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Revenue - Impact of ASC 606 on Net Revenue and Balance Sheet (Details) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2020
Sep. 30, 2020
Jun. 30, 2020
Mar. 31, 2020
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue $ 39,633 $ 29,762 $ 22,067 $ 17,430 $ 26,076 $ 22,104 $ 25,183 $ 19,484 $ 108,892 $ 92,847 $ 52,192
Assets                      
Current contract assets 50,386       29,782       50,386 29,782  
Total current assets 162,777       45,212       162,777 45,212 34,302
Non-current contract assets 38,956       33,169       38,956 33,169  
Total assets 294,009       79,186       294,009 79,186  
Total 89,342       62,951       89,342 62,951 41,260
Calculated under Revenue Guidance in Effect before Topic 606                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   73,616  
Assets                      
Unbilled revenue         10,793         10,793  
Total current assets                     24,455
Difference between Revenue Guidance in Effect before and after Topic 606 | Accounting Standards Update 2014-09                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   19,231  
Assets                      
Unbilled revenue         (10,793)         (10,793)  
Current contract assets         29,782         29,782  
Total current assets         18,989         18,989 9,847
Non-current contract assets         33,169         33,169  
Total assets         52,158         52,158  
As reported                      
Assets                      
Current contract assets         29,782         29,782  
Non-current contract assets         33,169         33,169  
Total         62,951         62,951  
Program fees                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                 43,995 36,667 25,044
Assets                      
Total 5,343       5,009       5,343 5,009 3,088
Program fees | Calculated under Revenue Guidance in Effect before Topic 606                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   36,667  
Program fees | Difference between Revenue Guidance in Effect before and after Topic 606 | Accounting Standards Update 2014-09                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   0  
Profit share                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                 60,392 53,038 24,835
Assets                      
Total $ 83,177       $ 57,367       83,177 57,367 37,734
Profit share | Calculated under Revenue Guidance in Effect before Topic 606                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   33,807  
Profit share | Difference between Revenue Guidance in Effect before and after Topic 606 | Accounting Standards Update 2014-09                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   19,231  
Claims administration service fees                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                 $ 4,505 3,142 $ 2,313
Claims administration service fees | Calculated under Revenue Guidance in Effect before Topic 606                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   3,142  
Claims administration service fees | Difference between Revenue Guidance in Effect before and after Topic 606 | Accounting Standards Update 2014-09                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total revenue                   $ 0