ModivCare (MODV) 10-Q 5 Nov 21 2021 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2021	Nov. 01, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Document Transition Report	false
Entity File Number	001-34221
Entity Registrant Name	ModivCare Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	86-0845127
Entity Address, Address Line One	6900 Layton Avenue
Entity Address, Address Line Two	l2th Floor
Entity Address, City or Town	Denver
Entity Address, State or Province	CO
Entity Address, Postal Zip Code	80237
City Area Code	303
Local Phone Number	728-7030
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	MODV
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		13,999,767
Entity Central Index Key	0001220754
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Amendment Flag	false

Unaudited Condensed Consolidate

Unaudited Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 126,506	$ 183,281
Accounts receivable, net of allowance of $690 and $2,403, respectively	289,230	197,943
Other receivables	12,934	12,674
Prepaid expenses and other current assets	41,655	31,885
Restricted cash	186	75
Current assets of discontinued operations	141	758
Total current assets	470,652	426,616
Operating lease right-of-use assets	44,077	30,928
Property and equipment, net	52,538	27,544
Goodwill	929,986	444,927
Intangible assets, net	491,997	345,652
Equity investment	134,353	137,466
Other assets	11,550	12,780
Total assets	2,135,153	1,425,913
Current liabilities:
Accounts payable	33,458	8,464
Accrued contract payables	320,045	101,705
Accrued expenses and other current liabilities	109,571	117,010
Accrued transportation costs	92,028	79,674
Current portion of operating lease liabilities	9,287	8,277
Self-funded insurance programs	7,563	4,727
Deferred revenue	2,488	2,923
Current liabilities of discontinued operations	1,527	1,971
Total current liabilities	575,967	324,751
Long-term debt, net of deferred financing costs of $25,330 and $14,020, respectively	974,669	485,980
Deferred tax liabilities	112,461	92,195
Operating lease liabilities, less current portion	35,389	23,437
Long-term contract payables	5,793	72,183
Other long-term liabilities	26,887	15,756
Total liabilities	1,731,166	1,014,302
Commitments and contingencies (Note 14)
Stockholders’ equity
Common stock: Authorized 40,000,000 shares; $0.001 par value; 19,581,219 and 19,570,598, respectively, issued and outstanding (including treasury shares)	20	20
Additional paid-in capital	428,643	421,318
Retained earnings	243,356	218,414
Treasury shares, at cost, 5,561,826 and 5,287,283 shares, respectively	(268,032)	(228,141)
Total stockholders’ equity	403,987	411,611
Total liabilities and stockholders’ equity	$ 2,135,153	$ 1,425,913

Unaudited Condensed Consolida_2

Unaudited Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 690	$ 2,403
Deferred financing costs on credit facility	$ 25,330	$ 14,020
Common stock, shares authorized	40,000,000	40,000,000
Common stock, par (in USD per share)	$ 0.001	$ 0.001
Common stock, shares, issued	19,581,219	19,570,598
Common stock, shares, outstanding	19,581,219	19,570,598
Treasury stock, shares	5,561,826	5,287,283

Unaudited Condensed Consolida_3

Unaudited Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Service revenue, net	$ 493,059	$ 320,619	$ 1,421,117	$ 970,166
Grant income (Note 2)	0	0	3,500	0
Operating expenses:
Service expense	399,272	235,543	1,139,170	764,310
General and administrative expense	68,054	34,441	179,271	86,435
Depreciation and amortization	12,608	7,301	36,667	17,199
Total operating expenses	479,934	277,285	1,355,108	867,944
Operating income	13,125	43,334	69,509	102,222
Other expenses (income):
Interest expense, net	17,702	379	34,412	2,118
Equity in net loss (income) of investee	6,748	(10,325)	1,978	(12,200)
Income (loss) from continuing operations before income taxes	(11,325)	53,280	33,119	112,304
Provision (benefit) for income taxes	(3,863)	14,360	7,944	19,785
Income (loss) from continuing operations, net of tax	(7,462)	38,920	25,175	92,519
Loss from discontinued operations, net of tax	(108)	(115)	(232)	(618)
Net income (loss)	(7,570)	38,805	24,943	91,901
Net income (loss) available to common stockholders (Note 12)	$ (7,570)	$ 35,346	$ 24,943	$ 34,563
Basic earnings (loss) per common share:
Continuing operations (in dollars per share)	$ (0.53)	$ 2.53	$ 1.79	$ 2.63
Discontinued operations (in dollars per share)	(0.01)	(0.01)	(0.02)	(0.05)
Basic earnings (loss) per common share (in dollars per share)	(0.54)	2.52	1.77	2.58
Diluted earnings (loss) per common share:
Continuing operations (in dollars per share)	(0.53)	2.51	1.76	2.62
Discontinued operations (in dollars per share)	(0.01)	(0.01)	(0.02)	(0.05)
Diluted earnings (loss) per common share (in dollars per share)	$ (0.54)	$ 2.50	$ 1.74	$ 2.57
Weighted-average number of common shares outstanding:
Basic (in shares)	13,993,438	14,026,039	14,102,371	13,367,605
Diluted (in shares)	13,993,438	14,133,904	14,278,331	13,415,344

Unaudited Condensed Consolida_4

Unaudited Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Operating activities
Net income	$ 24,943	$ 91,901
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	8,839	6,980
Amortization	27,827	10,219
Provision for doubtful accounts	(1,712)	(3,139)
Stock-based compensation	4,225	2,949
Deferred income taxes	(3,295)	12,612
Amortization of deferred financing costs and debt discount	2,175	292
Equity in net loss (income) of investee	1,978	(12,200)
Reduction of right-of-use assets	8,681	6,769
Changes in operating assets and liabilities, net of effects of acquisitions:
Accounts receivable and other receivables	(69,597)	20,017
Prepaid expenses and other assets	(5,330)	(28,216)
Income tax refunds on sale of business	0	17,789
Self-funded insurance programs	2,837	1,259
Accrued contract payables	151,950	88,347
Accounts payable and accrued expenses	7,138	33,061
Accrued transportation costs	12,354	(5,506)
Deferred revenue	(502)	453
Other long-term liabilities	2,183	43,639
Net cash provided by operating activities	174,694	287,226
Investing activities
Purchase of property and equipment	(13,852)	(4,786)
Acquisition, net of cash acquired	(667,228)	(77,665)
Net cash used in investing activities	(681,080)	(82,451)
Financing activities
Proceeds from debt	625,000	162,000
Repayment of debt	(125,000)	(162,000)
Repurchase of common stock, for treasury	(39,040)	(10,186)
Payment of debt issuance costs	(13,486)	0
Proceeds from common stock issued pursuant to stock option exercise	3,099	21,581
Restricted stock surrendered for employee tax payment	(851)	(92)
Preferred stock redemption payment	0	(88,743)
Preferred stock redemption payment	0	(1,988)
Other financing activities	0	(204)
Net cash provided by (used in) financing activities	449,722	(79,632)
Net change in cash, cash equivalents and restricted cash	(56,664)	125,143
Cash, cash equivalents and restricted cash at beginning of period	183,356	61,673
Cash, cash equivalents and restricted cash at end of period	126,692	186,816
Supplemental cash flow information
Cash paid for interest	24,006	1,775
Cash paid for income taxes, net of refunds	12,846	11,805
Assets acquired under operating leases	$ 21,829	$ 5,488

Unaudited Condensed Consolida_5

Unaudited Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands		Total	Preferred Stock Conversion Agreement	Common Stock	Common StockPreferred Stock Conversion Agreement	Additional Paid-in Capital	Additional Paid-in CapitalPreferred Stock Conversion Agreement	Retained Earnings	Retained EarningsPreferred Stock Conversion Agreement	Treasury Stock
Beginning Balance (in shares) at Dec. 31, 2019				18,073,763						5,088,782
Beginning Balance at Dec. 31, 2019		$ 317,592		$ 18		$ 351,529		$ 183,733		$ (217,688)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		16,098						16,098
Stock-based compensation		1,005				1,005
Exercise of employee stock options (in shares)				39,111
Exercise of employee stock options		2,054				2,054
Restricted stock issued (in shares)				79,029						626
Restricted stock issued		(37)								$ (37)
Shares issued for bonus settlement and director stipends				701
Shares issued for bonus settlement and director stipends		38				38
Stock repurchase plan (in shares)										142,821
Stock repurchase plan		(7,299)								$ (7,299)
Conversion of convertible preferred stock to common stock (in shares)				40
Conversion of convertible preferred stock to common stock		2				2
Convertible preferred stock dividends	[1]	(1,095)						(1,095)
Ending Balance (in shares) at Mar. 31, 2020				18,192,644						5,232,229
Ending Balance at Mar. 31, 2020		328,358		$ 18		354,628		198,736		$ (225,024)
Beginning Balance (in shares) at Dec. 31, 2019				18,073,763						5,088,782
Beginning Balance at Dec. 31, 2019		317,592		$ 18		351,529		183,733		$ (217,688)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		91,901
Ending Balance (in shares) at Sep. 30, 2020				19,468,591						5,285,666
Ending Balance at Sep. 30, 2020		410,067		$ 20		416,504		221,509		$ (227,966)
Beginning Balance (in shares) at Mar. 31, 2020				18,192,644						5,232,229
Beginning Balance at Mar. 31, 2020		328,358		$ 18		354,628		198,736		$ (225,024)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		36,998						36,998
Stock-based compensation		691				691
Exercise of employee stock options (in shares)				129,722
Exercise of employee stock options		9,275				9,275
Restricted stock forfeited (in shares)				(8,496)
Shares issued for bonus settlement and director stipends				487
Shares issued for bonus settlement and director stipends		38				38
Stock repurchase plan (in shares)										52,856
Stock repurchase plan		(2,887)								$ (2,887)
Conversion of convertible preferred stock to common stock (in shares)				14,166	925,567
Conversion of convertible preferred stock to common stock		546	$ 31,259		$ 1	546	$ 37,255		$ (5,997)
Redemption of convertible preferred stock		(42,954)						(42,954)
Convertible preferred stock dividends	[1]	(866)						(866)
Ending Balance (in shares) at Jun. 30, 2020				19,254,090						5,285,085
Ending Balance at Jun. 30, 2020		360,458		$ 19		402,433		185,917		$ (227,911)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		38,805						38,805
Stock-based compensation		1,139				1,139
Exercise of employee stock options (in shares)				145,124
Exercise of employee stock options		10,251		$ 1		10,250
Restricted stock issued (in shares)				330
Restricted stock surrendered for employee tax payment (in shares)										581
Restricted stock surrendered for employee tax payment		(55)								$ (55)
Shares issued for bonus settlement and director stipends				414
Shares issued for bonus settlement and director stipends		38				38
Conversion of convertible preferred stock to common stock (in shares)					68,633
Conversion of convertible preferred stock to common stock			$ 2,644				$ 2,644
Redemption of convertible preferred stock		(3,186)						(3,186)
Dividends paid pursuant to the Conversion Agreement	[2]	(27)						(27)
Ending Balance (in shares) at Sep. 30, 2020				19,468,591						5,285,666
Ending Balance at Sep. 30, 2020		410,067		$ 20		416,504		221,509		$ (227,966)
Beginning Balance (in shares) at Dec. 31, 2020				19,570,598						5,287,283
Beginning Balance at Dec. 31, 2020		411,611		$ 20		421,318		218,414		$ (228,141)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		18,840						18,840
Stock-based compensation		1,149				1,149
Exercise of employee stock options (in shares)				36,338
Exercise of employee stock options		2,286				2,286
Restricted stock issued (in shares)				15,821
Restricted stock surrendered for employee tax payment (in shares)										4,253
Restricted stock surrendered for employee tax payment		(721)								$ (721)
Shares issued for bonus settlement and director stipends				260
Shares issued for bonus settlement and director stipends		38				38
Stock repurchase plan (in shares)										94,235
Stock repurchase plan		(14,450)								$ (14,450)
Ending Balance (in shares) at Mar. 31, 2021				19,623,017						5,385,771
Ending Balance at Mar. 31, 2021		418,753		$ 20		424,791		237,254		$ (243,312)
Beginning Balance (in shares) at Dec. 31, 2020				19,570,598						5,287,283
Beginning Balance at Dec. 31, 2020		411,611		$ 20		421,318		218,414		$ (228,141)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		24,943
Ending Balance (in shares) at Sep. 30, 2021				19,581,219						5,561,826
Ending Balance at Sep. 30, 2021		403,987		$ 20		428,643		243,356		$ (268,032)
Beginning Balance (in shares) at Mar. 31, 2021				19,623,017						5,385,771
Beginning Balance at Mar. 31, 2021		418,753		$ 20		424,791		237,254		$ (243,312)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		13,672						13,672
Stock-based compensation		1,416				1,416
Exercise of employee stock options (in shares)				866
Exercise of employee stock options		49				49
Restricted stock forfeited (in shares)				(55,162)
Restricted stock surrendered for employee tax payment (in shares)										713
Restricted stock surrendered for employee tax payment		(99)								$ (99)
Shares issued for bonus settlement and director stipends				324
Shares issued for bonus settlement and director stipends		56				56
Stock repurchase plan (in shares)										175,173
Stock repurchase plan		(24,590)								$ (24,590)
Ending Balance (in shares) at Jun. 30, 2021				19,569,045						5,561,657
Ending Balance at Jun. 30, 2021		409,257		$ 20		426,312		250,926		$ (268,001)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)		(7,570)						(7,570)
Stock-based compensation		1,505				1,505
Exercise of employee stock options (in shares)				12,296
Exercise of employee stock options		765				765
Restricted stock issued (in shares)				(455)
Restricted stock surrendered for employee tax payment (in shares)										169
Restricted stock surrendered for employee tax payment		(31)								$ (31)
Shares issued for bonus settlement and director stipends				333
Shares issued for bonus settlement and director stipends		61				61
Stock repurchase plan (in shares)										0
Stock repurchase plan		0								$ 0
Ending Balance (in shares) at Sep. 30, 2021				19,581,219						5,561,826
Ending Balance at Sep. 30, 2021		$ 403,987		$ 20		$ 428,643		$ 243,356		$ (268,032)
[1]	Cash dividends on redeemable convertible preferred stock of $1.37 per share were distributed to convertible preferred stockholders for the three months ended March 31, 2020 and June 30, 2020.
[2]	On September 3, 2020, accrued cash dividends of $1.37 per share were paid to Coliseum Capital Partners, L.P. and certain funds and accounts managed by Coliseum Capital Management, LLC pursuant to the Preferred Stock Conversion Agreement as discussed in Note 11, Stock-Based Compensation and Similar Arrangements.

