﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v6.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2025-08-15T07:12:12-05:00</ReturnTs>
    <TaxPeriodEndDt>2024-09-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>135565207</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>KPMG LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>60 SOUTH STREET</AddressLine1Txt>
        <CityNm>BOSTON</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>02111</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>463556853</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>BMC HEALTH SYSTEM INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>BMCH</BusinessNameControlTxt>
      <PhoneNum>6176387901</PhoneNum>
      <USAddress>
        <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PLACE</AddressLine1Txt>
        <CityNm>BOSTON</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>02118</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>DAVID BECK</PersonNm>
      <PersonTitleTxt>CLERK</PersonTitleTxt>
      <PhoneNum>6176387406</PhoneNum>
      <SignatureDt>2025-08-14</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <PreparerPersonGrp>
      <PreparerPersonNm>KRISTIN ANDERSON</PreparerPersonNm>
      <PTIN>P01231300</PTIN>
      <PhoneNum>6179881000</PhoneNum>
    </PreparerPersonGrp>
    <TaxYr>2023</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>ALASTAIR BELL MD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PLACE</AddressLine1Txt>
        <CityNm>BOSTON</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>02118</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>275159627</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>N/A</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2013</FormationYr>
      <LegalDomicileStateCd>MA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>BMC HEALTH SYSTEM, INC.'S MISSION IS TO PROVIDE GOVERNANCE, LONG-TERM STRATEGIC PLANNING, AND BUDGETARY AND FINANCIAL ASSISTANCE FOR BOSTON MEDICAL CENTER, BOSTON MEDICAL CENTER HEALTH PLAN AND OTHER BMC HEALTH SYSTEM AFFILIATES.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>14</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>16</TotalVolunteersCnt>
      <TotalGrossUBIAmt>35503374</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>4720783</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>949973</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>991480</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>21621</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>579719</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>298585494</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>273588428</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>299557088</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>275159627</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>149610553</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>156213599</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>142551949</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>116743348</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>292162502</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>272956947</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>7394586</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>2202680</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>48781842</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>50816540</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>33504079</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>33336097</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>15277763</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>17480443</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>BMC HEALTH SYSTEM, INC.'S MISSION IS TO PROVIDE GOVERNANCE, LONG-TERM STRATEGIC PLANNING, AND BUDGETARY AND FINANCIAL ASSISTANCE FOR BOSTON MEDICAL CENTER, BOSTON MEDICAL CENTER HEALTH PLAN, AND OTHER AFFILIATES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>241195908</ExpenseAmt>
      <RevenueAmt>239076534</RevenueAmt>
      <Desc>SINCE ITS FORMATION ON JULY 1, 2013, BMC HEALTH SYSTEM, INC. HAS, IN ACCORDANCE WITH ITS MISSION, PROVIDED GOVERNANCE, STRATEGIC PLANNING, AND BUDGETARY ASSISTANCE FOR BOSTON MEDICAL CENTER CORPORATION (BMC), BOSTON MEDICAL CENTER HEALTH PLAN, AND OTHER AFFILIATES.</Desc>
