﻿<?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="2016v3.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2017-11-13T08:40:00-06:00</ReturnTs>
    <TaxPeriodEndDt>2016-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>420794029</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>Denman &amp; Company LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1601 22nd Street Suite 400</AddressLine1Txt>
        <CityNm>West Des Moines</CityNm>
        <StateAbbreviationCd>IA</StateAbbreviationCd>
        <ZIPCd>502661453</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2016-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>203869767</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Iowa Healthcare Collaborative</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>IOWA</BusinessNameControlTxt>
      <PhoneNum>5152839330</PhoneNum>
      <USAddress>
        <AddressLine1Txt>100 East Grand No 360</AddressLine1Txt>
        <CityNm>Des Moines</CityNm>
        <StateAbbreviationCd>IA</StateAbbreviationCd>
        <ZIPCd>50309</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>THOMAS C EVANS MD</PersonNm>
      <PersonTitleTxt>PRESIDENT</PersonTitleTxt>
      <PhoneNum>5152839330</PhoneNum>
      <SignatureDt>2017-11-03</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>James J Hingtgen</PreparerPersonNm>
      <PTIN>P01301731</PTIN>
      <PhoneNum>5152258400</PhoneNum>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>167.142.53.102</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2017-11-03</IPDt>
      <IPTm>11:43:44</IPTm>
      <IPTimezoneCd>CD</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>DA39A3EE5E6B4B0D3255BFEF95601890AFD80709</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>ED278C2C01D608D0883719C85C403068E0CE6949</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2016</TaxYr>
    <BuildTS>2017-02-10 21:41:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="7">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>THOMAS C EVANS MD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>100 East Grand No 360</AddressLine1Txt>
        <CityNm>Des Moines</CityNm>
        <StateAbbreviationCd>IA</StateAbbreviationCd>
        <ZIPCd>50309</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>13206763</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.IHCONLINE.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2006</FormationYr>
      <LegalDomicileStateCd>IA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>IOWA HEALTHCARE COLLABORATIVE WAS ORGANIZED FOR THE PURPOSE OF PROMOTING QUALITY IMPROVEMENT, PATIENT SAFETY, AND VALUE THROUGH EDUCATION. THE COLLABORATIVE BRINGS TOGETHER PROVIDERS FROM ACROSS THE STATE OF IOWA TO WORK TOWARD THE COMMON GOAL OF EXCEPTIONAL HEALTHCARE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>13</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>16</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>4351651</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>12794880</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>85253</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>102478</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>58598</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>62850</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>200</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>964</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>4495702</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>12961172</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>1390658</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>1829101</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>2322465</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>7885085</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>3713123</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>9714186</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>782579</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>3246986</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>6830560</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>10614043</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>642035</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>1043326</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>6188525</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>9570717</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>IOWA HEALTHCARE COLLABORATIVE WAS ORGANIZED FOR THE PURPOSE OF PROMOTING QUALITY IMPROVEMENT, PATIENT SAFETY, AND VALUE THROUGH EDUCATION. THE COLLABORATIVE BRINGS TOGETHER PROVIDERS FROM ACROSS THE STATE OF IOWA TO WORK TOWARD THE COMMON GOAL OF EXCEPTIONAL HEALTHCARE.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>132841</ExpenseAmt>
      <RevenueAmt>102478</RevenueAmt>
      <Desc>THE COLLABORATIVE WORKS TOWARD THE GOAL OF EXCEPTIONAL HEALTH CARE IN IOWA. IHC PROMOTES QUALITY IMPROVEMENT, PATIENT SAFETY AND VALUE THROUGH EDUCATIONAL PROGRAMMING AND THE ORCHESTRATION OF STATEWIDE CLINICAL PERFORMANCE IMPROVEMENT PROJECTS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>2806650</ExpenseAmt>
        <Desc>STATE INNOVATIONS MODEL PROJECT-THE PURPOSE OF THE PROGRAM IS TO OFFER TECHNICAL ASSISTANCE IN LOCAL COMMUNITIES AND COORDINATE LEARNING EVENTS ACROSS THE STATE OF IOWA TO EQUIP COMMUNITY PARTNERS AND PROVIDERS IN HEALTH SYSTEM TRANSFORMATION. THE PROJECT SUPPORTS STATE-LED, MULTI-PAYER HEALTH CARE PAYMENT AND SERVICE DELIVERY MODELS THAT WILL IMPROVE HEALTH SYSTEM PERFORMANCE AND IMPROVE POPULATION HEALTH.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>6513431</ExpenseAmt>
        <Desc>TRANSFORMING CLINICAL PRACTICES INITIATIVE-THIS PROGRAM IS INTENDED TO TEST WHETHER A THREE-PRONGED APPROACH TO NATIONAL TECHNICAL ASSISTANCE WILL ENABLE LARGE SCALE TRANSFORMATION OF THOUSANDS OF CLINICAL PRACTICES TO DELIVER BETTER CARE AND RESULT IN BETTER HEALTH OUTCOMES AT LOWER COSTS FOR MEDICARE, MEDICAID AND CHILDREN'S HEALTH INSURANCE RPOGRAM ENROLLEES.</Desc>
      </ProgSrvcAccomActy3Grp>
      <TotalProgramServiceExpensesAmt>9452922</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>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">0</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">0</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd>0</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>18</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>16</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>13</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>THOMAS C EVANS MD</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5152839330</PhoneNum>
        <USAddress>
          <AddressLine1Txt>100 EAST GRAND</AddressLine1Txt>
          <CityNm>DES MOINES</CityNm>
          <StateAbbreviationCd>IA</StateAbbreviationCd>
