CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash Flows Used In Operating Activities
Net loss	$ (78,752)	$ (48,649)
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	(3,818)	100
Loss on disposal of assets	6,447	0
Loss from equity method investees	412	424
Depreciation and amortization expenses	16,138	14,266
Equity method investments impairment	47,133	0
Stock-based compensation expense	3,508	4,537
Deferred tax (benefit) provision	58	(492)
Amortization of contract cost assets	5,614	1,250
Amortization of deferred financing costs	3,009	2,279
Interest from customer advance for regulatory capital requirements	(650)	0
Other current operating cash inflows (outflows), net	524	427
Changes in assets and liabilities, net of acquisitions:
Accounts receivable, net and contract assets	(36,649)	14,796
Prepaid expenses and other current and noncurrent assets	1,459	(4,174)
Contract cost assets	(3,326)	(4,565)
Accounts payable	11,068	(204)
Accrued liabilities	(678)	3,605
Accrued compensation and employee benefits	(18,143)	(9,591)
Deferred revenue	(2,623)	1,736
Reserve for claims and performance-based arrangements	27,860	2,424
Right-of-use operating assets	6,695	(12,493)
Operating lease liabilities	(5,920)	13,233
Other long-term liabilities	93	(4,618)
Net cash and restricted cash used in operating activities	(20,541)	(25,709)
Cash Flows Used In Investing Activities
Cash paid for asset acquisitions or business combinations	0	(6,000)
Customer advance for regulatory capital requirements	0	(5,400)
Loan for implementation funding	(400)	0
Disposal of non-strategic assets	(2,287)	0
Investments in and advances to equity method investees	0	(337)
Purchases of investments	(1,338)	(3,779)
Maturities and sales of investments	618	0
Investments in internal-use software and purchases of property and equipment	(7,400)	(9,462)
Purchase and maturities of restricted investments	0	(500)
Net cash and restricted cash used in investing activities	(10,807)	(25,478)
Cash Flows (Used In) from Financing Activities
Changes in working capital balances related to claims processing on behalf of partners	33,678	(107,500)
Amount received from escrow in asset acquisition	0	500
Deferred financing costs related to 2025 Notes	0	(608)
Proceeds from stock option exercises	84	123
Taxes withheld and paid for vesting of restricted stock units	(1,188)	(2,180)
Net cash and restricted cash (used in) from financing activities	32,574	(109,665)
Effect of exchange rate on cash and cash equivalents and restricted cash	41	(19)
Net increase (decrease) in cash and cash equivalents	1,267	(160,871)
Cash and cash equivalents and restricted cash as of beginning-of-period	128,531	388,325
Cash and cash equivalents and restricted cash as of end-of-period	$ 129,798	$ 227,454