      <TotalProgramServiceExpensesAmt>241195908</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">0</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>201</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>14</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>1</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>KAREN FINE</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>6176387406</PhoneNum>
        <USAddress>
          <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PLACE</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALASTAIR BELL MD</PersonNm>
        <TitleTxt>PRESIDENT/CEO/TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>54.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1769199</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>180077</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID AMENT</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW BOTEIN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDRA COTTERELL</PersonNm>
        <TitleTxt>TRUSTEE (THRU 08/21/24)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM CREEVY MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RANDI CUTLER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TRICIA GLYNN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARIANNE HARRISON</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANTHONY HOLLENBERG MD</PersonNm>
        <TitleTxt>TRUSTEE (THRU 05/01/24)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>54.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD MARKS</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MONICA NOETHER PHD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK NUNNELLY</PersonNm>
        <TitleTxt>TRUSTEE/CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARTHA SAMUELSON</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT SWEET</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARK TABER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREW YOUNISS</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TERRI NEWSOM</PersonNm>
        <TitleTxt>TREASURER (THRU 07/01/24)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>51.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>809132</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>114386</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JESSE SOUWEINE</PersonNm>
        <TitleTxt>TREASURER (07/01/24-09/10/24)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>53.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>184790</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9325</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANKUR AGRAWAL</PersonNm>
        <TitleTxt>TREASURER (AS OF 09/10/24)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>50.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID BECK ESQ</PersonNm>
        <TitleTxt>CLERK</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>54.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>681033</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56003</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHLEEN E WALSH</PersonNm>
        <TitleTxt>FORMER PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>583594</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>5611</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>4027748</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>365402</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRICEWATERHOUSECOOPERS ADVISOR</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4040 W BOY SCOUT BOULEVARD</AddressLine1Txt>
            <CityNm>TAMPA</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>33607</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>BUSINESS CONSULTING SERVICES</ServicesDesc>
        <CompensationAmt>2094759</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RECRUITIFI INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>21 WEST 46TH STREET</AddressLine1Txt>
            <CityNm>NEW YORK</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>10036</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>RECRUITING SERVICES</ServicesDesc>
        <CompensationAmt>1604688</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DLA PIPER US LLP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6225 SMITH AVE</AddressLine1Txt>
            <CityNm>BALTIMORE</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>21209</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL SERVICES</ServicesDesc>
        <CompensationAmt>1553422</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>OPTIMUM HEALTHCARE IT</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1525 B THE GREENSWAY STE 100</AddressLine1Txt>
