CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash Flows Used In Operating Activities
Net loss	$ (305,580)	$ (54,191)	$ (69,767)
Adjustments to reconcile net loss to net cash and restricted cash used in operating activities:
Change in fair value of contingent consideration and indemnification asset	(3,997)	(4,104)	400
Gain on disposal of assets	(9,600)	0	0
Loss from equity method investees	9,465	4,736	1,755
Depreciation and amortization expenses	60,913	44,515	32,368
Goodwill impairment	199,800	0	0
Stock-based compensation expense	15,618	17,609	20,437
Deferred tax (benefit) provision	(23,124)	44	(7,271)
Amortization of contract cost assets	5,723	2,703	0
Amortization of deferred financing costs	9,370	2,455	914
Interest from customer advance for regulatory capital requirements	(1,300)	0	0
Other current operating cash inflows (outflows), net	(264)	448	490
Changes in assets and liabilities, net of acquisitions:
Accounts receivable, net and contract assets	6,326	(24,503)	(11,258)
Prepaid expenses and other current and noncurrent assets	791	(14,746)	2,729
Contract cost assets	(23,057)	(11,179)	0
Accounts payable	(5,480)	7,598	5,563
Accrued liabilities	(21,852)	12,180	(2,781)
Accrued compensation and employee benefits	9,246	(14,571)	(3,303)
Deferred revenue	(756)	(1,819)	3,548
Reserve for claims and performance-based arrangements	33,555	8,964	0
Right-of-use operating assets	(20,811)	0	0
Operating lease liabilities	27,724	0	0
Other long-term liabilities	(5,355)	3,210	(1,782)
Net cash and restricted cash used in operating activities	(42,645)	(20,651)	(27,958)
Cash Flows Used In Investing Activities
Cash paid for asset acquisitions or business combinations	(8,575)	(130,241)	(3,694)
Customer advance for regulatory capital requirements	(46,400)	0	0
Loan for implementation funding	0	0	(20,000)
Principal repayment of implementation funding loan and regulatory and capital requirements	5,400	20,000	0
Amount received from escrow in asset acquisition	0	500	0
Investments in and advances to equity method investees	(87,480)	(9,360)	(1,128)
Purchases of investments	(11,125)	(10,010)	0
Maturities and sales of investments	2,575	349	44,210
Investments in and purchases of property and equipment	(35,534)	(39,550)	(27,848)
Purchase and maturities of restricted investments	(495)	7,937	(3,805)
Net cash and restricted cash used in investing activities	(181,634)	(160,375)	(12,265)
Cash Flows (Used In) from Financing Activities
Proceeds from issuance of common stock, net of stock issuance costs	0	0	166,947
Changes in working capital balances related to claims processing on behalf of partners	(104,268)	96,153	(4,200)
Amount received from escrow in asset acquisition	500	0	0
Proceeds from stock option exercises	1,092	11,929	4,082
Change in warrant liability	7,092	0	0
Proceeds from issuance of long-term debt, net of issuance costs	62,648	167,178	0
Taxes withheld and paid for vesting of restricted stock units	(2,609)	(1,236)	(1,272)
Net cash and restricted cash (used in) from financing activities	(35,545)	274,024	165,557
Effect of exchange rate on cash and cash equivalents and restricted cash	30	(36)	0
Net increase (decrease) in cash and cash equivalents	(259,794)	92,962	125,334
Cash and cash equivalents and restricted cash as of beginning-of-period	388,325	295,363	170,029
Cash and cash equivalents and restricted cash as of end-of-period	$ 128,531	$ 388,325	$ 295,363