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
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
CASH FLOWS FROM OPERATING ACTIVITIES:    
Net loss $ (323,086) $ (310,378)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 84,163 86,058
Equity-based compensation 5,581 5,752
Provision for bad debts 2,996 0
Paid in-kind interest expense 29,718 7,895
Amortization of original issue discount and debt issuance costs 13,556 87
Gain on write off of contingent consideration 0 (4,907)
Gain (Loss) on Disposition of Property Plant Equipment, Excluding Oil and Gas Property and Timber Property 162 (13,269)
Mark-to-market adjustment of stock warrants (7,850) (22,114)
Premium deficiency reserve 18,749 53,698
Impairment of assets held for sale 0 8,058
Changes in operating assets and liabilities:    
Health plan receivable 28,677 (2,769)
Clinic fees, insurance, and other receivable (2,297) (990)
Prepaid expenses and other current assets 2,983 (10,834)
Other long-term assets (3,525) (43)
Accounts payable, accrued expenses, and other current liabilities 11,108 (8,101)
Accrued payroll (772) (784)
Health plan settlements payable 14,265 20,573
Claims payable 32,701 77,080
Accrued interest (1,876) 0
Operating lease liability 641 53
Other long-term liabilities 0 5,897
Deferred income taxes 2,868 (1,090)
Net cash used in operating activities (91,238) (110,128)
CASH FLOWS FROM INVESTING ACTIVITIES:    
Purchases of property and equipment 79 0
Proceeds from asset sale 50  
Net cash provided by investing activities 129 14,525
CASH FLOWS FROM FINANCING ACTIVITIES:    
Proceeds from long-term debt, net of original issue discount 73,000 88,057
Payment of debt issuance costs (186) (103)
Proceeds from liability-classified warrants and private placement offering, net of offering costs paid 0 40,496
Proceeds from at-the-market sales, net of offering costs paid 0 33
Deferred offering costs paid 0 (507)
Payment of tax withholdings upon settlement of restricted stock unit awards 0 (103)
Repayment of short-term and long-term debt (1,137) (30,973)
Proceeds from short-term debt 1,137 1,871
Net cash provided by financing activities 72,814 98,771
Net change in cash and restricted cash (18,295) 3,168
Cash and restricted cash, beginning of year 44,102 40,934
Cash and restricted cash, end of year 25,807 44,102
Supplemental disclosures of cash flow information:    
Interest Paid, Excluding Capitalized Interest, Operating Activity 13,636 14,191
Income Taxes Paid 1,439 5,477
Supplemental disclosures of non-cash investing and financing information:    
Operating lease liabilities arising from obtaining new right-of-use assets 361 617
Operating Lease Right Of Use Assets Reduced Due To Lease Modification And Termination 0 (92)
Increase in accrued expenses related to debt issuance costs and original issue discount 0 307
Increase in accounts payable related to private placement offering costs 0 686
Remeasurement adjustment to redeemable noncontrolling interest resulting from ownership changes (3,856) (22,831)
Fair value adjustment to redeemable noncontrolling interest 119,398 (20,579)
Warrants issued in connection with new debt 26,741 12,127
Reconciliation of cash and restricted cash:    
Cash 25,012 38,816
Restricted cash 795 5,286
Total cash and restricted cash $ 25,807 $ 44,102