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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018
Cash flows from operating activities |  |  |
Net income | $ 122,320 | $ 17,673 | $ 60,267
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 18,350 | 18,280 | 19,303
Amortization of debt issuance cost | 1,347 | 473 | 0
Loss on disposal of property and equipment | 91 | 0 | 42
Impairment of goodwill and intangible assets | 0 | 1,994 | 3,799
Provision for doubtful accounts | 0 | (1,363) | 3,888
Share-based compensation | 3,383 | 1,547 | 1,441
Gain on sale of equity method investment | (99,839) | 0 | 0
Gain on loan assumption | 0 | (2,250) | 0
Unrealized loss (gain) from investment in equity securities | 11 | (9) | 25
(Income) loss from equity method investments | (3,694) | 6,901 | 8,125
Deferred tax | (6,620) | (6,801) | (8,345)
Changes in operating assets and liabilities, net of acquisition amounts: |  |  |
Receivables, net | 4,134 | 10,714 | (263)
Receivables, net – related parties | (1,123) | (1,435) | (28,363)
Other receivables | 12,589 | (15,079) | 0
Prepaid expenses and other current assets | (6,432) | (2,756) | (2,814)
Right-of-use assets | 3,325 | 2,480 | 0
Other assets | (5,530) | (572) | 2
Accounts payable and accrued expenses | 8,204 | (4,883) | (22,669)
Fiduciary accounts payable | 7,615 | 488 | 0
Capitation incentives payable | 0 | 0 | (21,500)
Medical liabilities | (8,691) | (2,392) | 4,134
Income taxes payable | (304) | (7,093) | 8,424
Operating lease liabilities | (2,973) | (2,244) | 0
Net cash provided by operating activities | 46,163 | 13,673 | 25,496
Cash flows from investing activities |  |  |
Purchases of marketable securities | (1,793) | (115,402) | (9)
Proceeds from sale of marketable securities | 50,625 | 0 | 0
Proceeds from repayment of loans receivable - related parties | 16,500 | 0 | 0
Advances on loans receivable | (145) | (11,425) | (7,500)
Dividends received from equity method investments | 0 | 240 | 607
Proceeds from sale of fixed assets | 50 | 0 | 0
Payments for business acquisitions, net of cash acquired | (11,354) | (49,403) | 0
Purchases of investments in privately held entities | 0 | (491) | (405)
Proceeds from sale of equity method investment | 52,743 | 0 | 0
Purchases of investments – equity method | (9,969) | (3,108) | (16,706)
Purchases of property and equipment | (1,164) | (1,042) | (1,170)
Net cash provided by (used in) investing activities | 95,493 | (180,631) | (25,183)
Cash flows from financing activities |  |  |
Dividends paid | (51,319) | (61,717) | (17,759)
Repayments of debt | 0 | (2,375) | 0
Change in noncontrolling interest capital | 0 | 28 | 27
Borrowings on long-term debt | 0 | 250,000 | 8,000
Borrowings on line of credit | 0 | 39,600 | 0
Repayments on bank loan and lines of credit | 0 | (52,640) | (495)
Payment of capital lease obligations | (105) | (102) | (99)
Proceeds from exercise of stock options and warrants | 10,802 | 3,123 | 3,997
Proceeds from common stock offering | 0 | 755 | 200
Repurchase of common shares | (537) | (7,570) | (5,047)
Distribution to noncontrolling interest | (1,037) | 0 | 0
Cost of debt and equity issuances | 0 | (5,771) | 0
Net cash (used in) provided by financing activities | (51,696) | 163,331 | (11,176)
Net increase (decrease) in cash, cash equivalents and restricted cash | 89,960 | (3,627) | (10,863)
Cash, cash equivalents and restricted cash, beginning of year | 104,010 | 107,637 | 118,500
Cash, cash equivalents and restricted cash, end of year | 193,970 | 104,010 | 107,637
Supplemental disclosures of cash flow information |  |  |
Cash paid for income taxes | 62,002 | 20,200 | 23,643
Cash paid for interest | 8,510 | 4,258 | 462
Supplemental disclosures of non-cash investing and financing activities |  |  |
Cashless exercise of warrants | 599 | 0 | 0
Deferred tax liability adjusted to goodwill | 0 | 6,334 | 1,110
Reclassification of liability for equity shares | 0 | 1,185 | 0
Purchase price adjustment for acceleration of vested stock options | 0 | 0 | 868
Conversion of loan receivable to investment in Accountable Health Care, IPA | 0 | 0 | 5,000
Reclassification of dividends related to share repurchase | 0 | 0 | 4,216
Reclassification of APS noncontrolling interest to equity related to purchase of additional shares | 0 | 0 | 2,832
Deferred tax liability adjustment related to warrant exercises | 690 | 0 | 0
Preferred shares received from sale of equity method investment | 36,179 | 0 | 0
Beneficial interest acquired from sale of equity method investment | 15,723 | 0 | 0
Reconciliation of cash, cash equivalents, and restricted cash |  |  |
Cash and cash equivalents | 193,470 | 103,189 | 106,892
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows | 193,970 | 107,637 | 118,500
Affiliated Entity | APC |  |  |
Supplemental disclosures of non-cash investing and financing activities |  |  |
APC stock issued in exchange for AMG | 0 | 414 | 0
Term Loan |  |  |
Cash flows from financing activities |  |  |
Repayments of debt | $ (9,500) | $ 0 | $ 0

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