CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Cash flows from operating activities
Net income	$ 73,988	$ 83,988
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization	8,434	9,330
Amortization of debt issuance costs	741	658
Share-based compensation	2,902	1,910
Unrealized (gain) loss from investment in equity securities	(83,769)	25
Loss (income) from equity method investments	3,812	(2,888)
Gain on sale of equity method investments	0	(99,647)
Impairment of beneficial interest	15,723	0
Loss on interest rate swaps	1,195	0
Deferred tax	10,283	(4,473)
Other	189	0
Changes in operating assets and liabilities, net of business combinations:
Receivables, net	(9,975)	(6,284)
Receivables, net – related parties	(19,508)	(11,191)
Other receivables	(266)	966
Prepaid expenses and other current assets	4,613	(873)
Right-of-use assets	1,646	1,680
Other assets	(426)	(5,095)
Accounts payable and accrued expenses	16,984	(3,043)
Fiduciary accounts payable	(550)	(174)
Medical liabilities	8,977	11,252
Income taxes payable	(2,009)	37,681
Operating lease liabilities	(1,698)	(1,247)
Net cash provided by operating activities	31,286	12,575
Cash flows from investing activities
Proceeds from repayment of loans receivable – related parties	31	16,500
Payments for business acquisition, net of cash acquired	(117)	0
Purchases of marketable securities	(4,450)
Purchases of marketable securities	(670)	(1,142)
Purchase of investment – equity method	(1,660)	(500)
Proceeds from sale of equity method investment	0	52,743
Purchases of property and equipment	(7,364)	(451)
Cash received from consolidation of VIE	3,322	0
Proceeds from sale of marketable securities	1,106	0
Net cash (used in) provided by investing activities	(9,802)	67,150
Cash flows from financing activities
Dividends paid	(21,110)	(30,187)
Repayment of long-term debt	(238,208)	(2,375)
Payment of finance lease obligations	(54)	(61)
Proceeds from the exercise of stock options and warrants	4,816	2,863
Repurchase of shares	(2,981)	(788)
Purchase of noncontrolling interest	(75)	0
Proceeds from sale of noncontrolling interest	38	0
Borrowings on revolver	180,000	0
Proceeds from sale of shares	40,134	0
Payment of debt issuance costs	(727)	0
Net cash used in financing activities	(38,167)	(30,548)
Net (decrease) increase in cash, cash equivalents, and restricted cash	(16,683)	49,177
Cash, cash equivalents, and restricted cash, beginning of period	193,970	104,010
Cash, cash equivalents, and restricted cash, end of period	177,287	153,187
Supplementary disclosures of cash flow information:
Cash paid for income taxes	23,324	0
Cash paid for interest	2,507	2,623
Supplemental disclosures of non-cash investing and financing activities
Dividend declared included in dividend payable	50	160
Preferred shares received from sale of equity investment	0	36,179
Cancellation of Restricted Stock Awards	144	0
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	177,287	152,441
Restricted cash - noncurrent	0	746
Cash, cash equivalents, restricted cash total	$ 177,287	$ 153,187