Unaudited Condensed Consolida_6

Unaudited Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) - $ / shares	Sep. 03, 2020	Jun. 30, 2020	Mar. 31, 2020
Statement of Stockholders' Equity [Abstract]
Preferred stock, dividends per share, cash paid (in USD per share)	$ 1.37	$ 1.37	$ 1.37

Organization and Basis of Prese

Organization and Basis of Presentation	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	Organization and Basis of Presentation Description of Business ModivCare Inc. ("ModivCare" or the "Company") is a technology-enabled healthcare services company that provides a suite of integrated supportive care solutions for public and private payors and their patients. Its value-based solutions address the social determinants of health, or SDoH, enable greater access to care, reduce costs, and improve outcomes. ModivCare is a provider of non-emergency medical transportation, or NEMT, personal care, and remote patient monitoring, or RPM, solutions. The technology-enabled operating model includes NEMT core competencies in risk underwriting, contact center management, network credentialing, claims management and non-emergency medical transport management. Additionally, its personal care services include placements of non-medical personal care assistants, home health aides and nurses primarily to Medicaid patient populations in need of care monitoring and assistance performing daily living activities in the home setting, including senior citizens and disabled adults. ModivCare’s remote patient monitoring services include personal emergency response systems, vitals monitoring and data-driven patient engagement solutions. ModivCare is further expanding its offerings to include nutritional meal delivery and partner with communities throughout the country, providing food-insecure individuals delivery of nutritional meals. ModivCare’s solutions help health plans manage risks, close care gaps, reduce costs, and connect members to care. Through the combination of its historical NEMT business, its in-home personal care business that consists of Simplura Health Group and Care Finders Total Care LLC, and its recent addition of the remote patient monitoring business through its acquisition of VRI Intermediate Holdings, LLC, or VRI, ModivCare has united four complementary healthcare businesses that serve similar, highly vulnerable patient populations. On May 6, 2020, ModivCare acquired all of the outstanding equity of National MedTrans, LLC, or NMT, a New York limited liability company and provider of non-emergency medical transportation services under contractual relationships. On November 18, 2020, ModivCare acquired all of the outstanding equity of OEP AM, Inc., a Delaware corporation doing business as Simplura Health Group, or Simplura, which formed the foundation of our personal care business and Personal Care segment. On May 6, 2021, ModivCare acquired the WellRyde software from nuVizz, Inc., a Georgia corporation ("nuVizz"), a technology provider of Advanced Transportation Management Systems software enabling routing, automated trip assignments and real-time network monitoring. On September 14, 2021, ModivCare acquired Care Finders Total Care LLC, or Care Finders, a personal care provider in the Northeast, with a scaled presence in New Jersey, Pennsylvania, and Connecticut, as an addition to the Personal Care segment. On September 22, 2021, ModivCare acquired VRI, a provider of remote patient monitoring and data-driven patient engagement solutions. See Note 3, Acquisitions, for further information regarding the above acquisitions. ModivCare also holds a 43.6% minority interest in CCHN Group Holdings, Inc. and its subsidiaries, which operates under the Matrix Medical Network brand and which we refer to as “Matrix”. Matrix maintains a national network of community-based clinicians who deliver in-home and on-site services, and a fleet of mobile health clinics that provide community-based care with advanced diagnostic capabilities and enhanced care options. Matrix’s clinical care business ("Clinical Care") provides risk adjustment solutions that improve health outcomes for individuals and financial performance for health plans. Matrix’s clinical solutions business ("Clinical Solutions") provides employee health and wellness services focused on improving employee health with worksite certification solutions that reinforce business resilience and safe return-to-work outcomes. Its Clinical Solutions offerings also provide clinical trial services which support the delivery of safe and effective decentralized clinical trial operations to patients and eligible volunteers. Matrix also provides lab services, including services related to COVID-19 such as screening, testing, and vaccinations. Basis of Presentation The Company follows accounting standards established by the Financial Accounting Standards Board (“FASB”). The FASB establishes accounting principles generally accepted in the United States (“GAAP”). Rules and interpretive releases of the Securities and Exchange Commission (“SEC”) under the authority of federal securities laws are also sources of authoritative GAAP for SEC registrants. References to GAAP issued by the FASB in these notes are to the FASB Accounting Standards Codification (“ASC”), which serves as the single source of authoritative accounting and applicable reporting standards to be applied for non-governmental entities. All amounts are presented in U.S. dollars unless otherwise noted. The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with GAAP for interim financial information, and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and disclosures required by GAAP for annual audited financial statements. In the opinion of management, all adjustments considered necessary for the fair presentation of the results of the interim periods have been included. The Company has made estimates relating to the reporting of assets and liabilities, revenues and expenses, and certain disclosures in the preparation of these unaudited condensed consolidated financial statements in conformity with GAAP. Actual results could differ from those estimates. Operating results for the three and nine months ended September 30, 2021 are not necessarily indicative of the results that may be expected for the fiscal year ending December 31, 2021. Management has evaluated events and transactions that occurred after the balance sheet date and through the date these unaudited condensed consolidated financial statements were filed with the SEC and considered the effect of such events in the preparation of these condensed consolidated financial statements. The condensed consolidated balance sheet at December 31, 2020 included in this Form 10-Q has been derived from audited financial statements at that date, but does not include all the information and footnotes required by GAAP for annual audited financial statements. The unaudited condensed consolidated financial statements contained herein should be read in conjunction with the audited financial statements and notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. The Company accounts for its investment in Matrix using the equity method, as the Company does not control the decision-making process or business management practices of Matrix. While the Company has access to certain information and performs certain procedures to review the reasonableness of information, the Company relies on the management of Matrix to provide accurate financial information prepared in accordance with GAAP. The Company receives audit reports relating to such financial information from Matrix’s independent auditors on an annual basis. The Company is not aware of any errors in or possible misstatements of the financial information provided by Matrix that would have a material effect on the Company’s consolidated financial statements. See Note 7, Equity Investment , for further information. Impact of the COVID-19 Pandemic Since March 2020, the COVID-19 pandemic has impacted the Company’s business, as well as its patients, communities, and employees. The Company’s priorities during the COVID-19 pandemic remain protecting the health and safety of its employees, maximizing the availability of its services and products to support the SDoH, and the operational and financial stability of its business.

Significant Accounting Policies

Significant Accounting Policies and Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Significant Accounting Policies and Recent Accounting Pronouncements	Significant Accounting Policies and Recent Accounting Pronouncements Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Grant Income During the nine months ended September 30, 2021, the Company received distributions from the CARES Act PRF of approximately $3.5 million targeted to offset lost revenue and expenditures incurred in connection with the COVID-19 pandemic. During the three months ended September 30, 2021, Company did not receive distributions from the CARES Act PRF. The PRF payments are subject to certain restrictions and are subject to recoupment if not used for designated purposes. As a condition to receiving distributions, providers must agree to certain terms and conditions, including, among other things, that the funds are being used for lost revenues and unreimbursed COVID-19 related expenses as defined by the U.S. Department of Health and Human Services ("HHS"). All recipients of PRF payments are required to comply with the reporting requirements described in the terms and conditions and as determined by HHS. The Company recognizes grant payments as grant income when there is reasonable assurance that it has complied with the conditions associated with the grant. Grant income recognized by the Company is presented in grant income in the accompanying condensed consolidated statements of operations. HHS guidance related to PRF grant funds is still evolving and subject to change. The Company is continuing to monitor the reporting requirements as they evolve. CARES Act Payroll Deferral The CARES Act also provides for certain federal income and other tax changes, including the deferral of the employer portion of Social Security payroll taxes. The Company has deferred payment of approximately $20.8 million related to the deferral of employer payroll taxes as of September 30, 2021 under the CARES Act. Of this amount, approximately 50% is due in December of 2021 and 50% is due in December of 2022; therefore, $10.4 million is recorded in accrued expenses, and $10.4 million is recorded in other long-term liabilities. Recent Accounting Pronouncements The Company adopted the following accounting pronouncements during the nine months ended September 30, 2021: In January 2020, the FASB issued ASU 2020-01, Clarifying the Interactions Between Topic 321, Topic 323, and Topic 815 ("ASU 2020-01"), to clarify the interaction among the accounting standards for equity securities, equity method investments and certain derivatives. ASU 2020-01 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods therein. There was no material impact to the financial statements from the adoption of this ASU. In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes ("ASU 2019-12"). The ASU removes certain exceptions to the general principles in ASC 740, Income Taxes , and also clarifies and amends existing guidance to reduce complexity in accounting for income taxes. The ASU is effective for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year, with early adoption permitted. There was no material impact to the financial statements from the adoption of this ASU. Recent accounting pronouncements that the Company has yet to adopt are as follows: In March 2020, the FASB issued ASU 2020-04, Facilitation of the Effects of Reference Rate Reform on Financial Reporting ("ASU 2020-04") which provides optional expedients and exceptions for applying GAAP to contract modifications, hedging relationships, and other transactions that reference the London Interbank Offered Rate ("LIBOR") or another reference rate expected to be discontinued due to reference rate reform. The relief granted in ASC 848, Reference Rate Reform ("ASC 848"), is applicable only to legacy contracts if the amendments made to the agreements are solely for reference rate reform activities. The provisions of ASC 848 must be applied for all transactions other than derivatives, which may be applied at a hedging relationship level. Entities may apply the provisions as of the beginning of the reporting period when the election is made (i.e. as early as the first quarter 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to be completed. The Company is currently evaluating the impact ASU 2020-04 will have on its consolidated financial statements or disclosures; however, does not expect the adoption to have a material impact. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging— Contracts in Entity’s Own Equity (Subtopic 815-40) ("ASU 2020-06") which addresses the complexity associated with applying GAAP for certain financial instruments with characteristics of liabilities and equity. The update limits the accounting models for convertible instruments resulting in fewer embedded conversion features being separately recognized from the host contract. Specifically, ASU 2020-06 removes from GAAP the separation models for convertible debt with a cash conversion feature and convertible instruments with a beneficial conversion feature. As a result, after adopting the ASU’s guidance, entities will not separately present an embedded conversion feature in such debt within equity. ASU 2020-06 is effective for public business entities for fiscal years beginning after December 15, 2021, including interim periods therein. The Company is currently evaluating the impact ASU 2020-06 will have on its consolidated financial statements or disclosures; however, does not expect the adoption to have a material impact.

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions Business Combinations Simplura Health Group On November 18, 2020, the Company completed its acquisition of Simplura Heath Group, or Simplura. Simplura was a nonpublic entity that specializes in personal care services offering placements of personal care assistants, home health aides, and skilled nurses for senior citizens, disabled adults and other high-needs patients. Simplura operates from its headquarters in Valley Stream, New York, with approximately 57 branches across seven states, including in several of the nation’s largest personal care markets. The acquisition of Simplura added a new business segment in personal care—a sector of healthcare that complements the NEMT segment. The stock transaction was accounted for in accordance with ASC 805, Business Combinations in which a wholly-owned subsidiary of ModivCare Inc. acquired 100 percent of the voting stock of Simplura for $548.6 million (a preliminary purchase price of $569.8 million less $21.2 million of cash that was acquired). The following is a preliminary estimate, based on certain preliminary items noted in the table below, of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of November 18, 2020 (in thousands): Cash $ 21,182 Accounts receivable (1) 69,882 Prepaid expenses and other (2) 9,688 Property and equipment (3) 1,640 Intangible assets (4) 264,770 Operating right of use asset (5) 10,285 Goodwill (6) 317,085 Other assets (7) 628 Accounts payable and accrued liabilities (7) (46,073) Accrued expense (7) (2,564) Deferred revenue (7) (2,871) Deferred acquisition payments (8) (4,046) Deferred acquisition note payable (7) (1,050) Operating lease liabilities (5) (10,285) Deferred tax liabilities (9) (58,452) Total of assets acquired and liabilities assumed $ 569,819 The acquisition method of accounting incorporates fair value measurements that can be highly subjective, and it is possible the application of reasonable judgment could develop different assumptions resulting in a range of alternative estimates using the same facts and circumstances. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. This estimate is preliminary as the Company's evaluation of the collectability of receivables is ongoing. (2) Given the short-term nature of the balance of prepaid expenses carrying value represents the fair value. (3) The acquired property and equipment consists primarily of leasehold improvements, furniture and fixtures, and vehicles. The fair value of the property and equipment was determined based upon the best and highest use of the property with final values determined using cost and comparable sales methods. (4) The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 15 years $ 221,000 Trademarks and trade names Amortizable 10 years 43,000 Licenses Not Amortizable Indefinite 770 $ 264,770 The Company valued trademarks and trade names utilizing the relief of royalty method and payor network utilizing the multi-period excess earnings method, a form of the income approach. This assessment is preliminary and will be finalized in the fourth quarter of 2021. (5) The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) were recorded at $11.7 million based on market rates available to the Company during our preliminary purchase price allocation. This assessment has since been updated through the implementation of ASC 842 at the Personal Care segment as of September 30, 2021, and the related balances have been updated to $10.3 million. This assessment remains preliminary as of the date of our filing and will be finalized with final purchase accounting in the fourth quarter of 2021. (6) The acquisition preliminarily resulted in $309.7 million of goodwill as a result of expected synergies due to value-based care and solutions being provided to similar patient populations that partner with many of the same payor groups. In the second quarter of 2021 a closing cash adjustment of $3.5 million was paid to OEP AM and in the third quarter of 2021 other assets acquired were adjusted down by $3.9 million which, along with other immaterial adjustments, increased the goodwill related to this transaction to $317.1 million. This assessment is preliminary and purchase accounting will be finalized in the fourth quarter of 2021. None of the acquired goodwill is deductible for tax purposes. (7) Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the acquisition date. (8) Deferred acquisition payments are associated with historical acquisitions by Simplura. (9) Net deferred tax liabilities represent the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 13, Income Taxes , for additional discussion of the Company’s combined income tax position subsequent to the acquisition. CareFinders Total Care On September 14, 2021, the Company completed its acquisition of Care Finders. Care Finders is a personal care provider in the Northeast, with operations in New Jersey, Pennsylvania, and Connecticut. The acquisition of Care Finders broadens access to in-home personal care solutions for patients and supports the Company's strategy to expand on its personal care platform, which already includes Simplura. The equity transaction was accounted for in accordance with ASC 805, Business Combinations in which a wholly-owned subsidiary of ModivCare Inc. acquired 100% percent of the equity securities of Care Finders for $332.3 million (a preliminary purchase price of $344.3 million less $12.0 million of cash that was acquired). The Company has not yet obtained and assessed all relevant historical financial information needed to perform the valuation and has not completed the final valuations of certain assets and liabilities. As such, the following is a preliminary estimate, based on certain preliminary items noted in the table below, of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of September 14, 2021 (in thousands): Cash $ 11,963 Accounts receivable (1) 12,253 Prepaid expenses and other (2) 653 Property and equipment (3) 3,206 Inventories (4) 145 Intangibles (5) 75,900 Goodwill (6) 248,518 Other assets (7) 226 Accounts payable and accrued liabilities (8) (5,347) Accrued expense (8) (871) Other liabilities (8) (80) Deferred tax liabilities (9) (2,275) Total of assets acquired and liabilities assumed $ 344,291 The acquisition method of accounting incorporates fair value measurements that can be highly subjective, and it is possible the application of reasonable judgment could develop different assumptions resulting in a range of alternative estimates using the same facts and circumstances. Upon finalization of the preliminary items noted below there may be related adjustments to certain of such items and to goodwill and income taxes. All items are expected to be finalized by the third quarter of 2022. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. This estimate is preliminary as the Company's evaluation of the collectability of receivables is ongoing. (2) Given the short-term nature of the balance of prepaid expenses carrying value represents the fair value. (3) The acquired property and equipment consists primarily of capitalized software, construction in progress, and computer equipment. This estimate is preliminary as the Company's evaluation of the fair value of property and equipment is ongoing. (4) Inventories are stated at fair value as of the acquisition date. (5) The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 9 years $ 68,300 Trade name Amortizable 8 years 7,600 $ 75,900 The intangible valuation amounts disclosed in the table above represent a preliminary estimate, as of the acquisition date of September 14, 2021. Final purchase accounting is expected to be finalized by the third quarter of 2022. (6) The acquisition preliminarily resulted in $248.5 million of goodwill as a result of expected synergies due to future customers driven by expansion into different markets, an increase in market share, and a growing demographic that will need VRI's monitoring products. Purchase accounting will be finalized in the third quarter of 2022. All of the acquired goodwill is deductible for tax purposes. Goodwill allocation to reporting units is not completed as of the date of the financial statements, September 30, 2021. (7) Included in Other assets are security deposits with a value of $0.2 million. (8) Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the acquisition date. (9) Net deferred tax liabilities represent the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 13, Income Taxes , for additional discussion of the Company’s combined income tax position subsequent to the acquisition. Since the date of the acquisition, Care Finders sales of $8.9 million and net income of $0.5 million are included in the Company's consolidated results of operations. VRI Intermediate Holdings, LLC On September 22, 2021, the Company completed its acquisition of VRI, a provider of remote patient monitoring solutions, managing a comprehensive suite of services including personal emergency response systems, vitals monitoring and data-driven patient engagement solutions. The acquisition of VRI accelerates the Company's strategy to build a holistic suite of supportive care solutions that address social determinants of health, introduces new technology-enabled in-home solutions that deepen the Company's engagement with payors and patients, and adds a strategic pillar and operating team to advance the Company's broader technology and data strategy. As a result of the acquisition, ModivCare adds remote patient monitoring, or RPM, as a business segment. The stock transaction was accounted for in accordance with ASC 805, Business Combinations in which a wholly-owned subsidiary of ModivCare Inc. acquired 100% percent of the equity securities of VRI for $314.8 million (a preliminary purchase price of $317.7 million less $2.9 million of cash that was acquired). The Company has not yet obtained and assessed all relevant historical financial information needed to perform the valuation and has not completed the final valuations of certain assets and liabilities. As such, the following is a preliminary estimate, based on certain preliminary items noted in the table below, of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of September 22, 2021 (in thousands): Cash $ 2,922 Accounts receivable (1) 6,849 Inventory (2) 1,684 Prepaid expenses and other (3) 284 Property and equipment (4) 16,775 Intangible assets (5) 85,800 Goodwill (6) 228,884 Other assets (7) 217 Accounts payable and accrued liabilities (8) (1,890) Accrued expense (8) (2,481) Deferred revenue (8) (66) Deferred tax liabilities (8) (21,285) Total of assets acquired and liabilities assumed $ 317,693 The acquisition method of accounting incorporates fair value measurements that can be highly subjective, and it is possible the application of reasonable judgment could develop different assumptions resulting in a range of alternative estimates using the same facts and circumstances. Upon finalization of the preliminary items noted below there may be related adjustments to certain of such items and to goodwill and income taxes. All items are expected to be finalized by the third quarter of 2022. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. This estimate is preliminary as the Company's evaluation of the collectability of receivables is ongoing. (2) Inventory is stated at fair value as of the acquisition date. (3) Given the short-term nature of the balance of prepaid expenses carrying value represents the fair value. (4) The acquired property and equipment consists primarily of monitoring equipment, buildings, and vitals equipment. This estimate is preliminary as the Company's evaluation of the fair value of property and equipment is ongoing. (5) The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 9 years $ 70,700 Trade name Amortizable 8 years 13,300 Internally developed software Amortizable 7 years 1,800 $ 85,800 The intangible valuation amounts disclosed in the table above represent a preliminary estimate, as of the acquisition date of September 22, 2021. Final purchase accounting is expected to be finalized by the third quarter of 2022. (6) The acquisition preliminarily resulted in $228.9 million of goodwill as a result of expected synergies due to future customers driven by expansion into different markets and an increase in market share. Purchase accounting will be finalized in the third quarter of 2022. The amount of goodwill deductible for tax purposes has yet to be determined. Goodwill allocation to reporting units is not completed as of the date of the financial statements, September 30, 2021. (7) Included in other assets are other receivables and employees advances with a value of approximately $0.2 million. (8) Accounts payable as well as certain other current and non-current liabilities are stated at fair value as of the acquisition date. Net deferred tax liabilities represent the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 13, Income Taxes , for additional discussion of the Company’s combined income tax position subsequent to the acquisition. Since the date of the acquisition, VRI sales of $1.6 million and net income of $0.4 million are included in the Company's consolidated results of operations. Pro Forma Financial Information Assuming Simplura had been acquired as of January 1, 2019, and Care Finders and VRI had been acquired as of January 1, 2020, and the results of each of them had been included in operations beginning on January 1, 2020, the following table provides estimated unaudited pro forma results of operations for the three and nine months ended September 30, 2021 and 2020 (in thousands, except earnings per share). The estimated pro forma net income adjusts for the effect of fair value adjustments related to each of the acquisitions, transaction costs and other non-recurring costs directly attributable to the transactions and the impact of the additional debt to finance the applicable acquisitions. Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Pro forma: Revenue $ 547,965 $ 489,104 $ 1,603,015 $ 1,475,668 Income (loss) from continuing operations, net (13,678) 30,043 11,568 (4,417) Diluted earnings (loss) per share $ (0.98) $ 2.13 $ 0.81 $ (0.33) Estimated unaudited pro forma information is not necessarily indicative of the results that actually would have occurred had the acquisitions been completed on the date indicated or of future operating results. The supplemental proforma earnings were adjusted to exclude the impact of historical interest expense of Simplura, Care Finders and VRI of $6.2 million, $1.1 million and $1.1 million, respectively, for the three months ended September 30, 2020, and $20.1 million, $3.6 million and $3.8 million, respectively, for the nine months ended September 30, 2020. Acquisition-related costs of approximately $5.9 million and $4.5 million for Care Finders and VRI, respectively, were expensed as incurred, recorded in selling, general and administrative expenses during the period ended September 30, 2021, and are reflected in the pro forma table above at the assumed acquisition date. Acquisition-related costs consisted of professional fees for advisory, consulting and underwriting services as well as other incremental costs directly related to the acquisitions. Asset Acquisitions National MedTrans On May 6, 2020, ModivCare Solutions, LLC, entered into a purchase agreement with NMT, pursuant to which NMT was acquired for total consideration of $80.0 million, less certain adjustments, in an all cash transaction. The transaction was accounted for as an asset acquisition in accordance with ASC 805, Business Combinations . The Company incurred transaction costs for the acquisition of $0.8 million during the year ended December 31, 2020. These costs were capitalized as a component of the purchase price. The consideration paid for the acquisition is as follows (in thousands): Value Consideration paid $ 80,000 Transaction costs 774 Restricted cash received (3,109) Net consideration $ 77,665 Restricted cash acquired was related to a security reserve for a contract. No liabilities were assumed. The fair value allocation of the net consideration is as follows (in thousands, except useful lives): Type Useful Life Value Payor relationships Amortizable 6 years $ 75,514 Trade names and trademarks Amortizable 3 years 2,151 $ 77,665 WellRyde On May 6, 2021, the Company entered into an asset purchase agreement with nuVizz to purchase the software, WellRyde. Pursuant to the purchase agreement, the WellRyde software was acquired for total consideration of $12.0 million in cash, subject to certain adjustments. The transaction was accounted for as an asset acquisition in accordance with ASC 805, Business Combinations . The Company incurred transaction costs for the acquisition of $0.5 million during the period ended September 30, 2021. These costs were capitalized as a component of the purchase price. The consideration paid for the acquisition is as follows (in thousands): Value Consideration paid $ 12,000 Transaction costs 463 Net consideration $ 12,463 The fair value allocation of the net consideration is as follows (in thousands, except useful lives): Type Useful Life Value Transportation management software Amortizable 10 years $ 12,328 Assembled workforce Amortizable 10 years 135 $ 12,463

