Annual report [Section 13 and 15(d), not S-K Item 405]

CONSOLIDATED STATEMENTS OF CASH FLOWS

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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2023
Dec. 31, 2024
Dec. 31, 2023
CASH FLOWS FROM OPERATING ACTIVITIES:      
Net loss   $ (310,378) $ (186,426)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization   86,058 86,675
Equity-based compensation   5,752 5,979
Amortization of original issue discount and debt issuance costs   87 472
Accretion of contingent consideration   0 113
Gain on write off of contingent consideration   (4,907) 0
Gain (Loss) on Disposition of Property Plant Equipment, Excluding Oil and Gas Property and Timber Property   (13,269) 0
Mark-to-market adjustment of stock warrants   (22,114) (433)
Premium deficiency reserve   53,698 (12,705)
Impairment of assets held for sale   8,058 0
Changes in operating assets and liabilities:      
Health plan receivable   (2,769) (46,555)
Clinic fees, insurance, and other receivable   (990) 4,560
Prepaid expenses and other current assets   (10,834) (1,243)
Other long-term assets   (43) (58)
Accounts payable, accrued expenses, and other current liabilities   (8,101) 15,988
Accrued payroll   (784) 282
Health plan settlements payable   20,573 21,384
Claims payable   77,080 26,802
Accrued interest   7,895 9,587
Operating lease liability   53 (450)
Other long-term liabilities   5,897 0
Deferred income taxes   (1,090) 0
Net cash used in operating activities   (110,128) (76,028)
CASH FLOWS FROM INVESTING ACTIVITIES:      
Purchases of property and equipment   0 (1,827)
Proceeds from asset sale $ 0 14,525  
Net cash provided by (used in) investing activities   14,525 (1,827)
CASH FLOWS FROM FINANCING ACTIVITIES:      
Proceeds from long-term debt, net of original issue discount   88,057 14,101
Payment of debt issuance costs   (103) (173)
Proceeds from liability-classified warrants and private placement offering, net of offering costs paid   40,496 86,595
Proceeds from at-the-market sales, net of offering costs paid   33 0
Deferred offering costs paid   (507) (175)
Payment of tax withholdings upon settlement of restricted stock unit awards   (103) (16)
Repayment of short-term and long-term debt   (30,973) 0
Proceeds from short-term debt   1,871 0
Net cash provided by financing activities   98,771 100,332
Net change in cash and restricted cash   3,168 22,477
Cash and restricted cash, beginning of year   40,934 18,457
Cash and restricted cash, end of year 40,934 44,102 40,934
Supplemental disclosures of cash flow information:      
Interest Paid, Excluding Capitalized Interest, Operating Activities   14,191 5,813
Income Taxes Paid   5,477 567
Supplemental disclosures of non-cash investing and financing information:      
Operating lease liabilities arising from obtaining new right-of-use assets   617 7,222
Operating Lease Right Of Use Assets Reduced Due To Lease Modification And Termination   (92) 0
Increase in accrued expenses related to debt issuance costs and original issue discount   307 212
Increase in accounts payable related to private placement offering costs   686 12
Increase in accounts payable related to at-the-market offering costs   0 19
Increase in accrued expenses related to at-the-market offering costs   0 206
Increase in other receivable related to at-the-market sales proceeds   0 33
Restricted stock unit awards issued in satisfaction of executive transaction bonuses   0 5,000
Remeasurement adjustment to redeemable noncontrolling interest resulting from ownership changes   (22,831) (117,860)
Fair value adjustment to redeemable noncontrolling interest   (20,579) 20,579
Warrants issued in connection with new debt   12,127 0
Reconciliation of cash and restricted cash:      
Cash 36,320 38,816 36,320
Restricted cash 4,614 5,286 4,614
Total cash and restricted cash $ 40,934 $ 44,102 $ 40,934