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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.