Segments

Segments	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Segments	Segments Prior to the Company’s acquisition of Simplura in November 2020, the Company, based on how its chief operating decision maker then determined the allocation of resources and assessed the performance of the Company’s operations, determined that it had two reportable operating segments: NEMT, which represents the Company’s non-emergency medical transportation business; and Matrix Investment, which represents the Company’s Clinical Care and Clinical Solutions businesses, that is reported by the Company under the equity method of accounting. Following its acquisition of Simplura in November 2020, which operates as a personal care service provider, the Company began reporting a third operating segment: Personal Care. The acquisition of Care Finders in September 2021, another personal care service provider, added to the operations of the Personal Care segment. Finally, the acquisition of VRI in September of 2021, a provider of remote patient monitoring solutions, adds a fourth operating segment, RPM, with respect to which the Company’s chief operating decision maker reviews financial performance and allocates resources. The Company’s reportable segments are strategic units that offer different services under different financial and operating models to the Company’s customers. The segments are managed separately because each requires different technology and marketing strategies. Furthermore, the different segments were each generally acquired as a unit, with the management of each at the time of acquisition retained to continue to operate their respective businesses. The Company has determined each of the separate reportable segments based on the difference in services provided by each of the segments as provided in further detail below: • NEMT - which operates primarily under the brands ModivCare Solutions and Circulation, is the largest manager of non-emergency medical transportation programs for state governments and managed care organizations, or MCOs, in the U.S and includes the Company’s activities for executive, accounting, finance, internal audit, tax, legal and certain strategic and development functions; • Personal Care - which operates under the brands Simplura and Care Finders, provides personal care to Medicaid patient populations, including seniors and disabled adults, in need of care monitoring and assistance performing activities of daily living; • RPM - which operates under the VRI brand, is a provider of remote patient monitoring solutions, including personal emergency response systems, vitals monitoring and data driven patient engagement solutions; and • Matrix Investment - which consists of a minority investment in Matrix, including its Clinical Care and Clinical Solutions businesses. Matrix’s Clinical Care provides risk adjustment solutions that improve health outcomes for individuals and financial performance for health plans. Matrix’s Clinical Solutions provides employee health and wellness services, decentralized clinical trial services, and lab services to its customers. The following tables set forth certain financial information from continuing operations attributable to the Company’s business segments (in thousands): Three months ended September 30, 2021 NEMT Personal Care RPM Matrix Investment Total Service revenue, net $ 372,992 $ 118,503 $ 1,564 $ — $ 493,059 Grant income (1) — — — — — Service expense 304,398 94,107 767 — 399,272 General and administrative expense (2) 52,118 15,720 216 — 68,054 Depreciation and amortization 7,496 4,912 200 — 12,608 Operating income $ 8,980 $ 3,764 $ 381 $ — $ 13,125 Equity in net income (loss) of investee $ — $ — $ — $ (6,748) $ (6,748) Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,216 $ 565,886 $ 228,884 $ — $ 929,986 Total assets (continuing operations) $ 619,637 $ 1,037,886 $ 343,277 $ 134,353 $ 2,135,153 Nine months ended September 30, 2021 NEMT Personal Care RPM Matrix Investment Total Service revenue, net $ 1,081,168 $ 338,385 $ 1,564 $ — $ 1,421,117 Grant income (1) — 3,500 — — 3,500 Service expense 869,470 268,933 767 — 1,139,170 General and administrative expense (2) 133,706 45,349 216 — 179,271 Depreciation and amortization 21,744 14,723 200 — 36,667 Operating income $ 56,248 $ 12,880 $ 381 $ — $ 69,509 Equity in net income (loss) of investee $ — $ — $ — $ (1,978) $ (1,978) Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,216 $ 565,886 $ 228,884 $ — $ 929,986 Total assets (continuing operations) $ 619,637 $ 1,037,886 $ 343,277 $ 134,353 $ 2,135,153 (1) Grant income for the Personal Care segment includes $3.5 million of provider relief funds received under the CARES Act. These funds are intended to support healthcare providers by reimbursing them for expenses incurred, or revenue lost, as a result of the COVID-19 pandemic. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements. (2) General and administrative expense for the NEMT segment includes $1.4 million and $3.4 million of costs related to the development of the nutritional meal delivery business offering for the three and nine months ended September 30, 2021, respectively. As this line of business has not yet commenced, and there is no discrete financial information available related to it, it is not considered a separate reportable segment at this time. Three months ended September 30, 2020 NEMT Matrix Investment Total Service revenue, net $ 320,619 $ — $ 320,619 Service expense 235,543 — 235,543 General and administrative expense 34,441 — 34,441 Depreciation and amortization 7,301 — 7,301 Operating income $ 43,334 $ — $ 43,334 Equity in net income of investee $ — $ 10,325 $ 10,325 Nine months ended September 30, 2020 NEMT Matrix Investment Total Service revenue, net $ 970,166 $ — $ 970,166 Service expense 764,310 — 764,310 General and administrative expense 86,435 — 86,435 Depreciation and amortization 17,199 — 17,199 Operating income $ 102,222 $ — $ 102,222 Equity in net income of investee $ — $ 12,200 $ 12,200 December 31, 2020 NEMT Personal Care Matrix Investment Total Equity investment $ — $ — $ 137,466 $ 137,466 Goodwill $ 135,216 $ 309,711 $ — $ 444,927 Total assets (continuing operations) $ 594,952 $ 693,495 $ 137,466 $ 1,425,913

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition Under ASC 606, the Company recognizes revenue as it transfers promised services to its customers and generates all of its revenue from contracts with customers. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled in exchange for these services. The Company satisfies substantially all of its performance obligations and recognizes revenue over time instead of at points in time. Revenue Contract Structure NEMT Capitated Contracts Under capitated contracts, payors pay a fixed amount per eligible member. We assume the responsibility of meeting the covered healthcare related transportation requirements based on per-member per-month fees for the number of eligible members in the customer’s program. Revenue is recognized based on the population served during the period. Certain capitated contracts have provisions for reconciliations, risk corridors or profit rebates. For contracts with reconciliation provisions, capitation payment is received as a prepayment during the month service is provided. These prepayments are periodically reconciled based on actual trip volume and may result in refunds to the customer, or additional payments due from the customer. Contracts with risk corridor or profit rebate provisions allow for profit within a certain corridor and once we reach profit level thresholds or maximums, we discontinue recognizing revenue and instead record a liability within the accrued contract payable account. This liability may be reduced through future increases in trip volume or periodic settlements with the customer. While a profit rebate provision could only result in a liability from this profit threshold, a risk corridor provision could potentially result in receivables if the Company does not reach certain profit minimums, which would be recorded in the reconciliation contract receivables account. Capitation rates are generally based on expected costs and volume of services. Because Medicare pays capitation using a “risk adjustment model,” which compensates payors based on the health status (acuity) of each individual enrollee, payors with higher acuity enrollees receive more, and those with lower acuity enrollees receive less of the capitation that can be allocated to service providers. Under the risk adjustment model, capitation is paid on an interim basis based on enrollee data submitted for the preceding year and is adjusted in subsequent periods after the final data is compiled. NEMT Fee-for-service Contracts Fee-for-service ("FFS") revenue represents revenue earned under non-capitated contracts in which we bill and collect a specified amount for each service that we provide. FFS revenue is recognized in the period in which the services are rendered and is reduced by the estimated impact of contractual allowances. Personal Care Fee-for-service Contracts Personal Care FFS service revenue is reported at the estimated net realizable amount from clients, patients and third-party payors for services rendered. Payment for services received from third-party payors includes, but is not limited to, insurance companies, hospitals, governmental agencies and other home health care providers who subcontract work to the Company. Certain contracts are subject to retroactive audit and possible adjustment by those payors based on the nature of the contract or costs incurred. The Company makes estimates of retroactive adjustments and considers these in the recognition of revenue in the period in which the related services are rendered. The difference between estimated settlement and actual settlement is reported in net service revenues as adjustments become known or as years are no longer subject to such audits, reviews, or investigations. RPM Service Contracts RPM service revenue consists of revenue from monitoring services provided to the customer. Under RPM contracts, payors pay per-enrolled-member-per month, based on enrolled membership. Consideration is generally fixed for each type of monitoring service and the contracts do not typically contain variable components of consideration. As such, the RPM segment recognizes revenue based on the monthly fee paid by customers. Disaggregation of Revenue by Contract Type Three months ended September 30, 2021 Three months ended September 30, 2020 Nine months ended September 30, 2021 Nine months ended September 30, 2020 NEMT Capitated Contracts $ 287,768 $ 277,908 $ 854,269 $ 832,490 NEMT FFS Contracts 85,224 42,711 226,899 137,676 Total NEMT Segment Revenue 372,992 320,619 1,081,168 970,166 Personal Care FFS Contracts 118,503 — 338,385 — RPM Service Contracts 1,564 — 1,564 — Total service revenue, net $ 493,059 $ 320,619 $ 1,421,117 $ 970,166 Payor Information Service revenue, net, is derived from state Medicaid contracts, managed Medicaid and Medicare contracts (also known as MCOs), as well as a small amount from private pay and other contracts. Of the NEMT segment’s revenue, 9.7% and 10.4% were derived from one U.S. state Medicaid program for the nine months ended September 30, 2021, and 2020, respectively. Personal Care segment revenue is derived from services rendered to Medicaid program beneficiaries and reimbursed by the Medicaid, Medicaid waiver and Medicaid managed care programs. Of the Personal Care segment's revenue, 28.1% was derived from one U.S. state Medicaid program for the nine months ended September 30, 2021. RPM segment revenue is also derived from state Medicaid contracts and managed Medicaid and Medicare contracts (MCOs). The following table summarizes disaggregated revenue from contracts with customers by payor type (in thousands): Three months ended September 30, 2021 Three months ended September 30, 2020 Nine months ended September 30, 2021 Nine months ended September 30, 2020 State Medicaid contracts $ 204,403 $ 154,318 $ 615,154 $ 486,971 Managed Medicaid contracts 237,399 141,365 659,506 407,723 Managed Medicare contracts 44,074 24,936 125,571 75,472 Private pay and other contracts 7,183 — 20,886 — Total service revenue, net $ 493,059 $ 320,619 $ 1,421,117 $ 970,166 During the three months ended September 30, 2021 and 2020, the Company recognized a $0.1 million and a $3.6 million reduction of service revenue respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the customer agreed. During the nine months ended September 30, 2021 and 2020, the Company recognized a $0.2 million increase to and a $3.5 million reduction of service revenue, respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the customer agreed. Related Balance Sheet Accounts The following table provides information about accounts receivable, net (in thousands): September 30, 2021 December 31, 2020 Accounts receivable $ 269,391 $ 164,622 Reconciliation contracts receivable (1) 20,529 35,724 Allowance for doubtful accounts (690) (2,403) Accounts receivable, net $ 289,230 $ 197,943 (1) Reconciliation contracts receivable, primarily represent underpayments and receivables on certain contracts with reconciliation and risk corridor provisions. See the contract payables and receivables rollforward below. The following table provides information about other revenue related accounts included on the accompanying condensed consolidated balance sheets (in thousands): September 30, 2021 December 31, 2020 Accrued contract payables (1) $ 320,045 $ 101,705 Long-term contract payables (2) $ 5,793 $ 72,183 Deferred revenue, current $ 2,488 $ 2,923 (1) Accrued contract payables primarily represent overpayments and liability reserves on certain risk corridor, profit rebate and reconciliation contracts due to lower activity as a result of COVID-19. (2) Long-term contract payables primarily represent liability reserves on certain risk corridor, profit rebate and reconciliation contracts due to lower activity as a result of COVID-19 that may be repaid in greater than 12 months. The following table provides a summary rollforward of total contract payables and receivables as reported within the condensed consolidated balance sheets (in thousands): December 31, 2020 Additional Amounts Recorded Amounts Paid or Settled September 30, 2021 Reconciliation contract payables $ 33,330 $ 34,912 $ (20,549) $ 47,693 Profit rebate/corridor contract payables 123,239 137,003 (47) 260,195 Overpayments and other cash items 17,319 13,366 (12,735) 17,950 Total contract payables $ 173,888 $ 185,281 $ (33,331) $ 325,838 Reconciliation contract receivables $ 35,580 $ 9,984 $ (25,140) $ 20,424 Corridor contract receivables 144 (39) — 105 Total contract receivables $ 35,724 $ 9,945 $ (25,140) $ 20,529

