Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Operating activities
Net income (loss)	$ 4.2	$ (39.6)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operations:
Depreciation and amortization	39.9	27.6
Amortization of debt issuance costs	1.4	0.9
Share-based compensation	12.8	13.8
Loss on disposal	0.0	0.8
Loss on debt extinguishment	18.8	0.0
Provision for doubtful receivables	2.3	0.5
Deferred income taxes	(9.4)	(12.7)
Non-cash lease expense	8.5	0.0
Changes in operating assets and liabilities:
Accounts receivable and related party accounts receivable	9.8	(10.8)
Prepaid expenses and other assets	(20.1)	(18.0)
Accounts payable	10.5	(6.0)
Accrued compensation and benefits	(7.3)	15.2
Lease liabilities	(8.9)	0.0
Other liabilities	1.0	16.3
Customer liabilities and customer liabilities - related party	(20.2)	6.0
Net cash provided by (used in) operating activities	43.3	(6.0)
Investing activities
Purchases of property, equipment, and software	(43.1)	(20.1)
Acquisition of Intermedix, net of cash acquired	0.0	(462.8)
Net cash used in investing activities	(43.1)	(482.9)
Financing activities
Issuance of subordinated notes, net of discount and issuance costs	0.0	105.5
Repayment of senior secured debt and revolver	(272.7)	0.0
Repayment of subordinated notes and prepayment penalty	(112.2)	0.0
Issuance of common stock and stock warrants, net of issuance costs	0.0	19.2
Exercise of vested stock options	9.5	3.6
Shares withheld for taxes	(4.7)	(2.9)
Finance lease payments	(0.6)	0.0
Net cash (used in) provided by financing activities	(8.9)	378.1
Effect of exchange rate changes in cash, cash equivalents and restricted cash	(0.3)	(0.9)
Net increase in cash, cash equivalents and restricted cash	(9.0)	(111.7)
Cash, cash equivalents and restricted cash, at beginning of period	65.1	166.4
Cash, cash equivalents and restricted cash, at end of period	56.1	54.7
Supplemental disclosures of cash flow information
Accrued dividends payable to preferred stockholders	5.2	4.8
Accrued and other liabilities related to purchases of property, equipment and software	20.1	21.7
Accounts payable related to purchases of property, equipment and software	5.2	0.6
Interest paid	22.6	7.5
Income taxes paid	3.5	2.5
Income taxes refunded	0.1	0.4
Senior Term Loan
Financing activities
Issuance of senior secured debt, net and borrowings on revolver	321.8	253.1
Senior Revolver
Financing activities
Issuance of senior secured debt, net and borrowings on revolver	60.0	0.0
Repayment of senior secured debt and revolver	(10.0)	0.0
Senior Revolver | Line of Credit
Financing activities
Payment of debt issuance costs related to the Senior Revolver	$ 0.0	$ (0.4)