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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash Flows Provided by Operating Activities    
Net loss before preferred dividends and accretion of Series A preferred stock $ (38,821) $ (79,629)
Adjustments to reconcile net loss to net cash and restricted cash provided by (used in) operating activities:    
Change in fair value of contingent consideration 9,108 12,047
Loss on disposal of non-strategic assets 0 2,097
Loss (gain) from equity method investees 3,623 (1,262)
Depreciation and amortization expenses 89,074 93,813
Stock-based compensation expense 45,861 29,898
Deferred tax benefit (1,916) (78,196)
Amortization of contract cost assets 3,604 8,005
Amortization of deferred financing costs 2,650 2,912
Right-of-use assets impairment 0 24,065
Change in tax receivables agreement liability 173 66,184
Right-of-use operating assets 2,739 11,129
Other current operating cash inflows (outflows), net 180 (120)
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets 38,844 (112,177)
Prepaid expenses and other current and non-current assets 7,751 (16,394)
Contract cost assets (4,687) (3,958)
Accounts payable 1,260 (12,628)
Accrued liabilities 17,648 27,537
Operating lease liabilities (12,209) (10,432)
Accrued compensation and employee benefits (24,780) (8,807)
Deferred revenue (3,355) (136)
Reserve for claims and performance-based arrangements (91,361) 100,012
Other long-term liabilities (390) (759)
Net cash and restricted cash provided by operating activities 44,996 53,201
Cash Flows Used In Investing Activities    
Cash paid for asset acquisitions and business combinations (16,947) (388,246)
Disposal of non-strategic assets and divestiture of discontinued operations, net 0 577
Return of equity method investments 7 870
Purchases of investments and contributions to equity method investees (7,320) 0
Investments in internal-use software and purchases of property and equipment (18,742) (22,693)
Net cash and restricted cash used in investing activities (43,002) (409,492)
Cash Flows (Used In) Provided by Financing Activities    
Changes in working capital balances related to claims processing 584 7,925
Payment of contingent consideration (70,355) 0
Proceeds from stock option exercises 3,462 9,183
Proceeds from issuance of long-term debt, net of offering costs (529) 256,063
Repayment of long-term debt 0 (47,500)
Proceeds from issuance of preferred stock, net of offering costs 0 168,000
Payment of preferred dividends (15,279) (13,631)
Taxes withheld and paid for vesting of equity awards (15,390) (14,348)
Net cash and restricted cash (used in) provided by financing activities (97,507) 365,692
Effect of exchange rate on cash and cash equivalents and restricted cash (93) (61)
Net (decrease) increase in cash and cash equivalents and restricted cash (95,606) 9,340
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 $ 127,851 $ 224,498