Cash, Cash Equivalents and Rest

Cash, Cash Equivalents and Restricted Cash	9 Months Ended
	Sep. 30, 2021
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Abstract]
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents and Restricted Cash The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the condensed consolidated balance sheets to the amounts shown in the condensed consolidated statements of cash flows (in thousands): September 30, 2021 2020 Cash and cash equivalents $ 126,506 $ 183,277 Restricted cash, current 186 3,182 Current assets of discontinued operations — 357 Cash, cash equivalents and restricted cash $ 126,692 $ 186,816

Equity Investment

Equity Investment	9 Months Ended
	Sep. 30, 2021
Equity Method Investment, Summarized Financial Information [Abstract]
Equity Investment	Equity InvestmentAs of September 30, 2021 and December 31, 2020, the Company owned a 43.6% non-controlling interest in Matrix. Pursuant to a Shareholder’s Agreement, affiliates of Frazier Healthcare Partners hold rights necessary to control the fundamental operations of Matrix. The Company accounts for this investment in Matrix under the equity method of accounting and the Company’s share of Matrix’s income or losses are recorded as “Equity in net loss (income) of investee” in the accompanying consolidated statements of operations. The carrying amount of the assets included in the Company’s condensed consolidated balance sheets and the maximum loss exposure related to the Company’s interest in Matrix as of September 30, 2021 and December 31, 2020 totaled $134.4 million and $137.5 million , respectively. Summary financial information for Matrix on a standalone basis is as follows (in thousands): September 30, 2021 December 31, 2020 Current assets $ 127,994 $ 143,110 Long-term assets $ 596,562 $ 619,642 Current liabilities $ 60,835 $ 81,920 Long-term liabilities $ 339,699 $ 351,036 Three months ended September 30, 2021 Three months ended September 30, 2020 Revenue $ 78,458 $ 140,728 Operating income (loss) $ (16,833) $ 35,489 Net income (loss) $ (15,627) $ 21,382 Nine months ended September 30, 2021 Nine months ended September 30, 2020 Revenue $ 316,830 $ 292,699 Operating income $ 3,324 $ 49,074 Net income (loss) $ (7,143) $ 23,917

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets	9 Months Ended
	Sep. 30, 2021
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid Expenses and Other Current Assets	Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets consisted of the following (in thousands): September 30, 2021 December 31, 2020 Prepaid income taxes $ 13,499 $ 14,633 Prepaid insurance 12,519 7,577 Deferred financing costs on credit facility 2,452 — Inventory 1,733 — Prepaid rent 260 1,196 Other prepaid expenses 11,192 8,479 Total prepaid expenses and other current assets $ 41,655 $ 31,885

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities	Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the following (in thousands): September 30, 2021 December 31, 2020 Accrued compensation and related liabilities (1) $ 57,461 $ 57,201 Accrued interest 13,735 4,927 Deferred operating expenses 10,375 8,018 Union pension obligations 9,073 6,632 Accrued legal fees 4,862 3,228 Deferred acquisition payments 3,978 3,978 Accrued cash settled stock-based compensation 163 19,376 Other 9,924 13,650 Total accrued expenses and other current liabilities $ 109,571 $ 117,010

Debt

Debt	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Debt	Debt Senior Unsecured Notes On November 4, 2020, the Company issued $500.0 million in aggregate principal amount of 5.875% senior unsecured notes due on November 15, 2025 (the “Senior Notes due 2025”). Additionally on August 24, 2021, the Company issued $500 million in aggregate principal amount of 5.000% senior unsecured notes due on October 1, 2029 (the “Senior Notes due 2029”). The Senior Notes due 2025 and the Senior Notes due 2029 were issued pursuant to two indentures, dated November 4, 2020 and August 24, 2021 respectively, between the Company and The Bank of New York Mellon Trust Company, N.A., as trustee. The Senior Notes due 2025 relate to the Company’s acquisition of Simplura and the Senior Notes due 2029 relate to the Company’s acquisition of VRI. The Senior Notes due 2025 and the Senior Notes due 2029 (collectively, the "Notes") are senior unsecured obligations and rank senior in right of payment to all of the Company's future subordinated indebtedness, rank equally in right of payment with all of the Company's existing and future senior indebtedness, are effectively subordinated to any of the Company's existing and future secured indebtedness, including indebtedness under the Credit Facility (as defined below), to the extent of the value of the assets securing such indebtedness, and are structurally subordinated to all of the existing and future liabilities (including trade payables) of each of the Company’s non-guarantor subsidiaries. The indentures for the Notes contain covenants that, among other things, restrict the Company’s ability and the ability of its restricted subsidiaries to, among other things: incur additional indebtedness or issue disqualified capital stock; make certain investments; create or incur certain liens; enter into certain transactions with affiliates; merge, consolidate, amalgamate or transfer substantially all of its assets; agree to dividend or other payment restrictions affecting its restricted subsidiaries; and transfer or sell assets, including capital stock of its restricted subsidiaries. These covenants, however, are subject to a number of important exceptions and qualifications, and certain covenants may be suspended in the event the Notes are assigned an investment grade rating from two of three ratings agencies. The indentures for both the Senior Notes due 2025 and the Senior Notes due 2029 provide that the notes may become subject to redemption under certain circumstances. In connection with the Senior Notes due 2025, the Company may redeem the notes, in whole or in part, at any time prior to November 15, 2022, at a price equal to 100% of the principal amount of the notes redeemed, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption plus a “make-whole” premium set forth in the Indenture. In addition, the Company may redeem up to 40% of the notes prior to November 15, 2022, at a redemption price of 105.875% of the principal amount, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption, with the proceeds of certain equity offerings, subject to certain conditions as specified in the Indenture Agreement. At any time prior to November 15, 2022, during each calendar year, the Company may redeem up to 10% of the aggregate principal amount of the notes at a purchase price equal to 103% of the aggregate principal amount of the Senior Notes due 2025 to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption. On or after November 15, 2022, the Company may redeem all or a part of the Senior Notes due 2025 upon not less than ten days’ nor more than 60 days’ notice, at the redemption prices (expressed as percentages of principal amount) set forth below plus accrued and unpaid interest, if any, on the Senior Notes due 2025 redeemed, to, but excluding, the applicable redemption date, if redeemed during the 12-month period beginning on November 15 of the years indicated below: Year Percentage 2022 102.938% 2023 101.469% 2024 and thereafter 100.000% The Company may also redeem the Senior Notes due 2029, in whole or in part, at any time prior to October 1, 2024, at a price equal to 100% of the principal amount of the notes redeemed, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption plus a “make-whole” premium set forth in the Indenture. In addition, the Company may redeem up to 40% of the Senior Notes due 2029 prior to October 1, 2024, at a redemption price of 105.000% of the principal amount, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption, with the proceeds of certain equity offerings, subject to certain conditions as specified in the Indenture Agreement. On or after October 1, 2024, the Company may redeem all or a part of the Senior Notes due 2029 upon not less than ten nor more than 60 days’ notice, at the redemption prices (expressed as percentages of principal amount) set forth below plus accrued and unpaid interest, if any, on the Notes redeemed, to, but excluding, the applicable redemption date, if redeemed during the 12-month period beginning on October 1 of the years indicated below: Year Percentage 2024 102.500% 2025 101.250% 2026 and thereafter 100.000% The Company will pay interest on the Senior Notes due 2025 at 5.875% per annum until maturity. Interest is payable semi-annually in arrears on May 15 and November 15 of each year, with the first interest payment date being May 15, 2021. Principal payments are not required until the maturity date on November 15, 2025 when 100% of the outstanding principal will be required to be repaid. As a part of the bond issuance process, we incurred a $9.0 million bridge commitment fee that provided a potential funding backstop in the event that the Notes did not meet the desired subscription level to be used to acquire Simplura. That commitment expired unused upon closing of the Notes and the fee was expensed in Q4 2020. Pursuant to the Senior Notes due 2029, the Company will pay interest on the notes at 5.000% per annum until maturity. Interest is payable semi-annually in arrears on April 1 and October 1 of each year, with the first interest payment date being April 1, 2022. Principal payments are not required until the maturity date on October 1, 2029 when 100% of the outstanding principal will be required to be repaid. As a part of the bond issuance process, we incurred a $6.6 million bridge commitment fee that provided a potential funding backstop in the event that the Notes did not meet the desired subscription level to be used to acquire VRI. That commitment expired unused upon closing of the Notes and the fee was expensed in Q3 2021. Debt issuance costs of $14.5 million in relation to the issuance of the Senior Notes due 2025 were incurred and these costs were deferred and are amortized to interest cost over the term of the Notes. Debt issuance costs of $13.5 million were incurred in relation to the issuance of the Senior Notes due 2029 and these costs were deferred and are amortized to interest cost over the term of the Notes. As of September 30, 2021, $25.3 million of unamortized deferred issuance costs was netted against the long-term debt balance on the condensed consolidated balance sheet. Credit Facility The Company is a party to the amended and restated credit and guaranty agreement, dated as of August 2, 2013 (as amended, the “Credit Agreement”), with Bank of America, N.A., as administrative agent, swing line lender and letter of credit issuer, and the other lenders party thereto. On May 6, 2020, the Company entered into the Seventh Amendment to the Amended and Restated Credit and Guaranty Agreement (the “Seventh Amendment”) which, among other things, extended the maturity date to August 1, 2021, expanded the amount available under the revolving credit facility (the “Credit Facility”) from $200.0 million to $225.0 million, and increased the sub-facility for letters of credit from $25.0 million to $40.0 million. Interest on the loans is payable quarterly in arrears. In addition, the Company is obligated to pay a quarterly commitment fee based on a percentage of the unused portion of each lender’s commitment under the Credit Facility and quarterly letter of credit fees based on a percentage of the maximum amount available to be drawn under each outstanding letter of credit. On October 16, 2020, the Company entered into the Eighth Amendment to the Amended and Restated Credit and Guaranty Agreement (the “Eighth Amendment”), which among other things, amended the Credit Facility to permit the incurrence of additional debt to finance the acquisition of Simplura (the "Simplura Acquisition"), permit borrowing under the Credit Facility to partially fund the Simplura Acquisition with limited conditions to such borrowing, increase the top interest rate margin that may apply to loans thereunder, and revise our permitted ratio of EBITDA to indebtedness. In addition, the Eighth Amendment extended the maturity date to August 2, 2023. On September 13, 2021, the Company entered into the Ninth Amendment to the Amended and Restated Credit and Guaranty Agreement (the “Ninth Amendment”), which among other things, amended the Credit Facility to permit the incurrence of additional debt to finance the acquisition of VRI and revise certain financial covenants therein to permit the consummation of the VRI acquisition. Effective as of the Ninth Amendment, interest on the outstanding principal amount of loans under the Credit Facility accrues, at the Company’s election, at a per annum rate equal to the greater of either LIBOR or 1.00%, plus an applicable margin, or the Base Rate as defined in the agreement plus an applicable margin respectively. The applicable margin ranges from 2.25% to 3.50% in the case of LIBOR loans and 1.25% to 2.50% in the case of the Base Rate loans, in each case, based on the Company’s consolidated leverage ratio as defined in the Credit Agreement that governs our Credit Facility. The commitment fee and letter of credit fee range from 0.35% to 0.50% and 2.25% to 3.50%, respectively, in each case based on the Company’s consolidated leverage ratio as defined in the credit agreement that governs our Credit Facility.

Stock-Based Compensation and Si

Stock-Based Compensation and Similar Arrangements	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement, Noncash Expense [Abstract]
Stock-Based Compensation and Similar Arrangements	Stock-Based Compensation and Similar Arrangements The Company provides stock-based compensation to employees and non-employee directors under the Company's 2006 Long-Term Incentive Plan, as amended and restated effective July 27, 2016 (the “Equity Incentive Plan”). The Equity Incentive Plan allows the flexibility to grant or award stock options, stock appreciation rights, restricted stock, unrestricted stock, stock units including restricted stock units and performance awards to eligible persons. The following table reflects the amount of stock-based compensation, for share settled awards, recorded in each financial statement line item for the three months ended September 30, 2021 and 2020 and nine months ended September 30, 2021 and 2020 (in thousands): Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Service expense $ — $ 55 $ — $ 174 General and administrative expense 1,566 1,122 4,225 2,775 Total stock-based compensation $ 1,566 $ 1,177 $ 4,225 $ 2,949 At September 30, 2021 , the Company had 270,962 stock options outstanding with a weighted-average exercise price of $88.03. The Company also had 19,975 unvested restricted stock awards ("RSAs") and 60,243 unvested restricted stock units ("RSUs") outstanding at September 30, 2021 with a weighted-average grant date fair value of $91.08 and $114.19, respectively.

