Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Operating Activities:
Net Loss	$ (128,071)	$ (148,173)	$ (149,639)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Provision for credit loss	123	91	150
(Gain) loss on right of use assets	143	(289)	510
Gain on sale of property and equipment	(9)	0	0
Depreciation and amortization	27,062	21,668	17,486
Amortization-debt issuance costs	1,293	1,254	1,850
Amortization-investment discount	(2,579)	(4,917)	0
Amortization of payment-in-kind interest	0	0	2,943
Loss on disposal of property and equipment	0	0	101
Equity-based compensation	71,132	66,835	81,718
Non-cash lease expense	1,764	2,318	2,811
Loss on extinguishment of debt	3,020	0	2,196
Changes in operating assets and liabilities:
Accounts receivable	(34,278)	(26,950)	(34,377)
Prepaid expenses and other current assets	7,887	(2,863)	(14,356)
Other assets	60	(142)	(86)
Medical expenses payable	84,389	35,264	44,250
Accounts payable and accrued expenses	(1,460)	(6,347)	13,743
Accrued compensation	5,819	6,574	3,609
Lease liabilities	(1,525)	(3,510)	(4,214)
Payment-in-kind interest	0	0	(14,122)
Net cash provided by (used in) operating activities	34,770	(59,187)	(45,427)
Investing Activities:
Purchase of business, net of cash received	0	0	(4,043)
Purchase of investments	(82,200)	(379,058)	(2,825)
Sale of property and equipment	14	0	0
Maturities of investments	162,795	267,790	2,425
Acquisition of property and equipment	(41,418)	(35,995)	(23,774)
Net cash provided by (used in) investing activities	39,191	(147,263)	(28,217)
Financing Activities:
Repurchase of noncontrolling interest	0	0	(100)
Proceeds from long-term debt	380,000	0	165,000
Debt issuance costs	(8,792)	0	(5,196)
Repayment of long-term debt	(215,000)	0	(143,179)
Payment of employment taxes related to release of restricted stock	(350)	0	0
Proceeds from exercise of stock options	155	0	0
Contributions from noncontrolling interest holders	15	105	68
Net cash provided by financing activities	156,028	105	16,593
Net increase (decrease) in cash	229,989	(206,345)	(57,051)
Cash, cash equivalents and restricted cash at beginning of period	204,954	411,299	468,350
Cash, cash equivalents and restricted cash at end of period	434,943	204,954	411,299
Supplemental disclosure of cash flow information:
Cash paid for interest	22,157	19,165	22,447
Supplemental non-cash investing and financing activities:
Acquisition of property in accounts payable	70	59	47
Purchase of business in accounts payable	0	0	505
Debt issuance costs in accounts payable	512	0	0
Reconciliation of cash, cash equivalents and restricted cash as shown in the statement of cash flows:
Cash and cash equivalents	432,859	202,904	409,549
Restricted cash in other assets	2,084	2,050	1,750
Total	$ 434,943	$ 204,954	$ 411,299