﻿<?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="2017v2.3">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2019-08-09T10:38:08-05:00</ReturnTs>
    <TaxPeriodEndDt>2018-09-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>861065772</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Deloitte Tax LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>Two Jericho Plaza</AddressLine1Txt>
        <CityNm>Jericho</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>11753</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2017-10-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>042105941</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>BAYS</BusinessNameControlTxt>
      <PhoneNum>4137940000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
        <CityNm>Springfield</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01199</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Dennis W Chalke</PersonNm>
      <PersonTitleTxt>SVP Finance, CFO &amp; Treasurer</PersonTitleTxt>
      <PhoneNum>4137940000</PhoneNum>
      <SignatureDt>2019-08-09</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>Jeanne Fahrenbach</PreparerPersonNm>
      <PTIN>P01365953</PTIN>
      <PhoneNum>5169187000</PhoneNum>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>208.99.255.205</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2019-08-09</IPDt>
      <IPTm>09:54:48</IPTm>
      <IPTimezoneCd>ED</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>8121CA463AABFA4EFE5158FD2073B628CA1C8F6D</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>D6D028B83EC7BAE48696A0FE418AC7215527A94E</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2017</TaxYr>
    <BuildTS>2019-02-21 02:37:17Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="10">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001 RetDoc2304700001">
      <PrincipalOfficerNm>Dennis W Chalke</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
        <CityNm>Springfield</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01199</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>65176594</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.baystatehealth.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1983</FormationYr>
      <LegalDomicileStateCd>MA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>The mission of the organization is to improve the health of people in our communities every day, with quality and compassion.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>21</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>17</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>22</TotalVolunteersCnt>
      <TotalGrossUBIAmt>595705</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>41794</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>11468715</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>16606363</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>2034414</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>5831176</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>2651414</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>3326309</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>73524</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>1055433</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>16228067</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>26819281</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>430626</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>451270</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1533208</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1622185</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>25545716</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>26115410</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>27509550</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>28188865</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-11281483</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1369584</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>238995907</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>236024226</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>132902485</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>129253129</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>106093422</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>106771097</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>19880034</ExpenseAmt>
      <GrantAmt>451270</GrantAmt>
      <RevenueAmt>2480818</RevenueAmt>
      <Desc>Baystate Health, Inc. (Baystate Health or BH) based in Springfield, Massachusetts is the parent corporation of an integrated health care delivery system with the mission "to improve the health of the people in our community every day, with quality and compassion." BH provides funding for strategic initiatives, as necessary, funding for research &amp; education initiatives and support of community health, development, and outreach activities, mostly funded by BH board-designated funds. Public Health Institute of Western Massachusetts, formerly Partners for a Healthier Community, is the primary recipient of BH support.Baystate Health currently includes the following:Baystate Medical Center (BMC) located in Springfield, Massachusetts, is the largest of the four hospitals in the Baystate Health system. BMC, the leading health facility in western Massachusetts is the only tertiary care referral medical center and Level I trauma center in the region. It is also home to western New England's only neonatal and pediatric intensive care units. BMC is a 718-bed, tax exempt, not-for-profit, academic teaching hospital.Baystate Franklin Medical Center (BFMC) located in Greenfield, Massachusetts, is a 89-bed, tax exempt, not-for-profit, acute care community hospital. BFMC serves the northern tier of northwestern Massachusetts and southern Vermont.Baystate Wing Hospital Corporation (BWH), located in Palmer, Massachusetts, is a 74-bed, tax-exempt, not-for-profit, acute care community hospital.Baystate Total Home Care, Inc. (BTHC), located in Springfield, Massachusetts, is a tax exempt, not-for-profit corporation organized to benefit, support and further the charitable activities of BMC.Baystate Noble Hospital, Inc. (BNH) is a 97-bed tax-exempt, not-for- profit acute care community hospital. BNH provides inpatient, outpatient and emergency care services for residents in the greater Westfield community. Westfield Medical Corporation (WMC) is a tax-exempt, not-for-profit physician practice that provides medical services to residents of the greater Westfield community.Noble Visiting Nurse Services, Inc. (NVNS) is a tax-exempt, not-for-profit cummunity-based home health care agency, whose primary purpose is to provide home health care services and promote and maintain community health to the city of Westfield and surrounding communities.Baystate Medical Practices, Inc.