ModivCare (MODV) 10-Q 7 Nov 22 2022 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2022	Oct. 28, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
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 E Layton Avenue
Entity Address, Address Line Two	12th 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		14,138,324
Entity Central Index Key	0001220754
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false

Unaudited Condensed Consolidate

Unaudited Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 72,703	$ 133,139
Accounts receivable, net of allowance of $2,670 and $2,296, respectively	266,177	233,121
Other receivables	6,117	4,740
Prepaid expenses and other current assets	36,681	38,551
Restricted cash	28	283
Total current assets	381,706	409,834
Property and equipment, net	67,413	53,549
Goodwill	968,420	924,787
Payor network, net	408,147	425,516
Other intangible assets, net	51,643	64,697
Equity investment	43,477	83,069
Operating lease right-of-use assets	38,368	43,750
Other assets	30,671	22,223
Total assets	1,989,845	2,027,425
Current liabilities:
Accounts payable	44,242	8,690
Accrued contract payables	243,800	281,586
Accrued transportation costs	90,114	103,294
Accrued expenses and other current liabilities	145,217	123,791
Current portion of operating lease liabilities	10,134	9,873
Total current liabilities	533,507	527,234
Long-term debt, net of deferred financing costs of $21,699 and $24,775, respectively	978,301	975,225
Deferred tax liabilities	62,666	94,611
Operating lease liabilities, less current portion	30,595	34,524
Other long-term liabilities	30,628	22,564
Total liabilities	1,635,697	1,654,158
Commitments and contingencies (Note 13)
Stockholders’ equity
Common stock: Authorized 40,000,000 shares; $0.001 par value; 19,632,749 and 19,589,422, respectively, issued and outstanding (including treasury shares)	20	20
Additional paid-in capital	436,839	430,449
Retained earnings	186,970	211,829
Treasury shares, at cost, 5,574,905 and 5,568,983 shares, respectively	(269,681)	(269,031)
Total stockholders’ equity	354,148	373,267
Total liabilities and stockholders’ equity	$ 1,989,845	$ 2,027,425

Unaudited Condensed Consolida_2

Unaudited Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 2,670	$ 2,296
Deferred financing fees	$ 21,699	$ 24,775
Common stock, shares authorized (in shares)	40,000,000	40,000,000
Common stock, par (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares, issued (in shares)	19,632,749	19,589,422
Common stock, shares, outstanding (in shares)	19,632,749	19,589,422
Treasury stock, shares (in shares)	5,574,905	5,568,983

Unaudited Condensed Consolida_3

Unaudited Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Statement [Abstract]
Service revenue, net	$ 647,782	$ 493,059	$ 1,850,472	$ 1,421,117
Grant income (Note 2)	789	0	4,587	3,500
Operating expenses:
Service expense	534,563	399,272	1,498,108	1,139,170
General and administrative expense	75,889	68,205	232,108	179,595
Depreciation and amortization	25,672	12,608	74,376	36,667
Total operating expenses	636,124	480,085	1,804,592	1,355,432
Operating income	12,447	12,974	50,467	69,185
Other expenses:
Interest expense, net	15,557	17,702	46,429	34,412
Income (loss) before income taxes and equity method investment	(3,110)	(4,728)	4,038	34,773
Provision (benefit) for income taxes	(1,053)	(2,001)	877	8,409
Equity in net loss of investee, net of tax	26,448	4,845	28,020	1,424
Net income (loss)	$ (28,505)	$ (7,572)	$ (24,859)	$ 24,940
Earnings (loss) per common share:
Basic earnings per share (in dollars per share)	$ (2.03)	$ (0.54)	$ (1.77)	$ 1.77
Diluted earnings per share (in dollars per share)	$ (2.03)	$ (0.54)	$ (1.77)	$ 1.75
Weighted-average number of common shares outstanding:
Basic (in shares)	14,051,794	13,993,438	14,041,224	14,102,371
Diluted (in shares)	14,051,794	13,993,438	14,041,224	14,278,331

Unaudited Condensed Consolida_4

Unaudited Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Operating activities
Net income (loss)	$ (24,859)	$ 24,940
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	14,398	8,839
Amortization	59,978	27,828
Provision for doubtful accounts	(2,670)	(1,712)
Stock-based compensation	5,152	4,225
Deferred income taxes	(31,232)	(3,295)
Amortization of deferred financing costs and debt discount	3,878	2,175
Equity in net loss of investees	38,883	1,978
Reduction of right-of-use assets	8,680	8,681
Changes in operating assets and liabilities:
Accounts receivable and other receivables	(28,507)	(69,597)
Prepaid expenses and other	(4,194)	(5,330)
Accrued contract payables	(37,786)	151,950
Accounts payable and accrued expenses	55,887	9,475
Accrued transportation costs	(13,180)	12,354
Other long-term liabilities	1,098	2,183
Net cash provided by operating activities	45,526	174,694
Investing activities
Purchase of property and equipment	(25,518)	(13,852)
Acquisition, net of cash acquired	(78,872)	(667,228)
Net cash used in investing activities	(104,390)	(681,080)
Financing activities
Proceeds from debt	100,000	625,000
Repayment of debt	(100,000)	(125,000)
Repurchase of common stock, for treasury	0	(39,040)
Debt issuance costs	(2,415)	(13,486)
Proceeds from common stock issued pursuant to stock option exercise	1,237	3,099
Restricted stock surrendered for employee tax payment	(649)	(851)
Net cash provided by (used in) financing activities	(1,827)	449,722
Net change in cash, cash equivalents and restricted cash	(60,691)	(56,664)
Cash, cash equivalents and restricted cash at beginning of period	133,422	183,356
Cash, cash equivalents and restricted cash at end of period	72,731	126,692
Supplemental cash flow information
Cash paid for interest	31,460	24,006
Cash paid for income taxes	4,159	12,846
Assets acquired under operating leases	3,298	21,829
Purchase price	79,199	682,113
Cash acquired	327	14,885
Acquisitions, net of cash acquired	$ 78,872	$ 667,228

