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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Cash Flows Provided by (Used In) Operating Activities |  |  |  |
Net loss |  | $ 19,164,000 | $ 37,601,000 | $ 334,246,000
Adjustments to reconcile net loss to net cash and restricted cash used in operating activities: |  |  |  |
Change in fair value of contingent consideration |  | (23,522,000) | 13,281,000 | 3,860,000
Loss on discontinued operations |  | 463,000 | 6,786,000 | 698,000
Gain from equity method investees |  | (4,569,000) | (13,179,000) | (10,039,000)
Depreciation and amortization expenses |  | 67,195,000 | 60,037,000 | 61,475,000
Impairment of equity method investments |  | 0 | 0 | 47,133,000
Stock-based compensation expense |  | 33,981,000 | 16,711,000 | 14,606,000
Deferred tax benefit |  | (45,608,000) | (526,000) | (1,132,000)
Amortization of contract cost assets |  | 23,056,000 | 13,041,000 | 21,195,000
Amortization of deferred financing costs |  | 2,302,000 | 18,045,000 | 14,780,000
Gain on transfer of membership |  | 0 | (45,938,000) | 0
Goodwill impairment |  | 0 | 0 | 215,100,000
Loss on extinguishment/repayment of debt, net |  | 10,192,000 | 21,343,000 | 4,789,000
Change in tax receivable agreement liability |  | 45,950,000 | 0 | 0
Other current operating cash inflows (outflows), net |  | 2,612,000 | 392,000 | 875,000
Changes in assets and liabilities, net of acquisitions: |  |  |  |
Accounts receivable, net and contract assets |  | (102,980,000) | (5,779,000) | (47,017,000)
Prepaid expenses and other current and non-current assets |  | 1,673,000 | 5,599,000 | 7,340,000
Contract cost assets |  | (7,693,000) | (18,979,000) | (11,400,000)
Accounts payable |  | 13,165,000 | 7,250,000 | 3,547,000
Accrued liabilities |  | (28,791,000) | (324,000) | 8,801,000
Accrued compensation and employee benefits |  | 447,000 | 3,538,000 | 11,143,000
Deferred revenue |  | (6,508,000) | (739,000) | (8,943,000)
Reserve for claims and performance-based arrangements |  | 28,436,000 | (3,799,000) | (36,108,000)
Right-of-use operating assets |  | 2,500,000 | 8,844,000 | 11,934,000
Operating lease liabilities |  | (2,983,000) | (6,522,000) | (2,782,000)
Other long-term liabilities |  | (1,707,000) | (2,734,000) | 8,166,000
Net cash and restricted cash provided by (used in) operating activities |  | (11,553,000) | 38,747,000 | (16,225,000)
Cash Flows Provided by (Used In) Investing Activities |  |  |  |
Cash paid for asset acquisitions and business combinations |  | (248,111,000) | (49,012,000) | (300,000)
Loan for implementation funding |  | 0 | 0 | 1,000,000
Proceeds from transfer of membership and release of Passport escrow |  | 30,969,000 | 42,996,000 | 0
Disposal of non-strategic assets and divestiture of discontinued operations, net |  | (9,164,000) | 3,490,000 | (2,287,000)
Return of equity method investments |  | 5,552,000 | 14,218,000 | 0
Impact to cash and cash equivalents and restricted cash from initial consolidation |  | 0 | 0 | 159,755,000
Purchases of investments |  | 0 | (2,995,000) | (11,170,000)
Maturities and sales of investments |  | 0 | 500,000 | 143,441,000
Investments in internal-use software and purchases of property and equipment |  | (38,361,000) | (24,983,000) | (29,473,000)
Other investing activities |  | 0 | 0 | 106,000
Net cash and restricted cash provided by (used in) investing activities |  | (259,115,000) | (15,786,000) | 261,072,000
Cash Flows Provided by (Used In) Financing Activities |  |  |  |
Changes in working capital balances related to claims processing on behalf of partners |  | (59,449,000) | 61,162,000 | (6,044,000)
Repayment of Credit Agreement including settlement of warrants |  | 0 | (98,420,000) | 0
Proceeds from stock option exercises |  | 4,452,000 | 13,289,000 | 2,577,000
Proceeds from issuance of long-term debt, net of offering costs |  | 219,740,000 | 0 | 30,062,000
Repayment and repurchase of 2021 Notes and financing fees |  | 0 | (429,000) | (16,606,000)
Distributions to Sponsors |  | (14,884,000) | (1,300,000) | (20,000,000)
Taxes withheld and paid for vesting of equity awards |  | (18,318,000) | (3,850,000) | (1,851,000)
Net cash and restricted cash provided by (used in) financing activities |  | 131,541,000 | (29,548,000) | (11,862,000)
Effect of exchange rate on cash and cash equivalents and restricted cash |  | (657,000) | (52,000) | 65,000
Net decrease in cash and cash equivalents and restricted cash |  | (139,784,000) | (6,639,000) | 233,050,000
Cash and cash equivalents and restricted cash as of beginning-of-period | [1] | 354,942,000 | 361,581,000 | 128,531,000
Cash and cash equivalents and restricted cash as of end-of-period | [1] | $ 215,158,000 | $ 354,942,000 | $ 361,581,000
[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 years ended December 31, 2021 and 2020. See Note 5.

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