(BMP)is a multi-specialty academic group practice established as a tax exempt, not-for-profit organization to support the educational and research programs of Baystate Health as well as numerous community primary care and outreach services.Visiting Nurse Association and Hospice of Western New England, Inc. (VNAH) is a tax exempt, not-for-profit organization that provides comprehensive home health care committed to providing the highest quality care to patients and families, primarily in the home setting. BVNAH meets individual needs by bringing experienced nurses, rehabilitation therapists, social workers, and home care aides to patients' homes. Health New England, Inc. (HNE) is a health maintenance organization that converted from a taxable for profit corporation to a non-profit corporation as of January 1, 2013. It is located in Springfield, Massachusetts. HNE's service area in Massachusetts includes Franklin, Berkshire, Hampden and Hampshire counties and part of Worcester county. HNE also serves Hartford, Litchfield and Tolland counties in Connecticut.Ingraham Corporation (IC) is a for-profit, taxable corporation that served as a holding company for Baystate Health Ambulance, Inc.Baystate Administrative Services, Inc. (BAS) is a tax exempt, not-for-profit corporation that provides management support for the BH subsidiaries, including human resources, marketing, strategic planning, information services and financial services.Baystate Health Foundation, Inc. (BHF) is a tax exempt, charitable organization established for the purpose of fund-raising for healthcare related activities, in support, and for the benefit, of BH and those subsidiaries of BH that are tax exempt, not-for-profit corporations, and to hold endowment, charitable donations, and other funds for their benefit.Baystate Health Insurance Company, Ltd. (BHIC) is a captive insurance company organized and licensed in the Cayman Islands, British West Indies. BHIC provides professional liability and other insurance coverage to BH and its corporate affiliates and their employees. In 2004, BHIC began offering malpractice insurance to members of BH's medical staff who meet criteria for participation.</Desc>
      <TotalProgramServiceExpensesAmt>19880034</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</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>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc1040000001">1</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd referenceDocumentId="RetDoc1040500001">1</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd referenceDocumentId="RetDoc1040500001">0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd referenceDocumentId="RetDoc1040500001">0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">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>
      <BusinessRlnWithOfficerEntInd>0</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">1</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>48</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>1</ForeignFinancialAccountInd>
      <ForeignCountryCd>CJ</ForeignCountryCd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>21</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>17</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>1</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</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>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>1</InvestmentInJointVentureInd>
      <WrittenPolicyOrProcedureInd>1</WrittenPolicyOrProcedureInd>
      <StatesWhereCopyOfReturnIsFldCd>MA</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>OR</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>CA</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>GA</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>FL</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>IL</StatesWhereCopyOfReturnIsFldCd>
      <StatesWhereCopyOfReturnIsFldCd>NC</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>Dennis W Chalke Baystate Health</PersonNm>
        <PhoneNum>4137940000</PhoneNum>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011990001</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <InfoInScheduleOPartVIIInd>X</InfoInScheduleOPartVIIInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>Anne M Paradis</PersonNm>
        <TitleTxt>Chair</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John F Maybury</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mark A Keroack MD</PersonNm>
        <TitleTxt>President, CEO &amp; Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>49.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>1888794</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32862</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Adrian J Levsky</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>Claudia R Coplein DO</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>Colleen W Holmes</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>Edward J Noonan</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>Grace Makari-Judson MD</PersonNm>
        <TitleTxt>Trustee/Hematologist (Thru 12/31/17)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>340368</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>77945</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Gregory L Braden 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>Harriet A DeVerry</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>Hector Toledo</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>Irene Rodriguez Martin</PersonNm>
        <TitleTxt>Trustee (As of 1/1/2018)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James P Sadowsky</PersonNm>
        <TitleTxt>Trustee (Through 12/31/17)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James R Phaneuf</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>John A Egelhofer 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>John H Davis</PersonNm>
        <TitleTxt>Trustee (Through 12/31/17)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kathleen B Scoble</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>Kevin P Moriarty MD</PersonNm>
