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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