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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Cash Flows Provided by (Used In) Operating Activities    
Net loss before dividends declared and accretion of Series A preferred stock $ (79,629) $ (7,815)
Adjustments to reconcile net loss to net cash and restricted cash provided by (used in) operating activities:    
Change in fair value of contingent consideration 12,047 (5,822)
Loss on disposal of assets 2,097 0
Loss on discontinued operations 0 463
Gain from equity method investees (1,262) (3,940)
Depreciation and amortization expenses 93,813 47,414
Stock-based compensation expense 29,898 19,350
Deferred tax benefit (78,196) (46,385)
Amortization of contract cost assets 8,005 14,768
Amortization of deferred financing costs 2,912 1,762
Loss on extinguishment/repayment of debt, net 0 10,192
Right-of-use asset impairment 24,065 0
Change in tax receivables agreement liability 66,184 42,870
Right-of-use operating assets 11,129 831
Operating lease liabilities (10,432) (1,223)
Other current operating cash outflows, net (120) 2,163
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets (112,177) (34,796)
Prepaid expenses and other current and non-current assets (16,394) (2,409)
Contract cost assets (3,958) (6,732)
Accounts payable (12,628) 5,936
Accrued liabilities 27,537 (27,903)
Accrued compensation and employee benefits (8,807) (14,451)
Deferred revenue (136) (4,741)
Reserve for claims and performance-based arrangements 100,012 (35,596)
Other long-term liabilities (759) (1,184)
Net cash and restricted cash provided by (used in) operating activities 53,201 (47,248)
Cash Flows Used In Investing Activities    
Cash paid for asset acquisitions and business combinations (388,246) (245,021)
Proceeds from transfer of membership and release of Passport escrow 0 22,969
Disposal of non-strategic assets and divestiture of discontinued operations, net 577 (9,164)
Return of equity method investments 870 4,175
Investments in internal-use software and purchases of property and equipment (22,693) (27,618)
Net cash and restricted cash used in investing activities (409,492) (254,659)
Cash Flows Provided by Financing Activities    
Changes in working capital balances related to claims processing on behalf of partners 7,925 (48,322)
Proceeds from stock option exercises 9,183 3,280
Proceeds from issuance of long-term debt, net of offering costs 256,063 219,740
Repayment of long-term debt (47,500) 0
Distributions to Sponsors 0 (14,884)
Proceeds from issuance of preferred stock, net of offering costs 168,000 0
Payment of preferred dividends (13,631) 0
Taxes withheld and paid for vesting of equity awards (14,348) (17,419)
Net cash and restricted cash provided by financing activities 365,692 142,395
Effect of exchange rate on cash and cash equivalents and restricted cash (61) (612)
Net increase (decrease) in cash and cash equivalents and restricted cash 9,340 (160,124)
Cash and cash equivalents and restricted cash as of beginning-of-period 215,158 354,942
Cash and cash equivalents and restricted cash as of end-of-period $ 224,498 $ 194,818