        <TitleTxt>Trustee/ Chief Ped Surgery</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>686449</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38262</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maria P Goncalves</PersonNm>
        <TitleTxt>Trustee (As of 1/1/2018)</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Paul R Murphy</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 J Bacon</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 L Pura PhD</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>Timothy F Farrell</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>Victor Woolridge</PersonNm>
        <TitleTxt>Trustee (Through 12/31/17)</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 R Webber</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>Dennis Chalke</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>48.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>994659</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>87008</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kristin R Delaney</PersonNm>
        <TitleTxt>Clerk</TitleTxt>
        <AverageHoursPerWeekRt>39.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>143978</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37512</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Madeline Torres</PersonNm>
        <TitleTxt>Assistant Clerk</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>57772</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15600</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1026817</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>3085203</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>289189</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>1</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Baystate Administrative Services Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
            <CityNm>Springfield</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>011990001</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Management Services</ServicesDesc>
        <CompensationAmt>2106152</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Premier Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>13034 Ballantyne Corporate Place</AddressLine1Txt>
            <CityNm>Charlotte</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>28277</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT Services</ServicesDesc>
        <CompensationAmt>663641</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Birdsall Voss &amp; Associates Inc dba</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>250 W Coventry Ct Ste 300</AddressLine1Txt>
            <CityNm>Milwaukee</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53217</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consulting Services</ServicesDesc>
        <CompensationAmt>377479</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>VLink Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>701 John Fitch Blvd</AddressLine1Txt>
            <CityNm>South Windsor</CityNm>
            <StateAbbreviationCd>CT</StateAbbreviationCd>
            <ZIPCd>06074</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>IT Services</ServicesDesc>
        <CompensationAmt>354623</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Workday Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6110 Stoneridge Mall Road</AddressLine1Txt>
            <CityNm>Pleasanton</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>94588</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consulting Services</ServicesDesc>
        <CompensationAmt>229978</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>16480228</RelatedOrganizationsAmt>
      <AllOtherContributionsAmt>126135</AllOtherContributionsAmt>
      <TotalContributionsAmt>16606363</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Subpart F Income from Captive Ins</Desc>
        <BusinessCd>525990</BusinessCd>
        <TotalRevenueColumnAmt>3270018</TotalRevenueColumnAmt>
        <ExclusionAmt>3270018</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Premier Purchasing Partners, L.P.</Desc>
        <BusinessCd>525990</BusinessCd>
        <TotalRevenueColumnAmt>1282789</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1189229</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>93560</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Misc (incl CPIP admin revenue)</Desc>
        <BusinessCd>524298</BusinessCd>
        <TotalRevenueColumnAmt>444950</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>139950</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>305000</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Medical Staff Dues</Desc>
        <BusinessCd>524298</BusinessCd>
        <TotalRevenueColumnAmt>391240</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>391240</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Intercompany Rent</Desc>
        <BusinessCd>531120</BusinessCd>
        <TotalRevenueColumnAmt>277197</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>277197</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>164982</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>164982</UnrelatedBusinessRevenueAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>5831176</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1440497</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>32163</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1408334</ExclusionAmt>
      </InvestmentIncomeGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>4170</TotalRevenueColumnAmt>
        <ExclusionAmt>4170</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>40243125</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>38357313</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1885812</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1885812</TotalRevenueColumnAmt>
        <ExclusionAmt>1885812</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>Loomis &amp; PVAC loans principal rec</Desc>
        <BusinessCd>561499</BusinessCd>
        <TotalRevenueColumnAmt>558601</TotalRevenueColumnAmt>
        <ExclusionAmt>558601</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Federal Tax Refund</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>386549</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>386549</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MA state Tax Refund</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>96653</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>96653</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>9460</TotalRevenueColumnAmt>