Earnings (Loss) Per Share

Earnings (Loss) Per Share	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) Per Share The following table details the computation of basic and diluted earnings per share (in thousands, except share and per share data): Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Numerator: Net income (loss) $ (7,570) $ 38,805 $ 24,943 $ 91,901 Dividends on convertible preferred stock outstanding — — — (1,171) Dividends paid pursuant to the Conversion Agreement — (27) — (817) Consideration paid in excess of preferred cost basis pursuant to the Conversion Agreement — (3,186) — (52,137) Income allocated to participating securities — (246) — (3,213) Net income (loss) available to common stockholders $ (7,570) $ 35,346 $ 24,943 $ 34,563 Continuing operations $ (7,462) $ 35,461 $ 25,175 $ 35,181 Discontinued operations (108) (115) (232) (618) Net income (loss) available to common stockholders $ (7,570) $ 35,346 $ 24,943 $ 34,563 Denominator: Denominator for basic earnings per share -- weighted-average shares 13,993,438 14,026,039 14,102,371 13,367,605 Effect of dilutive securities: Common stock options — 61,312 130,221 15,730 Restricted stock — 46,553 45,739 32,009 Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion 13,993,438 14,133,904 14,278,331 13,415,344 Basic earnings (loss) per share: Continuing operations $ (0.53) $ 2.53 $ 1.79 $ 2.63 Discontinued operations (0.01) (0.01) (0.02) (0.05) Basic earnings (loss) per share $ (0.54) $ 2.52 $ 1.77 $ 2.58 Diluted earnings (loss) per share: Continuing operations $ (0.53) $ 2.51 $ 1.76 $ 2.62 Discontinued operations (0.01) (0.01) (0.02) (0.05) Diluted earnings (loss) per share $ (0.54) $ 2.50 $ 1.74 $ 2.57 Income allocated to participating securities is calculated by allocating a portion of net income attributable to ModivCare, less dividends on convertible stock, to the convertible preferred stockholders on a pro-rata, as converted basis; however, the convertible preferred stockholders are not allocated losses. The following weighted-average shares were not included in the computation of diluted earnings per share as the effect of their inclusion would have been anti-dilutive: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Stock options to purchase common stock 49,158 3,481 53,550 170,076 Convertible preferred stock — 38,851 — 487,576 Issuer Purchases of Equity Securities On March 8, 2021, the Board of Directors authorized a stock repurchase program under which the Company may repurchase up to $75.0 million in aggregate value of the Company’s Common Stock through December 31, 2021, unless terminated earlier. Through September 30, 2021, 269,407 shares were repurchased under the program for $39.0 million.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company’s effective tax rate for continuing operations for the three and nine months ended September 30, 2021 was 34.1% and 24.0% respectively. The effective tax rate for continuing operations for the three and nine months ended September 30, 2020 was 27.0% and 17.6%, respectively. For the nine months ended September 30, 2021, t he effective tax rate was higher th an the U.S. federal statutory rate of 21.0% primarily due to state income taxes and certain non-deductible expenses. For the nine months ended September 30, 2020, the effective tax rate was lower than the U.S. federal statutory rate of 21.0% primarily due to the favorable impact of the CARES Act on the Company’s 2018 U.S. net operating losses ("NOLs"). During 2019, the Company received refunds from the Internal Revenue Service (“IRS”) totaling $30.8 million resulting from the loss on the sale of our workforce development segment ("WD Services segment") in 2018. As a result of the size of the refunds received, in October 2019, the IRS commenced a Joint Committee Review of the refunds. The review was completed in the third quarter of 2021 with no material adjustments being made. The 2017 Tax Reform Act reduced the U.S. corporate income tax rate from 35% to 21% and provided that U.S. NOLs incurred after 2017 could only be carried forward to offset future taxable income. Pursuant to the CARES Act, which was enacted on March 27, 2020, the Company carried its 2018 NOL back five years. As a result, during the nine months ended September 30, 2020, the Company recorded a $27.3 million receivable for the 2018 U.S. NOL carryback, and a $11.0 million tax benefit from the favorable carryback tax rate of 35% compared to a carryforward tax rate of 21%. The Company also recorded an additional income tax payable of $3.5 million for 2019 as a result of the 2018 NOL being carried back instead of carried forward. As of September 30, 2021, the Company has received all of the $27.3 million receivable for the 2018 U.S. NOL carryback. This $27.3 million was also subject to the IRS Joint Committee Review, which was completed in the third quarter of 2021 with no material adjustments being made.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Legal proceedings In the ordinary course of business, the Company may from time to time be or become involved in various lawsuits. Unless otherwise expressly stated, our management does not expect any ongoing lawsuits involving the Company to have a material impact on the business, liquidity, financial condition, or results of operations of the Company. On August 6, 2020, LogistiCare Solutions, LLC, the Company’s subsidiary now known as ModivCare Solutions, LLC (“ModivCare Solutions”), was served with a putative class action law suit filed against it by Mohamed Farah, the owner of transportation provider Dalmar Transportation, in the Western District of Missouri, seeking to represent all non-employee transportation providers contracted with ModivCare Solutions. The lawsuit alleges claims under the Fair Labor Standards Act of 1938, as amended (the “FLSA”), and the Missouri Minimum Wage Act, and asserts that all transportation providers to ModivCare Solutions in the putative class should be considered ModivCare Solutions’ employees rather than independent contractors. On June 6, 2021, the Court conditionally certified as the putative class all current and former In Network Transportation Providers who, individually or through their companies, were issued 1099 payments from ModivCare Solutions for providing non-emergency medical transportation services for ModivCare Solutions for the previous three years. Notice of the proposed collective class was issued on October 5, 2021, and potential members of the class have until January 3, 2022 to opt-in. ModivCare Solutions believes it will be able to decertify this class action after discovery and in any event intends to defend itself vigorously with respect to this matter, believes that it is and has been in compliance in all material respects with the laws and regulations regarding the characterization of the transportation providers as independent contractors, and does not believe that the ultimate outcome of this matter will have a material adverse effect on the Company’s business, liquidity, financial condition or results of operations. On January 21, 2019, the United States District Court for the Southern District of Ohio unsealed a qui tam complaint, filed in December 2015, against Mobile Care Group, Inc., Mobile Care Group of Ohio, LLC, Mobile Care EMS & Transport, Inc. (collectively, the “Mobile Care Entities”) and ModivCare Solutions by Brandee White, Laura Cunningham, and Jeffery Wisier (the “Relators”) alleging that the Mobile Care Entities and indirectly ModivCare Solutions violated the federal False Claims Act by presenting claims for payment to government healthcare programs knowing that the prerequisites for such claims to be paid had not been met. The Relators seek to recover damages, fees and costs under the federal False Claims Act, including treble damages, civil penalties and attorneys’ fees. In addition, the Relators seek reinstatement to their jobs with the Mobile Care Entities. None of the Relators were employed by ModivCare Solutions. The federal government has declined to intervene against ModivCare Solutions. ModivCare Solutions filed a motion to dismiss the Complaint on April 22, 2019, but such motion was denied on October 26, 2021. ModivCare Solutions intends to file an interlocutory appeal of this ruling and believes, in any event, that the case will not have a material adverse effect on the Company’s business, liquidity, financial condition or results of operations.

Transactions with Related Parti

Transactions with Related Parties	9 Months Ended
	Sep. 30, 2021
Related Party Transactions [Abstract]
Transactions with Related Parties	Transactions with Related Parties Cash-Settled Awards On an annual basis, the Company grants stock equivalent unit awards (“SEUs”) to Coliseum Capital Management, LLC (“Coliseum”) as compensation for the board of directors’ service of Christopher Shackelton in lieu of the restricted share awards that are given to our other non-employee directors. These SEUs typically have a one-year vesting schedule and are paid out in cash upon vesting based upon the closing price of the Company’s common stock on the date of vesting. On February 10, 2021, the Company granted Coliseum 725 SEUs under this program. In addition, on September 11, 2014, the Company granted 200,000 stock option equivalent units (“SOEUs”) to Coliseum at an exercise price of $43.81 per share that were fully vested. The SOEUs were accounted for as liability awards, with the recorded expense adjustment attributable to the Company’s change in stock price from the previous reporting period. On August 12, 2021, Coliseum exercised all of the SOEUs at a stock price of $182.73 per share for a total cash settlement of $27.8 million. At September 30, 2021, there were no SOEU's outstanding.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events Management has evaluated subsequent events through November 5, 2021, the date which the financial statements were available to be issued. All subsequent events requiring recognition as of September 30, 2021 have been incorporated into these financial statements and there are no subsequent events that require disclosure, other than the updated status on the legal matters, as discussed in Note 14 Commitments and Contingencies

Significant Accounting Polici_2

Significant Accounting Policies and Recent Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The Company follows accounting standards established by the Financial Accounting Standards Board (“FASB”). The FASB establishes accounting principles generally accepted in the United States (“GAAP”). Rules and interpretive releases of the Securities and Exchange Commission (“SEC”) under the authority of federal securities laws are also sources of authoritative GAAP for SEC registrants. References to GAAP issued by the FASB in these notes are to the FASB Accounting Standards Codification (“ASC”), which serves as the single source of authoritative accounting and applicable reporting standards to be applied for non-governmental entities. All amounts are presented in U.S. dollars unless otherwise noted. The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with GAAP for interim financial information, and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all the information and disclosures required by GAAP for annual audited financial statements. In the opinion of management, all adjustments considered necessary for the fair presentation of the results of the interim periods have been included. The Company has made estimates relating to the reporting of assets and liabilities, revenues and expenses, and certain disclosures in the preparation of these unaudited condensed consolidated financial statements in conformity with GAAP. Actual results could differ from those estimates. Operating results for the three and nine months ended September 30, 2021 are not necessarily indicative of the results that may be expected for the fiscal year ending December 31, 2021. Management has evaluated events and transactions that occurred after the balance sheet date and through the date these unaudited condensed consolidated financial statements were filed with the SEC and considered the effect of such events in the preparation of these condensed consolidated financial statements. The condensed consolidated balance sheet at December 31, 2020 included in this Form 10-Q has been derived from audited financial statements at that date, but does not include all the information and footnotes required by GAAP for annual audited financial statements. The unaudited condensed consolidated financial statements contained herein should be read in conjunction with the audited financial statements and notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. The Company accounts for its investment in Matrix using the equity method, as the Company does not control the decision-making process or business management practices of Matrix. While the Company has access to certain information and performs certain procedures to review the reasonableness of information, the Company relies on the management of Matrix to provide accurate financial information prepared in accordance with GAAP. The Company receives audit reports relating to such financial information from Matrix’s independent auditors on an annual basis. The Company is not aware of any errors in or possible misstatements of the financial information provided by Matrix that would have a material effect on the Company’s consolidated financial statements. See Note 7, Equity Investment , for further information.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Recent Accounting Pronouncements	Recent Accounting Pronouncements The Company adopted the following accounting pronouncements during the nine months ended September 30, 2021: In January 2020, the FASB issued ASU 2020-01, Clarifying the Interactions Between Topic 321, Topic 323, and Topic 815 ("ASU 2020-01"), to clarify the interaction among the accounting standards for equity securities, equity method investments and certain derivatives. ASU 2020-01 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods therein. There was no material impact to the financial statements from the adoption of this ASU. In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes ("ASU 2019-12"). The ASU removes certain exceptions to the general principles in ASC 740, Income Taxes , and also clarifies and amends existing guidance to reduce complexity in accounting for income taxes. The ASU is effective for fiscal years beginning after December 15, 2020, including interim periods within that fiscal year, with early adoption permitted. There was no material impact to the financial statements from the adoption of this ASU. Recent accounting pronouncements that the Company has yet to adopt are as follows: In March 2020, the FASB issued ASU 2020-04, Facilitation of the Effects of Reference Rate Reform on Financial Reporting ("ASU 2020-04") which provides optional expedients and exceptions for applying GAAP to contract modifications, hedging relationships, and other transactions that reference the London Interbank Offered Rate ("LIBOR") or another reference rate expected to be discontinued due to reference rate reform. The relief granted in ASC 848, Reference Rate Reform ("ASC 848"), is applicable only to legacy contracts if the amendments made to the agreements are solely for reference rate reform activities. The provisions of ASC 848 must be applied for all transactions other than derivatives, which may be applied at a hedging relationship level. Entities may apply the provisions as of the beginning of the reporting period when the election is made (i.e. as early as the first quarter 2020). Unlike other topics, the provisions of this update are only available until December 31, 2022, when the reference rate replacement activity is expected to be completed. The Company is currently evaluating the impact ASU 2020-04 will have on its consolidated financial statements or disclosures; however, does not expect the adoption to have a material impact. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging— Contracts in Entity’s Own Equity (Subtopic 815-40) ("ASU 2020-06") which addresses the complexity associated with applying GAAP for certain financial instruments with characteristics of liabilities and equity. The update limits the accounting models for convertible instruments resulting in fewer embedded conversion features being separately recognized from the host contract. Specifically, ASU 2020-06 removes from GAAP the separation models for convertible debt with a cash conversion feature and convertible instruments with a beneficial conversion feature. As a result, after adopting the ASU’s guidance, entities will not separately present an embedded conversion feature in such debt within equity. ASU 2020-06 is effective for public business entities for fiscal years beginning after December 15, 2021, including interim periods therein. The Company is currently evaluating the impact ASU 2020-06 will have on its consolidated financial statements or disclosures; however, does not expect the adoption to have a material impact.

