v3.26.1
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2026
Jun. 30, 2025
Cash Flows Used In Operating Activities    
Loss before preferred dividends and accretion of Series A Preferred Stock $ (54,996) $ (84,515)
Adjustments to reconcile net loss to net cash and restricted cash used in operating activities:    
Change in fair value of contingent consideration 0 2,926
Loss (gain) from equity method investees 52 (178)
Extinguishment of Series A Preferred Stock and other refinancing fees 0 9,000
Loss on option exercise 0 52,544
Depreciation and amortization expenses 43,121 47,199
Stock-based compensation expense 25,850 22,661
Deferred tax expense 2,970 (570)
Amortization of contract cost assets 2,023 2,523
Amortization of deferred financing costs 5,930 2,403
Loss on lease termination 0 1,906
Right-of-use operating assets 1,663 792
Changes in assets and liabilities, net of acquisitions:    
Accounts receivable, net and contract assets (139,257) 55,925
Prepaid expenses and other current and non-current assets (4,031) (1,803)
Contract cost assets (2,533) (1,649)
Accounts payable (17,810) 18,189
Accrued liabilities (22,350) (5,867)
Operating lease liabilities (15,194) (20,973)
Accrued compensation and employee benefits (22,021) 4,543
Deferred revenue 5 (174)
Reserve for claims and performance-based arrangements 186,202 (131,454)
Other long-term liabilities 80 803
Net cash and restricted cash used in operating activities (10,296) (25,769)
Cash Flows Used In Investing Activities    
Cash paid for asset acquisitions and business combinations 0 (56,047)
Return of equity method investments 150 788
Purchases of investments and contributions to equity method investees 0 (1,000)
Investments in internal-use software and purchases of property and equipment (13,255) (17,365)
Net cash and restricted cash used in investing activities (13,105) (73,624)
Cash Flows (Used In) Provided by Financing Activities    
Changes in working capital balances related to claims processing (3,143) (44,754)
Payment of contingent consideration 0 (1,000)
Proceeds from issuance of long-term debt, net of offering costs 0 221,000
Repayment of debt (10,000) (62,500)
Payment of preferred dividends 0 (9,198)
Taxes withheld and paid for vesting of equity awards (1,823) (4,621)
Net cash and restricted cash (used in) provided by financing activities (14,966) 98,927
Effect of exchange rate on cash and cash equivalents and restricted cash (863) (60)
Net decrease in cash and cash equivalents and restricted cash (39,230) (526)
Cash and cash equivalents and restricted cash as of beginning-of-period 180,696 178,496
Cash and cash equivalents and restricted cash as of end-of-period $ 141,466 $ 177,970