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Restructuring and integration expense (Tables)
9 Months Ended
Sep. 30, 2023
Restructuring and Related Activities [Abstract]  
Restructuring and integration expense
Restructuring and integration expense is reflected on the consolidated statements of comprehensive (loss) income as follows:
 Quarter Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
Total cost of revenue$6,429 $131 $10,868 $216 
Operating expenses22,935 15,188 60,067 46,614 
Restructuring and integration expense$29,364 $15,319 $70,935 $46,830 

Restructuring and integration expense for each period was comprised of the following:
 Quarter Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2023202220232022
External consulting fees$10,939 $7,670 $31,561 $24,670 
Employee severance benefits11,179 3,826 17,526 8,232 
Internal labor2,469 1,877 6,341 6,177 
Other4,777 1,946 15,507 7,751 
Restructuring and integration expense$29,364 $15,319 $70,935 $46,830 
Changes in restructuring and integration accruals
Changes in our restructuring and integration accruals were as follows:
(in thousands)Employee severance benefits
Balance, December 31, 2022
$8,528 
Charges17,961 
Reversals(435)
Payments(11,448)
Balance, September 30, 2023
$14,606