Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Operating activities
Net income (loss)	$ (20.5)	$ 61.2
Adjustments to reconcile net income (loss) to net cash (used in) provided by operations:
Depreciation and amortization	107.8	56.8
Amortization of debt issuance costs	2.2	0.8
Share-based compensation	46.5	62.0
(Gain)/loss on disposal and right-of-use asset write-downs	3.9	(0.3)
Provision for credit losses	10.7	0.6
Deferred income taxes	(9.1)	18.0
Non-cash lease expense	10.5	7.4
Other	1.5	0.8
Changes in operating assets and liabilities:
Accounts receivable and related party accounts receivable	(29.7)	(18.8)
Contract assets	(12.8)	0.0
Prepaid expenses and other assets	(38.3)	(19.8)
Accounts payable	(23.9)	4.5
Accrued compensation and benefits	(79.6)	34.3
Lease liabilities	(11.4)	(9.9)
Other liabilities	(3.2)	(8.9)
Customer liabilities and customer liabilities - related party	2.9	30.1
Net cash (used in) provided by operating activities	(39.5)	218.8
Investing activities
Purchases of property, equipment, and software	(74.6)	(33.4)
Proceeds from disposal of assets	0.4	2.6
Net cash used in investing activities	(921.9)	(325.5)
Financing activities
Payment of debt issuance costs	(1.0)	(1.9)
Payment of contingent consideration liability	0.0	(4.8)
Deferred payment related to acquisition of RevWorks	0.0	(12.5)
Inducement of preferred stock conversion	0.0	(105.0)
Exercise of vested stock options	4.6	6.3
Purchase of treasury stock	(12.5)	(29.5)
Shares withheld for taxes	(26.9)	(4.8)
Other	(0.2)	(0.1)
Net cash provided by financing activities	965.5	91.7
Effect of exchange rate changes in cash, cash equivalents and restricted cash	(3.1)	(0.6)
Net increase (decrease) in cash, cash equivalents and restricted cash	1.0	(15.6)
Cash, cash equivalents and restricted cash, at beginning of period	130.1	174.8
Cash, cash equivalents and restricted cash, at end of period	131.1	159.2
Supplemental disclosures of cash flow information
Property, equipment and software purchases not paid	27.4	25.7
CoyCo 2
Adjustments to reconcile net income (loss) to net cash (used in) provided by operations:
Share-based compensation	3.0	0.0
Senior Term Loan
Financing activities
Issuance of senior secured debt, net of discount and issuance costs and Borrowings on revolver	1,016.6	698.6
Repayment of senior secured debt and Repayments on revolver	(13.1)	(484.6)
Senior Revolver
Financing activities
Issuance of senior secured debt, net of discount and issuance costs and Borrowings on revolver	30.0	120.0
Repayment of senior secured debt and Repayments on revolver	(30.0)	(90.0)
Payment of equity issuance costs	(2.0)	0.0
Cloudmed
Investing activities
Acquisition of Cloudmed, net of cash acquired	(847.7)	0.0
VisitPay
Investing activities
Acquisition of Cloudmed, net of cash acquired	$ 0.0	$ (294.7)