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Variable Interest Entities (VIEs) - Schedule of Assets and Liabilities, Variable Interest Entities (Details) - USD ($) $ in Thousands | Sep. 30, 2025 | Dec. 31, 2024 | Sep. 30, 2024 | Dec. 31, 2023
--- | --- | --- | --- | ---
Current assets |  |  |  |  |
Cash and cash equivalents |  | $ 462,227 | $ 288,455 | $ 347,994 |
Investment in marketable securities |  | 1,221 | 2,378 |  |
Receivables, net (including amounts with related parties) |  | 381,215 | 275,990 |  |
Income taxes receivable |  | 0 | 19,316 |  |
Other receivables |  | 9,891 | 29,496 |  |
Prepaid expenses and other current assets |  | 23,162 | 22,861 |  |
Loans receivable |  | 5,913 | 0 |  |
Total current assets |  | 883,629 | 638,496 |  |
Non-current assets |  |  |  |  |
Intangible assets, net |  | 285,060 | 118,179 |  |
Goodwill |  | 863,266 | 419,253 |  |
Income taxes receivable, non-current |  | 15,943 | 15,943 |  |
Loans receivable, non-current |  | 48,474 | 51,266 |  |
Investments in other entities – equity method |  | 18,462 | 39,319 |  |
Operating lease right-of-use assets |  | 33,936 | 32,601 |  |
Other assets |  | 23,356 | 16,667 |  |
Total non-current assets |  | 1,353,557 | 716,398 |  |
Total assets | [1] | 2,237,186 | 1,354,894 |  |
Current liabilities |  |  |  |  |
Accounts payable and accrued expenses |  | 209,747 | 106,142 |  |
Fiduciary accounts payable |  | 4,476 | 8,223 |  |
Medical liabilities |  | 333,969 | 209,039 | $ 160,279 | $ 106,657
Income taxes payable |  | 4,919 | 0 |  |
Operating lease liabilities |  | 7,181 | 5,350 |  |
Other liabilities |  | 21,773 | 27,479 |  |
Total current liabilities |  | 629,930 | 365,608 |  |
Non-current liabilities |  |  |  |  |
Deferred tax liability |  | 4,429 | 4,555 |  |
Operating lease liabilities, net of current portion |  | 30,171 | 30,654 |  |
Other long-term liabilities |  | 15,906 | 14,610 |  |
Total non-current liabilities |  | 1,052,532 | 475,118 |  |
Total liabilities | [1] | 1,682,462 | 840,726 |  |
Variable Interest Entity, Primary Beneficiary |  |  |  |  |
Current assets |  |  |  |  |
Cash and cash equivalents |  | 216,574 | 158,922 |  |
Investment in marketable securities |  | 1,114 | 2,259 |  |
Other receivables |  | 2,624 | 15,303 |  |
Prepaid expenses and other current assets |  | 13,561 | 10,161 |  |
Amount due from affiliates |  | 30,569 | 0 |  |
Loans receivable |  | 933 | 0 |  |
Total current assets |  | 472,930 | 318,873 |  |
Non-current assets |  |  |  |  |
Property and equipment, net |  | 42,271 | 5,875 |  |
Intangible assets, net |  | 227,335 | 87,840 |  |
Goodwill |  | 526,803 | 243,283 |  |
Income taxes receivable, non-current |  | 15,943 | 15,943 |  |
Loans receivable, non-current |  | 264 | 0 |  |
Investments in other entities – equity method |  | 16,472 | 15,442 |  |
Investment in a privately held entity |  | 405 | 405 |  |
Investment in affiliates |  | 173,865 | 224,894 |  |
Operating lease right-of-use assets |  | 26,924 | 21,585 |  |
Other assets |  | 3,587 | 3,059 |  |
Total non-current assets |  | 1,033,869 | 618,326 |  |
Total assets |  | 1,506,799 | 937,199 |  |
Current liabilities |  |  |  |  |
Accounts payable and accrued expenses |  | 110,569 | 43,800 |  |
Fiduciary accounts payable |  | 4,476 | 8,223 |  |
Medical liabilities |  | 189,411 | 105,486 |  |
Income taxes payable |  | 27,604 | 11,041 |  |
Operating lease liabilities |  | 5,361 | 3,487 |  |
Other liabilities |  | 5,219 | 2,509 |  |
Amount due to affiliates |  | 0 | 48,142 |  |
Total current liabilities |  | 342,640 | 222,688 |  |
Non-current liabilities |  |  |  |  |
Deferred tax liability |  | 9,219 | 11,237 |  |
Operating lease liabilities, net of current portion |  | 24,744 | 21,012 |  |
Other long-term liabilities |  | 6,665 | 1,139 |  |
Total non-current liabilities |  | 40,628 | 33,388 |  |
Total liabilities |  | 383,268 | 256,076 |  |
Variable Interest Entity, Primary Beneficiary | Related Party |  |  |  |  |
Current assets |  |  |  |  |
Receivables, net (including amounts with related parties) |  | $ 207,555 | $ 132,228 |  |
[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 $1,302.4 million and $712.3 million as of September 30, 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 $383.3 million and $207.9 million as of September 30, 2025 and December 31, 2024, respectively. These VIE balances do not include $173.9 million of investment in affiliates and $30.6 million of amounts due from affiliates as of September 30, 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 15 — “Variable Interest Entities (VIEs)” for further details. The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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