          <ZIPCd>50309</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>JEFFREY MAIRE DO</PersonNm>
        <TitleTxt>CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL ROMANO MD</PersonNm>
        <TitleTxt>VICE-CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRAN TRAMP</PersonNm>
        <TitleTxt>SECRETARY/TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JACK DUSENBERY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JIM FITZPATRICK</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA JACKSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLARE KELLY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIRK NORRIS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLIFF ROBERTSON MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELLIOTT SMITH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT TRUHLAR MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE WHITE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID WILLIAMS MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS EVANS MD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>400400</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>43608</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>400400</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>43608</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TELLIGEN</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1776 WEST LAKE PARKWAY</AddressLine1Txt>
            <CityNm>WEST DES MOINES</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>50266</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GRANT SUPPORT SERVICES</ServicesDesc>
        <CompensationAmt>1073314</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ENHANCE HEALTH NETWORK</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2021 TRANSFORMATION DR 3210</AddressLine1Txt>
            <CityNm>LINCOLN</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68508</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GRANT SUPPORT SERVICES</ServicesDesc>
        <CompensationAmt>1072412</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>IOWA HOSPITAL ASSOCIATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>100 EAST GRAND</AddressLine1Txt>
            <CityNm>DES MOINES</CityNm>
            <StateAbbreviationCd>IA</StateAbbreviationCd>
            <ZIPCd>50309</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ADMINISTRATIVE SUPPORT AND GRANT SUPPORT</ServicesDesc>
        <CompensationAmt>1021537</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DAKOTA STATE UNIVERSITY</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>820 WASHINGTON AVE N</AddressLine1Txt>
            <CityNm>MADISON</CityNm>
            <StateAbbreviationCd>SD</StateAbbreviationCd>
            <ZIPCd>57042</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GRANT SUPPORT SERVICES</ServicesDesc>
        <CompensationAmt>359040</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>KANSAS HEALTHCARE COLLABORATIVE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>623 SW 10TH AVE</AddressLine1Txt>
            <CityNm>TOPEKA</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66612</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>GRANT SUPPORT SERVICES</ServicesDesc>
        <CompensationAmt>335488</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>12319880</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>475000</AllOtherContributionsAmt>
      <TotalContributionsAmt>12794880</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCE REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>102478</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>102478</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>102478</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>62064</TotalRevenueColumnAmt>
        <ExclusionAmt>62064</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>246377</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>245591</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>786</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>786</TotalRevenueColumnAmt>
        <ExclusionAmt>786</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>964</TotalRevenueColumnAmt>
        <ExclusionAmt>964</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>964</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>12961172</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>102478</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>63814</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>444008</TotalAmt>
        <ProgramServicesAmt>444008</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>1121444</TotalAmt>
        <ProgramServicesAmt>1121444</ProgramServicesAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>65454</TotalAmt>
        <ProgramServicesAmt>65454</ProgramServicesAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>104850</TotalAmt>
        <ProgramServicesAmt>104850</ProgramServicesAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>93345</TotalAmt>
        <ProgramServicesAmt>93345</ProgramServicesAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>186000</TotalAmt>
        <ProgramServicesAmt>139500</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46500</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>43443</TotalAmt>
        <ProgramServicesAmt>32051</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11392</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>13975</TotalAmt>
        <ManagementAndGeneralAmt>13975</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>6250353</TotalAmt>
        <ProgramServicesAmt>6250353</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <OfficeExpensesGrp>
        <TotalAmt>57174</TotalAmt>
        <ManagementAndGeneralAmt>57174</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>225711</TotalAmt>
        <ProgramServicesAmt>196372</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29339</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>105156</TotalAmt>
        <ProgramServicesAmt>101393</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3763</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>82815</TotalAmt>
        <ProgramServicesAmt>82815</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>208674</TotalAmt>
        <ProgramServicesAmt>196219</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12455</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>71439</TotalAmt>
        <ManagementAndGeneralAmt>71439</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>15227</TotalAmt>
        <ManagementAndGeneralAmt>15227</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CONSULTANT</Desc>
        <TotalAmt>523965</TotalAmt>
        <ProgramServicesAmt>523965</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>OTHER PROGRAM EXPENSE</Desc>
        <TotalAmt>101153</TotalAmt>
        <ProgramServicesAmt>101153</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>9714186</TotalAmt>