        <ExclusionAmt>9460</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>1051263</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>26819281</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2480818</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>595705</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>7136395</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>451270</TotalAmt>
        <ProgramServicesAmt>451270</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1622185</TotalAmt>
        <ProgramServicesAmt>1622185</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>131644</TotalAmt>
        <ManagementAndGeneralAmt>131644</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>69418</TotalAmt>
        <ManagementAndGeneralAmt>69418</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>376500</TotalAmt>
        <ProgramServicesAmt>376500</ProgramServicesAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>68874</TotalAmt>
        <ManagementAndGeneralAmt>68874</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>2052558</TotalAmt>
        <ProgramServicesAmt>2025835</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26723</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>5837</TotalAmt>
        <ProgramServicesAmt>5837</ProgramServicesAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>32078</TotalAmt>
        <ManagementAndGeneralAmt>32078</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>33645</TotalAmt>
        <ProgramServicesAmt>32541</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1104</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>29615</TotalAmt>
        <ManagementAndGeneralAmt>29615</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>69487</TotalAmt>
        <ProgramServicesAmt>69487</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>117627</TotalAmt>
        <ProgramServicesAmt>93045</ProgramServicesAmt>
        <ManagementAndGeneralAmt>24582</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>1054409</TotalAmt>
        <ManagementAndGeneralAmt>1054409</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>2569624</TotalAmt>
        <ProgramServicesAmt>1700050</ProgramServicesAmt>
        <ManagementAndGeneralAmt>869574</ManagementAndGeneralAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>5449</TotalAmt>
        <ProgramServicesAmt>5449</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>27261</TotalAmt>
        <ManagementAndGeneralAmt>27261</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>STRATEGIC INITIATIVES</Desc>
        <TotalAmt>12956761</TotalAmt>
        <ProgramServicesAmt>12956761</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>457b PENSION PLAN EXP</Desc>
        <TotalAmt>5072626</TotalAmt>
        <ManagementAndGeneralAmt>5072626</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>RESEARCH INITIATIVES</Desc>
        <TotalAmt>352941</TotalAmt>
        <ProgramServicesAmt>352941</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>INCOME TAX PROVISION</Desc>
        <TotalAmt>340328</TotalAmt>
        <ManagementAndGeneralAmt>340328</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>748728</TotalAmt>
        <ProgramServicesAmt>188133</ProgramServicesAmt>
        <ManagementAndGeneralAmt>560595</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>28188865</TotalAmt>
        <ProgramServicesAmt>19880034</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8308831</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>25293599</BOYAmt>
        <EOYAmt>19048564</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>344799</BOYAmt>
        <EOYAmt>381384</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>306237</BOYAmt>
        <EOYAmt>507820</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>348445</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>270007</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>74864</BOYAmt>
        <EOYAmt>78438</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>16384722</BOYAmt>
        <EOYAmt>18795339</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>66330502</BOYAmt>
        <EOYAmt>70830159</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>4132000</BOYAmt>
        <EOYAmt>4132000</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>126129184</BOYAmt>
        <EOYAmt>122250522</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>238995907</BOYAmt>
        <EOYAmt>236024226</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1958355</BOYAmt>
        <EOYAmt>2246472</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>305000</BOYAmt>
        <EOYAmt>305000</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>50021101</BOYAmt>
        <EOYAmt>40800655</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>80618029</BOYAmt>
        <EOYAmt>85901002</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>132902485</BOYAmt>
        <EOYAmt>129253129</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>76214352</BOYAmt>
        <EOYAmt>76382445</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>5234000</BOYAmt>
        <EOYAmt>5234000</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>24645071</BOYAmt>
        <EOYAmt>25154652</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>106093422</BOYAmt>
        <EOYAmt>106771097</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>238995907</BOYAmt>
        <EOYAmt>236024226</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1369584</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>4949445</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-2902186</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">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>11882171</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>11809195</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11427115</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11468715</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>15863186</CurrentTaxYearAmt>
        <TotalAmt>62450382</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>11882171</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>11809195</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>11427115</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>11468715</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>15863186</CurrentTaxYearAmt>
