Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Operating Activities:
Net loss	$ (978)	$ (128,071)	$ (148,173)
Adjustments to reconcile Net loss to net cash provided by (used in) operating activities:
Provision for credit loss	833	123	91
(Gain) loss on right of use assets	0	143	(289)
Gain on sale of property and equipment	(72)	(9)	0
Depreciation and amortization	30,482	27,062	21,668
Amortization-debt issuance costs	1,761	1,293	1,254
Amortization-investment discount	(1,298)	(2,579)	(4,917)
Equity-based compensation	62,082	71,132	66,835
Non-cash lease expense	1,609	1,764	2,318
Loss on extinguishment of debt	0	3,020	0
Changes in operating assets and liabilities:
Accounts receivable	(100,106)	(34,278)	(26,950)
Prepaid expenses and other current assets	(57,059)	7,887	(2,863)
Other assets	(50)	60	(142)
Medical expenses payable	184,781	84,389	35,264
Accounts payable and accrued expenses	10,364	(1,460)	(6,347)
Accrued compensation	9,082	5,819	6,574
Lease liabilities	(1,504)	(1,525)	(3,510)
Net cash provided by (used in) operating activities	139,927	34,770	(59,187)
Investing Activities:
Purchase of investments	(65,633)	(82,200)	(379,058)
Sale of property and equipment	75	14	0
Maturities of investments	76,300	162,795	267,790
Sale of business	1,065	0	0
Acquisition of property and equipment, net	(26,781)	(41,418)	(35,995)
Net cash provided by (used in) investing activities	(14,974)	39,191	(147,263)
Financing Activities:
Proceeds from long-term debt	0	380,000	0
Debt issuance costs	(26)	(8,792)	0
Repayment of long-term debt	0	(215,000)	0
Payment of employment taxes related to release of restricted stock	0	(350)	0
Proceeds from exercise of stock options	18,067	155	0
Contributions from noncontrolling interest holders	0	15	105
Net cash provided by financing activities	18,041	156,028	105
Net increase (decrease) in cash	142,994	229,989	(206,345)
Cash, cash equivalents and restricted cash at beginning of period	434,943	204,954	411,299
Cash, cash equivalents and restricted cash at end of period	577,937	434,943	204,954
Supplemental disclosure of cash flow information:
Cash paid for interest	13,752	22,157	19,165
Supplemental non-cash investing and financing activities:
Acquisition of property in accounts payable	97	70	59
Debt issuance costs in accounts payable	0	512	0
Reconciliation of cash, cash equivalents and restricted cash as shown in the statement of cash flows:
Cash and cash equivalents	575,817	432,859	202,904
Restricted cash in other assets	2,120	2,084	2,050
Total	$ 577,937	$ 434,943	$ 204,954