CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities
Net income	$ 50,060	$ 68,603
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	13,480	13,105
Amortization of debt issuance cost	703	900
Share-based compensation	10,477	4,322
Gain on sale of investments	(2,272)	(2,193)
Unrealized loss (gain) on investments	21,894	(22,826)
(Income) loss from equity method investments	(4,397)	3,680
Impairment of beneficial interest	0	15,723
Unrealized (gain) loss on interest rate swaps	(4,302)	1,069
Deferred tax	(2,330)	6,847
Other	901	189
Changes in operating assets and liabilities, net of business combinations:
Receivables, net	(58,325)	(10,686)
Receivables, net – related parties	(21,832)	(4,367)
Other receivables	(31,988)	(1,477)
Prepaid expenses and other current assets	3,228	5,064
Right-of-use assets	2,843	2,440
Other assets	(682)	(954)
Accounts payable and accrued expenses	765	14,362
Fiduciary accounts payable	(4,029)	(815)
Medical liabilities	37,491	(7,633)
Income taxes payable	(14,555)	(300)
Operating lease liabilities	(3,059)	(2,528)
Other long-term liabilities	3,118	0
Net cash (used in) provided by operating activities	(2,811)	82,525
Cash flows from investing activities
Payments for business acquisition, net of cash acquired	(5,614)	(2,575)
Proceeds from repayment of loans receivable – related parties	4,051	41
Purchase of marketable securities	(1,750)	(1,009)
Purchase of investment – equity method	0	(13,384)
Proceeds from sale of equity method investment	0	6,375
Purchases of property and equipment	(22,054)	(16,420)
Cash received from consolidation of VIE	0	3,322
Proceeds from sale of marketable securities	6,438	1,106
Distribution from investment - equity method	400	0
Contribution to investment - equity method	(1,785)	0
Net cash used in investing activities	(20,314)	(22,544)
Cash flows from financing activities
Dividends paid	(12,676)	(31,089)
Repayment of long-term debt	(3,714)	(238,254)
Payment of finance lease obligations	(417)	(81)
Proceeds from the exercise of stock options and warrants	2,784	6,601
Repurchase of shares	(9,648)	(5,739)
Proceeds from sale of non-controlling interest	67	48
Purchase of non-controlling interest	(4,338)	(75)
Borrowings on loans	1,986	180,000
Proceeds from sale of shares	0	40,133
Payment of debt issuance costs	0	(727)
Net cash used in financing activities	(25,956)	(49,183)
Net (decrease) increase in cash, cash equivalents and restricted cash	(49,081)	10,798
Cash, cash equivalents, and restricted cash, beginning of period	233,097	193,970
Cash, cash equivalents, and restricted cash, end of period	184,016	204,768
Supplementary disclosures of cash flow information
Cash paid for income taxes	41,811	24,800
Cash paid for interest	4,386	3,330
Supplemental disclosures of non-cash investing and financing activities
Dividend declared included in dividend payable	0	71
Deferred tax liability adjustment to goodwill	0	1,786
Fixed asset obtained in exchange for finance lease liabilities	398	0
Common stock issued in business combination	1,000	0
Cancellation of restricted stock awards	0	334
Mortgage loan	16,275	0
Cashless exercise of warrants	694	0
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	184,016
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows	$ 184,016	$ 204,768