        <TotalAmt>62450382</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>62450382</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>1035551</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1073789</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>992385</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>1384810</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1412504</CurrentTaxYearAmt>
        <TotalAmt>5899039</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus4YearsAmt>760524</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1312952</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1033540</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>-433675</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>110186</CurrentTaxYearAmt>
        <TotalAmt>2783527</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>904912</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>921681</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>955072</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>71455</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1051263</CurrentTaxYearAmt>
        <TotalAmt>3904383</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>75037331</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>17892961</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.83230</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.80640</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001" />
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>376500</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>376500</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>BH paid Rauschenbach Associates for lobbying activities related to healthcare policy, bills and appropriations-related activities. BH paid HospitalMax Associates, Inc., Philip W. Johnston Associates, Lisa Andoscia (Rosewood Consulting), Capitol Counsel, LLC, Buoniconti &amp; McCary, LLC and Brian P. Lees for technical and strategic advisory services including public advocacy and interpretation of proposed and actual program and legislative changes.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>21340210</BeginningYearBalanceAmt>
        <ContributionsAmt>98063</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>546805</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>21985078</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>19873475</BeginningYearBalanceAmt>
        <ContributionsAmt>93080</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1373655</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>21340210</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>18868167</BeginningYearBalanceAmt>
        <ContributionsAmt>98310</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>906998</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>19873475</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>20376609</BeginningYearBalanceAmt>
        <ContributionsAmt>103225</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-1611667</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>18868167</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>19758115</BeginningYearBalanceAmt>
        <ContributionsAmt>100868</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>517626</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>20376609</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>1.00000</BoardDesignatedBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>1</EndowmentsHeldRelatedOrgInd>
      <RelatedOrgListSchRInd>1</RelatedOrgListSchRInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>59124</OtherCostOrOtherBasisAmt>
        <BookValueAmt>59124</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>233233</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>231176</DepreciationAmt>
        <BookValueAmt>2057</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>18589</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>14665</DepreciationAmt>
        <BookValueAmt>3924</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>37499</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>24166</DepreciationAmt>
        <BookValueAmt>13333</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>78438</TotalBookValueLandBuildingsAmt>
      <OtherSecuritiesGrp>
        <Desc>Investments - Other Securities</Desc>
        <BookValueAmt>70830159</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>70830159</TotalBookValueSecuritiesAmt>
      <OtherAssetsOrgGrp>
        <Desc>Due from Affiliated Companies</Desc>
        <BookValueAmt>2193942</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Equity Investment in Subsidiaries (Ingraham, Wing and Noble)</Desc>
        <BookValueAmt>48315602</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Affiliate Line of Credit</Desc>
        <BookValueAmt>27460928</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Interest in Net Assets in BHF</Desc>
        <BookValueAmt>23974835</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deferred Expenses</Desc>
        <BookValueAmt>20305215</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>122250522</TotalBookValueOtherAssetsAmt>
      <FederalIncomeTaxLiabilityAmt>76392</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Affiliated Companies</Desc>
        <Amt>2728575</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to Board-Designated Funds</Desc>
        <Amt>1116431</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Insurance Reserves</Desc>
        <Amt>19382762</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Compensation Obligations</Desc>
        <Amt>62596842</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>85901002</TotalLiabilityAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Endowment assets are to provide funding to support programs that further Baystate Health's mission.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleF documentId="RetDoc1040500001">
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Caribbean</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Insurance</TypeOfActivitiesConductedTxt>
        <RegionTotalExpendituresAmt>22629606</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Bermuda</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Investments</TypeOfActivitiesConductedTxt>
        <RegionTotalExpendituresAmt>223360</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>United Kingdom</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Investments</TypeOfActivitiesConductedTxt>
        <RegionTotalExpendituresAmt>51618302</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>Caribbean</RegionTxt>
