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        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Peter Lee</PersonNm>
        <TitleTxt>Director</TitleTxt>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Susan Pon-Gee</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Teresa Wolownik</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Amber Pilgrim</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>aldy Duffield</PersonNm>
        <TitleTxt>director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Linne Hillock</PersonNm>
        <TitleTxt>director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Laurie Dornan</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kristen Brown</PersonNm>
        <TitleTxt>director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>David Courchaine</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>david lansky PhD</PersonNm>
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        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>435164</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34153</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>William Kramer</PersonNm>
        <TitleTxt>Executive Director</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Emma Hoo</PersonNm>
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        <OtherCompensationAmt>27944</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Maria Mangiante</PersonNm>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>33680</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Diane Stewart</PersonNm>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lauren Vela</PersonNm>
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        <OtherCompensationAmt>41980</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>Israel Ghebretinsae</PersonNm>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ContractorAddress>
          <USAddress>
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      <ContractorCompensationGrp>
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          <USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          <USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ContractorAddress>
          <USAddress>
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            <CityNm>The Hills</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
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        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Sharp Rees Stealy</BusinessNameLine1Txt>
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        <ContractorAddress>
          <USAddress>
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      <MembershipDuesAmt>1401865</MembershipDuesAmt>
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      <OtherRevenueTotalAmt>52575</OtherRevenueTotalAmt>
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        <ManagementAndGeneralAmt>45601</ManagementAndGeneralAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>50972</EOYAmt>
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      <TotalAssetsGrp>
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      <AccountsPayableAccrExpnssGrp>
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      <UnsecuredNotesLoansPayableGrp>
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      <OtherLiabilitiesGrp>
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      <TotalLiabilitiesGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation, compensation increases, and incentive payments for the Chief Executive Officer and President are based upon a performance review conducted by the Chairman of the Board. Compensation for officers and key employees is based upon industry-specific benchmark studies conducted by Human Resources periodically. The benchmark studies are then provided to the Compensation Committee to assess CEO compensation. The CEO also receives copies of the benchmark studies to assess compensation for key employees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy and financial statements are all available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 11g</FormAndLineReferenceDesc>
        <ExplanationTxt>Consulting fees: Program service expenses 4,162,546. Management and general expenses 177,691. Fundraising expenses 0. Total expenses 4,340,237. Recruitment Expense: Program service expenses 12,462. Management and general expenses 532. Fundraising expenses 0. Total expenses 12,994.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2 &amp; Part IV, Line 12</FormAndLineReferenceDesc>
        <ExplanationTxt>Although the Organization's audited financial statements were prepared on a consolidated basis, supplemental schedules were prepared as part of the audit that provided separate financial information for this organization. The financial information from the separately prepared supplemental schedules has been used to prepared Parts XI, XII and XIII of Schedule D.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2c:</FormAndLineReferenceDesc>
        <ExplanationTxt>The process has not changed since the prior year.</ExplanationTxt>
      </SupplementalInformationDetail>
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          <AddressLine1Txt>575 Market Street Ste 600</AddressLine1Txt>
          <CityNm>San Francisco</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>94105</ZIPCd>
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        <EIN>943219430</EIN>
        <PrimaryActivitiesTxt>Healthcare improvement - negotiate lower healthcare costs</PrimaryActivitiesTxt>
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        <MethodOfAmountDeterminationTxt>AR YE balance</MethodOfAmountDeterminationTxt>
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        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
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