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Long-term debt (Tables) | 9 Months Ended
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Sep. 30, 2024
Debt Disclosure [Abstract] |
Long-term Debt | Long-term debt comprised the following:
|  |  |  |  |  |  | As of September 30, 2024
| September 30, 2024 |  | December 31, 2023 |  | Maturity date |  | Interest rate |  | Estimated fair value(1)
Senior Secured Credit Facilities: |  |  |  |  |  |  |  |  |
Term Loan A-1 | $ | 2,289,022 |  |  | $ | 1,234,375 |  |  | 4/28/2028 |  | Base +1.75%(2) |  | $ | 2,277,577 |
Term Loan B-1 | — |  |  | 2,603,786 |  |  | 8/12/2026 |  |  |  | $ | — |
Extended Term Loan B-1 | 1,640,251 |  |  |  |  | 5/9/2031 |  | SOFR + 2.00% |  | $ | 1,638,201 |
Revolving line of credit | — |  |  | — |  |  | 4/28/2028 |  | Base +1.75%(2) |  | $ | — |
Senior Notes: |  |  |  |  |  |  |  |  |
4.625% Senior Notes | 2,750,000 |  |  | 2,750,000 |  |  | 6/1/2030 |  | 4.625 | % |  | $ | 2,622,813 |
3.75% Senior Notes | 1,500,000 |  |  | 1,500,000 |  |  | 2/15/2031 |  | 3.75 | % |  | $ | 1,350,000 |
6.875% Senior Notes | 1,000,000 |  |  | — |  |  | 9/1/2032 |  | 6.875 | % |  | $ | 1,035,000 |
Acquisition obligations and other notes payable(3) | 87,945 |  |  | 102,328 |  |  | 2024-2036 |  | 6.55 | % |  | $ | 87,945 |
Financing lease obligations(4) | 236,722 |  |  | 255,491 |  |  | 2025-2040 |  | 4.62 | % |  |
CHC temporary funding assistance(5) | 119,814 |  |  |  |  |  |  | — | % |  | $ | 119,814 |
Total debt principal outstanding | 9,623,754 |  |  | 8,445,980 |  |  |  |  |  |  |
Discount, premium and deferred financing costs(6) | (67,168) |  |  | (54,347) |  |  |  |  |  |  |
| 9,556,586 |  |  | 8,391,633 |  |  |  |  |  |  |
Less current portion | (296,255) |  |  | (123,299) |  |  |  |  |  |  |
| $ | 9,260,331 |  |  | $ | 8,268,334 |  |  |  |  |  |  |
(1)For the Company's senior secured credit facilities, fair value estimates are based on bid and ask quotes, a level 2 input. For the Company's senior notes, fair value estimates are based on market level 1 inputs. For acquisition obligations and other notes payable, the carrying values presented here approximate their estimated fair values, based on estimates of their present values typically using level 2 interest rate inputs. For the CHC temporary funding assistance, the carrying value presented here approximates the estimated fair value based on the short-term nature of settlement. (2)The Company's senior secured credit facilities bear interest at Term SOFR, plus an interest rate margin, with certain portions also subject to a credit spread adjustment (CSA). Term SOFR plus CSA is referred to as "Base" in the table above. The Term Loan A-1 and revolving line of credit bear a CSA of 0.10%. (3)The interest rate presented for acquisition obligations and other notes payable is their weighted average interest rate based on the current fixed and variable interest rate components in effect as of September 30, 2024. (4)Financing lease obligations are measured at their approximate present values at inception. The interest rate presented is the weighted average discount rate embedded in financing leases outstanding. (5)The Change Healthcare (CHC) temporary funding assistance, as described below, is interest-free and amounts provided under this program are subject to repayment within 45 business days from a future date to be mutually agreed to by the parties. The balance is included in the Company's current portion of long-term debt as of September 30, 2024. (6)As of September 30, 2024, the carrying amount of the Company's senior secured credit facilities has been reduced by a discount of $8,410 and deferred financing costs of $30,740, and the carrying amount of the Company's senior notes has been reduced by deferred financing costs of $38,729 and increased by a debt premium of $10,711. As of December 31, 2023, the carrying amount of the Company's senior secured credit facilities was reduced by a discount of $2,487 and deferred financing costs of $32,498, and the carrying amount of the Company's senior notes was reduced by deferred financing costs of $31,491 and increased by a debt premium of $12,129.
Schedule of Derivative Instruments | The following table summarizes the Company’s interest rate cap agreements outstanding during the nine months ended September 30, 2024:
Year cap agreements executed | Notional amount |  | SOFR maximum rate |  | Approximate effective date |  | Notional reduction or contractual maturity date At December 31 unless noted
|  |  | 2024(1) |  | 2025 |  | 2026 |  | 2027
2019 | $ | 3,500,000 |  |  | 2.00% |  | 6/30/2020 |  | $ | 3,500,000 |  |  |  |  |  |  |
2023 | $ | 1,000,000 |  |  | 3.75% |  | 6/30/2024 |  | $ | 500,000 |  |  | $ | 500,000 |  |  |  |  |
2023 | $ | 1,000,000 |  |  | 4.00%(2) |  | 6/30/2024 |  | $ | 250,000 |  |  | $ | 750,000 |  |  |  |  |
2023 | $ | 1,000,000 |  |  | 4.75%(3) |  | 6/30/2024 |  | $ | 250,000 |  |  | $ | 750,000 |  |  |  |  |
2023 | $ | 500,000 |  |  | 5.00%(4) |  | 6/30/2024 |  |  |  |  |  | $ | 500,000 |  |  |
2023 | $ | 250,000 |  |  | 4.50% |  | 12/31/2024 |  |  |  | $ | 250,000 |  |  |  |  |
2023 | $ | 750,000 |  |  | 4.00% |  | 12/31/2024 |  |  |  | $ | 250,000 |  |  | $ | 500,000 |  |  |
2024 | $ | 1,000,000 |  |  | 4.50%(5) |  | 12/31/2025 |  |  |  |  |  | $ | 500,000 |  |  | $ | 500,000 |
2024 | $ | 750,000 |  |  | 4.00%(6) |  | 12/31/2025 |  |  |  |  |  | $ | 250,000 |  |  | $ | 500,000 |
(1)The Company's 2019 cap agreements matured on June 30, 2024. (2)Effective January 1, 2025, the maximum rate of 4.00% decreases to 3.75% for these interest rate caps. (3)Effective January 1, 2025, the maximum rate of 4.75% decreases to 4.00% for these interest rate caps. (4)Effective January 1, 2025, the maximum rate of 5.00% decreases to 4.50% for these interest rate caps. (5)Effective December 31, 2026, the maximum rate of 4.50% increases to 4.75% for these interest rate caps. (6)Effective December 31, 2026, the maximum rate of 4.00% increases to 4.25% for these interest rate caps.

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