CERTIFICATION</Desc>
        <TotalAmt>156245</TotalAmt>
        <ProgramServicesAmt>150351</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5894</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DATA PROCESSING</Desc>
        <TotalAmt>126140</TotalAmt>
        <ProgramServicesAmt>701</ProgramServicesAmt>
        <ManagementAndGeneralAmt>125439</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>13735529</TotalAmt>
        <ProgramServicesAmt>9582374</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4153155</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3177373</BOYAmt>
        <EOYAmt>4265497</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>1550012</BOYAmt>
        <EOYAmt>2071202</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2749823</BOYAmt>
        <EOYAmt>2511792</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>329040</BOYAmt>
        <EOYAmt>418763</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>5847332</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3966812</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>1880520</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>11147774</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1564858</BOYAmt>
        <EOYAmt>2020788</EOYAmt>
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      <DeferredRevenueGrp>
        <BOYAmt>8803</BOYAmt>
        <EOYAmt>6423</EOYAmt>
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      <TotalLiabilitiesGrp>
        <BOYAmt>1573661</BOYAmt>
        <EOYAmt>2027211</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>8174103</BOYAmt>
        <EOYAmt>9120563</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>8174103</BOYAmt>
        <EOYAmt>9120563</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>9747764</BOYAmt>
        <EOYAmt>11147774</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>833958</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>112502</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>11505789</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12035992</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11164637</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12051348</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13991644</CurrentTaxYearAmt>
        <TotalAmt>60749410</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>11505789</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12035992</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11164637</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12051348</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>13991644</CurrentTaxYearAmt>
        <TotalAmt>60749410</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>60749410</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>254563</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>282672</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>283551</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>473886</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>517067</CurrentTaxYearAmt>
        <TotalAmt>1811739</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>254563</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>282672</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>283551</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>473886</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>517067</CurrentTaxYearAmt>
        <TotalAmt>1811739</TotalAmt>
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        <CurrentTaxYearMinus4YearsAmt>282170</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>188201</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>222780</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>283519</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>335262</CurrentTaxYearAmt>
        <TotalAmt>1311932</TotalAmt>
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      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>12042522</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>12506865</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11670968</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>12808753</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>14843973</CurrentTaxYearAmt>
        <TotalAmt>63873081</TotalAmt>
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      <PublicSupportCY509Pct>0.95110</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.95190</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.02840</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.02510</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>ADMINISTRATIVE SERVICES FOR RELATED ORGANIZATION - 2020 AMOUNT: $ 282,170. 2021 AMOUNT: $ 188,121. 2022 AMOUNT: $ 222,780. 2023 AMOUNT: $ 283,519. 2024 AMOUNT: $ 335,262. MISCELLANEOUS REVENUE - 2021 AMOUNT: $ 80.</ExplanationTxt>
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    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <OtherCostOrOtherBasisAmt>405880</OtherCostOrOtherBasisAmt>
        <BookValueAmt>405880</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <DepreciationAmt>3774927</DepreciationAmt>
        <BookValueAmt>1413470</BookValueAmt>
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      <EquipmentGrp>
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        <BookValueAmt>61170</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>1880520</TotalBookValueLandBuildingsAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
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      <RevenueNotReportedAmt>274486</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>14569487</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>14569487</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>14010015</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>274486</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>274486</ExpensesNotReportedAmt>
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      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>13735529</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS A TAX-EXEMPT, NON-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THERE ARE NO DEFERRED INCOME TAXES RESULTING FROM TIMING DIFFERENCES BETWEEN FINANCIAL AND TAX ACCOUNTING. THE ORGANIZATION PAID $0 IN TAXES FOR THE YEARS ENDING DECEMBER 31, 2024 AND 2023. THE ORGANIZATION HAD NO MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2024 AND 2023. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2021 FOR FEDERAL PURPOSES AND 2020 FOR STATE PURPOSES. THE ORGANIZATION IS NOT CURRENTLY UNDER EXAMINATION BY ANY TAXING JURISDICTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES 274,486.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>RENTAL EXPENSES 274,486.</ExplanationTxt>
      </SupplementalInformationDetail>
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    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
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      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
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        <TotalCompensationFilingOrgAmt>340946</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL NEITZEL</PersonNm>
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        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>66784</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>25972</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>21321</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>304504</TotalCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EMILY NELSON</PersonNm>
        <TitleTxt>VP HEALTHCARE TRANSFORMATION</TitleTxt>
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        <TotalCompensationFilingOrgAmt>227678</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HEATHER LEBEAU</PersonNm>
        <TitleTxt>VP FINANCE/HUMAN RESOURCE</TitleTxt>
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        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>23697</OtherCompensationFilingOrgAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30754</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>224248</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KARL STEBBINS</PersonNm>
        <TitleTxt>DIRECTOR OF INFO. TECH</TitleTxt>
        <BaseCompensationFilingOrgAmt>122458</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>57409</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>18013</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21478</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>219358</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JENNIFER KLINK</PersonNm>
        <TitleTxt>VP MHLTC</TitleTxt>
        <BaseCompensationFilingOrgAmt>138521</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>37241</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>18013</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21272</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>215047</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MANUEL MARTIN</PersonNm>
        <TitleTxt>VP COMMERICAL SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>142768</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>30486</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17286</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15661</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>206201</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HUMAN RESOURCES MANAGER ANNUALLY PROVIDES COMPENSATION SURVEY DATA TO THE COMPENSATION COMMITTEE &amp; BOARD FOR REVIEW AND APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CFO AND TREASURER REVIEWS THE ENTIRE 990 BEFORE THE RETURN IS SIGNED AND SUBMITTED. THE RETURN IS MADE AVAILABLE TO THE FINANCE COMMITTEE AND BOARD TO REVIEW AS WELL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUALLY, THE COMPLIANCE OFFICER HAS THE BOARD OF DIRECTORS AND EMPLOYEES READ THE APPLICABLE CONFLICT OF INTEREST POLICY AND ATTEST THAT THEY UNDERSTAND IT AND ARE IN COMPLIANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>PER ITS EXECUTIVE LIMITATION POLICY LP6, THE FULL BOARD OF TRUSTEES APPROVES THE CEO COMPENSATION ANNUALLY. ALL OTHER EMPLOYEES RECEIVE THE SAME COST OF LIVING AND MERIT INCREASE PERCENT ANNUALLY. EVERY TWO OR THREE YEARS, THE HUMAN RESOURCES DEPARTMENT COMPARES LOCAL AND LIKE INDUSTRY SURVEYS TO STAFF SALARIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>A COPY OF THE DOCUMENT IS MADE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFER FROM SUPERIOR HEALTH QUALITY ALLIANCE, INC. 112,502.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS OF OVERSEEING THE AUDIT BY THE COMMITTEE HAS NOT CHANGED THIS PAST CALENDAR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <AddressLine1Txt>2909 LANDMARK PLACE</AddressLine1Txt>
          <CityNm>MADISON</CityNm>
          <StateAbbreviationCd>WI</StateAbbreviationCd>
          <ZIPCd>53713</ZIPCd>
        </USAddress>
        <EIN>830900646</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE QUALITY IMPROVEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>METASTAR INC</BusinessNameLine1Txt>
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      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SUPERIOR HEALTH QUALITY ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>112502</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH TRANSFER</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>SUPERIOR HEALTH QUALITY ALLIANCE</BusinessNameLine1Txt>
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        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>2958564</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH TRANSFER</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>