Quarterly report [Sections 13 or 15(d)]

CONSOLIDATED STATEMENTS OF CASH FLOWS

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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended 12 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Dec. 31, 2025
CASH FLOWS FROM OPERATING ACTIVITIES:          
Net income (loss) $ 30,777 $ (69,461) $ 49,468 $ (157,372)  
Noncash Reduction of Prior Period Medical Expense     (56,000) 0  
Adjustments to reconcile net income (loss) to net cash used in operating activities:          
Depreciation and amortization 21,038 21,033 63,156 63,168  
Premium deficiency reserve (27,950) (23,736) (41,324) (36,665)  
Paid in-kind interest expense     16,568 19,813  
Amortization of original issue discount and debt issuance costs     3,450 11,383  
Equity-based compensation     1,496 4,482  
Provision for bad debts     1,275 0  
Deferred income taxes     478 0  
Loss on asset sale and disposal     152 340  
Mark-to-market adjustment of stock warrants and purchased put option (7,612) 2,540 8,424 (2,784)  
Changes in operating assets and liabilities:          
Health plan receivable     (27,559) 39,242  
Clinic fees, insurance, and other receivable     (16,723) 209  
Prepaid expenses and other current assets     (1,355) 3,015  
Other long-term assets     5,088 (12,274)  
Accounts payable, accrued expenses, and other current liabilities     (6,261) 7,786  
Accrued payroll     1,520 (1,373)  
Health plan settlements payable     (51,449) (2,085)  
Claims payable     (40,293) (1,425)  
Accrued interest     0 (2,034)  
Operating lease liability     (177) 1,063  
Net cash used in operating activities     (90,066) (65,511)  
CASH FLOWS FROM INVESTING ACTIVITIES:          
Other, net     (251) (69)  
Net cash used in investing activities     (251) (69)  
CASH FLOWS FROM FINANCING ACTIVITIES:          
Proceeds from long-term debt, net of original issue discount     27,000 60,000  
Proceeds from short-term debt     1,044 1,137  
Repayment of short-term and long-term debt     (940) (1,023)  
Payment of debt issuance costs     (30) (174)  
Proceeds from issuance of preferred stock, net of issuance costs     56,461 0  
Net cash provided by financing activities     26,781 0  
Payment of tax withholdings upon settlement of restricted stock unit awards     (4) 0  
Net cash provided by financing activities     110,312 59,940  
Net change in cash and restricted cash     19,995 (5,640)  
Cash and restricted cash, beginning of period     25,807 44,102 $ 44,102
Cash and restricted cash, end of period 45,802 38,462 45,802 38,462 25,807
Debt Conversion, Converted Instrument, Amount     195,118 0  
Reconciliation of cash and restricted cash:          
Cash 43,900 37,714 43,900 37,714 25,012
Restricted cash 1,902 748 1,902 748 795
Total cash and restricted cash $ 45,802 $ 38,462 $ 45,802 $ 38,462 $ 25,807