            <CityNm>JACKSONVILLE BEACH</CityNm>
            <StateAbbreviationCd>FL</StateAbbreviationCd>
            <ZIPCd>32250</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SERVICE CONTRACTORS</ServicesDesc>
        <CompensationAmt>1357997</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TALENT GROUPS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4 SOUTH MARKET BUILDING 3RD FLOOR</AddressLine1Txt>
            <CityNm>BOSTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02109</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>RECRUITING CONSULTING</ServicesDesc>
        <CompensationAmt>1275927</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>52</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>991480</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>991480</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>991480</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>579719</TotalRevenueColumnAmt>
        <ExclusionAmt>579719</ExclusionAmt>
      </InvestmentIncomeGrp>
      <OtherRevenueMiscGrp>
        <Desc>CORPORATE OVERHEAD ALLOCATION</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>238085054</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>238085054</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PHARMACY CONSULTING REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>35503374</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>35503374</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>273588428</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>275159627</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>239076534</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>35503374</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>579719</ExclusionAmt>
      </TotalRevenueGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>125497004</TotalAmt>
        <ProgramServicesAmt>106530238</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18966766</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>22951309</TotalAmt>
        <ProgramServicesAmt>18693543</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4257766</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>7765286</TotalAmt>
        <ProgramServicesAmt>7765286</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>2693124</TotalAmt>
        <ProgramServicesAmt>1995289</ProgramServicesAmt>
        <ManagementAndGeneralAmt>697835</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>1006877</TotalAmt>
        <ProgramServicesAmt>994877</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12000</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>590303</TotalAmt>
        <ProgramServicesAmt>590303</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>24951088</TotalAmt>
        <ProgramServicesAmt>24418400</ProgramServicesAmt>
        <ManagementAndGeneralAmt>532688</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>2136432</TotalAmt>
        <ProgramServicesAmt>1965164</ProgramServicesAmt>
        <ManagementAndGeneralAmt>171268</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>5462208</TotalAmt>
        <ProgramServicesAmt>5394174</ProgramServicesAmt>
        <ManagementAndGeneralAmt>68034</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>9918209</TotalAmt>
        <ProgramServicesAmt>9869598</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48611</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>1306709</TotalAmt>
        <ProgramServicesAmt>717863</ProgramServicesAmt>
        <ManagementAndGeneralAmt>588846</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>702343</TotalAmt>
        <ProgramServicesAmt>266890</ProgramServicesAmt>
        <ManagementAndGeneralAmt>435453</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>265794</TotalAmt>
        <ManagementAndGeneralAmt>265794</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>198591</TotalAmt>
        <ProgramServicesAmt>90000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>108591</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>LICENSE FEES</Desc>
        <TotalAmt>48291369</TotalAmt>
        <ProgramServicesAmt>48102572</ProgramServicesAmt>
        <ManagementAndGeneralAmt>188797</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>7086346</TotalAmt>
        <ProgramServicesAmt>7086346</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CORPORATE OVERHEAD ALLO</Desc>
        <TotalAmt>3134202</TotalAmt>
