Exhibit 3.3

		SECRETARY OF STATE DIVISION OF CORPORATIONS FILED 12:00 PM 12/03/2002 020740455 — 3596873

CERTIFICATE OF FORMATION

OF

ASPEN ACQUISITION LLC

Under Section 18-201 of the Delaware

Limited Liability Company Act

     This Certificate of Formation of Aspen Acquisition LLC (the “Company”), dated as of December 3, 2002 is being duly executed and filed by Patrick de Carbuccia, as an authorized person, to form a limited liability company under the Delaware Limited Liability Company Act (6 Del.C. Section 18-101, et seq.)

     FIRST: The name of the limited liability company formed hereby is Aspen Acquisition LLC.

     SECOND: The address of the Company’s registered office in the State of Delaware is c/o the Corporation Service Company, 2711 Centerville Road, Suite 400, in the City of Wilmington, County of New Castle, Delaware 19808.

     THIRD: The name of the Company’s registered agent for service of process at that address is the Corporation Service Company, 2711 Centerville Road, Suite 400, in the City of Wilmington, County of New Castle, Delaware 19808.

     FOURTH: This Certificate of Formation shall be effective on the date it is filed with the Secretary of the State of Delaware.

     IN WITNESS WHEREOF, I have subscribed this certificate and do hereby affirm the foregoing as true under the penalties of perjury, this 3^rd day of December, 2002.

CERTIFICATE OF AMENDMENT

OF

CERTIFICATE OF FORMATION

OF

ASPEN ACQUISITION LLC

Under Section 18-201 of the Delaware

Limited Liability Company Act

********

          It is hereby certified that:

          1. The name of the limited liability company (hereinafter called the “limited liability company”) is Aspen Acquisition LLC.

          2. The certificate of formation of the limited liability company, filed with the Secretary of State of the State of Delaware on December 3, 2002, is hereby amended by striking out Article I thereof and by substituting in lieu of said Article I the following new Article:

“ARTICLE I

          The name of the limited liability company formed hereby is “Aspen Healthcare Metrics LLC”.”

          The effective time of the amendment herein shall be April 3, 2003.

Executed on April 3, 2003

		STATE OF DELAWARE SECRETARY OF STATE DIVISION OF CORPORATIONS FILED 02:00 PM 04/03/2003 030222058 — 3596873

		State of Delaware Secretary of State Division of Corporations Delivered 04:32 PM 08/21/2006 FILED 12:57 PM 08/21/2006 SRV 060778325 — 3596873 FILE

STATE OF DELAWARE
CERTIFICATE OF AMENDMENT

     IN WITNESS WHEREOF, the undersigned have executed this Certificate on the 18 day of August, A.D. 2006.

		State of Delaware Secretary of State Division of Corporations Delivered 12:13 PM 03/18/2009 FILED 11:17 AM 03/18/2009 SRV 090277819 — 3596873 FILE

Certificate of Amendment to Certificate of Formation

of

ASPEN HEALTHCARE METRICS LLC

It is hereby certified that:

          1. The name of the limited liability company (hereinafter called the “limited liability company”) is:

ASPEN HEALTHCARE METRICS LLC

          2. The certificate of formation of the limited liability company is hereby amended by striking out the statement relating to the limited liability company’s registered agent and registered office and by substituting in lieu thereof the following new statement:

“The address of the registered office and the name and the address of the registered agent of the limited liability company required to be maintained by Section 18-104 of the Delaware Limited Liability Company Act are Corporation Service Company, 2711 Centerville Road, Suite 400, Wilmington, Delaware 19808.”

Executed on March 18, 2009.