Unaudited Condensed Consolida_5

Unaudited Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Retained Earnings	Treasury Stock
Beginning balance (in shares) at Dec. 31, 2020		19,570,598
Beginning balance at Dec. 31, 2020	$ 411,611	$ 20	$ 421,318	$ 218,414	$ (228,141)
Beginning balance (in shares) at Dec. 31, 2020					5,287,283
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 (in shares)		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
Ending balance at Mar. 31, 2021	418,753	$ 20	424,791	237,254	$ (243,312)
Ending balance (in shares) at Mar. 31, 2021					5,385,771
Beginning balance (in shares) at Dec. 31, 2020		19,570,598
Beginning balance at Dec. 31, 2020	411,611	$ 20	421,318	218,414	$ (228,141)
Beginning balance (in shares) at Dec. 31, 2020					5,287,283
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	24,940
Ending balance (in shares) at Sep. 30, 2021		19,581,219
Ending balance at Sep. 30, 2021	403,985	$ 20	428,643	243,354	$ (268,032)
Ending balance (in shares) at Sep. 30, 2021					5,561,826
Beginning balance (in shares) at Mar. 31, 2021		19,623,017
Beginning balance at Mar. 31, 2021	418,753	$ 20	424,791	237,254	$ (243,312)
Beginning balance (in shares) at Mar. 31, 2021					5,385,771
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 (in shares)		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
Ending balance at Jun. 30, 2021	409,257	$ 20	426,312	250,926	$ (268,001)
Ending balance (in shares) at Jun. 30, 2021					5,561,657
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(7,572)			(7,572)
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 forfeited (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 (in shares)		333
Shares issued for bonus settlement and director stipends	61		61
Ending balance (in shares) at Sep. 30, 2021		19,581,219
Ending balance at Sep. 30, 2021	$ 403,985	$ 20	428,643	243,354	$ (268,032)
Ending balance (in shares) at Sep. 30, 2021					5,561,826
Beginning balance (in shares) at Dec. 31, 2021	19,589,422	19,589,422
Beginning balance at Dec. 31, 2021	$ 373,267	$ 20	430,449	211,829	$ (269,031)
Beginning balance (in shares) at Dec. 31, 2021	5,568,983				5,568,983
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	$ 318			318
Stock-based compensation	1,963		1,963
Exercise of employee stock options (in shares)		20,683
Exercise of employee stock options	1,138		1,138
Restricted stock issued (in shares)		16,306
Restricted stock surrendered for employee tax payment (in shares)					5,179
Restricted stock surrendered for employee tax payment	(572)				$ (572)
Shares issued for bonus settlement and director stipends (in shares)		732
Shares issued for bonus settlement and director stipends	86		86
Ending balance (in shares) at Mar. 31, 2022		19,627,143
Ending balance at Mar. 31, 2022	$ 376,200	$ 20	433,636	212,147	$ (269,603)
Ending balance (in shares) at Mar. 31, 2022					5,574,162
Beginning balance (in shares) at Dec. 31, 2021	19,589,422	19,589,422
Beginning balance at Dec. 31, 2021	$ 373,267	$ 20	430,449	211,829	$ (269,031)
Beginning balance (in shares) at Dec. 31, 2021	5,568,983				5,568,983
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	$ (24,859)
Ending balance (in shares) at Sep. 30, 2022	19,632,749	19,632,749
Ending balance at Sep. 30, 2022	$ 354,148	$ 20	436,839	186,970	$ (269,681)
Ending balance (in shares) at Sep. 30, 2022	5,574,905				5,574,905
Beginning balance (in shares) at Mar. 31, 2022		19,627,143
Beginning balance at Mar. 31, 2022	$ 376,200	$ 20	433,636	212,147	$ (269,603)
Beginning balance (in shares) at Mar. 31, 2022					5,574,162
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	3,328			3,328
Stock-based compensation	2,363		2,363
Exercise of employee stock options (in shares)		16
Exercise of employee stock options	0		0
Restricted stock forfeited (in shares)		(551)
Restricted stock surrendered for employee tax payment (in shares)					322
Restricted stock surrendered for employee tax payment	(36)				$ (36)
Shares issued for bonus settlement and director stipends (in shares)		1,000
Shares issued for bonus settlement and director stipends	85		85
Ending balance (in shares) at Jun. 30, 2022		19,627,608
Ending balance at Jun. 30, 2022	381,940	$ 20	436,084	215,475	$ (269,639)
Ending balance (in shares) at Jun. 30, 2022					5,574,484
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(28,505)			(28,505)
Stock-based compensation	570		570
Exercise of employee stock options (in shares)		3,381
Exercise of employee stock options	100		100
Restricted stock issued (in shares)		914
Restricted stock surrendered for employee tax payment (in shares)					421
Restricted stock surrendered for employee tax payment	(42)				$ (42)
Shares issued for bonus settlement and director stipends (in shares)		846
Shares issued for bonus settlement and director stipends	$ 85		85
Ending balance (in shares) at Sep. 30, 2022	19,632,749	19,632,749
Ending balance at Sep. 30, 2022	$ 354,148	$ 20	$ 436,839	$ 186,970	$ (269,681)
Ending balance (in shares) at Sep. 30, 2022	5,574,905				5,574,905

Organization and Basis of Prese

Organization and Basis of Presentation	9 Months Ended
	Sep. 30, 2022
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, connect members to care, help health plans manage risks, 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, which serve similar, highly vulnerable patient populations. The technology-enabled operating model includes NEMT core competencies in risk underwriting, contact center management, network credentialing, claims management and non-emergency medical transportation 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. 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 meal delivery and working with communities to provide food-insecure individuals delivery of meals. ModivCare also holds a 43.6% minority interest in CCHN Group Holdings, Inc. and its subsidiaries, which operates under the Matrix Medical Network brand, 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. 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 complete 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, 2022 are not necessarily indicative of the results that may be expected for the fiscal year ending December 31, 2022. 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 unaudited condensed consolidated financial statements. The unaudited condensed consolidated balance sheet at December 31, 2021 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 complete 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, 2021. Reclassifications: Certain prior year amounts have been reclassified to conform to current year presentation. Impact of the COVID-19 Pandemic Since March 2020, the COVID-19 pandemic and the measures enacted by state and government officials to prevent, prepare for, and respond to COVID-19 or slow its spread have had an ongoing adverse impact on the Company’s business, as well as its patients, communities, and employees. With ongoing uncertainties around the duration and magnitude of the pandemic, the ultimate impact to the business remains uncertain. Accordingly, the COVID-19 pandemic could continue to have an adverse impact on the Company's financial statements with potential for (i) labor shortages or other disruptions that impact our ability to provide services, and (ii) decreased member comfort leaving the house to obtain transportation for non-emergency medical purposes; among other things. Despite ongoing uncertainties, the Company’s priorities throughout the COVID-19 pandemic remain intact with emphasis on protecting the health and safety of its employees, maximizing the availability of its services and products to support the SDoH, and supporting the operational and financial stability of its business. Federal, state, and local authorities have taken several actions designed to assist healthcare providers in providing care to COVID-19 and other patients and to mitigate the adverse economic impact of the COVID-19 pandemic. Legislative actions taken by the federal government include the CARES Act and the American Rescue Plan Act of 2021 ("ARPA"). Through the CARES Act, the federal government has authorized payments to be distributed to healthcare providers through the Public Health and Social Services Emergency Fund ("Provider Relief Fund" or "PRF"). The Government further initiated ARPA which established the Coronavirus State and Local Fiscal Recovery Fund ("SLFRF") to send relief payments to state and local governments impacted by the pandemic to assist with responding to the public health emergency (“PHE”) including the economic hardships that continue to impact communities and to respond to workers performing essential work during the COVID-19 PHE, including providers. These funds are not subject to repayment, provided we are able to attest and comply with any terms and conditions of such funding, as applicable.