        <ManagementAndGeneralAmt>3134202</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>2730726</TotalAmt>
        <ProgramServicesAmt>2272719</ProgramServicesAmt>
        <ManagementAndGeneralAmt>458007</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>6269027</TotalAmt>
        <ProgramServicesAmt>4442646</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1826381</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>272956947</TotalAmt>
        <ProgramServicesAmt>241195908</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31761039</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>10364932</BOYAmt>
        <EOYAmt>21508480</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>10169006</BOYAmt>
        <EOYAmt>4375262</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>24710599</BOYAmt>
        <EOYAmt>17728141</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>4940909</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2253788</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>784994</BOYAmt>
        <EOYAmt>2687121</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>2752311</BOYAmt>
        <EOYAmt>4517536</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>48781842</BOYAmt>
        <EOYAmt>50816540</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>14440593</BOYAmt>
        <EOYAmt>15338923</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>19063486</BOYAmt>
        <EOYAmt>17997174</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>33504079</BOYAmt>
        <EOYAmt>33336097</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>15277763</BOYAmt>
        <EOYAmt>17480443</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>15277763</BOYAmt>
        <EOYAmt>17480443</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>48781842</BOYAmt>
        <EOYAmt>50816540</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>2202680</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <SupportingOrganization509a3Ind>X</SupportingOrganization509a3Ind>
      <SupportingOrgType2Ind>X</SupportingOrgType2Ind>
      <IRSWrittenDeterminationInd>X</IRSWrittenDeterminationInd>
      <SupportedOrganizationsCnt>2</SupportedOrganizationsCnt>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>BOSTON MEDICAL CTR</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>043314093</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>1</GoverningDocumentListedInd>
        <SupportAmt>0</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>BMC HEALTH PLAN INC</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>043373331</EIN>
        <OrganizationTypeCd>10</OrganizationTypeCd>
        <GoverningDocumentListedInd>1</GoverningDocumentListedInd>
        <SupportAmt>0</SupportAmt>
        <OtherSupportAmt>0</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrganizationsTotalCnt>2</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>0</SupportSumAmt>
      <OtherSupportSumAmt>0</OtherSupportSumAmt>
      <Form990SchASupportingOrgGrp>
        <ListedByNameGoverningDocInd>1</ListedByNameGoverningDocInd>
        <SuprtOrgNoIRSDeterminationInd>0</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>0</SupportedOrgSectionC456Ind>
        <SupportedOrgNotOrganizedUSInd>0</SupportedOrgNotOrganizedUSInd>
        <OrganizationChangeSuprtOrgInd>0</OrganizationChangeSuprtOrgInd>
        <SupportNonSupportedOrgInd>0</SupportNonSupportedOrgInd>
        <PaymentSubstantialContribtrInd>0</PaymentSubstantialContribtrInd>
        <LoanDisqualifiedPersonInd>0</LoanDisqualifiedPersonInd>
        <ControlledDisqualifiedPrsnInd>0</ControlledDisqualifiedPrsnInd>
        <DisqualifiedPrsnControllIntInd>0</DisqualifiedPrsnControllIntInd>
        <DisqualifiedPrsnOwnrIntInd>0</DisqualifiedPrsnOwnrIntInd>
        <ExcessBusinessHoldingsRulesInd>0</ExcessBusinessHoldingsRulesInd>
        <ContributionControllerInd>0</ContributionControllerInd>
        <ContributionFamilyInd>0</ContributionFamilyInd>
        <Contribution35ControlledInd>0</Contribution35ControlledInd>
      </Form990SchASupportingOrgGrp>