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following is a preliminary estimate, based on certain preliminary items noted in the table below, of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of November 18, 2020 (in thousands): Cash $ 21,182 Accounts receivable (1) 69,882 Prepaid expenses and other (2) 9,688 Property and equipment (3) 1,640 Intangible assets (4) 264,770 Operating right of use asset (5) 10,285 Goodwill (6) 317,085 Other assets (7) 628 Accounts payable and accrued liabilities (7) (46,073) Accrued expense (7) (2,564) Deferred revenue (7) (2,871) Deferred acquisition payments (8) (4,046) Deferred acquisition note payable (7) (1,050) Operating lease liabilities (5) (10,285) Deferred tax liabilities (9) (58,452) Total of assets acquired and liabilities assumed $ 569,819 The acquisition method of accounting incorporates fair value measurements that can be highly subjective, and it is possible the application of reasonable judgment could develop different assumptions resulting in a range of alternative estimates using the same facts and circumstances. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. This estimate is preliminary as the Company's evaluation of the collectability of receivables is ongoing. (2) Given the short-term nature of the balance of prepaid expenses carrying value represents the fair value. (3) The acquired property and equipment consists primarily of leasehold improvements, furniture and fixtures, and vehicles. The fair value of the property and equipment was determined based upon the best and highest use of the property with final values determined using cost and comparable sales methods. (4) The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 15 years $ 221,000 Trademarks and trade names Amortizable 10 years 43,000 Licenses Not Amortizable Indefinite 770 $ 264,770 The Company valued trademarks and trade names utilizing the relief of royalty method and payor network utilizing the multi-period excess earnings method, a form of the income approach. This assessment is preliminary and will be finalized in the fourth quarter of 2021. (5) The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) were recorded at $11.7 million based on market rates available to the Company during our preliminary purchase price allocation. This assessment has since been updated through the implementation of ASC 842 at the Personal Care segment as of September 30, 2021, and the related balances have been updated to $10.3 million. This assessment remains preliminary as of the date of our filing and will be finalized with final purchase accounting in the fourth quarter of 2021. (6) The acquisition preliminarily resulted in $309.7 million of goodwill as a result of expected synergies due to value-based care and solutions being provided to similar patient populations that partner with many of the same payor groups. In the second quarter of 2021 a closing cash adjustment of $3.5 million was paid to OEP AM and in the third quarter of 2021 other assets acquired were adjusted down by $3.9 million which, along with other immaterial adjustments, increased the goodwill related to this transaction to $317.1 million. This assessment is preliminary and purchase accounting will be finalized in the fourth quarter of 2021. None of the acquired goodwill is deductible for tax purposes. (7) Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the acquisition date. (8) Deferred acquisition payments are associated with historical acquisitions by Simplura. (9) Net deferred tax liabilities represent the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 13, Income Taxes , for additional discussion of the Company’s combined income tax position subsequent to the acquisition. Cash $ 11,963 Accounts receivable (1) 12,253 Prepaid expenses and other (2) 653 Property and equipment (3) 3,206 Inventories (4) 145 Intangibles (5) 75,900 Goodwill (6) 248,518 Other assets (7) 226 Accounts payable and accrued liabilities (8) (5,347) Accrued expense (8) (871) Other liabilities (8) (80) Deferred tax liabilities (9) (2,275) Total of assets acquired and liabilities assumed $ 344,291 The acquisition method of accounting incorporates fair value measurements that can be highly subjective, and it is possible the application of reasonable judgment could develop different assumptions resulting in a range of alternative estimates using the same facts and circumstances. Upon finalization of the preliminary items noted below there may be related adjustments to certain of such items and to goodwill and income taxes. All items are expected to be finalized by the third quarter of 2022. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. This estimate is preliminary as the Company's evaluation of the collectability of receivables is ongoing. (2) Given the short-term nature of the balance of prepaid expenses carrying value represents the fair value. (3) The acquired property and equipment consists primarily of capitalized software, construction in progress, and computer equipment. This estimate is preliminary as the Company's evaluation of the fair value of property and equipment is ongoing. (4) Inventories are stated at fair value as of the acquisition date. (5) The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 9 years $ 68,300 Trade name Amortizable 8 years 7,600 $ 75,900 The intangible valuation amounts disclosed in the table above represent a preliminary estimate, as of the acquisition date of September 14, 2021. Final purchase accounting is expected to be finalized by the third quarter of 2022. (6) The acquisition preliminarily resulted in $248.5 million of goodwill as a result of expected synergies due to future customers driven by expansion into different markets, an increase in market share, and a growing demographic that will need VRI's monitoring products. Purchase accounting will be finalized in the third quarter of 2022. All of the acquired goodwill is deductible for tax purposes. Goodwill allocation to reporting units is not completed as of the date of the financial statements, September 30, 2021. (7) Included in Other assets are security deposits with a value of $0.2 million. (8) Accounts payable as well as certain other current and non-current assets and liabilities are stated at fair value as of the acquisition date. (9) Net deferred tax liabilities represent the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 13, Income Taxes , for additional discussion of the Company’s combined income tax position subsequent to the acquisition. The Company has not yet obtained and assessed all relevant historical financial information needed to perform the valuation and has not completed the final valuations of certain assets and liabilities. As such, the following is a preliminary estimate, based on certain preliminary items noted in the table below, of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of September 22, 2021 (in thousands): Cash $ 2,922 Accounts receivable (1) 6,849 Inventory (2) 1,684 Prepaid expenses and other (3) 284 Property and equipment (4) 16,775 Intangible assets (5) 85,800 Goodwill (6) 228,884 Other assets (7) 217 Accounts payable and accrued liabilities (8) (1,890) Accrued expense (8) (2,481) Deferred revenue (8) (66) Deferred tax liabilities (8) (21,285) Total of assets acquired and liabilities assumed $ 317,693 The acquisition method of accounting incorporates fair value measurements that can be highly subjective, and it is possible the application of reasonable judgment could develop different assumptions resulting in a range of alternative estimates using the same facts and circumstances. Upon finalization of the preliminary items noted below there may be related adjustments to certain of such items and to goodwill and income taxes. All items are expected to be finalized by the third quarter of 2022. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. This estimate is preliminary as the Company's evaluation of the collectability of receivables is ongoing. (2) Inventory is stated at fair value as of the acquisition date. (3) Given the short-term nature of the balance of prepaid expenses carrying value represents the fair value. (4) The acquired property and equipment consists primarily of monitoring equipment, buildings, and vitals equipment. This estimate is preliminary as the Company's evaluation of the fair value of property and equipment is ongoing. (5) The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 9 years $ 70,700 Trade name Amortizable 8 years 13,300 Internally developed software Amortizable 7 years 1,800 $ 85,800 The intangible valuation amounts disclosed in the table above represent a preliminary estimate, as of the acquisition date of September 22, 2021. Final purchase accounting is expected to be finalized by the third quarter of 2022. (6) The acquisition preliminarily resulted in $228.9 million of goodwill as a result of expected synergies due to future customers driven by expansion into different markets and an increase in market share. Purchase accounting will be finalized in the third quarter of 2022. The amount of goodwill deductible for tax purposes has yet to be determined. Goodwill allocation to reporting units is not completed as of the date of the financial statements, September 30, 2021. (7) Included in other assets are other receivables and employees advances with a value of approximately $0.2 million. (8) Accounts payable as well as certain other current and non-current liabilities are stated at fair value as of the acquisition date. Net deferred tax liabilities represent the expected future tax consequences of temporary differences between the fair values of the assets acquired and liabilities assumed and their tax bases. See Note 13, Income Taxes , for additional discussion of the Company’s combined income tax position subsequent to the acquisition.
Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination	The allocation of consideration exchanged to intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 15 years $ 221,000 Trademarks and trade names Amortizable 10 years 43,000 Licenses Not Amortizable Indefinite 770 $ 264,770 Type Useful Life Value Payor network Amortizable 9 years $ 68,300 Trade name Amortizable 8 years 7,600 $ 75,900 Type Useful Life Value Payor network Amortizable 9 years $ 70,700 Trade name Amortizable 8 years 13,300 Internally developed software Amortizable 7 years 1,800 $ 85,800 The fair value allocation of the net consideration is as follows (in thousands, except useful lives): Type Useful Life Value Payor relationships Amortizable 6 years $ 75,514 Trade names and trademarks Amortizable 3 years 2,151 $ 77,665 The fair value allocation of the net consideration is as follows (in thousands, except useful lives): Type Useful Life Value Transportation management software Amortizable 10 years $ 12,328 Assembled workforce Amortizable 10 years 135 $ 12,463
Business Acquisition, Pro Forma Information	Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Pro forma: Revenue $ 547,965 $ 489,104 $ 1,603,015 $ 1,475,668 Income (loss) from continuing operations, net (13,678) 30,043 11,568 (4,417) Diluted earnings (loss) per share $ (0.98) $ 2.13 $ 0.81 $ (0.33)
Schedule of Business Acquisitions, by Acquisition	The consideration paid for the acquisition is as follows (in thousands): Value Consideration paid $ 80,000 Transaction costs 774 Restricted cash received (3,109) Net consideration $ 77,665 The consideration paid for the acquisition is as follows (in thousands): Value Consideration paid $ 12,000 Transaction costs 463 Net consideration $ 12,463

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Financial Information Attributable to the Company's Business Segments	The following tables set forth certain financial information from continuing operations attributable to the Company’s business segments (in thousands): Three months ended September 30, 2021 NEMT Personal Care RPM Matrix Investment Total Service revenue, net $ 372,992 $ 118,503 $ 1,564 $ — $ 493,059 Grant income (1) — — — — — Service expense 304,398 94,107 767 — 399,272 General and administrative expense (2) 52,118 15,720 216 — 68,054 Depreciation and amortization 7,496 4,912 200 — 12,608 Operating income $ 8,980 $ 3,764 $ 381 $ — $ 13,125 Equity in net income (loss) of investee $ — $ — $ — $ (6,748) $ (6,748) Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,216 $ 565,886 $ 228,884 $ — $ 929,986 Total assets (continuing operations) $ 619,637 $ 1,037,886 $ 343,277 $ 134,353 $ 2,135,153 Nine months ended September 30, 2021 NEMT Personal Care RPM Matrix Investment Total Service revenue, net $ 1,081,168 $ 338,385 $ 1,564 $ — $ 1,421,117 Grant income (1) — 3,500 — — 3,500 Service expense 869,470 268,933 767 — 1,139,170 General and administrative expense (2) 133,706 45,349 216 — 179,271 Depreciation and amortization 21,744 14,723 200 — 36,667 Operating income $ 56,248 $ 12,880 $ 381 $ — $ 69,509 Equity in net income (loss) of investee $ — $ — $ — $ (1,978) $ (1,978) Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,216 $ 565,886 $ 228,884 $ — $ 929,986 Total assets (continuing operations) $ 619,637 $ 1,037,886 $ 343,277 $ 134,353 $ 2,135,153 (1) Grant income for the Personal Care segment includes $3.5 million of provider relief funds received under the CARES Act. These funds are intended to support healthcare providers by reimbursing them for expenses incurred, or revenue lost, as a result of the COVID-19 pandemic. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements. (2) General and administrative expense for the NEMT segment includes $1.4 million and $3.4 million of costs related to the development of the nutritional meal delivery business offering for the three and nine months ended September 30, 2021, respectively. As this line of business has not yet commenced, and there is no discrete financial information available related to it, it is not considered a separate reportable segment at this time. Three months ended September 30, 2020 NEMT Matrix Investment Total Service revenue, net $ 320,619 $ — $ 320,619 Service expense 235,543 — 235,543 General and administrative expense 34,441 — 34,441 Depreciation and amortization 7,301 — 7,301 Operating income $ 43,334 $ — $ 43,334 Equity in net income of investee $ — $ 10,325 $ 10,325 Nine months ended September 30, 2020 NEMT Matrix Investment Total Service revenue, net $ 970,166 $ — $ 970,166 Service expense 764,310 — 764,310 General and administrative expense 86,435 — 86,435 Depreciation and amortization 17,199 — 17,199 Operating income $ 102,222 $ — $ 102,222 Equity in net income of investee $ — $ 12,200 $ 12,200 December 31, 2020 NEMT Personal Care Matrix Investment Total Equity investment $ — $ — $ 137,466 $ 137,466 Goodwill $ 135,216 $ 309,711 $ — $ 444,927 Total assets (continuing operations) $ 594,952 $ 693,495 $ 137,466 $ 1,425,913

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	Three months ended September 30, 2021 Three months ended September 30, 2020 Nine months ended September 30, 2021 Nine months ended September 30, 2020 NEMT Capitated Contracts $ 287,768 $ 277,908 $ 854,269 $ 832,490 NEMT FFS Contracts 85,224 42,711 226,899 137,676 Total NEMT Segment Revenue 372,992 320,619 1,081,168 970,166 Personal Care FFS Contracts 118,503 — 338,385 — RPM Service Contracts 1,564 — 1,564 — Total service revenue, net $ 493,059 $ 320,619 $ 1,421,117 $ 970,166 Three months ended September 30, 2021 Three months ended September 30, 2020 Nine months ended September 30, 2021 Nine months ended September 30, 2020 State Medicaid contracts $ 204,403 $ 154,318 $ 615,154 $ 486,971 Managed Medicaid contracts 237,399 141,365 659,506 407,723 Managed Medicare contracts 44,074 24,936 125,571 75,472 Private pay and other contracts 7,183 — 20,886 — Total service revenue, net $ 493,059 $ 320,619 $ 1,421,117 $ 970,166
Schedule of Accounts Receivable	The following table provides information about accounts receivable, net (in thousands): September 30, 2021 December 31, 2020 Accounts receivable $ 269,391 $ 164,622 Reconciliation contracts receivable (1) 20,529 35,724 Allowance for doubtful accounts (690) (2,403) Accounts receivable, net $ 289,230 $ 197,943 (1) Reconciliation contracts receivable, primarily represent underpayments and receivables on certain contracts with reconciliation and risk corridor provisions. See the contract payables and receivables rollforward below.
Other Account Liabilities	The following table provides information about other revenue related accounts included on the accompanying condensed consolidated balance sheets (in thousands): September 30, 2021 December 31, 2020 Accrued contract payables (1) $ 320,045 $ 101,705 Long-term contract payables (2) $ 5,793 $ 72,183 Deferred revenue, current $ 2,488 $ 2,923 (1) Accrued contract payables primarily represent overpayments and liability reserves on certain risk corridor, profit rebate and reconciliation contracts due to lower activity as a result of COVID-19. (2) Long-term contract payables primarily represent liability reserves on certain risk corridor, profit rebate and reconciliation contracts due to lower activity as a result of COVID-19 that may be repaid in greater than 12 months. The following table provides a summary rollforward of total contract payables and receivables as reported within the condensed consolidated balance sheets (in thousands): December 31, 2020 Additional Amounts Recorded Amounts Paid or Settled September 30, 2021 Reconciliation contract payables $ 33,330 $ 34,912 $ (20,549) $ 47,693 Profit rebate/corridor contract payables 123,239 137,003 (47) 260,195 Overpayments and other cash items 17,319 13,366 (12,735) 17,950 Total contract payables $ 173,888 $ 185,281 $ (33,331) $ 325,838 Reconciliation contract receivables $ 35,580 $ 9,984 $ (25,140) $ 20,424 Corridor contract receivables 144 (39) — 105 Total contract receivables $ 35,724 $ 9,945 $ (25,140) $ 20,529

Cash, Cash Equivalents and Re_2

Cash, Cash Equivalents and Restricted Cash (Tables)	9 Months Ended
	Sep. 30, 2021
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Abstract]
Cash, Cash Equivalents and Restricted Cash	The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the condensed consolidated balance sheets to the amounts shown in the condensed consolidated statements of cash flows (in thousands): September 30, 2021 2020 Cash and cash equivalents $ 126,506 $ 183,277 Restricted cash, current 186 3,182 Current assets of discontinued operations — 357 Cash, cash equivalents and restricted cash $ 126,692 $ 186,816

Equity Investment (Tables)

Equity Investment (Tables)	9 Months Ended
	Sep. 30, 2021
Equity Method Investment, Summarized Financial Information [Abstract]
Income Statement and Balance Sheet Disclosure	Summary financial information for Matrix on a standalone basis is as follows (in thousands): September 30, 2021 December 31, 2020 Current assets $ 127,994 $ 143,110 Long-term assets $ 596,562 $ 619,642 Current liabilities $ 60,835 $ 81,920 Long-term liabilities $ 339,699 $ 351,036 Three months ended September 30, 2021 Three months ended September 30, 2020 Revenue $ 78,458 $ 140,728 Operating income (loss) $ (16,833) $ 35,489 Net income (loss) $ (15,627) $ 21,382 Nine months ended September 30, 2021 Nine months ended September 30, 2020 Revenue $ 316,830 $ 292,699 Operating income $ 3,324 $ 49,074 Net income (loss) $ (7,143) $ 23,917

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets (Tables)	9 Months Ended
	Sep. 30, 2021
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets consisted of the following (in thousands): September 30, 2021 December 31, 2020 Prepaid income taxes $ 13,499 $ 14,633 Prepaid insurance 12,519 7,577 Deferred financing costs on credit facility 2,452 — Inventory 1,733 — Prepaid rent 260 1,196 Other prepaid expenses 11,192 8,479 Total prepaid expenses and other current assets $ 41,655 $ 31,885

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses and other current liabilities consisted of the following (in thousands): September 30, 2021 December 31, 2020 Accrued compensation and related liabilities (1) $ 57,461 $ 57,201 Accrued interest 13,735 4,927 Deferred operating expenses 10,375 8,018 Union pension obligations 9,073 6,632 Accrued legal fees 4,862 3,228 Deferred acquisition payments 3,978 3,978 Accrued cash settled stock-based compensation 163 19,376 Other 9,924 13,650 Total accrued expenses and other current liabilities $ 109,571 $ 117,010

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Debt Instrument Redemption	On or after November 15, 2022, the Company may redeem all or a part of the Senior Notes due 2025 upon not less than ten days’ nor more than 60 days’ notice, at the redemption prices (expressed as percentages of principal amount) set forth below plus accrued and unpaid interest, if any, on the Senior Notes due 2025 redeemed, to, but excluding, the applicable redemption date, if redeemed during the 12-month period beginning on November 15 of the years indicated below: Year Percentage 2022 102.938% 2023 101.469% 2024 and thereafter 100.000% The Company may also redeem the Senior Notes due 2029, in whole or in part, at any time prior to October 1, 2024, at a price equal to 100% of the principal amount of the notes redeemed, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption plus a “make-whole” premium set forth in the Indenture. In addition, the Company may redeem up to 40% of the Senior Notes due 2029 prior to October 1, 2024, at a redemption price of 105.000% of the principal amount, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption, with the proceeds of certain equity offerings, subject to certain conditions as specified in the Indenture Agreement. On or after October 1, 2024, the Company may redeem all or a part of the Senior Notes due 2029 upon not less than ten nor more than 60 days’ notice, at the redemption prices (expressed as percentages of principal amount) set forth below plus accrued and unpaid interest, if any, on the Notes redeemed, to, but excluding, the applicable redemption date, if redeemed during the 12-month period beginning on October 1 of the years indicated below: Year Percentage 2024 102.500% 2025 101.250% 2026 and thereafter 100.000%