        <ProgramServicesAmt>9452922</ProgramServicesAmt>
        <ManagementAndGeneralAmt>261264</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>228376</BOYAmt>
        <EOYAmt>356403</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>4682559</BOYAmt>
        <EOYAmt>7430615</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1757357</BOYAmt>
        <EOYAmt>2703852</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>3473</BOYAmt>
        <EOYAmt>12183</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>325693</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>214703</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>158795</BOYAmt>
        <EOYAmt>110990</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>6830560</BOYAmt>
        <EOYAmt>10614043</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>505538</BOYAmt>
        <EOYAmt>858879</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <EOYAmt>2150</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>136497</BOYAmt>
        <EOYAmt>182297</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>642035</BOYAmt>
        <EOYAmt>1043326</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>6188525</BOYAmt>
        <EOYAmt>9570717</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>6188525</BOYAmt>
        <EOYAmt>9570717</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>6830560</BOYAmt>
        <EOYAmt>10614043</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>3246986</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>135206</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>3816128</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3963213</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3672557</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4351651</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12794880</CurrentTaxYearAmt>
        <TotalAmt>28598429</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>3816128</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3963213</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3672557</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4351651</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>12794880</CurrentTaxYearAmt>
        <TotalAmt>28598429</TotalAmt>
      </TotalCalendarYear170Grp>
      <PublicSupportTotal170Amt>28598429</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>3351</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>23247</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>56615</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>56496</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>62064</CurrentTaxYearAmt>
        <TotalAmt>201773</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>577</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>110</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus1YearAmt>200</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>964</CurrentTaxYearAmt>
        <TotalAmt>1851</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>28802053</TotalSupportAmt>
      <PublicSupportCY170Pct>0.99290</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.99160</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>325693</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>214703</DepreciationAmt>
        <BookValueAmt>110990</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>110990</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>ACCRUED EMPLOYEE COMPENSATION</Desc>
        <Amt>182297</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>182297</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>13096378</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>135206</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>135206</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>12961172</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>12961172</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>9714186</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>9714186</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>9714186</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COLLABORATIVE AND RECOGNIZE A TAX LIABILITY OR ASSET FOR AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS EVALUATED THEIR MATERIAL TAX POSITIONS AND DETERMINED THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURES IN THE FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS EVANS MD</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>400400</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>29150</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14458</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>444008</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JAMES KIRK NORRIS</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>PRESIDENT OF IOWA HOSPITAL ASSOCIATION AND BOARD MEMBER OF IHC</RelationshipDescriptionTxt>
        <TransactionAmt>1021537</TransactionAmt>
        <TransactionDesc>IOWA HOSPITAL ASSOCIATION PROVIDES ADMINISTRATIVE AND SUPPORTING SERVICES TO THE COLLABORATIVE, INCLUDING THE HEN CONTRACT. THESE SERVICES INCLUDE ADMINISTRATIVE, FINANCIAL, HUMAN RESOURCES, DATA PROCESSING AND IT SUPPORT.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>JACK DUSENBERY</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>BOARD MEMBER OF IOWA HOSPITAL ASSOCIATION AND IOWA HEALTHCARE COLLABORATIVE</RelationshipDescriptionTxt>
        <TransactionAmt>1021537</TransactionAmt>
        <TransactionDesc>IOWA HOSPITAL ASSOCIATION PROVIDES ADMINISTRATIVE AND SUPPORTING SERVICES TO THE COLLABORATIVE, INCLUDING THE HEN CONTRACT. THESE SERVICES INCLUDE ADMINISTRATIVE, FINANCIAL, HUMAN RESOURCES,DATA PROCESSING AND IT SUPPORT.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH BOARD MEMBER RECEIVES A COPY OF THE FORM 990 FOR THEIR REVIEW IN ADVANCE OF ITS SUBMISSION TO THE IRS. MANAGEMENT REVIEWS THE FORM IN DETAIL BEFORE SENDING TO THE BOARD FOR THEIR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. A NEW DISCLOSURE FORM IS COMPLETED BY EACH BOARD MEMBER ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTOR'S EXECUTIVE COMMITTEE, CONSISTING OF THE CHAIR, VICE-CHAIR AND SECRETARY-TREASURER, MEET TO ANNUALLY REVIEW PERFORMANCE EVALUATION FEEDBACK FROM A SURVEY OF THE BOARD. THE EXECUTIVE COMMITTEE REVIEWS THE EVALUATION WITH THE PRESIDENT. THE EXECUTIVE COMMITTEE USES THE RESULTS FROM A COMPENSATION REVIEW PERFORMED BY AN INDEPENDENT THIRD PARTY AS GUIDE IN THEIR NEGOTIATION OF ADDITIONAL COMPENSATION FOR THE PRESIDENT. THE EXCUTIVE COMMITTEE'S RECOMMENDATION ON SALARY ADJUSTMENT COMES TO THE BOARD FOR THEIR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>OHTER CONTRACT FEES: Program service expenses 6,250,353. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,250,353.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>