      <MajorityDirTrstSupportedOrgInd>0</MajorityDirTrstSupportedOrgInd>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART IV, SECTION C, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>BMC HEALTH SYSTEM, INC. (BMCHS) IS SUPERVISED AND CONTROLLED IN CONNECTION WITH BOSTON MEDICAL CENTER CORPORATION (BMC), A SUPPORTED ORGANIZATION. THE OVERLAP OF THE PERSONS CONTROLLING OR MANAGING BMCHS AND THOSE CONTROLLING OR MANAGING BMC IS SUFFICIENT SO THAT WHEN CONSIDERED TOGETHER WITH ALL THE FACTS AND CIRCUMSTANCES THERE IS A CLEAR SHOWING THAT BMC CAN ENSURE THAT BMCHS WILL BE RESPONSIVE TO ITS NEEDS OR DEMANDS, AND WILL CONSTITUTE AN INTEGRAL PART OF OR MAINTAIN A SIGNIFICANT INVOLVEMENT IN ITS OPERATIONS. THE PERSONS SERVING AS PRESIDENT, TREASURER, AND CLERK OF BMC ALSO SERVED IN THOSE ROLES FOR BMCHS FOR ALL OR A PORTION OF THE TAX YEAR. SEVEN OF THE 16 BMCHS TRUSTEES THAT SERVED FOR ALL OR A PORTION OF THE TAX YEAR WERE ALSO TRUSTEES OF BMC FOR ALL OR A PORTION OF THE TAX YEAR. THE CHAIR OF THE BMC BOARD WAS A TRUSTEE OF BMCHS. BMCHS SERVES AS THE PARENT OF AN INTEGRATED HEALTH SYSTEM IN WHICH BMC WAS THE SOLE HOSPITAL DURING THE TAX YEAR, AND BMCHS'S HISTORIC AND CONTINUING PURPOSE IS TO ASSIST BMC TO EFFECTIVELY DELIVER HEALTHCARE SERVICES TO ITS COMMUNITY. ACCORDINGLY, BMCHS CONSTITUTES AN INTEGRAL PART OF, MAINTAINS A SIGNIFICANT INVOLVEMENT IN, AND IS RESPONSIVE TO THE NEEDS AND DEMANDS OF BMC. BMCHS IS SUPERVISED AND CONTROLLED IN CONNECTION WITH BOSTON MEDICAL CENTER HEALTH PLAN D.B.A. WELLSENSE HEALTH PLAN (WELLSENSE), A SUPPORTED ORGANIZATION. THE OVERLAP OF THE PERSONS CONTROLLING OR MANAGING BMCHS AND THOSE CONTROLLING OR MANAGING WELLSENSE IS SUFFICIENT SO THAT WHEN CONSIDERED TOGETHER WITH ALL THE FACTS AND CIRCUMSTANCES THERE IS A CLEAR SHOWING THAT WELLSENSE CAN ENSURE THAT BMCHS WILL BE RESPONSIVE TO ITS NEEDS OR DEMANDS, AND WILL CONSTITUTE AN INTEGRAL PART OF OR MAINTAIN A SIGNIFICANT INVOLVEMENT IN ITS OPERATIONS. THE CHAIR OF THE WELLSENSE BOARD IS ALSO A BMCHS TRUSTEE AND BMCHS' PRESIDENT APPOINTS THE PRESIDENT OF WELLSENSE. THREE OF THE 13 WELLSENSE TRUSTEES ARE ALSO TRUSTEES OF BMCHS. ADDITIONALLY, BMCHS AND WELLSENSE ARE PARTIES TO A SERVICE AGREEMENT UNDER WHICH BMCHS PROVIDES CARE MANAGEMENT AND PROVIDER SERVICES, AND OTHER ADMINISTRATIVE AND PERSONNEL SERVICES TO WELLSENSE. BY REASON OF THE FOREGOING RELATIONSHIP, BMCHS AND ITS TRUSTEES AND OFFICERS ARE RESPONSIVE TO THE NEEDS AND DEMANDS OF WELLSENSE.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>1</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>1</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>481000</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>109303</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>590303</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HEALTH SYSTEM MONITORS LEGISLATION AND OTHER GOVERNMENTAL DEVELOPMENTS AT THE FEDERAL, STATE, AND LOCAL LEVELS THAT MAY AFFECT THE HEALTH SYSTEM AND ITS AFFILIATES. THE HEALTH SYSTEM ENGAGES LOBBYISTS TO REPRESENT IT AND ADVANCE ITS MISSION. IT ALSO HAS A STAFF OF APPROXIMATELY FIVE WHOSE RESPONSIBILITIES INCLUDE MONITORING LEGISLATION AND GOVERNMENTAL DEVELOPMENTS OF INTEREST TO, OR AFFECTING, THE HEALTH SYSTEM. THE HEALTH SYSTEM FILES REPORTS WITH THE COMMONWEALTH OF MASSACHUSETTS AND THE CITY OF BOSTON DETAILING THESE ACTIVITIES AND EXPENSES RELATED TO STATE AND LOCAL MATTERS. IT IS POSSIBLE THAT OTHER INDIVIDUALS MAY HAVE SPENT AN INSUBSTANTIAL PORTION OF THEIR TIME ON LEGISLATIVE MATTERS OF DIRECT CONCERN TO BMC HEALTH SYSTEM AND THE HEALTHCARE INDUSTRY AND MAY HAVE INCURRED INSUBSTANTIAL EXPENSES IN CONNECTION WITH THIS ACTIVITY. THE HEALTH SYSTEM PAID DEMPSEY, LUCEY &amp; ASSOCIATES $72,000 TO REPRESENT THE ORGANIZATION. THE HEALTH SYSTEM PAID MCLANE MIDDLETON $144,000 TO REPRESENT THE ORGANIZATION. THE HEALTH SYSTEM PAID NATHANSON &amp; HAUCK $240,000 TO REPRESENT THE ORGANIZATION. THE HEALTH SYSTEM PAID WILL FARRELL AND ASSOCIATES $25,000 TO REPRESENT THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4940909</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2253788</DepreciationAmt>
        <BookValueAmt>2687121</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>2687121</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>LOAN RECEIVABLE</Desc>
        <BookValueAmt>1131059</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>OTHER ASSETS</Desc>
        <BookValueAmt>3244368</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>INCOME TAX BENEFIT</Desc>
        <BookValueAmt>142109</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>4517536</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES</Desc>