Significant Accounting Policies

Significant Accounting Policies and Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2022
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. Changes in Accounting Estimate In accordance with its policy, the Company reviews the estimated useful lives of its fixed assets and intangible assets on an ongoing basis. As a result of this review, the Company adjusted the estimated useful life of the Simplura trademarks and trade names intangible asset from 10 years to 3 years and adjusted the estimated useful life of the payor network from 15 years to 10 years effective as of January 1, 2022. This change was driven by strategic shifts in the Company's personal care segment operations, partially contributed to by the acquisition of Care Finders Total Care, LLC ("Care Finders"). Based on the intangible asset values as of December 31, 2021, the effect of the change in estimate during the three and nine months ended September 30, 2022 was an increase in amortization expense of $3.6 million, a decrease in net income of $2.4 million, and a decrease in earnings per share of $0.17 per diluted common share outstanding, and an increase in amortization expense of $10.7 million, a decrease in net income of $8.4 million, and a decrease in earnings per share of $0.60 per diluted common share outstanding, respectively. Government Grants The Company has received government grants under the CARES Act PRF and the ARPA SLFRF to provide economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic. Under these acts, the Company received distributions of approximately $1.4 million during the three months ended September 30, 2022. No distributions were received during the three months ended September 30, 2021. The Company received distributions of approximately $10.4 million and $3.5 million during the nine months ended September 30, 2022 and September 30, 2021, respectively. Distributions received under these acts are targeted to assist with incremental health care related expenses or lost revenue attributable to the COVID-19 pandemic as well as provide stimulus to support long-term growth and recovery. The payments from these acts are subject to certain restrictions and possible recoupment if not used for designated purposes. As a condition to receiving PRF distributions, providers must agree to certain terms and conditions, including that the funds are being used for healthcare related expenses and lost revenues attributable to COVID-19, 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 has submitted the required documents to meet reporting requirements through reporting period three, which ended September 30, 2022. The Company received an audit inquiry letter from HHS related to one of the business units that received PRF payments, to which the Company has responded and submitted all requested information and believes that the payments received are substantiated and within the terms and conditions defined by the HHS and continues to include these amounts as grant income. At this time, the Company is unaware of any other pending or upcoming audits or inquiries related to PRF received. As a condition to receiving SLFRF, providers must agree to use the funds to respond to the PHE or its negative economic impacts, to respond to workers performing essential work by providing premium pay to eligible workers and to offset reduction in revenue due to the COVID-19 PHE as stipulated by the states in which the funds were received. All recipients of SLFRF payments are required to comply with the reporting requirements that the state in which the funds originated has requested in order for the states to meet the requirements as described in the terms and conditions as determined by the Department of the Treasury. The Company has complied with all known reporting requirements to date. The Company recognizes distributions from government grants as grant income in line with the loss of revenues or expenses for which the grants are intended to compensate when there is reasonable assurance that it has complied with the conditions associated with the grant. 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 $12.3 million related to the deferral of employer payroll taxes as of September 30, 2022 and December 31, 2021 under the CARES Act which is recorded in accrued expenses on the unaudited condensed consolidated balance sheets. This balance is expected to be paid in the fourth quarter of 2022. Recent Accounting Pronouncements The Company adopted the following accounting pronouncements during the nine months ended September 30, 2022: 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. There was no material impact to the financial statements from the adoption of this ASU. In October 2021, the FASB issued ASU 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers ("ASU 2021-08"). The new guidance requires contract assets and contract liabilities acquired in a business combination to be recognized and measured by the acquirer on the acquisition date in accordance with ASC 606, Revenue from Contracts with Customers

