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Transactions - Equity Investments (Details) - USD ($) $ in Thousands |  |  |  |  |  | 1 Months Ended | 3 Months Ended | 12 Months Ended |  |
--- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Dec. 31, 2020 | Nov. 16, 2020 | Sep. 01, 2020 | Jun. 06, 2019 | May 28, 2019 | Jan. 31, 2021 | Mar. 31, 2021 | Mar. 31, 2020 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 30, 2019 | Jun. 18, 2019
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Payments to redeem Sponsors' equity |  |  |  |  |  |  |  |  | $ 1,300 | $ 20,000 | $ 0 |  |
Loss (gain) on disposal of assets and consolidation |  |  |  |  |  |  |  |  | $ 0 | $ 698 | $ (9,600) |  |
Passport Asset Acquisition |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Cash and equivalents |  |  | $ 159,800 |  |  |  |  |  |  |  |  |  |
Debt securities, available-for-sale |  |  | 88,600 |  |  |  |  |  |  |  |  |  |
Receivables related to unsettled sales of securities |  |  | 43,000 |  |  |  |  |  |  |  |  |  |
Other assets |  |  | 50,200 |  |  |  |  |  |  |  |  |  |
Accrued medical expenses |  |  | 164,800 |  |  |  |  |  |  |  |  |  |
Accrued liabilities |  |  | 50,000 |  |  |  |  |  |  |  |  |  |
Molina |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Asset Purchase Agreement, escrow payments |  |  | $ 20,000 |  |  |  |  |  |  |  |  |  |
Cash released from escrow |  |  |  |  |  | $ 20,000 |  |  |  |  |  |  |
Passport Note |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Interest rate |  |  |  |  |  |  |  |  |  |  |  |  | 6.50%
Proceeds from collection of notes receivable | $ 40,000 |  |  |  |  |  |  |  |  |  |  |  |
Proceeds from interest received | $ 3,600 |  |  |  |  |  |  |  |  |  |  |  |
Passport Note | Notes Receivable |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Notes receivable, net |  |  |  |  |  |  |  |  |  |  |  |  | $ 40,000
Passport | Variable Interest Entity, Not Primary Beneficiary |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Payments to acquire interest |  |  |  |  | $ 70,000 |  |  |  |  |  |  |  |
Interest in investment |  | 30.00% | 30.00% |  | 30.00% |  |  |  |  |  |  |  |
Performance bond amount |  |  |  | $ 25,000 |  |  |  |  |  |  |  |  |
Payments to acquire equity method investments, amount held back |  |  |  |  |  |  |  |  |  |  |  | $ 16,200 |
Payments to redeem Sponsors' equity |  | $ 20,000 |  |  |  |  |  |  |  |  |  |  |
Proceeds from transfer of membership |  |  |  |  |  |  | $ 23,000 |  |  |  |  |  |
Transfer of membership, percentage of payment based on number of enrollees |  |  |  |  |  |  | 50.00% |  |  |  |  |  |
Transfer of membership, percentage of payment subject to satisfaction of contingencies |  |  |  |  |  |  |  |  | 50.00% |  |  |  |
Vivant |  |  |  |  |  |  |  |  |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |  |  |  |  |  |  |  |  |
Loss (gain) on disposal of assets and consolidation |  |  |  |  |  |  |  | $ 6,400 |  |  |  |  |

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