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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
Cash Flows Used In Operating Activities    
Net loss $ (5,350) $ (9,807)
Adjustments to reconcile net loss to net cash and restricted cash used in operating activities:    
Change in fair value of contingent consideration 6,078 (594)
Gain on discontinued operations 0 (1,904)
Gain from equity method investees (596) (7,783)
Unrealized loss on investments 0 0
Depreciation and amortization expenses 15,106 15,347
Stock-based compensation expense 5,346 3,706
Deferred tax provision (132) (59)
Amortization of contract cost assets 11,689 3,055
Amortization of deferred financing costs 539 4,370
Gain on transfer of membership 0 (22,969)
Loss on repayment of debt 0 19,158
Other current operating cash inflows (outflows), net (357) 2,341
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets (46,299) (63,233)
Prepaid expenses and other current and non-current assets (6,071) 1,037
Contract cost assets (1,106) (1,690)
Accounts payable 426 9,395
Accrued liabilities 2,220 (9,698)
Accrued compensation and employee benefits (32,435) (28,014)
Deferred revenue 1,344 2,684
Reserve for claims and performance-based arrangements (7,056) 32,501
Right-of-use operating assets 1,718 2,840
Operating lease liabilities (1,992) (771)
Other long-term liabilities (514) 1,925
Net cash and restricted cash used in operating activities (57,442) (48,163)
Cash Flows Provided by Investing Activities    
Cash paid for asset acquisitions and business combinations (70) (1,472)
Proceeds from transfer of membership and release of Passport escrow 22,969 42,996
Disposal of non-strategic assets and divestiture of discontinued operations, net 0 3,490
Return of equity method investments 2,375 9,372
Purchases of investments 0 (2,994)
Maturities and sales of investments 0 500
Investments in internal-use software and purchases of property and equipment (8,508) (5,941)
Net cash and restricted cash provided by investing activities 16,766 45,951
Cash Flows Used In Financing Activities    
Changes in working capital balances related to claims processing on behalf of partners (34,371) 39,005
Repayment and termination of Credit Agreement including settlement of warrants 0 (98,420)
Proceeds from stock option exercises 309 6,518
Distributions to Sponsors (1,100) 0
Taxes withheld and paid for vesting of equity awards (16,214) (2,687)
Net cash and restricted cash used in financing activities (51,376) (55,584)
Effect of exchange rate on cash and cash equivalents and restricted cash (104) 1
Net decrease in cash and cash equivalents and restricted cash (92,156) (57,795)
Cash and cash equivalents and restricted cash as of beginning-of-period [1] 354,942 361,564
Cash and cash equivalents and restricted cash as of end-of-period [1] $ 262,786 $ 303,769
[1] As a result of the closing of the sale of True Health during the first quarter of 2021, the consolidated statement of operations and related financial information reflect the Company’s operations and assets and liabilities of True Health as discontinued operations. 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 the three months ended March 31, 2021. See Note 5.