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions Business Combinations Care Finders Total Care, LLC On September 14, 2021, the Company acquired Care Finders which 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 its personal care platform. The equity transaction was accounted for in accordance with ASC 805, Business Combinations in which a wholly-owned subsidiary of the Company acquired 100.0% of the equity securities of Care Finders for $333.4 million (a purchase price of $344.8 million less $11.4 million of cash that was acquired). The following table summarizes information from 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 $ 11,424 Accounts receivable (1) 14,708 Prepaid expenses and other (2) 2,625 Property and equipment (3) 2,527 Inventories (4) 231 Operating right of use asset (5) 1,939 Intangibles (6) 100,750 Goodwill (7) 232,103 Other assets (8) 226 Accounts payable (9) (2,720) Accrued expenses and other accrued liabilities (9) (14,344) Operating lease liability (5) (1,939) Deferred tax liabilities (10) (2,327) Other liabilities (9) (378) Total of assets acquired less liabilities assumed $ 344,825 (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. (2) Given the short-term nature of the balance of prepaid expenses, the carrying value represents the fair value. (3) The acquired property and equipment consists primarily of capitalized software, computer equipment, and automobiles. (4) Given the short-term nature of the balance of inventories, the carrying value represents the fair value. (5) The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) was recorded at $1.9 million based on market rates available to the Company during the purchase price allocation. (6) The allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 97,200 Trade name Amortizable 3 years 1,950 Non-compete agreement Amortizable 5 years 1,600 $ 100,750 The Company valued the payor network utilizing the multi-period excess earnings method, trade names utilizing the relief-from-royalty method and the non-compete agreement utilizing the with/without method. (7) The acquisition initially resulted in $232.2 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 home care solutions. In the third quarter of 2022, goodwill decreased by $0.1 million as a result of changes to accounts payable and deferred tax liabilities, as discussed in detail below. All of the acquired goodwill is deductible for tax purposes. (8) Included in other assets are security deposits with a value of $0.2 million. (9) Due to the short-term nature of the accounts, the carrying value is assumed to represent the fair value for accounts payable as well as certain other current and non-current liabilities as of the acquisition date. In the third quarter of 2022, it was determined that an additional $0.2 million of accounts payable existed as of the acquisition date, and therefore, the initial balance of $2.5 million was increased to $2.7 million. (10) 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 basis. In the third quarter of 2022, deferred tax liabilities of $2.6 million decreased by $0.3 million due to tax impacts of the acquisition. VRI Intermediate Holdings, LLC On September 22, 2021, the Company acquired VRI, a provider of remote patient monitoring solutions that manages 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 SDoH, introduces new technology-enabled in-home solutions that deepen the Company's engagement with payors and patients, and adds a new suite of services and operating team to advance the Company's broader technology and data strategy. The stock transaction was accounted for in accordance with ASC 805, Business Combinations in which a wholly-owned subsidiary of the Company acquired 100.0% of the equity securities of VRI for $314.6 million (a purchase price of $317.5 million less $2.9 million of cash that was acquired). The following table summarizes 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) 6,800 Inventory (2) 1,684 Prepaid expenses and other (3) 805 Property and equipment (4) 14,908 Intangible assets (5) 75,590 Goodwill (6) 236,317 Accounts payable and accrued liabilities (7) (1,884) Accrued expense (7) (2,487) Deferred revenue (7) (67) Deferred tax liabilities (8) (17,070) Total of assets acquired less liabilities assumed $ 317,518 (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. (2) Given the short-term nature of the balance of inventories, the carrying value represents the fair value. (3) Given the short-term nature of the balance of prepaid expenses, the carrying value represents the fair value. (4) The acquired property and equipment consists primarily of personal emergency response system devices, with the remainder consisting of computer equipment, buildings and other equipment. The Company valued the personal emergency response system devices, computer equipment and other equipment utilizing the cost approach at $12.7 million. The carrying value of the remainder of the property, plant and equipment, consisting primarily of buildings and land, is assumed to represent the fair value. (5) The allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 72,150 Trade name Amortizable 3 years 890 Developed technology Amortizable 3 years 2,550 $ 75,590 The Company valued the payor network utilizing the multi-period excess earnings method, trade names utilizing the relief-from-royalty method and developed technology utilizing the cost approach. (6) The acquisition initially resulted in $236.7 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. In the third quarter of 2022, goodwill decreased by $0.4 million due to a decrease in deferred tax liabilities, as discussed in more detail below. The related goodwill is not deductible for tax purposes. (7) Due to the short-term nature of the accounts, the carrying value is assumed to represent the fair value for accounts payable as well as certain other current and non-current liabilities as of the acquisition date. (8) 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 basis. In the third quarter of 2022, deferred tax liabilities of $17.5 million decreased by $0.4 million due to tax impacts of the acquisition. Guardian Medical Monitoring On May 11, 2022, the Company acquired Guardian Medical Monitoring ("GMM"), a provider of remote patient monitoring solutions that manages a comprehensive suite of services including personal emergency response systems and medication management. The acquisition of GMM supports the Company's strategy to expand its RPM segment and enhances the Company's suite of supportive care solutions that address SDoH. The stock transaction was accounted for in accordance with ASC 805, Business Combinations in which a wholly-owned subsidiary of the Company acquired 100.0% of the equity securities of GMM for $71.3 million (a purchase price of $71.6 million less $0.3 million of cash that was acquired). The following is a preliminary estimate of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of May 11, 2022 (in thousands): Cash $ 327 Accounts receivable (1) 2,548 Prepaid expenses and other (2) 770 Property and equipment (3) 2,744 Intangible assets (4) 21,950 Goodwill (5) 44,113 Accounts payable (6) (281) Accrued expenses and other current liabilities (6) (577) Total of assets acquired less liabilities assumed $ 71,594 The acquisition method of accounting requires us to record the assets acquired and liabilities assumed at their fair values as of the date of acquisition, which requires management to use currently available information to make estimates and assumptions. The Company believes that the available information provides a reasonable basis for estimating the fair values of assets acquired and liabilities assumed, however, if new information becomes available related to facts that existed at the acquisition date, preliminary estimates may be adjusted. Upon finalization of the preliminary items noted below, there may be related adjustments to certain of such items and to goodwill and income taxes. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. In the third quarter of 2022, it was determined that $0.4 million of the initial accounts receivable balance was uncollectible, and therefore, the initial balance of $2.9 million was decreased to $2.5 million. 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 and other assets, the carrying value represents the fair value. (3) The acquired property and equipment consists primarily of personal emergency response system devices, with the remainder consisting of computer equipment and furniture and fixtures. The Company valued the personal emergency response system devices utilizing the cost approach. The carrying value of the remainder of the property, plant and equipment, consisting primarily of computer equipment and furniture and fixtures, is assumed to represent the fair value. Management's assessment of the fair value for PP&E is ongoing. (4) The preliminary allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 21,600 Trade name Amortizable 2 years 350 $ 21,950 The Company valued the payor network utilizing the multi-period excess earnings method and trade names utilizing the relief-from-royalty method. (5) The acquisition preliminarily resulted in $43.7 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. In the third quarter of 2022, accounts receivable was adjusted down by $0.4 million which caused a corresponding increase to goodwill for a total goodwill balance of $44.1 million. The amount of goodwill deductible for tax purposes has yet to be determined. (6) Due to the short-term nature of the accounts, the carrying value is assumed to represent the fair value for accounts payable and accrued expenses and other current liabilities as of the acquisition date. Pro Forma Financial Information (unaudited) Assuming Care Finders, VRI, and GMM had been acquired as of January 1, 2021, and the results of each had been included in operations beginning on January 1, 2021, the following table provides estimated unaudited pro forma results of operations for the three and nine months ended September 30, 2022 and September 30, 2021 (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, 2022 2021 2022 2021 Revenue $ 647,782 $ 552,342 $ 1,850,472 $ 1,616,115 Income (loss) from continuing operations, net (9,714) (13,442) (7,242) 12,439 Diluted earnings (loss) per share $ (0.69) $ (0.96) $ (0.52) $ 0.87 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 pro forma earnings were adjusted to exclude the impact of historical interest expense of Care Finders and VRI of $1.1 million and $1.0 million, respectively, for the three months ended September 30, 2021 and $3.7 million and $3.2 million, respectively, for the nine months ended September 30, 2021. Acquisition-related costs of approximately $0.4 million and $2.0 million for the three and nine months ended September 30, 2022 for GMM were expensed as incurred, recorded in selling, general and administrative expenses 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 acquisition. Asset Acquisition On May 30, 2022, the Company entered into an asset purchase agreement with a private entity to purchase certain customer contracts. Pursuant to the purchase agreement, the contracts were acquired for total preliminary consideration of $7.6 million in cash, subject to certain adjustments. The transaction was accounted for as an asset acquisition in accordance with ASC 805, Business Combinations . The preliminary fair value of the net consideration is fully allocated to a payor network intangible asset recorded at the personal care segment and will be amortized over a period of 6 years.