Stock-Based Compensation and _2

Stock-Based Compensation and Similar Arrangements (Tables)	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement, Noncash Expense [Abstract]
Disclosure of Stock-based Compensation by Line Item	The following table reflects the amount of stock-based compensation, for share settled awards, recorded in each financial statement line item for the three months ended September 30, 2021 and 2020 and nine months ended September 30, 2021 and 2020 (in thousands): Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Service expense $ — $ 55 $ — $ 174 General and administrative expense 1,566 1,122 4,225 2,775 Total stock-based compensation $ 1,566 $ 1,177 $ 4,225 $ 2,949

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
Schedule of Earnings (Loss) Per Share	The following table details the computation of basic and diluted earnings per share (in thousands, except share and per share data): Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Numerator: Net income (loss) $ (7,570) $ 38,805 $ 24,943 $ 91,901 Dividends on convertible preferred stock outstanding — — — (1,171) Dividends paid pursuant to the Conversion Agreement — (27) — (817) Consideration paid in excess of preferred cost basis pursuant to the Conversion Agreement — (3,186) — (52,137) Income allocated to participating securities — (246) — (3,213) Net income (loss) available to common stockholders $ (7,570) $ 35,346 $ 24,943 $ 34,563 Continuing operations $ (7,462) $ 35,461 $ 25,175 $ 35,181 Discontinued operations (108) (115) (232) (618) Net income (loss) available to common stockholders $ (7,570) $ 35,346 $ 24,943 $ 34,563 Denominator: Denominator for basic earnings per share -- weighted-average shares 13,993,438 14,026,039 14,102,371 13,367,605 Effect of dilutive securities: Common stock options — 61,312 130,221 15,730 Restricted stock — 46,553 45,739 32,009 Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion 13,993,438 14,133,904 14,278,331 13,415,344 Basic earnings (loss) per share: Continuing operations $ (0.53) $ 2.53 $ 1.79 $ 2.63 Discontinued operations (0.01) (0.01) (0.02) (0.05) Basic earnings (loss) per share $ (0.54) $ 2.52 $ 1.77 $ 2.58 Diluted earnings (loss) per share: Continuing operations $ (0.53) $ 2.51 $ 1.76 $ 2.62 Discontinued operations (0.01) (0.01) (0.02) (0.05) Diluted earnings (loss) per share $ (0.54) $ 2.50 $ 1.74 $ 2.57
Schedule of Antidilutive Securities	The following weighted-average shares were not included in the computation of diluted earnings per share as the effect of their inclusion would have been anti-dilutive: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Stock options to purchase common stock 49,158 3,481 53,550 170,076 Convertible preferred stock — 38,851 — 487,576

Organization and Basis of Pre_2

Organization and Basis of Presentation (Details)	Sep. 30, 2021
Matrix Investment
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Effects of Changes, Net [Line Items]
Equity method investment, ownership percentage	43.60%

Significant Accounting Polici_3

Significant Accounting Policies and Recent Accounting Pronouncements (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Grant income	$ 0	$ 0	$ 3,500	$ 0
Accrued cash benefit, due from deferral of payroll taxes	$ 20,800		$ 20,800
Accrued cash benefit, percent due In year one	50.00%		50.00%
Accrued cash benefit, percent due in year two	50.00%		50.00%
Accrued Liabilities
Disaggregation of Revenue [Line Items]
Accrued cash benefit, due from deferral of payroll taxes	$ 10,400		$ 10,400
Other Noncurrent Liabilities
Disaggregation of Revenue [Line Items]
Accrued cash benefit, due from deferral of payroll taxes	$ 10,400		10,400
Grant income
Disaggregation of Revenue [Line Items]
Grant income			$ 3,500

Acquisitions (Details)

Acquisitions (Details) $ in Thousands	Sep. 22, 2021USD ($)	Sep. 14, 2021USD ($)	May 06, 2021USD ($)	Nov. 18, 2020USD ($)statebranch	May 06, 2020USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Business Acquisition, Contingent Consideration [Line Items]
Operating lease right-of-use assets						$ 44,077		$ 44,077		$ 30,928
Goodwill						929,986		929,986		444,927
Service revenue, net						493,059	$ 320,619	1,421,117	$ 970,166
Net income						(7,570)	38,805	24,943	91,901
Personal Care
Business Acquisition, Contingent Consideration [Line Items]
Goodwill						565,886		565,886		309,711
Service revenue, net						118,503		338,385
Simplura Health Group
Business Acquisition, Contingent Consideration [Line Items]
Number of branches | branch				57
Number of states in which entity operates | state				7
Business acquisition, percentage of voting interests acquired				100.00%
Net consideration				$ 548,600
Business combination, consideration transferred, cash from acquisition excluded				569,800
Cash acquired from acquisition				21,200
Operating lease, liability				11,700
Operating lease right-of-use assets				11,700		10,300		10,300
Goodwill				317,085
Closing cash adjustment						3,500
Other assets acquired, adjustment, other assets, decrease						$ 3,900
Historical interest expense							6,200		20,100
Deferred acquisition payments				4,046
Simplura Health Group | Pro Forma
Business Acquisition, Contingent Consideration [Line Items]
Goodwill				$ 309,700
CareFinders Total Care
Business Acquisition, Contingent Consideration [Line Items]
Business acquisition, percentage of voting interests acquired		100.00%
Net consideration		$ 332,300
Business combination, consideration transferred, cash from acquisition excluded		344,300
Cash acquired from acquisition		12,000
Goodwill		248,518
Historical interest expense							1,100		3,600
Business combination, indemnification assets, amount as of acquisition date		200
Service revenue, net		8,900
Net income		500
CareFinders Total Care | Selling, General and Administrative Expenses
Business Acquisition, Contingent Consideration [Line Items]
Transaction costs								4,500
CareFinders Total Care | Pro Forma
Business Acquisition, Contingent Consideration [Line Items]
Goodwill		$ 248,500
VRI Intermediate Holdings, LLC
Business Acquisition, Contingent Consideration [Line Items]
Business acquisition, percentage of voting interests acquired	100.00%
Net consideration	$ 314,800
Business combination, consideration transferred, cash from acquisition excluded	317,700
Cash acquired from acquisition	2,900
Goodwill	228,884
Historical interest expense							$ 1,100		$ 3,800
Business combination, indemnification assets, amount as of acquisition date	200
Service revenue, net	1,600
Net income	400
VRI Intermediate Holdings, LLC | Selling, General and Administrative Expenses
Business Acquisition, Contingent Consideration [Line Items]
Transaction costs								5,900
VRI Intermediate Holdings, LLC | Pro Forma
Business Acquisition, Contingent Consideration [Line Items]
Goodwill	$ 228,900
National MedTrans
Business Acquisition, Contingent Consideration [Line Items]
Net consideration					$ 77,665
Cash acquired from acquisition					3,109
Consideration paid					80,000
Acquisition costs										$ 800
Transaction costs					$ 774
WellRyde
Business Acquisition, Contingent Consideration [Line Items]
Net consideration			$ 12,463
Consideration paid			12,000
Payments to acquire productive assets			12,000
Transaction costs			$ 463					$ 500

Acquisitions - Purchase Price A

Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Sep. 22, 2021	Sep. 14, 2021	Dec. 31, 2020	Nov. 18, 2020
Business Acquisition [Line Items]
Goodwill	$ 929,986			$ 444,927
Simplura Health Group
Business Acquisition [Line Items]
Cash					$ 21,182
Accounts receivable					69,882
Prepaid expenses and other					9,688
Property and equipment					1,640
Intangible assets					264,770
Operating right of use asset					10,285
Goodwill					317,085
Other assets					628
Accounts payable and accrued liabilities					(46,073)
Accrued expense					(2,564)
Deferred revenue					(2,871)
Deferred acquisition payments					(4,046)
Deferred acquisition note payable					(1,050)
Operating lease liabilities					(10,285)
Deferred tax liabilities					(58,452)
Total of assets acquired and liabilities assumed					$ 569,819
CareFinders Total Care
Business Acquisition [Line Items]
Cash			$ 11,963
Accounts receivable			12,253
Prepaid expenses and other			653
Property and equipment			3,206
Inventories			145
Intangible assets			75,900
Goodwill			248,518
Other assets			226
Accounts payable and accrued liabilities			(5,347)
Accrued expense			(871)
Other liabilities			(80)
Deferred tax liabilities			(2,275)
Total of assets acquired and liabilities assumed			$ 344,291
VRI Intermediate Holdings, LLC
Business Acquisition [Line Items]
Cash		$ 2,922
Accounts receivable		6,849
Prepaid expenses and other		284
Property and equipment		16,775
Inventories		1,684
Intangible assets		85,800
Goodwill		228,884
Other assets		217
Accounts payable and accrued liabilities		(1,890)
Accrued expense		(2,481)
Deferred revenue		(66)
Deferred tax liabilities		(21,285)
Total of assets acquired and liabilities assumed		$ 317,693

Acquisitions - Intangible Asset

Acquisitions - Intangible Assets Acquired (Details) - USD ($) $ in Thousands	Sep. 22, 2021	Sep. 14, 2021	May 06, 2021	Nov. 18, 2020	May 06, 2020
Simplura Health Group
Business Acquisition [Line Items]
Intangible assets				$ 264,770
Simplura Health Group | Payor network
Business Acquisition [Line Items]
Useful Life				15 years
Finite-lived intangibles				$ 221,000
Simplura Health Group | Trademarks and trade names
Business Acquisition [Line Items]
Useful Life				10 years
Finite-lived intangibles				$ 43,000
Simplura Health Group | Licenses
Business Acquisition [Line Items]
Indefinite-lived intangibles				$ 770
CareFinders Total Care
Business Acquisition [Line Items]
Intangible assets		$ 75,900
CareFinders Total Care | Payor network
Business Acquisition [Line Items]
Useful Life		9 years
Finite-lived intangibles		$ 68,300
CareFinders Total Care | Trademarks and trade names
Business Acquisition [Line Items]
Useful Life		8 years
Finite-lived intangibles		$ 7,600
VRI Intermediate Holdings, LLC
Business Acquisition [Line Items]
Intangible assets	$ 85,800
VRI Intermediate Holdings, LLC | Payor network
Business Acquisition [Line Items]
Useful Life	9 years
Finite-lived intangibles	$ 70,700
VRI Intermediate Holdings, LLC | Trademarks and trade names
Business Acquisition [Line Items]
Useful Life	8 years
Finite-lived intangibles	$ 13,300
VRI Intermediate Holdings, LLC | Internally developed software
Business Acquisition [Line Items]
Useful Life	7 years
Finite-lived intangibles	$ 1,800
National MedTrans
Business Acquisition [Line Items]
Finite-lived intangibles					$ 77,665
National MedTrans | Payor network
Business Acquisition [Line Items]
Useful Life					6 years
Finite-lived intangibles					$ 75,514
National MedTrans | Trademarks and trade names
Business Acquisition [Line Items]
Useful Life					3 years
Finite-lived intangibles					$ 2,151
WellRyde
Business Acquisition [Line Items]
Finite-lived intangibles			$ 12,463
WellRyde | Payor network
Business Acquisition [Line Items]
Useful Life			10 years
Finite-lived intangibles			$ 12,328
WellRyde | Trademarks and trade names
Business Acquisition [Line Items]
Useful Life			10 years
Finite-lived intangibles			$ 135

Acquisitions - Pro Forma Inform

Acquisitions - Pro Forma Information (Details) - Business Acquisitions - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Business Acquisition, Pro Forma Information [Abstract]
Revenue	$ 547,965	$ 489,104	$ 1,603,015	$ 1,475,668
Income (loss) from continuing operations, net	$ (13,678)	$ 30,043	$ 11,568	$ (4,417)
Diluted earnings (loss) per share (in USD per share)	$ (0.98)	$ 2.13	$ 0.81	$ (0.33)

Acquisitions - Consideration Tr

Acquisitions - Consideration Transferred (Details) - USD ($) $ in Thousands	May 06, 2021	May 06, 2020	Sep. 30, 2021
National MedTrans
Business Acquisition, Contingent Consideration [Line Items]
Consideration paid		$ 80,000
Transaction costs		774
Restricted cash received		(3,109)
Net consideration		$ 77,665
WellRyde
Business Acquisition, Contingent Consideration [Line Items]
Consideration paid	$ 12,000
Transaction costs	463		$ 500
Net consideration	$ 12,463

Segments - Narrative (Details)

Segments - Narrative (Details)	9 Months Ended
	Sep. 30, 2021segment
Segment Reporting [Abstract]
Number of operating segments	2

Segments - Segments (Details)

Segments - Segments (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Segment Reporting Information [Line Items]
Service revenue, net	$ 493,059	$ 320,619	$ 1,421,117	$ 970,166
Grant income	0	0	3,500	0
Service expense	399,272	235,543	1,139,170	764,310
General and administrative expense (2)	68,054	34,441	179,271	86,435
Depreciation and amortization	12,608	7,301	36,667	17,199
Operating income	13,125	43,334	69,509	102,222
Equity in net income (loss) of investee	(6,748)	10,325	(1,978)	12,200
Equity investment	134,353		134,353		$ 137,466
Goodwill	929,986		929,986		444,927
Total assets (continuing operations)	2,135,153		2,135,153		1,425,913
Grant income
Segment Reporting Information [Line Items]
Grant income			3,500
NEMT
Segment Reporting Information [Line Items]
Service revenue, net	372,992	320,619	1,081,168	970,166
Grant income	0		0
Service expense	304,398	235,543	869,470	764,310
General and administrative expense (2)	52,118	34,441	133,706	86,435
Depreciation and amortization	7,496	7,301	21,744	17,199
Operating income	8,980	43,334	56,248	102,222
Equity in net income (loss) of investee	0	0	0	0
Equity investment	0		0		0
Goodwill	135,216		135,216		135,216
Total assets (continuing operations)	619,637		619,637		594,952
Personal Care
Segment Reporting Information [Line Items]
Service revenue, net	118,503		338,385
Grant income	0		3,500
Service expense	94,107		268,933
General and administrative expense (2)	15,720		45,349
Depreciation and amortization	4,912		14,723
Operating income	3,764		12,880
Equity in net income (loss) of investee	0		0
Equity investment	0		0		0
Goodwill	565,886		565,886		309,711
Total assets (continuing operations)	1,037,886		1,037,886		693,495
Remote Patient Monitoring
Segment Reporting Information [Line Items]
Service revenue, net	1,564		1,564
Grant income	0		0
Service expense	767		767
General and administrative expense (2)	216		216
Depreciation and amortization	200		200
Operating income	381		381
Equity in net income (loss) of investee	0		0
Equity investment	0		0
Goodwill	228,884		228,884
Total assets (continuing operations)	343,277		343,277
Matrix Investment
Segment Reporting Information [Line Items]
Service revenue, net	0	0	0	0
Grant income	0		0
Service expense	0	0	0	0
General and administrative expense (2)	0	0	0	0
Depreciation and amortization	0	0	0	0
Operating income	0	0	0	0
Equity in net income (loss) of investee	(6,748)	$ 10,325	(1,978)	$ 12,200
Equity investment	134,353		134,353		137,466
Goodwill	0		0		0
Total assets (continuing operations)	134,353		134,353		$ 137,466
Nutritional Meal Delivery Business
Segment Reporting Information [Line Items]
General and administrative expense (2)	$ 1,400		$ 3,400

