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Variable Interest Entities (VIEs) (Details) - USD ($)
$ in Thousands
Sep. 30, 2020
Dec. 31, 2019
Sep. 30, 2019
Dec. 31, 2018
Current assets        
Cash and cash equivalents $ 166,082 $ 103,189 $ 230,299 $ 106,892
Restricted cash 0 75    
Investment in marketable securities 118,309 116,539    
Receivables, net 18,257 11,004    
Receivables, net – related party 41,518 48,136    
Other receivables 3,988 16,885    
Prepaid expenses and other current assets 12,119 10,315    
Loan receivable 6,425 6,425    
Loan receivable – related parties 0 16,500    
Total current assets 366,698 329,068    
Noncurrent assets        
Intangible assets, net 90,781 103,012    
Goodwill 239,053 238,505    
Investments in other entities – equity method 27,220 28,427    
Restricted cash 746 746    
Operating lease right-of-use assets 19,298 14,248    
Other assets 22,473 1,681    
Total noncurrent assets 447,575 399,645    
Total assets [1] 814,273 728,713    
Current liabilities        
Accounts payable and accrued expenses 40,474 27,279    
Fiduciary accounts payable 3,986 2,027    
Medical liabilities 57,455 58,725 $ 53,820 $ 33,642
Dividends payable 485 271    
Finance lease liabilities 102 102    
Operating lease liabilities 3,290 2,990    
Total current liabilities 131,461 105,423    
Noncurrent liabilities        
Deferred tax liability 11,659 18,269    
Finance lease liabilities, net of current portion 337 416    
Operating lease liabilities, net of current portion 16,616 11,373    
Total noncurrent liabilities 254,663 262,230    
Total liabilities [1] 386,124 367,653    
Variable Interest Entity, Primary Beneficiary        
Current assets        
Cash and cash equivalents 94,751 87,110    
Restricted cash 0 75    
Investment in marketable securities 118,262 123,948    
Receivables, net 15,365 9,300    
Receivables, net – related party 39,506 42,976    
Other receivables 734 744    
Prepaid expenses and other current assets 9,667 7,403    
Loan receivable 6,425 6,425    
Loan receivable – related parties 0 16,500    
Total current assets 284,710 294,481    
Noncurrent assets        
Land, property and equipment, net 8,877 9,547    
Intangible assets, net 72,107 81,439    
Goodwill 109,460 108,913    
Investment in affiliates 310,491 318,315    
Investment in privately held entities 36,584 1,615    
Investments in other entities – equity method 27,268 28,427    
Restricted cash 746 746    
Operating lease right-of-use assets 6,654 4,751    
Other assets 20,736 1,057    
Total noncurrent assets 592,923 554,810    
Total assets 877,633 849,291    
Current liabilities        
Accounts payable and accrued expenses 13,444 11,187    
Fiduciary accounts payable 3,986 2,027    
Medical liabilities 42,546 49,019    
Income taxes payable 15,408 4,530    
Amount due to affiliate 22,131 28,058    
Dividends payable 485 271    
Finance lease liabilities 102 102    
Operating lease liabilities 1,300 1,088    
Total current liabilities 99,402 96,282    
Noncurrent liabilities        
Deferred tax liability 7,725 14,059    
Finance lease liabilities, net of current portion 337 416    
Operating lease liabilities, net of current portion 5,512 3,742    
Total noncurrent liabilities 13,574 18,217    
Total liabilities $ 112,976 $ 114,499    
[1] The Company's consolidated balance sheets include the assets and liabilities of its consolidated variable interest entities ("VIEs"). The consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $877.6 million and $849.3 million as of September 30, 2020 and December 31, 2019, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $113.0 million and $114.5 million as of September 30, 2020 and December 31, 2019, respectively. See Note 15 – Variable Interest Entities (VIEs) for further detail.