CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities
Net income	$ 49,294	$ 122,320	$ 17,673
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	17,517	18,350	18,280
Amortization of debt issuance cost	1,078	1,347	473
Other	189	0	0
Loss of disposal of property and equipment	0	91	0
Impairment of goodwill and intangible assets	0	0	1,994
Provision for doubtful accounts	0	0	(1,363)
Share-based compensation	6,745	3,383	1,547
Gain on sale of equity method investment	(2,193)	(99,839)	0
Gain on consolidation of equity method investment	(2,752)	0	0
Gain on contingent equity securities	(4,270)	0	0
Gain on loan assumption	0	0	(2,250)
Unrealized loss (gain) from investment in equity securities	10,845	11	(9)
Gain from investment in warrants	(1,145)		0
Loss in interest rate swaps	1,071	0	0
Impairment of beneficial interest	15,723	0	0
Loss (income) from equity method investments, net	4,306	(3,694)	6,901
Deferred tax	(5,952)	(6,620)	(6,801)
Changes in operating assets and liabilities, net of acquisition amounts:
Receivable, net	(1,518)	4,134	10,714
Receivable, net – related parties	(20,116)	(1,123)	(1,435)
Other receivable	(5,351)	12,589	(15,079)
Prepaid expenses and other current assets	2,708	(6,432)	(2,756)
Right-of-use assets	3,133	3,325	2,480
Other assets	(1,529)	(5,530)	(572)
Accounts payable and accrued expenses	3,217	8,204	(4,883)
Fiduciary accounts payable	892	7,615	488
Medical liabilities	5,279	(8,691)	(2,392)
Income taxes payable	(3,621)	(304)	(7,093)
Operating lease liabilities	(3,215)	(2,973)	(2,244)
Net cash provided by operating activities	70,335	46,163	13,673
Cash flows from investing activities
Purchases of marketable securities	(28,000)	(1,793)	(115,402)
Proceeds from sale of marketable securities	67,612	50,625	0
Proceeds from repayment of loans receivable - related parties	56	16,500	0
Advances on loans receivable	0	(145)	(11,425)
Dividends received from equity method investments	0	0	240
Proceeds from sale of fixed assets	0	50	0
Payments for business acquisition, net of cash acquired	(2,585)	(11,354)	(49,403)
Purchases of investments in privately held entities	0	0	(491)
Proceeds from sale of equity method investment	6,375	52,743	0
Purchases of investments – equity method	(13,622)	(9,969)	(3,108)
Purchases of property and equipment	(19,223)	(1,164)	(1,042)
Cash recorded from consolidation of VIE	5,927	0	0
Net cash provided by (used in) investing activities	16,540	95,493	(180,631)
Cash flows from financing activities
Dividends paid	(31,089)	(51,319)	(61,717)
Repayment of term loan	0	(9,500)	0
Change in non-controlling interest capital	48	0	28
Borrowings on long-term debt	569	0	250,000
Borrowings on line of credit	180,000	0	39,600
Repayments on long-term debt	(201)	0	(2,375)
Repayments on bank loan and lines of credit	(238,125)	0	(52,640)
Payment of capital lease obligations	(208)	(105)	(102)
Proceeds from exercise of stock options and warrants	9,061	10,802	3,123
Proceeds from sale of shares	40,134	0	0
Proceeds from common stock offering	0	0	755
Repurchase of common shares	(5,739)	(537)	(7,570)
Distribution to non-controlling interest	(1,471)	(1,037)	0
Cost of debt and equity issuances	(727)	0	(5,771)
Net cash (used in) provided by financing activities	(47,748)	(51,696)	163,331
Net increase (decrease) in cash, cash equivalents, and restricted cash	39,127	89,960	(3,627)
Cash, cash equivalents, and restricted cash, beginning of year	193,970	104,010	107,637
Cash, cash equivalents and restricted cash, end of year	233,097	193,970	104,010
Supplemental disclosures of cash flow information
Cash paid for income taxes	37,201	62,002	20,200
Cash paid for interest	4,158	8,510	4,258
Supplemental disclosures of non-cash investing and financing activities
Issuance of financing obligation for business combinations	12,706	0	0
Cashless exercise of warrants	0	599	0
Cancellation of Restricted Stock Awards	334	0	0
Dividend declared included in dividend payable	71	485	271
Reclassification of liability for equity shares	0	0	1,185
Deferred tax liability adjustment related to warrant exercises	0	690	0
Preferred shares received from sale of equity method investment	0	36,179	0
Beneficial interest acquired from sale of equity method investment	0	15,723	0
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	233,097	193,470	103,189
Restricted cash – long-term - letters of credit	0	500	746
Restricted cash – short-term	0	0	75
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows	233,097	193,970	104,010
Affiliated Entity | APC
Supplemental disclosures of non-cash investing and financing activities
APC stock issued in exchange for AMG	$ 0	$ 0	$ 414