Revenue Recognition - Narrative

Revenue Recognition - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
NEMT
Deferred Revenue
Performance obligation satisfied in previous period	$ 0.1	$ (3.6)	$ 0.2	$ (3.5)
NEMT | One US State | Revenue Benchmark | Government Contracts Concentration Risk | Continuing operations
Deferred Revenue
Concentration risk, percentage			9.70%	10.40%
Personal Care | One US State | Revenue Benchmark | Government Contracts Concentration Risk | Continuing operations
Deferred Revenue
Concentration risk, percentage			28.10%

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation of Revenue (NET Services) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Total service revenue, net	$ 493,059	$ 320,619	$ 1,421,117	$ 970,166
National MedTrans
Disaggregation of Revenue [Line Items]
Total service revenue, net	372,992	320,619	1,081,168	970,166
NEMT Capitated Contracts | National MedTrans
Disaggregation of Revenue [Line Items]
Total service revenue, net	287,768	277,908	854,269	832,490
NEMT FFS Contracts | National MedTrans
Disaggregation of Revenue [Line Items]
Total service revenue, net	85,224	42,711	226,899	137,676
Personal Care FFS Contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	118,503	0	338,385	0
RPM Service Contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	1,564	0	1,564	0
State Medicaid contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	204,403	154,318	615,154	486,971
Managed Medicaid contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	237,399	141,365	659,506	407,723
Managed Medicare contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	44,074	24,936	125,571	75,472
Private pay and other contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	$ 7,183	$ 0	$ 20,886	$ 0

Revenue Recognition - Schedule

Revenue Recognition - Schedule of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Accounts receivable	$ 269,391	$ 164,622
Reconciliation contracts receivable	20,529	35,724
Allowance for doubtful accounts	(690)	(2,403)
Accounts receivable, net	$ 289,230	$ 197,943

Revenue Recognition - Schedul_2

Revenue Recognition - Schedule of Other Accounts (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Accrued contract payables	$ 320,045	$ 101,705
Long-term contract payables	5,793	72,183
Deferred revenue, current	$ 2,488	$ 2,923

Revenue Recognition - Summary o

Revenue Recognition - Summary of Contract Payables and Receivables (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	$ 325,838	$ 173,888
Additional Amounts Recorded	185,281
Amounts Paid or Settled	(33,331)
Contract with customer, liability end of period	325,838
Summary of Receivables [Roll Forward]
Contract with customer, asset, after allowance for credit loss beginning of period	35,724
Additional Amounts Recorded	9,945
Amounts Paid or Settled	(25,140)
Contract with customer, asset, after allowance for credit loss end of period	20,529
Reconciliation contract payables
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	47,693	33,330
Additional Amounts Recorded	34,912
Amounts Paid or Settled	(20,549)
Contract with customer, liability end of period	47,693
Summary of Receivables [Roll Forward]
Contract with customer, asset, after allowance for credit loss beginning of period	35,580
Additional Amounts Recorded	9,984
Amounts Paid or Settled	(25,140)
Contract with customer, asset, after allowance for credit loss end of period	20,424
Profit rebate/corridor contract payables
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	260,195	123,239
Additional Amounts Recorded	137,003
Amounts Paid or Settled	(47)
Contract with customer, liability end of period	260,195
Summary of Receivables [Roll Forward]
Contract with customer, asset, after allowance for credit loss beginning of period	144
Additional Amounts Recorded	(39)
Amounts Paid or Settled	0
Contract with customer, asset, after allowance for credit loss end of period	105
Overpayments and other cash items
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	17,950	$ 17,319
Additional Amounts Recorded	13,366
Amounts Paid or Settled	(12,735)
Contract with customer, liability end of period	$ 17,950

Cash, Cash Equivalents and Re_3

Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020	Dec. 31, 2019
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents [Abstract]
Cash and cash equivalents	$ 126,506	$ 183,281	$ 183,277
Restricted cash	186	75	3,182
Current assets of discontinued operations	141	758	357
Cash, cash equivalents and restricted cash	$ 126,692	$ 183,356	$ 186,816	$ 61,673

Equity Investment - Narrative (

Equity Investment - Narrative (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Schedule of Equity Method Investments [Line Items]
Equity investment	$ 134,353	$ 137,466
Matrix
Schedule of Equity Method Investments [Line Items]
Equity method investment, ownership percentage	43.60%	43.60%
Equity investment	$ 134,400	$ 137,500

Equity Investment - Summary of

Equity Investment - Summary of Financial Information for Matrix (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Schedule of Investments [Line Items]
Current assets	$ 470,652						$ 470,652		$ 426,616
Current liabilities	575,967						575,967		324,751
Service revenue, net	493,059			$ 320,619			1,421,117	$ 970,166
Operating income (loss)	13,125			43,334			69,509	102,222
Net income (loss)	(7,570)	$ 13,672	$ 18,840	38,805	$ 36,998	$ 16,098	24,943	91,901
Matrix
Schedule of Investments [Line Items]
Current assets	127,994						127,994		143,110
Long-term assets	596,562						596,562		619,642
Current liabilities	60,835						60,835		81,920
Long-term liabilities	339,699						339,699		$ 351,036
Service revenue, net	78,458			140,728			316,830	292,699
Operating income (loss)	(16,833)			35,489			3,324	49,074
Net income (loss)	$ (15,627)			$ 21,382			$ (7,143)	$ 23,917

Prepaid Expenses and Other Cu_3

Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid income taxes	$ 13,499	$ 14,633
Prepaid insurance	12,519	7,577
Deferred financing costs on credit facility	2,452	0
Inventory	1,733	0
Prepaid rent	260	1,196
Other prepaid expenses	11,192	8,479
Total prepaid expenses and other current assets	$ 41,655	$ 31,885

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Payables and Accruals [Abstract]
Accrued compensation and related liabilities	$ 57,461	$ 57,201
Accrued interest	13,735	4,927
Deferred operating expenses	10,375	8,018
Union pension obligations	9,073	6,632
Accrued legal fees	4,862	3,228
Deferred acquisition payments	3,978	3,978
Accrued cash settled stock-based compensation	163	19,376
Other	9,924	13,650
Total accrued expenses and other current liabilities	$ 109,571	$ 117,010

Accrued Expenses and Other Cu_4

Accrued Expenses and Other Current Liabilities - Narrative (Details) $ in Millions	Sep. 30, 2021USD ($)
Condensed Balance Sheet Statements, Captions [Line Items]
Accrued cash benefit, due from deferral of payroll taxes	$ 20.8
Accrued cash benefit, percent due In year one	50.00%
Accrued cash benefit, percent due in year two	50.00%
Accrued Liabilities
Condensed Balance Sheet Statements, Captions [Line Items]
Accrued cash benefit, due from deferral of payroll taxes	$ 10.4
Other Noncurrent Liabilities
Condensed Balance Sheet Statements, Captions [Line Items]
Accrued cash benefit, due from deferral of payroll taxes	$ 10.4

Debt (Details)

Debt (Details)	3 Months Ended	9 Months Ended
	Dec. 31, 2020USD ($)	Sep. 30, 2021USD ($)	Aug. 24, 2021USD ($)	Nov. 04, 2020USD ($)	May 07, 2020USD ($)	May 06, 2020USD ($)
Line of Credit Facility [Line Items]
Deferred financing costs on credit facility	$ 14,020,000	$ 25,330,000
Line of credit facility, outstanding		0
Letters of credit outstanding, amount		21,100,000
Remaining borrowing capacity		203,900,000
Line of credit facility additional maximum borrowing capacity		75,000,000
Senior Notes
Line of Credit Facility [Line Items]
Unamortized debt issuance expense		$ 25,300,000
Credit Facility, Fourth Amendment, Term Loan Tranche
Line of Credit Facility [Line Items]
Line of credit available					$ 40,000,000	$ 25,000,000
Credit Facility, Eighth Amendment, Term Loan Tranche | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Base rate for variable rate		1.00%
Credit Facility, Eighth Amendment, Term Loan Tranche | Minimum | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Basis spread on variable rate		2.25%
Credit Facility, Eighth Amendment, Term Loan Tranche | Minimum | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate		1.25%
Credit Facility, Eighth Amendment, Term Loan Tranche | Maximum | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Basis spread on variable rate		3.50%
Credit Facility, Eighth Amendment, Term Loan Tranche | Maximum | Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate		2.50%
Credit Facility, Second Amendment, Term Loan Tranche | Minimum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage		0.35%
Credit Facility, Second Amendment, Term Loan Tranche | Maximum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage		0.50%
Revolving Credit Facility
Line of Credit Facility [Line Items]
Debt amount					$ 225,000,000	$ 200,000,000
Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage		2.25%
Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage		3.50%
2025 Senior Notes
Line of Credit Facility [Line Items]
Redemption, potential redemption of notes, percentage		0.40
Redemption price, percentage		105.875%
Debt instrument, redemption, potential redemption of principal amount, percentage		0.10
Redemption price, percentage of principal amount redeemed		103.00%
Debt related commitment fees and debt issuance costs	$ 9,000,000
2025 Senior Notes | Senior Notes
Line of Credit Facility [Line Items]
Long-term debt, gross				$ 500,000,000
Interest rate, stated percentage				5.875%
Deferred financing costs on credit facility		$ 14,500,000
2025 Senior Notes | Senior Credit Facility | Senior Notes | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Interest rate, stated percentage		5.875%
2029 Senior Notes
Line of Credit Facility [Line Items]
Redemption, potential redemption of notes, percentage		0.40
Redemption price, percentage		105.00%
2029 Senior Notes | VRI Intermediate Holdings, LLC
Line of Credit Facility [Line Items]
Acquisition costs		$ 6,600,000
2029 Senior Notes | Senior Notes
Line of Credit Facility [Line Items]
Long-term debt, gross			$ 500,000,000
Interest rate, stated percentage			5.00%
Deferred financing costs on credit facility		$ 13,500,000
2029 Senior Notes | Senior Credit Facility | Senior Notes | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Interest rate, stated percentage		5.00%

Debt - Schedule Of Redemption P

Debt - Schedule Of Redemption Percentages (Details)	9 Months Ended
	Sep. 30, 2021
2025 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	105.875%
2029 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	105.00%
Period One | Senior Notes | 2025 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	102.938%
Period One | Senior Notes | 2029 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	102.50%
Period Two | Senior Notes | 2025 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	101.469%
Period Two | Senior Notes | 2029 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	101.25%
Period Three | Senior Notes | 2025 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	100.00%
Period Three | Senior Notes | 2029 Senior Notes
Debt Instrument [Line Items]
Redemption price, percentage	100.00%

Stock-Based Compensation and _3

Stock-Based Compensation and Similar Arrangements - Stock-based Compensation Activity (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	$ 1,566	$ 1,177	$ 4,225	$ 2,949
Service expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	0	55	0	174
General and administrative expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	$ 1,566	$ 1,122	$ 4,225	$ 2,775

Stock-Based Compensation and _4

Stock-Based Compensation and Similar Arrangements - Narrative (Details)	Sep. 30, 2021$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options outstanding (in shares) | shares	270,962
Weighted-average exercise price (in usd per share) | $ / shares	$ 88.03
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of unvested RSAs outstanding | shares	19,975
Weighted-average grant date fair value (in usd per share) | $ / shares	$ 91.08
Stock Equivalent Unit Awards and Stock Option Equivalent Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of unvested RSAs outstanding | shares	60,243
Weighted-average grant date fair value (in usd per share) | $ / shares	$ 114.19

Earnings (Loss) Per Share - Sch

Earnings (Loss) Per Share - Schedule of Earnings (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Sep. 30, 2020
Numerator:
Net income (loss)	$ (7,570)	$ 13,672	$ 18,840	$ 38,805	$ 36,998	$ 16,098	$ 24,943	$ 91,901
Dividends on convertible preferred stock outstanding	0			0			0	(1,171)
Consideration paid in excess of preferred cost basis pursuant to the Conversion Agreement	0			(3,186)			0	(52,137)
Income allocated to participating securities	0			(246)			0	(3,213)
Net income (loss) available to common stockholders	$ (7,570)			$ 35,346			$ 24,943	$ 34,563
Denominator:
Denominator for basic earnings per share -- weighted-average shares	13,993,438			14,026,039			14,102,371	13,367,605
Effect of dilutive securities:
Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion (in shares)	13,993,438			14,133,904			14,278,331	13,415,344
Basic earnings (loss) per share:
Continuing operations (in dollars per share)	$ (0.53)			$ 2.53			$ 1.79	$ 2.63
Discontinued operations (in dollars per share)	(0.01)			(0.01)			(0.02)	(0.05)
Basic earnings (loss) per common share (in dollars per share)	(0.54)			2.52			1.77	2.58
Diluted earnings (loss) per share:
Continuing operations (in dollars per share)	(0.53)			2.51			1.76	2.62
Discontinued operations (in dollars per share)	(0.01)			(0.01)			(0.02)	(0.05)
Diluted earnings (loss) per common share (in dollars per share)	$ (0.54)			$ 2.50			$ 1.74	$ 2.57
Common stock options
Effect of dilutive securities:
Common stock options (in shares)	0			61,312			130,221	15,730
Restricted stock
Effect of dilutive securities:
Common stock options (in shares)	0			46,553			45,739	32,009
Continuing operations
Numerator:
Net income (loss) available to common stockholders	$ (7,462)			$ 35,461			$ 25,175	$ 35,181
Discontinued operations
Numerator:
Net income (loss) available to common stockholders	(108)			(115)			(232)	(618)
Preferred Stock Conversion Agreement
Numerator:
Dividends paid pursuant to the Conversion Agreement	$ 0			$ (27)			$ 0	$ (817)

Earnings (Loss) Per Share - S_2

Earnings (Loss) Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Stock options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	49,158	3,481	53,550	170,076
Convertible preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	0	38,851	0	487,576

Earnings (Loss) Per Share - Nar

Earnings (Loss) Per Share - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended					7 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020	Sep. 30, 2021	Mar. 08, 2021
Earnings Per Share [Abstract]
Stock repurchase program, authorized amount							$ 75,000
Stock repurchase plan (in shares)						269,407
Treasury stock, value, acquired, cost method	$ 0	$ 24,590	$ 14,450	$ 2,887	$ 7,299	$ 39,000

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Effective income tax rate	34.10%	27.00%	24.00%	17.60%
Income tax refunds on sale of business					$ 30.8
Income taxes receivable	$ 27.3	$ 27.3	$ 27.3	$ 27.3
Tax benefit				$ 11
Increase income taxes payable					$ 3.5

Transactions with Related Par_2

Transactions with Related Parties (Details) - USD ($) $ / shares in Units, $ in Millions	Aug. 12, 2021	Feb. 10, 2021	Sep. 11, 2014	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Related Party Transaction [Line Items]
Stock options outstanding (in shares)				270,962		270,962
Affiliated Entity | Coliseum Capital Mgmt.
Related Party Transaction [Line Items]
Stock equivalent units outstanding (in shares)				1,344		1,344
Stock Equivalent Unit Awards and Stock Option Equivalent Units | Affiliated Entity | Coliseum Capital Mgmt.
Related Party Transaction [Line Items]
Award vesting period						1 year
Awards granted (in shares)		725
Exercise of employee stock options (in shares)			200,000
Awards exercised (in dollars per share)	$ 182.73		$ 43.81
Share-based payment arrangement, cash used to settle award	$ 27.8
Stock options outstanding (in shares)				0		0
Stock Equivalent Unit Awards and Stock Option Equivalent Units | Accrued Expenses | Affiliated Entity | Coliseum Capital Mgmt.
Related Party Transaction [Line Items]
Liability for unexercised cash settled share-based payment awards				$ 0.2		$ 0.2		$ 19.4
Stock Equivalent Unit Awards and Stock Option Equivalent Units | General and administrative expense | Affiliated Entity | Coliseum Capital Mgmt.
Related Party Transaction [Line Items]
Allocated share-based compensation expense (benefit)				$ 2.6	$ 2.9	$ 9.1	$ 6.9