        <Amt>17997174</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>17997174</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>BMC HEALTH SYSTEM, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF BMC HEALTH SYSTEM (BMCHS). THESE STATEMENTS INCLUDE THE FOLLOWING LANGUAGE REGARDING LIABILITY FOR UNCERTAIN TAX POSITIONS WITHIN THE INCOME TAXES FOOTNOTE. BMCHS RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED AS OF SEPTEMBER 30, 2024 AND 2023. BMCHS ANNUALLY ASSESSES WHETHER IT MUST RECOGNIZE UBIT EXPENSE. THE AMOUNTS RECOGNIZED AS UBIT EXPENSE WERE NOT MATERIAL TO BMCHS'S CONSOLIDATED OPERATIONS OR CHANGES IN NET ASSETS FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALASTAIR BELL MD</PersonNm>
        <TitleTxt>PRESIDENT/CEO/TRUSTEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>1228295</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>459250</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>81654</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>169725</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10352</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1949276</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>68250</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TERRI NEWSOM</PersonNm>
        <TitleTxt>TREASURER (THRU 07/01/24)</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>648132</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>156000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>5000</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>107400</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>6986</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>923518</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID BECK ESQ</PersonNm>
        <TitleTxt>CLERK</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>506187</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>112500</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>62346</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>23100</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>32903</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>737036</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHLEEN E WALSH</PersonNm>
        <TitleTxt>FORMER PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>271094</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>312500</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>4442</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1169</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>589205</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JESSE SOUWEINE</PersonNm>
        <TitleTxt>TREASURER (07/01/24-09/10/24)</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>158602</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>26188</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>9325</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>194115</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S PRESIDENT IS COMPENSATED BY ITS RELATED/SUPPORTED ORGANIZATION, BOSTON MEDICAL CENTER, WHICH USED ALL METHODS INCLUDED IN QUESTION 3 TO ESTABLISH HIS COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B:</FormAndLineReferenceDesc>
        <ExplanationTxt>CERTAIN EXECUTIVES REPORTED ON THE BMC HEALTH SYSTEM, INC. FORM 990, PART VII SECTION A AND SCHEDULE J, PART II ARE COMPENSATED BY BMC. BMC HAS A 457(F) DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES LISTED IN SCHEDULE J, PART II.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>ANDREW YOUNISS DAVID BECK MARTHA SAMUELSON RANDI CUTLER RICHARD MARKS ANKUR AGRAWAL SANDRA COTTERELL TERRI NEWSOM ALASTAIR BELL, M.D. ANTHONY HOLLENBERG, M.D. JESSIE SOUWEINE BUSINESS RELATIONSHIP - THE OFFICERS AND TRUSTEES ABOVE WERE ALSO EMPLOYEES, OFFICERS, AND/OR TRUSTEES OF BOSTON MEDICAL CENTER. WILLIAM CREEVY, M.D. ANTHONY HOLLENBERG, M.D. ALASTAIR BELL, M.D. MONICA NOETHER BUSINESS RELATIONSHIP - THE OFFICERS AND TRUSTEES ABOVE WERE ALSO EMPLOYEES, OFFICERS, OR TRUSTEES OF FACULTY PRACTICE FOUNDATION, INC. AND AFFILIATES. MONICA NOETHER ROBERT SWEET ANTHONY HOLLENBERG, M.D. BUSINESS RELATIONSHIP - MONICA NOETHER, ROBERT SWEET, AND ANTHONY HOLLENBERG, M.D. ARE DIRECTORS OF BMC INSURANCE COMPANY, LTD. ANTHONY HOLLENBERG,M.D. (THROUGH MAY 31, 2024) DAVID BECK BUSINESS RELATIONSHIP THE OFFICERS AND DIRECTORS ABOVE WERE ALSO EMPLOYEES, OFFICERS, OR TRUSTEES OF EVANS MEDICAL FOUNDATION, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>BMC HEALTH SYSTEM, INC.'S FORM 990 IS PREPARED BY KPMG LLP AND REVIEWED BY BMC HEALTH SYSTEM'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, BMC HEALTH SYSTEM'S INTERNAL MANAGEMENT AND KPMG PRESENT THE FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO THE FORM BEING