Segments

Segments	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segments	Segments The Company’s reportable segments are identified based on a number of factors related to how its chief operating decision maker ("CODM") determines the allocation of resources and assesses the performance of the Company’s operations. The Company's CODM manages the Company under four reportable segments. 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 - The Company's NEMT segment is its legacy segment and operates primarily under the brands ModivCare Solutions and Circulation. The NEMT segment is the largest manager of non-emergency medical transportation programs for state governments and managed care organizations, or MCOs, in the U.S. This segment also holds the results of the Company's captive insurance program. • Personal Care - The Company's Personal Care segment began operations in November 2020 with the acquisition of Simplura and expanded in September 2021 with the acquisition of Care Finders. The Personal Care segment operates under the brands Simplura and Care Finders and provides personal care to State and Managed Medicaid, Medicare, and Private Pay patient populations in need of care monitoring and assistance performing activities of daily living; • RPM - The Company's RPM segment began operations in September 2021 with the acquisition of VRI and expanded in May 2022 with the acquisition of GMM. The RPM segment operates under the VRI brand and is a provider of remote patient monitoring solutions, including personal emergency response systems, vitals monitoring and data-driven patient engagement solutions; • Corporate and Other - Effective January 1, 2022, the Company completed its segment reorganization which resulted in the addition of a Corporate and Other segment that includes the costs associated with the Company's corporate operations. The operating results of the Corporate and Other segment include activities related to executive, accounting, finance, internal audit, tax, legal and certain strategic and corporate development functions for each segment, as well as the results of the Matrix investment. Prior to the segment reorganization, we reported the investment in Matrix as a separate operating segment, however based on the relative size of the Matrix investment and all related activity to the overall financial statements, the CODM no longer views it as a separate operating segment but reviews results in conjunction with the other corporate results of the business. The Company reclassified certain costs associated with this reorganization for the three and nine months ended September 30, 2021, to conform to this presentation. The Company evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses directly attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. The following table sets forth certain financial information from continuing operations attributable to the Company’s business segments for the three and nine months ended September 30, 2022 and 2021 (in thousands): Three months ended September 30, 2022 NEMT Personal Care RPM Corporate and Other Total Service revenue, net $ 459,796 $ 169,226 $ 18,760 $ — $ 647,782 Grant income (1) — 789 — — 789 Service expense 394,981 132,746 6,836 — 534,563 General and administrative expense 31,815 22,057 5,816 16,201 75,889 Depreciation and amortization 7,079 12,919 5,467 207 25,672 Operating income (loss) $ 25,921 $ 2,293 $ 641 $ (16,408) $ 12,447 Equity in net loss (income) of investee, net of tax $ (208) $ — $ — $ 26,656 $ 26,448 Equity investment $ 208 $ — $ — $ 43,269 $ 43,477 Goodwill (2) $ 135,186 $ 552,775 $ 280,429 $ 30 $ 968,420 Total assets $ 517,930 $ 962,425 $ 402,929 $ 106,561 $ 1,989,845 Nine months ended September 30, 2022 NEMT Personal Care RPM Corporate and Other Total Service revenue, net $ 1,309,449 $ 491,661 $ 49,362 $ — $ 1,850,472 Grant income (1) — 4,587 — — 4,587 Service expense 1,100,801 379,423 17,884 — 1,498,108 General and administrative expense 102,736 68,536 17,520 43,316 232,108 Depreciation and amortization 21,576 37,976 14,201 623 74,376 Operating income (loss) $ 84,336 $ 10,313 $ (243) $ (43,939) $ 50,467 Equity in net loss (income) of investee, net of tax $ (143) $ — $ — $ 28,163 $ 28,020 Equity investment $ 208 $ — $ — $ 43,269 $ 43,477 Goodwill (2) $ 135,186 $ 552,775 $ 280,429 $ 30 $ 968,420 Total assets $ 517,930 $ 962,425 $ 402,929 $ 106,561 $ 1,989,845 (1) Grant income for the Personal Care segment includes funding received on a periodic basis from the PRF in relation to relief under the CARES Act and funding received from the SLFRF under ARPA in relation to economic recovery to combat health and economic impacts of the COVID-19 pandemic. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements. (2) In May 2022, the Company completed the acquisition of GMM which is included within the RPM segment. The Company recorded goodwill of $43.7 million related to the acquisition during the second quarter of 2022. During the third quarter of 2022, the Company recorded an increase in GMM goodwill of $0.4 million and a decrease in VRI goodwill of $0.4 million related to measurement period adjustments as discussed in Note 3, Acquisitions, for a total GMM goodwill balance of $44.1 million and a total VRI goodwill balance of $236.3 million. Additionally, during the third quarter of 2022, the Company recorded a net decrease in goodwill of $0.1 million in the Personal Care segment related to measurement period adjustments at the Care Finders subsidiary as discussed in Note 3, Acquisitions . Three months ended September 30, 2021 NEMT Personal Care RPM Corporate and Other 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 29,875 15,802 216 22,312 68,205 Depreciation and amortization 7,496 4,912 200 — 12,608 Operating income (loss) $ 31,223 $ 3,682 $ 381 $ (22,312) $ 12,974 Equity in net loss of investee, net of tax $ — $ — $ — $ 4,845 $ 4,845 Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,186 $ 565,886 $ 228,884 $ 30 $ 929,986 Total assets $ 552,912 $ 1,037,886 $ 343,277 $ 201,078 $ 2,135,153 Nine months ended September 30, 2021 NEMT Personal Care RPM Corporate and Other 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 85,961 45,606 216 47,812 179,595 Depreciation and amortization 21,744 14,723 200 — 36,667 Operating income (loss) $ 103,993 $ 12,623 $ 381 $ (47,812) $ 69,185 Equity in net loss of investee, net of tax $ — $ — $ — $ 1,424 $ 1,424 Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,186 $ 565,886 $ 228,884 $ 30 $ 929,986 Total assets $ 552,912 $ 1,037,886 $ 343,277 $ 201,078 $ 2,135,153

