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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash Flows Provided by (Used In) Operating Activities    
Loss before preferred dividends and accretion of Series A Preferred Stock including excise tax $ (105,379) $ (38,821)
Adjustments to reconcile net loss to net cash and restricted cash provided by (used in) operating activities:    
Change in fair value of contingent consideration 1,837 9,108
Loss (gain) from equity method investees (334) 3,623
Extinguishment of Series A Preferred Stock and other refinancing fees 15,000 0
Gain on extinguishment of short-term debt (431) 0
Loss on option exercise 52,544 0
Depreciation and amortization expenses 70,814 89,074
Stock-based compensation expense 37,343 45,861
Deferred tax expense (benefit) 57 (1,916)
Amortization of contract cost assets 5,704 3,604
Amortization of deferred financing costs 4,762 2,650
Loss on lease termination 676 0
Change in tax receivables agreement liability 0 173
Right-of-use operating assets 1,297 2,739
Other current operating cash inflows (outflows), net 0 180
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets 7,364 38,844
Prepaid expenses and other current and non-current assets 388 7,751
Contract cost assets (3,486) (4,687)
Accounts payable 21,501 1,260
Accrued liabilities (4,399) 17,648
Operating lease liabilities (29,987) (12,209)
Accrued compensation and employee benefits 21,661 (24,780)
Deferred revenue (636) (3,355)
Reserve for claims and performance-based arrangements (107,053) (91,361)
Other long-term liabilities 800 (390)
Net cash and restricted cash (used in) provided by operating activities (9,957) 44,996
Cash Flows Used In Investing Activities    
Cash paid for asset acquisitions and business combinations (56,045) (16,947)
Return of equity method investments 986 7
Purchases of investments and contributions to equity method investees (1,000) (7,320)
Investments in internal-use software and purchases of property and equipment (26,327) (18,742)
Net cash and restricted cash used in investing activities (82,386) (43,002)
Cash Flows (Used In) Provided by Financing Activities    
Changes in working capital balances related to claims processing (45,332) 584
Payment of contingent consideration (1,750) (70,355)
Proceeds from stock option exercises 0 3,462
Proceeds from issuance of long-term debt, net of offering costs 389,740 (529)
Repayment of long-term debt (229,255) 0
Repurchase of common stock (39,996) 0
Payment of preferred dividends (11,127) (15,279)
Taxes withheld and paid for vesting of equity awards (5,168) (15,390)
Net cash and restricted cash provided by (used in) financing activities 57,112 (97,507)
Effect of exchange rate on cash and cash equivalents and restricted cash (261) (93)
Net decrease in cash and cash equivalents and restricted cash (35,492) (95,606)
Cash and cash equivalents and restricted cash as of beginning-of-period 178,496 223,457
Cash and cash equivalents and restricted cash as of end-of-period $ 143,004 $ 127,851