FILED WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST QUESTIONNAIRES FOR THE FISCAL YEAR ENDED SEPTEMBER 30,2024 WERE DISTRIBUTED BY BMC HEALTH SYSTEM'S CORPORATE COMPLIANCE DEPARTMENT. THE CHIEF COMPLIANCE OFFICER OF BMC HEALTH SYSTEM, INC. OR THE CHIEF COMPLIANCE OFFICER'S DESIGNEE QUERIES TRUSTEES, OFFICERS AND DIRECTORS ON AT LEAST AN ANNUAL BASIS REGARDING RELATIONSHIPS THAT MAY CREATE POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER OR THE CHIEF COMPLIANCE OFFICER'S DESIGNEE REVIEWS ALL DISCLOSURES AND DETERMINES WHETHER THERE ARE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER OR THE CHIEF COMPLIANCE OFFICER'S DESIGNEE INFORMS THE CHIEF LEGAL COUNSEL OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CHIEF LEGAL COUNSEL ADVISES THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION ACCORDINGLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>BMC HEALTH SYSTEM, INC. IS A SUPPORTING ORGANIZATION OF BOTH BMC AND WELLSENSE. ALL THREE ENTITIES HAVE THE SAME INDEPENDENT COMPENSATION COMMITTEE, FORMED OF INDIVIDUALS WHOSE COMPENSATION IS NOT IN ISSUE, THAT ESTABLISHES THE COMPENSATION OF THE PRESIDENT AND CEO AND APPROVES THE COMPENSATION OF SENIOR MANAGEMENT. THE BMC HEALTH SYSTEM, INC. COMMITTEE MEMBERS ARE NOT UNDER THE CONTROL OR DIRECTION OF ANY BMC HEALTH SYSTEM, INC., BMC, OR WELLSENSE EXECUTIVE SEEKING COMPENSATION. INDIVIDUAL COMPENSATION IS SUPPORTED BY COMPARABLE DATA, WHICH INCLUDES COMPENSATION PAID FOR COMPARABLE POSITIONS BY SIMILARLY SITUATED ORGANIZATIONS (BOTH TAXABLE AND TAX-EXEMPT), INDEPENDENTLY COMPILED COMPENSATION SURVEYS, AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE EXECUTIVE. THE COMMITTEE MAY ALSO UTILIZE AN INDEPENDENT COMPENSATION CONSULTANT AS PART OF THE COMPENSATION-SETTING PROCESS. THE INDEPENDENT COMMITTEE'S ASSESSMENTS OF THESE CONSIDERATIONS ARE CONTAINED IN THE MINUTES OF THE COMMITTEE MEETINGS. THE REVIEW PROCESS INCLUDES, AND THE MINUTES INDICATE, DISCUSSIONS AND EVALUATIONS OF EACH EXECUTIVE'S PERFORMANCE, QUALIFICATIONS, AND EXPERIENCE. THE EXECUTIVES ARE NOT PRESENT FOR THE INDEPENDENT COMMITTEE'S DISCUSSIONS OR THE COMMITTEE'S VOTE ON COMPENSATION. THE MINUTES REFLECT THE FACT THAT NO EXECUTIVE WAS PRESENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>BMC HEALTH SYSTEM, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS PUBLICLY AVAILABLE. THE ARTICLES OF THE ORGANIZATION ARE AVAILABLE ON THE SECRETARY OF THE COMMONWEALTH'S WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CLEARWAY HEALTH LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PLACE</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
        <EIN>852764256</EIN>
        <PrimaryActivitiesTxt>PHARMACY CONSULTING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <TotalIncomeAmt>36083093</TotalIncomeAmt>
        <EndOfYearAssetsAmt>30541921</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BMCHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BOSTON MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PL</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
        <EIN>043314093</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BOSTON MEDICAL CENTER HEALTH PLAN INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>529 MAIN STREET SUITE 500</AddressLine1Txt>
          <CityNm>CHARLESTOWN</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
        <EIN>043373331</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 A-I</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BOSTON UNIVERSITY AFFILIATED PHYSICIANS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PL</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
        <EIN>043218267</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BOSTON MEDICAL CENTER-SOUTH CORPORATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PL</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
        <EIN>994491180</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BMCHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BOSTON MEDICAL CENTER-BRIGHTON CORPORATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE BOSTON MEDICAL CENTER PL</AddressLine1Txt>
          <CityNm>BOSTON</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02118</ZIPCd>
        </USAddress>
        <EIN>994793550</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>BMCHS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <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>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>