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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.