Quarterly report pursuant to Section 13 or 15(d)

Variable Interest Entities (VIEs) (Details)

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Variable Interest Entities (VIEs) (Details) - USD ($)
$ in Thousands
Sep. 30, 2021
Dec. 31, 2020
Sep. 30, 2020
Dec. 31, 2019
Current assets        
Cash and cash equivalents $ 204,768 $ 193,470 $ 166,082 $ 103,189
Investments in marketable securities 128,558 67,695    
Receivables, net 18,753 7,058    
Receivables, net – related party 53,626 49,260    
Other receivables 5,773 4,297    
Prepaid expenses and other current assets 11,734 16,797    
Total current assets 427,212 338,577    
Noncurrent assets        
Intangible assets, net 83,594 86,985    
Goodwill 243,353 239,053    
Loans receivable – related party 0 4,145    
Investments in other entities – equity method 45,046 43,292    
Restricted cash 0 500    
Operating lease right-of-use assets 16,134 18,574    
Other assets 5,195 18,915    
Total noncurrent assets 444,082 478,909    
Total assets [1] 871,294 817,486    
Current liabilities        
Accounts payable and accrued expenses 57,505 36,143    
Fiduciary accounts payable 8,827 9,642    
Medical liabilities 42,872 50,330 $ 57,455 $ 58,725
Dividends payable 556 485    
Current portion of long-term debt 207 10,889    
Finance lease liabilities 110 102    
Operating lease liabilities 2,658 3,177    
Total current liabilities 116,759 114,992    
Noncurrent liabilities        
Long-term debt, net of current portion and deferred financing costs 182,813 230,211    
Deferred tax liability 19,592 10,959    
Finance lease liabilities, net of current portion 221 311    
Operating lease liabilities, net of current portion 13,856 15,865    
Other long-term liabilities 6,232 0    
Total noncurrent liabilities 222,714 257,346    
Total liabilities [1] 339,473 372,338    
Variable Interest Entity, Primary Beneficiary        
Current assets        
Cash and cash equivalents 121,258 126,158    
Investments in marketable securities 124,569 67,637    
Receivables, net 15,927 5,155    
Receivables, net – related party 50,454 46,718    
Income taxes receivable 4,267 0    
Other receivables 293 1,084    
Prepaid expenses and other current assets 9,808 14,863    
Loan receivable – related party 4,000 0    
Amount due from affiliate 15,764 0    
Total current assets 346,340 261,615    
Noncurrent assets        
Land, property and equipment, net 47,253 27,599    
Intangible assets, net 61,140 69,250    
Goodwill 109,460 109,460    
Loans receivable – related party 104 4,145    
Investment in affiliates 994,785 225,144    
Investments in other entities – equity method 45,046 43,516    
Investment in privately held entities 405 36,584    
Restricted cash 0 500    
Operating lease right-of-use assets 5,258 6,298    
Other assets 2,533 17,177    
Total noncurrent assets 1,265,984 539,673    
Total assets 1,612,324 801,288    
Current liabilities        
Accounts payable and accrued expenses 15,202 12,963    
Fiduciary accounts payable 8,827 9,642    
Medical liabilities 34,998 37,684    
Income taxes payable 0 4,225    
Dividends payable 556 485    
Amount due to affiliate 0 22,698    
Current portion of long-term debt 207 201    
Finance lease liabilities 110 102    
Operating lease liabilities 1,231 1,242    
Total current liabilities 61,131 89,242    
Noncurrent liabilities        
Long-term debt, net of current portion and deferred financing costs 7,245 7,379    
Deferred tax liability 18,941 9,144    
Finance lease liabilities, net of current portion 221 311    
Operating lease liabilities, net of current portion 4,262 5,242    
Other long-term liabilities 1,010 0    
Total noncurrent liabilities 31,679 22,076    
Total liabilities $ 92,810 $ 111,318    
[1] The Company’s consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The consolidated balance sheets include total assets that can be used only to settle obligations of the Company’s consolidated VIEs totaling $601.8 million and $576.1 million as of September 30, 2021 and December 31, 2020, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $92.8 million and $88.6 million as of September 30, 2021 and December 31, 2020, respectively. The VIE balances do not include $994.8 million of investment in affiliates and $15.8 million of amounts due from affiliates as of September 30, 2021 and $225.1 million of investment in affiliates and $22.7 million of amounts due to affiliates as of December 31, 2020 as these are eliminated upon consolidation and not presented within the consolidated balance sheets. See Note 16 – Variable Interest Entities (VIEs) for further detail.