        <OfficesCnt>0</OfficesCnt>
        <EmployeeCnt>0</EmployeeCnt>
        <TypeOfActivitiesConductedTxt>Investments</TypeOfActivitiesConductedTxt>
        <RegionTotalExpendituresAmt>31598471</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>0</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>0</SubtotalEmployeesCnt>
      <ContinuationTotalOfficeCnt>0</ContinuationTotalOfficeCnt>
      <ContinuationTotalEmployeeCnt>0</ContinuationTotalEmployeeCnt>
      <TotalOfficeCnt>0</TotalOfficeCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <SubtotalSpentAmt>106069739</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>106069739</TotalSpentAmt>
      <TransferToForeignCorpInd>1</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>0</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>1</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>1</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>1</ForeignPartnershipInd>
      <BoycottCountriesInd>0</BoycottCountriesInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Expenditures of $22,629,606 in the Caribbean are comprised of insurance related cash transfers of $22,509,606 and Baystate Health's book value of the $120,000 BHIC investment.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleF>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>0</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Public Health Institute of Western Massachusetts</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 4895</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011014895</ZIPCd>
        </USAddress>
        <RecipientEIN>043342182</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>250000</CashGrantAmt>
        <PurposeOfGrantTxt>To assist the Public Health Institute of Western Massachusetts, formerly Partners for a Healthier Community, in narrowing the gap in health disparities for some of Springfield's most vulnerable citizens, and to be a source of support for building civic leaders, creating strategies for change, and promoting policy actions to create healthier communities.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Baystate Health Foundation Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <RecipientEIN>043549011</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>65000</CashGrantAmt>
        <PurposeOfGrantTxt>To provide support for the Health Science Library and Medical Staff Pledge.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Develop Springfield</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>83 Maple Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01105</ZIPCd>
        </USAddress>
        <RecipientEIN>263862976</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>30000</CashGrantAmt>
        <PurposeOfGrantTxt>To promote development and redevelopment projects that stimulate and support economic growth and expedite City of Springfield revitalization.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Massachusetts Health Policy Forum</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>415 South Street MS 035</AddressLine1Txt>
          <CityNm>Waltham</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>024549110</ZIPCd>
        </USAddress>
        <RecipientEIN>042103552</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>30000</CashGrantAmt>
        <PurposeOfGrantTxt>The Massachusetts Health Policy Forum is dedicated to improving health and the health care system in the Commonwealth of MA by convening forums and presenting the highest quality research to legislators, stakeholders and the public.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Health Resources in Action Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>2 Boylston Street 4th Floor</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02116</ZIPCd>
        </USAddress>
        <RecipientEIN>042229839</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>20000</CashGrantAmt>
        <PurposeOfGrantTxt>Health Resources in Action, Inc. develops programs that advance public health and medical research. The organization collaborates with others to resolve public health issues through policy, research, prevention and health promotion.</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>5</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, line 1, Column (h):</FormAndLineReferenceDesc>
        <ExplanationTxt>Baystate Health, Inc. has a close relationship with its grantees, which include Baystate Health Foundation (BHF). Through this close relationship, management is able to ensure the granted money is used for the intended purposes. For BHF, funds are accounted for and monitored in individual temporarily restricted purpose funds in accordance with the restrictions. Fund administrators of the related entity are assigned responsibility to assure that the fund purpose is met before releasing from restrictions.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mark A Keroack MD</PersonNm>
        <TitleTxt>President, CEO &amp; Trustee</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>1001554</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>525000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>362240</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>17550</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15312</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1921656</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Grace Makari-Judson MD</PersonNm>
        <TitleTxt>Trustee/Hematologist (Thru 12/31/17)</TitleTxt>
        <BaseCompensationFilingOrgAmt>291317</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>44081</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4970</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>56259</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21686</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>418313</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kevin P Moriarty MD</PersonNm>
        <TitleTxt>Trustee/ Chief Ped Surgery</TitleTxt>
        <BaseCompensationFilingOrgAmt>543203</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>100207</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>43039</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>22950</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15312</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>724711</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dennis Chalke</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>518753</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>189630</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>286276</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>58410</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>28598</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1081667</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kristin R Delaney</PersonNm>
