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Variable Interest Entities (VIEs) - Schedule of Assets and Liabilities, Variable Interest Entities (Details) - USD ($)
$ in Thousands
Mar. 31, 2025
Dec. 31, 2024
Mar. 31, 2024
Dec. 31, 2023
Current assets        
Cash and cash equivalents $ 258,517 $ 288,455 $ 334,796  
Investment in marketable securities 2,397 2,378    
Income taxes receivable 15,802 19,316    
Other receivables 14,919 29,496    
Prepaid expenses and other current assets 23,711 22,861    
Total current assets 613,270 638,496    
Non-current assets        
Intangible assets, net 111,916 118,179    
Goodwill 416,386 419,253    
Income taxes receivable, non-current 15,943 15,943    
Investments in other entities – equity method 38,005 39,319 35,893 $ 25,774
Operating lease right-of-use assets 30,698 32,601    
Other assets 30,512 16,021    
Total non-current assets 717,986 716,398    
Total assets [1] 1,331,256 1,354,894    
Current liabilities        
Accounts payable and accrued expenses 105,559 106,142    
Fiduciary accounts payable 4,840 8,223    
Medical liabilities 204,101 209,039 $ 136,494 $ 106,657
Dividend payable 638 638    
Finance lease liabilities 471 554    
Operating lease liabilities 4,979 5,350    
Other liabilities 28,180 26,287    
Total current liabilities 361,268 365,608    
Non-current liabilities        
Deferred tax liability 4,197 4,555    
Finance lease liabilities, net of current portion 543 607    
Operating lease liabilities, net of current portion 28,963 30,654    
Other long-term liabilities 14,685 14,003    
Total non-current liabilities 452,282 475,118    
Total liabilities [1] 813,550 840,726    
Nonrelated Party        
Current assets        
Receivables, net 241,078 225,733    
Related Party        
Current assets        
Receivables, net 56,846 50,257    
Variable Interest Entity, Primary Beneficiary        
Current assets        
Cash and cash equivalents 150,013 158,922    
Investment in marketable securities 2,283 2,259    
Receivables, net 71,820 83,977    
Other receivables 22 15,303    
Prepaid expenses and other current assets 6,917 10,161    
Total current assets 285,928 318,873    
Non-current assets        
Property and equipment, net 6,528 5,875    
Intangible assets, net 83,582 87,840    
Goodwill 241,531 243,283    
Income taxes receivable, non-current 15,943 15,943    
Investments in other entities – equity method 15,063 15,442    
Investment in a privately held entity 405 405    
Investment in affiliates 190,178 224,894    
Restricted cash 40 40    
Operating lease right-of-use assets 26,033 21,585    
Other assets 3,055 3,019    
Total non-current assets 582,358 618,326    
Total assets 868,286 937,199    
Current liabilities        
Accounts payable and accrued expenses 37,804 43,800    
Fiduciary accounts payable 4,840 8,223    
Medical liabilities 100,547 105,486    
Dividend payable 638 638    
Income tax payable 14,140 11,041    
Finance lease liabilities 451 520    
Operating lease liabilities 4,076 3,487    
Other liabilities 6,348 1,351    
Amount due to affiliates 4,548 48,142    
Total current liabilities 173,392 222,688    
Non-current liabilities        
Deferred tax liability 10,905 11,237    
Finance lease liabilities, net of current portion 451 520    
Operating lease liabilities, net of current portion 25,006 21,012    
Other long-term liabilities 6,890 619    
Total non-current liabilities 43,252 33,388    
Total liabilities 216,644 256,076    
Variable Interest Entity, Primary Beneficiary | Related Party        
Current assets        
Receivables, net $ 54,873 $ 48,251    
[1] The Company’s condensed consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The condensed consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $678.1 million and $712.3 million as of March 31, 2025 and December 31, 2024, 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 $212.1 million and $207.9 million as of March 31, 2025 and December 31, 2024, respectively. These VIE balances do not include $190.2 million of investment in affiliates and $4.5 million of amounts due to affiliates as of March 31, 2025, and $224.9 million of investment in affiliates and $48.1 million of amounts due to affiliates as of December 31, 2024, as these are eliminated upon consolidation and not presented within the condensed consolidated balance sheets. See Note 16 — “Variable Interest Entities (VIEs)” for further details.

 

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.