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2022
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 (per-member-per-month) Under capitated contracts, payors pay a fixed amount per eligible member per month. Capitation rates are generally based on expected costs and volume of services. 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 payor’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 cost and/or trip volume and may result in refunds to the payor, or additional payments due from the payor. 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 payor. 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. 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 revenue is reported at the estimated net realizable amount from clients, patients and third-party payors for services rendered based on actual personal care hours provided. 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 per-member-per-month Contracts RPM per-member-per-month ("PMPM") 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 The following table summarizes disaggregated revenue from contracts with customers by contract type for the three and nine months ended September 30, 2022 and September 30, 2021 (in thousands): Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 NEMT capitated contracts $ 399,859 $ 311,913 $ 1,145,694 $ 916,976 NEMT FFS contracts 59,937 61,079 163,755 164,192 Total NEMT revenue 459,796 372,992 1,309,449 1,081,168 Personal Care FFS contracts 169,226 118,503 491,661 338,385 RPM PMPM contracts 18,760 1,564 49,362 1,564 Total service revenue, net $ 647,782 $ 493,059 $ 1,850,472 $ 1,421,117 Payor Information Service revenue, net, is derived from state and managed Medicaid contracts, managed Medicare contracts, as well as a small amount from private pay and other contracts. Of the NEMT segment’s revenue, 10.4% and 10.8% were derived from one payor for the three months ended September 30, 2022 and 2021, respectively, and 11.0% and 9.7% were derived from one payor for the nine months ended September 30, 2022 and 2021, respectively. Of the Personal Care segment's revenue, 12.1% and 12.0% were derived from one payor for the three months ended September 30, 2022 and 2021, respectively, and 12.0% and 13.0% were derived from one payor for the nine months ended September 30, 2022 and 2021, respectively. Of the RPM segment's revenue, 18.4% was derived from one payor for the three months ended September 30, 2022, and 20.4% was derived from one payor for the nine months ended September 30, 2022. As the RPM segment was established on September 22, 2021, the concentration of revenue is not meaningful for the three and nine months ended September 30, 2021. Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 State and Managed Medicaid contracts $ 547,423 $ 441,802 $ 1,565,738 $ 1,274,660 Managed Medicare contracts 92,228 44,074 254,835 125,571 Private pay and other contracts 8,131 7,183 29,899 20,886 Total service revenue, net $ 647,782 $ 493,059 $ 1,850,472 $ 1,421,117 Revenue Adjustments During the three months ended September 30, 2022 and 2021, the Company recognized an increase of $1.7 million and a reduction of $0.1 million in service revenue, respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the payor agreed. During the nine months ended September 30, 2022 and 2021, the Company recognized an increase of $6.5 million and $0.2 million in service revenue, respectively, from contractual adjustments relating to performance obligations satisfied in previous periods to which the payor agreed. Related Balance Sheet Accounts The following table provides information about accounts receivable, net (in thousands): September 30, 2022 December 31, 2021 Accounts receivable $ 208,787 $ 210,937 Reconciliation contracts receivable (1) 60,060 24,480 Allowance for doubtful accounts (2,670) (2,296) Accounts receivable, net $ 266,177 $ 233,121 (1) Reconciliation contracts receivable primarily represent underpayments and receivables on certain contracts with reconciliation and risk corridor provisions. See the contract payables and receivables activity below. The following table provides information about other revenue related accounts included on the accompanying unaudited condensed consolidated balance sheets (in thousands): September 30, 2022 December 31, 2021 Accrued contract payables (1) $ 243,800 $ 281,586 Deferred revenue, current $ 2,213 $ 2,714 (1) Accrued contract payables primarily represent overpayments and liability reserves on certain risk corridor, profit rebate and reconciliation contracts. The following table provides the summary activity of total contract payables and receivables as reported within the unaudited condensed consolidated balance sheets (in thousands): December 31, 2021 Additional Amounts Recorded Amounts Paid or Settled September 30, 2022 Reconciliation contract payables $ 22,035 $ 15,675 $ (13,011) $ 24,699 Profit rebate/corridor contract payables 246,424 59,129 (99,123) 206,430 Overpayments and other cash items 13,127 7,529 (7,985) 12,671 Total contract payables $ 281,586 $ 82,333 $ (120,119) $ 243,800 Reconciliation contract receivables $ 24,403 $ 37,838 $ (15,848) $ 46,393 Corridor contract receivables 77 13,590 — 13,667 Total reconciliation contract receivables $ 24,480 $ 51,428 $ (15,848) $ 60,060

Equity Investment

Equity Investment	9 Months Ended
	Sep. 30, 2022
Equity Method Investment, Summarized Financial Information [Abstract]
Equity Investment	Equity Investment As of September 30, 2022 and December 31, 2021, 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 its 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 (income) loss of investee” in the accompanying unaudited condensed consolidated statements of operations. During the three and nine months ended September 30, 2022, Matrix recorded asset impairment charges of $82.2 million and during the year ended December 31, 2021, Matrix recorded asset impairment charges of $111.4 million. No asset impairment charges were recorded for the three and nine months ended September 30, 2021. The Company's gross share of its Matrix's operations for the three months ended September 30, 2022 and September 30, 2021 was a loss of $36.1 million and a loss of $6.7 million, respectively, which is presented net of tax on the unaudited condensed consolidated statements of operations for a loss of $26.7 million and a loss of $4.8 million, respectively. For the nine months ended September 30, 2022 and September 30, 2021, the Company's gross share of its investment in Matrix was a loss of $39.0 million and a loss of $2.0 million, respectively, which is presented net of tax on the unaudited condensed consolidated statements of operations for a loss of $28.2 million and a loss of $1.4 million, respectively. The carrying amount of the assets included in the Company’s unaudited condensed consolidated balance sheets and the maximum loss exposure related to the Company’s interest in Matrix as of September 30, 2022 and December 31, 2021 totaled $43.5 million and $83.1 million, respectively. Summary financial information for Matrix on a standalone basis is as follows (in thousands): September 30, 2022 December 31, 2021 Current assets $ 110,892 $ 124,081 Long-term assets $ 381,096 $ 482,063 Current liabilities $ 44,557 $ 57,048 Long-term liabilities $ 330,794 $ 340,448 Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 Revenue $ 76,461 $ 78,458 $ 235,582 $ 316,830 Operating income (loss) $ (79,992) $ (16,833) $ (81,604) $ 3,324 Net loss $ (85,081) $ (15,627) $ (93,211) $ (7,143)

Prepaid Expenses and Other Curr

Prepaid Expenses and Other Current Assets	9 Months Ended
	Sep. 30, 2022
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 were comprised of the following (in thousands): September 30, 2022 December 31, 2021 Prepaid insurance $ 8,331 $ 9,487 Deferred ERP implementation costs 6,390 3,003 Deferred financing costs on credit facility 3,249 1,480 Prepaid income taxes 2,709 13,848 Inventory 1,864 1,458 Other prepaid expenses 14,138 9,275 Total prepaid expenses and other current assets $ 36,681 $ 38,551