        <TitleTxt>Clerk</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>128397</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>14975</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>606</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>13738</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>23774</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>181490</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Dennis W. Chalke - Supplemental Retirement of $186,459 is included in column B. This amount was earned and paid in 2017. Mark A. Keroack, MD - Total Supplemental Retirement of $334,356 is included in column B. This amount was earned in 2017. Grace Makari-Judson, MD- Supplemental Retirement of $9,031 is included in column B. This amount was earned in 2017. Kevin P. Moriarty, MD - Supplemental Retirement of $39,037 is included in column B. This amount was earned and paid in 2017.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Grace P. Makari-Judson, MD, James P. Sadowsky and John H. Davis, (2) Paul R. Murphy and Robert L. Pura, PhD, (3) John F. Maybury and Mark A. Keroack, MD, (4) Hector F. Toledo and Timothy F. Farrell, (5) Claudia R. Coplein, DO and Victor Woolridge, (6) Colleen W. Holmes and James P. Sadowsky, (7) John F. Maybury and Anne M. Paradis.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Baystate Health, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Two of the Trustees of the filing organization are required to be members of the Board of Directors of BWH, an affiliated organization, and their election is subject to approval by the Board of Directors of BWH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. This committee also reviews the audited financial statements for the health system. The Form 990 was provided to all members of the Board of Trustees prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Baystate Health, Inc. (BH) and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual "conflict of interest" form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit &amp; Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee. The compensation of other officers is administered under the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President and CEO is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII, Section A, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Transfers from/to Affiliated Companies, Net 7,453,117. Property, Plant &amp; Equipment Transfers -8,908,454. Equity Gain / (Loss) in Baycare 1,893,310. Equity Gain / (Loss) in Ingraham 76,427. BHIC UBTI -164,982. Net Assets released from restrictions from BHF 18,414. Subpart F Income from Captive Insurance Company -3,270,018.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>042790311</EIN>
        <PrimaryActivitiesTxt>Acute Care Teaching Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Franklin Medical Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>164 High Street</AddressLine1Txt>
          <CityNm>Greenfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01301</ZIPCd>
        </USAddress>
        <EIN>042103575</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Wing Hospital Corporation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>40 Wright Street</AddressLine1Txt>
          <CityNm>Palmer</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01069</ZIPCd>
        </USAddress>
        <EIN>222519813</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Visiting Nurse Assn and Hospice of Western New England Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>50 Maple Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>042105803</EIN>
        <PrimaryActivitiesTxt>Homehealth and Hospice care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Total Home Care Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>50 Maple Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>203260764</EIN>
        <PrimaryActivitiesTxt>Real Estate and Other</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12b, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Administrative Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>222747685</EIN>
        <PrimaryActivitiesTxt>Administrative services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12c, III</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Health Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>043549011</EIN>
        <PrimaryActivitiesTxt>Fundraising</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Noble Hospital Corporation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>115 West Silver Street</AddressLine1Txt>
          <CityNm>Westfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>010861634</ZIPCd>
        </USAddress>
        <EIN>222537423</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Westfield Medical Corporation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>115 West Silver Street</AddressLine1Txt>
          <CityNm>Westfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>010861634</ZIPCd>
        </USAddress>
        <EIN>043127730</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12a, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Noble Hospital Corporation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Noble Visiting Nurse Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>77 Mill Street</AddressLine1Txt>
          <CityNm>Westfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01085</ZIPCd>
        </USAddress>
        <EIN>222757446</EIN>
        <PrimaryActivitiesTxt>Homehealth and Hospice care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Visiting Nurse Assn and Hospice of Western New England Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Health New England Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>042864973</EIN>
        <PrimaryActivitiesTxt>HMO/Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (4)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HNE of Connecticut Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>465190134</EIN>
