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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash Flows Provided by (Used In) Operating Activities      
Net loss before dividends declared and accretion of Series A preferred stock $ (113,040) $ (19,164) $ (37,601)
Adjustments to reconcile net loss to net cash and restricted cash provided by (used in) operating activities:      
Change in fair value of contingent consideration 17,984 (23,522) 13,281
Loss on disposal of non-strategic assets 8,107 0 0
Loss on discontinued operations 0 463 6,786
Gain from equity method investees (1,290) (4,569) (13,179)
Depreciation and amortization expenses 123,415 67,195 60,037
Stock-based compensation expense 40,501 33,981 16,711
Deferred tax benefit (93,254) (45,608) (526)
Amortization of contract cost assets 10,944 23,056 13,041
Amortization of deferred financing costs 3,812 2,302 18,045
Gain on transfer of membership 0 0 (45,938)
Loss on extinguishment/repayment of debt, net 21,010 10,192 21,343
Right-of-use asset impairment 24,065 0 0
Change in tax receivables agreement liability 61,982 45,950 0
Right-of-use operating assets 16,625 2,500 8,844
Operating lease liabilities (15,373) (2,983) (6,522)
Other current operating cash outflows, net (171) 2,612 392
Changes in assets and liabilities, net of acquisitions:      
Accounts receivable, net and contract assets (164,694) (102,980) (5,779)
Prepaid expenses and other current and non-current assets (10,613) 1,673 5,599
Contract cost assets (5,602) (7,693) (18,979)
Accounts payable (6,723) 13,165 7,250
Accrued liabilities 23,653 (28,791) (324)
Accrued compensation and employee benefits (2,052) 447 3,538
Deferred revenue (263) (6,508) (739)
Reserve for claims and performance-based arrangements 204,318 28,436 (3,799)
Other long-term liabilities (759) (1,707) (2,734)
Net cash and restricted cash provided by (used in) operating activities 142,582 (11,553) 38,747
Cash Flows Used In Investing Activities      
Cash paid for asset acquisitions and business combinations (388,246) (248,111) (49,012)
Proceeds from transfer of membership and release of Passport escrow 0 30,969 42,996
Disposal of non-strategic assets and divestiture of discontinued operations, net 577 (9,164) 3,490
Return of equity method investments 870 5,552 14,218
Purchases of investments 0 0 (2,995)
Maturities and sales of investments 0 0 500
Investments in internal-use software and purchases of property and equipment (28,745) (38,361) (24,983)
Net cash and restricted cash used in investing activities (415,544) (259,115) (15,786)
Cash Flows Provided by Financing Activities      
Changes in working capital balances related to claims processing on behalf of partners (1,514) (59,449) 61,162
Payment of contingent consideration (46,873) 0 0
Proceeds from stock option exercises 12,519 4,452 13,289
Proceeds from issuance of long-term debt, net of offering costs 647,494 219,740 0
Repayment and repurchase of 2021 Notes and financing fees 0 0 (429)
Repayment of long-term debt (464,201) 0 (98,420)
Distributions to Sponsors 0 (14,884) (1,300)
Proceeds from issuance of preferred stock, net of offering costs 168,000 0 0
Payment of preferred dividends (18,793) 0 0
Taxes withheld and paid for vesting of equity awards (15,292) (18,318) (3,850)
Net cash and restricted cash provided by (used in) financing activities 281,340 131,541 (29,548)
Effect of exchange rate on cash and cash equivalents and restricted cash (79) (657) (52)
Net increase (decrease) in cash and cash equivalents and restricted cash 8,299 (139,784) (6,639)
Cash and cash equivalents and restricted cash as of beginning-of-period 215,158 354,942 361,581
Cash and cash equivalents and restricted cash as of end-of-period $ 223,457 $ 215,158 $ 354,942