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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Cash Flows Provided by (Used In) Operating Activities    
Net loss before preferred dividends and accretion of Series A preferred stock $ (17,280) $ (19,982)
Adjustments to reconcile net loss to net cash and restricted cash provided by (used in) operating activities:    
Change in fair value of contingent consideration 8,908 8,569
Gain from equity method investees (306) (423)
Depreciation and amortization expenses 29,503 29,275
Stock-based compensation expense 18,786 10,710
Deferred tax provision 181 (68,728)
Amortization of contract cost assets 1,205 2,290
Amortization of deferred financing costs 882 911
Change in tax receivables agreement liability 173 66,184
Right-of-use operating assets 1,193 4,620
Other current operating cash outflows, net 6 (56)
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets 19,009 19,832
Prepaid expenses and other current and non-current assets 7,166 (13,758)
Contract cost assets (1,556) (1,326)
Accounts payable (8,421) (13,585)
Accrued liabilities 10,635 4,785
Operating lease liabilities (2,582) (4,250)
Accrued compensation and employee benefits (27,279) (31,401)
Deferred revenue 160 1,169
Reserve for claims and performance-based arrangements (35,409) (2,533)
Other long-term liabilities (65) (277)
Net cash and restricted cash provided by (used in) operating activities 4,909 (7,974)
Cash Flows Used In Investing Activities    
Cash paid for asset acquisitions and business combinations (1,385) (386,724)
Return of equity method investments 0 786
Purchases of investments (3,000) 0
Investments in internal-use software and purchases of property and equipment (5,347) (9,055)
Net cash and restricted cash used in investing activities (9,732) (394,993)
Cash Flows Provided by Financing Activities    
Changes in working capital balances related to claims processing 37,520 7,576
Payment of contingent consideration (3,755) 0
Proceeds from stock option exercises 1,058 1,581
Proceeds from issuance of long-term debt, net of offering costs (529) 256,330
Repayment of long-term debt 0 (37,500)
Proceeds from issuance of preferred stock, net of offering costs 0 168,000
Payment of preferred dividends (5,078) (3,651)
Taxes withheld and paid for vesting of equity awards (14,334) (12,607)
Net cash and restricted cash provided by financing activities 14,882 379,729
Effect of exchange rate on cash and cash equivalents and restricted cash (38) 50
Net increase (decrease) in cash and cash equivalents and restricted cash 10,021 (23,188)
Cash and cash equivalents and restricted cash as of beginning-of-period 223,457 215,158
Cash and cash equivalents and restricted cash as of end-of-period $ 233,478 $ 191,970