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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
 9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Cash Flows Used In Operating Activities    
Net loss $ (31,954,000) $ (320,443,000)
Adjustments to reconcile net loss to net cash and restricted cash used in operating activities:    
Change in fair value of contingent consideration and indemnification asset (819,000) (492,000)
(Gain) loss on disposal of assets (1,904,000) 6,447,000
(Gain) loss from equity method investees (12,725,000) (11,014,000)
Depreciation and amortization expenses 45,122,000 46,610,000
Impairment of equity method investments 0 47,133,000
Stock-based compensation expense 11,754,000 10,375,000
Deferred tax (benefit) provision (288,000) (773,000)
Amortization of contract cost assets 9,928,000 15,937,000
Amortization of deferred financing costs 13,399,000 10,093,000
Interest from customer advance for regulatory capital requirements (242,000) (1,788,000)
Gain on transfer of membership (22,969,000) 0
Goodwill impairment 0 215,100,000
Loss on repayment of debt 19,158,000 0
Loss on repayment of debt 0 4,789,000
Other current operating cash outflows, net 714,000 1,809,000
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets (52,878,000) (15,665,000)
Prepaid expenses and other current and non-current assets (140,000) 9,113,000
Contract cost assets (8,439,000) (7,946,000)
Accounts payable 8,164,000 (394,000)
Accrued liabilities (13,893,000) 6,264,000
Accrued compensation and employee benefits (12,811,000) (4,650,000)
Deferred revenue 3,103,000 (10,811,000)
Reserve for claims and performance-based arrangements 16,784,000 (16,479,000)
Right-of-use operating assets 6,408,000 9,493,000
Operating lease liabilities (4,589,000) (490,000)
Other long-term liabilities 1,208,000 4,408,000
Net cash and restricted cash used in operating activities (27,909,000) (3,374,000)
Cash Flows Provided by Investing Activities    
Cash paid for asset acquisitions (1,889,000) 0
Proceeds from transfer of membership and release of Passport escrow 42,996,000 0
Loan for implementation funding 0 (400,000)
Disposal of non-strategic assets and divestiture of discontinued operations, net 3,490,000 (2,287,000)
Return of equity method investments 14,218,000 0
Impact to cash and cash equivalents and restricted cash from initial consolidation 0 159,755,000
Purchases of investments (2,994,000) (11,168,000)
Maturities and sales of investments 500,000 140,905,000
Investments in internal-use software and purchases of property and equipment (17,739,000) (23,614,000)
Other investing activities 0 106,000
Net cash and restricted cash provided by investing activities 38,582,000 263,297,000
Cash Flows Provided by (Used In) Financing Activities    
Changes in working capital balances related to claims processing on behalf of partners 1,105,000 (2,212,000)
Repayment and termination of Credit Agreement including settlement of warrants. (98,420,000) 0
Proceeds from issuance of 2024 Notes, net of offering costs 0 30,062,000
Repurchase of 2021 Notes and financing fees 0 (16,388,000)
Proceeds from stock option exercises 11,566,000 1,974,000
Distributions to Sponsors (1,300,000) 0
Taxes withheld and paid for vesting of restricted stock units (3,397,000) (1,382,000)
Net cash and restricted cash provided by (used in) financing activities (90,446,000) 12,054,000
Effect of exchange rate on cash and cash equivalents and restricted cash (53,000) 43,000
Net increase (decrease) in cash and cash equivalents and restricted cash (79,826,000) 272,020,000
Cash and cash equivalents and restricted cash as of beginning-of-period [1] 361,581,000 128,531,000
Cash and cash equivalents and restricted cash as of end-of-period [1] $ 281,755,000 $ 400,551,000
[1] As a result of the closing of the sale of True Health SPA, the consolidated statements of operations, consolidated balance sheets, and related financial information reflect the Company’s operations and assets and liabilities of True Health as discontinued operations for all periods presented. Cash flows and comprehensive income have not been adjusted and are included in the consolidated statements of cash flows and consolidated statements of comprehensive income (loss) for all periods presented. See Note 5.