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	9 Months Ended
	Sep. 30, 2022
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities	Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities were comprised of the following (in thousands): September 30, 2022 December 31, 2021 Accrued compensation and related liabilities (1) $ 52,107 $ 54,564 Accrued interest 24,239 12,826 Accrued operating expenses 16,378 14,457 Insurance reserves 15,972 10,152 Accrued legal fees 11,016 5,081 Accrued government grants (2) 5,439 1,514 Union pension obligation 4,952 6,629 Deferred revenue 2,213 2,714 Deferred acquisition payments 50 3,578 Other 12,851 12,276 Total accrued expenses and other current liabilities $ 145,217 $ 123,791 (1) Accrued compensation and related liabilities include deferred payroll taxes, which are deferred as a result of the CARES Act. The CARES Act provides for certain federal income and other tax changes, including the deferral of the employer portion of Social Security payroll taxes. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements. (2) Accrued government grants include payments received from government entities in relation to the PRF and SLFRF to offset lost revenue or increased expenditures for which the related expenditure has not yet been incurred and thus the related payments are deferred as of as of September 30, 2022 and December 31, 2021.

Debt

Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Debt	Debt Senior Unsecured Notes Senior unsecured notes as of September 30, 2022 and December 31, 2021 consisted of the following (in thousands): Senior Unsecured Note Date of Issuance September 30, 2022 December 31, 2021 $500.0 million 5.875% due November 15, 2025 11/4/2020 $ 490,399 $ 488,368 $500.0 million 5.000% due October 1, 2029 8/24/2021 $ 487,902 $ 486,857 The Company pays interest on the Senior Unsecured Notes semi-annually in arrears. Principal payments are not required until the maturity date. 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, 2022, $21.7 million of unamortized deferred issuance costs was netted against the long-term debt balance on the unaudited condensed consolidated balance sheets. The Company was in compliance with all covenants as of September 30, 2022. Credit Facility On February 3, 2022, the Company entered into a new credit agreement (the “New Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent, swing line lender and an issuing bank, Wells Fargo Bank, National Association, as an issuing bank, Truist Bank and Wells Fargo Bank, National Association, as co-syndication agents, Deutsche Bank AG New York Branch, Bank of America, N.A., Regions Bank, Bank of Montreal and Capital One, National Association, as co-documentation agents, and JPMorgan Chase Bank, N.A., Truist Securities, Inc. and Wells Fargo Securities, LLC, as joint bookrunners and joint lead arrangers, and the other lenders party thereto. The New Credit Agreement provides the Company with a senior secured revolving credit facility (the “New Credit Facility”) in an aggregate principal amount of $325.0 million. The New Credit Facility includes sublimits for swingline loans, letters of credit and alternative currency loans in amounts of up to $25.0 million, $60.0 million and $75.0 million, respectively. The Company did not draw any amount of the New Credit Facility at closing of the New Credit Agreement. As of September 30, 2022, the Company had $38.0 million of outstanding letters of credit under the New Credit Facility. The proceeds of the New Credit Facility may be used (i) to finance working capital needs of the Company and its subsidiaries and (ii) for general corporate purposes of the Company and its subsidiaries (including to finance capital expenditures, permitted acquisitions and investments). The New Credit Facility replaces the Credit Facility under the Credit Agreement, which was terminated concurrently with the Company's entry into the New Credit Agreement. Under the New Credit Facility, the Company has an option to request an increase in the amount of the New Credit Facility or obtain incremental term loans from time to time (on substantially the same terms as apply to the existing facilities) by an aggregate amount of up to $175.0 million, plus an unlimited amount so long as the pro forma secured net leverage ratio does not exceed 3.50:1.00, with either additional commitments from lenders under the New Credit Agreement at such time or new commitments from financial institutions approved by the Company and the administrative agent (which approval is not to be unreasonably withheld), so long as, at the time of any such increase, no default or event of default exists, the representations and warranties of the Company set forth in the New Credit Agreement are true and correct in all material respects and the Company is in pro forma compliance with the financial covenants in the New Credit Agreement. The Company may not be able to access additional funds under this increase option as no lender is obligated to participate in any such increase under the New Credit Facility. The New Credit Facility matures on February 3, 2027. The Company may prepay the New Credit Facility in whole or in part, at any time without premium or penalty, subject to reimbursement of the lenders’ breakage and redeployment costs in connection with prepayments of Term Benchmark loans or RFR loans, each as defined in the New Credit Agreement. The unutilized portion of the commitments under the New Credit Facility may be irrevocably reduced or terminated by the Company at any time without penalty. Interest on the outstanding principal amount of the loans accrues at a per annum rate equal to the Alternate Base Rate, the Adjusted Term SOFR Rate, the Adjusted Daily Simple SOFR Rate, the Adjusted EURIBOR Rate or the Adjusted Daily Simple SONIA Rate, as applicable and each as defined in the New Credit Agreement, in each case, plus an applicable margin. The applicable margin ranges from 1.75% to 3.50% in the case of Term Benchmark loans or RFR loans, and 0.75% to 2.50% in the case of the Alternate Base Rate loans, in each case, based on the Company’s total net leverage ratio as defined in the New Credit Agreement. Interest on the loans is payable quarterly in arrears in the case of Alternate Base Rate loans, on the last day of the relevant interest period in the case of Term Benchmark loans, and monthly in arrears in the case of RFR loans. In addition, the Company is obligated to pay a quarterly commitment fee based on a percentage of the unused portion of the revolving 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. The commitment fee and letter of credit fee range from 0.30% to 0.50% and 1.75% to 3.50%, respectively, in each case, based on the Company’s total net leverage ratio. The New Credit Agreement contains customary representations and warranties, affirmative and negative covenants and events of default. The negative covenants include restrictions on the Company’s ability to, among other things, incur additional indebtedness, create liens, make investments, give guarantees, pay dividends, sell assets and merge and consolidate. The Company is subject to financial covenants, including total net leverage and interest coverage covenants. The Company’s obligations under the New Credit Facility are guaranteed by all of the Company’s present and future material domestic subsidiaries, excluding certain material domestic subsidiaries that are excluded from being guarantors pursuant to the terms of the New Credit Agreement. The Company’s obligations under, and each guarantor’s obligations under its guaranty of, the New Credit Facility are secured by a first priority lien on substantially all of the Company’s or such guarantor’s respective assets. If an event of default occurs, the required lenders may cause the administrative agent to declare all unpaid principal and any accrued and unpaid interest and all fees and expenses under the New Credit Facility to be immediately due and payable. All amounts outstanding under the New Credit Facility will automatically become due and payable upon the commencement of any bankruptcy, insolvency or similar proceedings. The New Credit Agreement also contains a cross default to any of the Company’s indebtedness having a principal amount in excess of $40.0 million. The Company was in compliance with all covenants under the Credit Agreement as of September 30, 2022 .