        <PrimaryActivitiesTxt>HMO/Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CT</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (4)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Health New England</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Baystate Health Systems Inc Health &amp; Welfare Benefits Plan</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>222531644</EIN>
        <PrimaryActivitiesTxt>Voluntary Employees' Benefit Association</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (c ) (9)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HNE Advisory Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>043012347</EIN>
        <PrimaryActivitiesTxt>Administrative Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HNE Insurance Services Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>043183019</EIN>
        <PrimaryActivitiesTxt>Ancilliary Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Ingraham Corporation</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>759 Chestnut Street</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01199</ZIPCd>
        </USAddress>
        <EIN>043016257</EIN>
        <PrimaryActivitiesTxt>Health care and other business activities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>464620480</EIN>
        <PrimaryActivitiesTxt>Holding shares in subsidiary corporations</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Health New England Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HNE Insurance Company Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Monarch Place Suite 1500</AddressLine1Txt>
          <CityNm>Springfield</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>011441500</ZIPCd>
        </USAddress>
        <EIN>454462433</EIN>
        <PrimaryActivitiesTxt>Health Ins svcs for Mass Medicare supplement members</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HNE Holding Corporation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Baystate Health Insurance Company LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>North Church St</AddressLine1Txt>
          <CityNm>Georgetown</CityNm>
          <CountryCd>CJ</CountryCd>
        </ForeignAddress>
        <EIN>980421413</EIN>
        <PrimaryActivitiesTxt>Offshore captive insurance</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Baystate Health Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Frances Lutolf BO Wesson Hosp</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046019056</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Daniel Wesson TUW W Maternity</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046019096</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Daniel Wesson TUW W Memorial</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046019097</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Louise G Pease BO Baystate Med</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046019113</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Gertrude Hibbard TUW W Mem</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046019230</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Herbert Thresher UW W Hosp</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046088132</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Tr UW H Dexter FB Wesson M</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046018707</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Tr UW H Dexter FB Wesson W</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046018708</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>L &amp; F Tifft BO BSHS Tr UA</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046046282</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>TW D B Wesson FB W M H</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046018682</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>TW D B Wesson FB WWH</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>Bank of America 100 Federal St</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02110</ZIPCd>
        </USAddress>
        <EIN>046018681</EIN>
        <PrimaryActivitiesTxt>Trust</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>T</EntityTypeTxt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Administrative Services Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>2546868</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Health Foundation Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>65000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Health Foundation Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>462470</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Health Foundation Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>991290</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Health Insurance Company Ltd</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>3530329</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>7380000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>K</TransactionTypeTxt>
        <InvolvedAmt>277197</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>66663000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>1111341</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Medical Center Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>2600448</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Franklin Medical Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>1500000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Health New England Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>410933</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Ingraham Corporation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>131641</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Visiting Nurse Assn and Hospice of Western New England Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>213520</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Wing Memorial Hospital Corporation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>50588</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Wing Memorial Hospital Corporation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>1398615</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>L &amp; F Tifft BO BSHS Tr UA</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>98063</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Noble Hospital Corporation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>169373</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Baystate Noble Hospital Corporation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>6518516</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>