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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash Flows Provided by (Used In) Operating Activities      
Net loss before preferred dividends and accretion of Series A preferred stock $ (61,623) $ (113,040) $ (19,164)
Adjustments to reconcile net loss to net cash and restricted cash provided by (used in) operating activities:      
Change in fair value of contingent consideration 4,908 17,984 (23,522)
Loss on disposal of non-strategic assets 0 8,107 0
Loss on discontinued operations 0 0 463
Loss (gain) from equity method investees 3,441 (1,290) (4,569)
Depreciation and amortization expenses 118,370 123,415 67,195
Stock-based compensation expense 39,746 40,501 33,981
Deferred tax benefit (2,989) (93,254) (45,608)
Amortization of contract cost assets 4,798 10,944 23,056
Amortization of deferred financing costs 3,547 3,812 2,302
Loss on extinguishment/repayment of debt, net 0 21,010 10,192
Right-of-use asset impairment 2,588 24,065 0
Loss on lease termination 18,922 0 0
Change in tax receivables agreement liability 173 61,982 45,950
Right-of-use operating assets 3,261 16,625 2,500
Other current operating cash inflows (outflows), net 180 (171) 2,612
Changes in assets and liabilities, net of acquisitions:      
Accounts receivable, net and contract assets 32,062 (164,694) (102,980)
Prepaid expenses and other current and non-current assets 4,510 (10,613) 1,673
Contract cost assets (6,056) (5,602) (7,693)
Accounts payable 4,248 (6,723) 13,165
Accrued liabilities (24,198) 23,653 (28,791)
Operating lease liabilities (14,983) (15,373) (2,983)
Accrued compensation and employee benefits (22,675) (2,052) 447
Deferred revenue (3,469) (263) (6,508)
Reserve for claims and performance-based arrangements (85,343) 204,318 28,436
Other long-term liabilities (653) (759) (1,707)
Net cash and restricted cash provided by (used in) operating activities 18,765 142,582 (11,553)
Cash Flows Used In Investing Activities      
Cash paid for asset acquisitions and business combinations (30,725) (388,246) (248,111)
Proceeds from transfer of membership and release of Passport escrow 0 0 30,969
Disposal of non-strategic assets and divestiture of discontinued operations, net 0 577 (9,164)
Return of equity method investments 7 870 5,552
Purchases of investments and contributions to equity method investees (7,321) 0 0
Investments in internal-use software and purchases of property and equipment (24,893) (28,745) (38,361)
Net cash and restricted cash used in investing activities (62,932) (415,544) (259,115)
Cash Flows (Used In) Provided by Financing Activities      
Changes in working capital balances related to claims processing 43,537 (1,514) (59,449)
Payment of contingent consideration (70,355) (46,873) 0
Proceeds from stock option exercises 3,461 12,519 4,452
Proceeds from issuance of long-term debt, net of offering costs 58,576 647,494 219,740
Repayment of long-term debt 0 (464,201) 0
Distributions to Sponsors 0 0 (14,884)
Proceeds from issuance of preferred stock, net of offering costs 0 168,000 0
Payment of preferred dividends (20,085) (18,793) 0
Taxes withheld and paid for vesting of equity awards (15,699) (15,292) (18,318)
Net cash and restricted cash (used in) provided by financing activities (565) 281,340 131,541
Effect of exchange rate on cash and cash equivalents and restricted cash (229) (79) (657)
Net (decrease) increase in cash and cash equivalents and restricted cash (44,961) 8,299 (139,784)
Cash and cash equivalents and restricted cash as of beginning-of-period 223,457 215,158 354,942
Cash and cash equivalents and restricted cash as of end-of-period $ 178,496 $ 223,457 $ 215,158