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v3.25.4

Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2025 | Dec. 31, 2024 | Dec. 31, 2023
Operating Activities: |  |  |
Net loss | $ (978) | $ (128,071) | $ (148,173)
Adjustments to reconcile Net loss to net cash provided by (used in) operating activities: |  |  |
Provision for credit loss | 833 | 123 | 91
(Gain) loss on right of use assets | 0 | 143 | (289)
Gain on sale of property and equipment | (72) | (9) | 0
Depreciation and amortization | 30,482 | 27,062 | 21,668
Amortization-debt issuance costs | 1,761 | 1,293 | 1,254
Amortization-investment discount | (1,298) | (2,579) | (4,917)
Equity-based compensation | 62,082 | 71,132 | 66,835
Non-cash lease expense | 1,609 | 1,764 | 2,318
Loss on extinguishment of debt | 0 | 3,020 | 0
Changes in operating assets and liabilities: |  |  |
Accounts receivable | (100,106) | (34,278) | (26,950)
Prepaid expenses and other current assets | (57,059) | 7,887 | (2,863)
Other assets | (50) | 60 | (142)
Medical expenses payable | 184,781 | 84,389 | 35,264
Accounts payable and accrued expenses | 10,364 | (1,460) | (6,347)
Accrued compensation | 9,082 | 5,819 | 6,574
Lease liabilities | (1,504) | (1,525) | (3,510)
Net cash provided by (used in) operating activities | 139,927 | 34,770 | (59,187)
Investing Activities: |  |  |
Purchase of investments | (65,633) | (82,200) | (379,058)
Sale of property and equipment | 75 | 14 | 0
Maturities of investments | 76,300 | 162,795 | 267,790
Sale of business | 1,065 | 0 | 0
Acquisition of property and equipment, net | (26,781) | (41,418) | (35,995)
Net cash provided by (used in) investing activities | (14,974) | 39,191 | (147,263)
Financing Activities: |  |  |
Proceeds from long-term debt | 0 | 380,000 | 0
Debt issuance costs | (26) | (8,792) | 0
Repayment of long-term debt | 0 | (215,000) | 0
Payment of employment taxes related to release of restricted stock | 0 | (350) | 0
Proceeds from exercise of stock options | 18,067 | 155 | 0
Contributions from noncontrolling interest holders | 0 | 15 | 105
Net cash provided by financing activities | 18,041 | 156,028 | 105
Net increase (decrease) in cash | 142,994 | 229,989 | (206,345)
Cash, cash equivalents and restricted cash at beginning of period | 434,943 | 204,954 | 411,299
Cash, cash equivalents and restricted cash at end of period | 577,937 | 434,943 | 204,954
Supplemental disclosure of cash flow information: |  |  |
Cash paid for interest | 13,752 | 22,157 | 19,165
Supplemental non-cash investing and financing activities: |  |  |
Acquisition of property in accounts payable | 97 | 70 | 59
Debt issuance costs in accounts payable | 0 | 512 | 0
Reconciliation of cash, cash equivalents and restricted cash as shown in the statement of cash flows: |  |  |
Cash and cash equivalents | 575,817 | 432,859 | 202,904
Restricted cash in other assets | 2,120 | 2,084 | 2,050
Total | $ 577,937 | $ 434,943 | $ 204,954

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