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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash flows from operating activities:    
Net loss $ (375.3) $ (274.3)
Adjustments to reconcile net loss to net cash used in operating activities:    
Amortization of discount on debt and related issuance costs 3.3 2.4
Accretion of discounts and amortization of premiums on short-term marketable securities, net 4.9 2.4
Fair value adjustment to contingent consideration 38.3 0.0
Depreciation and amortization 25.3 11.7
Non-cash operating lease costs 31.6 11.2
Stock-based compensation, net of forfeitures 120.0 121.9
Change in operating assets and liabilities, net of impact of acquisitions:    
Accounts receivables (273.4) (208.0)
Other assets (5.3) (10.5)
Accounts payable and accrued compensation and benefits 7.4 23.1
Liability for unpaid claims 230.9 180.2
Operating lease liabilities (15.6) (9.9)
Other liabilities (5.4) 23.9
Net cash used in operating activities (213.3) (125.9)
Cash flows from investing activities:    
Proceeds from sales and maturities of marketable debt securities 716.6 43.7
Purchases of marketable debt securities (392.2) (817.6)
Purchase of business, net of cash acquired (5.6) (1.4)
Purchases of property and equipment (67.6) (40.6)
Net cash provided by (used by) investing activities 251.2 (815.9)
Cash flows from financing activities:    
Proceeds from borrowings on term loan, net 72.3 0.0
Proceeds from borrowings on Convertible Senior Notes, net 0.0 897.9
Purchase of capped calls 0.0 (123.6)
Capital contributions from non-controlling interests 0.0 0.1
Settlement of contingent earnout liability (21.7) 0.0
Capital distributions to non-controlling interests (1.3) (1.5)
Purchase of joint venture minority interest (2.1) 0.0
Proceeds from exercise of options 13.4 4.5
Proceeds from issuance of common stock under the employee purchase plan 4.1 3.0
Net cash provided by financing activities 64.7 780.4
Net change in cash, cash equivalents and restricted cash 102.6 (161.4)
Cash, cash equivalents and restricted cash, beginning of period 120.4 419.7
Cash, cash equivalents and restricted cash, end of period 223.0 258.3
Supplemental disclosures    
Additions to construction in process funded through accounts payable $ 7.0 $ 4.7