CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Cash Flows from Operating Activities:
Net income	$ 61,821	$ 14,594
Adjustments to reconcile net income to net cash used in operating activities:
Depreciation and amortization (inclusive of depreciation included in cost of service)	6,787	6,138
Non-cash compensation	6,844	7,886
Amortization and impairment of operating lease right of use assets	8,645	8,566
(Gain) loss on disposal of property and equipment	(34)	4
Deferred income taxes	9,981	2,594
Gain on equity method investment	48,093	0
Equity in earnings from equity method investments	(1,794)	(910)
Amortization of deferred debt issuance costs	248	248
Return on equity method investments	2,320	170
Changes in operating assets and liabilities:
Patient accounts receivable	(23,564)	(46,806)
Other current assets	3,480	(1,696)
Operating lease right of use assets	(1,186)	(1,042)
Other assets	88	155
Accounts payable	(10,913)	8,652
Accrued expenses	(10,658)	3,029
Other long-term obligations	(34)	(591)
Operating lease liabilities	(7,625)	(7,532)
Net cash used in operating activities	(3,687)	(6,541)
Cash Flows from Investing Activities:
Proceeds from the sale of deferred compensation plan assets	27	21
Proceeds from sale of property, plant, and equipment	15	0
Purchases of property and equipment	(1,215)	(2,670)
Investments in technology assets	(201)	(223)
Investment in equity method investee	0	(196)
Net cash used in investing activities	(1,374)	(3,068)
Cash Flows from Financing Activities:
Proceeds from the issuance of stock upon exercise of stock options	93	0
Shares withheld to pay taxes on non-cash compensation	(2,864)	(617)
Noncontrolling interest contributions	0	1,764
Noncontrolling interest distributions	(785)	(756)
Principal payments of long-term obligations	(9,744)	(8,941)
Net cash used in financing activities	(13,300)	(8,550)
Net decrease in cash, cash equivalents and restricted cash	(18,361)	(18,159)
Cash, cash equivalents and restricted cash at beginning of period	303,242	138,863
Cash, cash equivalents and restricted cash at end of period	284,881	120,704
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	6,177	8,188
Cash paid for income taxes, net of refunds received	907	828
Cash paid for operating lease liabilities	8,811	8,574
Cash paid for finance lease liabilities	4,121	2,236
Supplemental Disclosures of Non-Cash Activity:
Right of use assets obtained in exchange for operating lease liabilities	7,006	7,173
Right of use assets obtained in exchange for finance lease liabilities	3,158	4,326
Reductions to right of use assets resulting from reductions to operating lease liabilities	75	168
Reductions to right of use assets resulting from reductions to finance lease liabilities	$ 415	$ 496