Stock-Based Compensation and Si

Stock-Based Compensation and Similar Arrangements	9 Months Ended
	Sep. 30, 2022
Share-Based Payment Arrangement, Noncash Expense [Abstract]
Stock-Based Compensation and Similar Arrangements	Stock-Based Compensation and Similar ArrangementsThe Company provides stock-based compensation to employees, non-employee directors, consultants and advisors under the Company’s 2006 Long-Term Incentive Plan (“2006 Plan”). The 2006 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. Stock options. The Company recognized a reversal of previously recognized stock-based compensation expense for non-qualified stock options (“NQs”) of $0.3 million during the three months ended September 30, 2022 due to forfeitures that occurred during the period and the Company recognized stock-based compensation expense for NQs of $0.5 million for the three months ended September 30, 2021 in general and administrative expense. For the nine months ended September 30, 2022 and 2021, the Company recognized stock-based compensation expense for NQs of $1.0 million and $1.5 million, respectively, in general and administrative expense. At September 30, 2022, the Company had 209,075 stock options outstanding with a weighted-average exercise price of $97.30. Restricted stock and restricted stock units. The Company recognized stock-based compensation expense for restricted stock awards ("RSAs") and restricted stock units ("RSUs") of $0.7 million and $1.0 million for the three months ended September 30, 2022 and 2021, respectively, and $3.5 million and $2.5 million for the nine months ended September 30, 2022 and 2021, respectively, in general and administrative expense. The Company had 13,137 unvested RSAs and 85,369 unvested RSUs outstanding at September 30, 2022 with a weighted-average grant date fair value of $94.44 and $113.19, respectively. Performance-based share awards. These awards include RSUs and were initially issued in the first quarter of 2022. The purpose of these awards is to align management’s compensation with the Company's financial performance and other operational objectives and to retain key employees. Awards granted under this category are based on the achievement of various targeted metrics as defined by the Plan. Stock-based compensation expense related to these performance-based share awards ("PRSUs") is recognized over the 3-year vesting period under the straight-line attribution method. Related to the PRSUs, the Company recorded a reversal of $0.2 million of previously recognized stock-based compensation expense for the three months ended September 30, 2022 due to forfeitures that occurred during the period and recorded $0.6 million of stock-based compensation expense for the nine months ended September 30, 2022, with the remaining portion expected to be recognized over the remainder of the 3-year requisite service period. The Company had 18,663 unvested PRSUs outstanding at September 30, 2022 with a weighted-average grant date fair value of $153.17. In the second quarter of 2022, an Employee Stock Purchase Program ("ESPP") was approved by the Board of Directors and the Company's shareholders, which will allow employees to purchase Company stock at a discounted rate. The first offering period will begin in the fourth quarter of 2022.

Earnings (Loss) Per Share

Earnings (Loss) Per Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) Per Share The following table details the computation of basic and diluted earnings (loss) per share (in thousands, except share and per share data): Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 Numerator: Net income (loss) $ (28,505) $ (7,572) $ (24,859) $ 24,940 Denominator: Denominator for basic earnings per share -- weighted-average shares 14,051,794 13,993,438 14,041,224 14,102,371 Effect of dilutive securities: Common stock options — — — 130,221 Restricted stock — — — 45,739 Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion 14,051,794 13,993,438 14,041,224 14,278,331 Earnings (loss) per share: Basic earnings (loss) per share $ (2.03) $ (0.54) $ (1.77) $ 1.77 Diluted earnings (loss) per share $ (2.03) $ (0.54) $ (1.77) $ 1.75 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, 2022 2021 2022 2021 Stock options to purchase common stock 115,686 49,158 123,534 53,550 Purchases of Equity Securities On March 8, 2021, the Board of Directors authorized a stock repurchase program under which the Company could 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. The program ended December 31, 2021. No repurchase program was authorized as of September 30, 2022.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThe Company’s effective tax rate for the three months ended September 30, 2022 and 2021 was a tax benefit of 33.9% and 42.3%, respectively. The effective tax rate for the nine months ended September 30, 2022 and 2021 was a tax provision of 21.7% and 24.2%, respectively. For the three and nine months ended September 30, 2022 and 2021, the effective tax rates were higher than the U.S. federal statutory rate of 21.0% primarily due to state income taxes and nondeductible expenses.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2022
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, 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 lawsuit 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 had until January 3, 2022 to opt-in. Plaintiff moved for class certification on August 15, 2022, and ModivCare Solutions filed an opposition to class certification on September 6, 2022. ModivCare Solutions believes it will be able to successfully oppose class certification of this 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 sought to recover damages, fees and costs under the federal False Claims Act, including treble damages, civil penalties and attorneys’ fees. None of the Relators were employed by ModivCare Solutions. The federal government 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 filed an interlocutory appeal of this ruling with the Sixth Circuit Court of Appeals which was subsequently denied. The Relators and Modivcare tentatively agreed to settle the Relators' substantive claims in September 2022 and continue discussions concerning the Relators' counsel’s attorney fees. The settlement will not have a material adverse effect on the Company’s business, liquidity, financial condition or results of operations. In 2017, one of our Personal Care segment subsidiaries, All Metro Home Care Services of New York, Inc. d/b/a All Metro Health Care (“All Metro”), received a class action lawsuit in state court claiming that, among other things, it failed to properly pay live-in caregivers who stay in patients’ homes for 24 hours per day (“live-ins”). The Company currently pays live-ins for 13 hours per day as supported through a written opinion letter from the New York State Department of Labor (“NYSDOL”). A similar case involving this issue has been heard by the New York Court of Appeals (New York’s highest court), which on March 26, 2019, issued a ruling reversing earlier lower courts’ decisions that an employer must pay live-ins for 24 hours. The Court of Appeals agreed with the NYSDOL’s interpretation to pay live-ins 13 hours instead of 24 hours if certain conditions were being met. If the class action lawsuit on this matter is allowed to proceed, and is successful, All Metro may be liable for back wages and litigated damages going back to November 2011. All Metro filed its motion to oppose class certification of this matter and the matter was heard on June 23, 2022. A ruling should be issued by end-of-year.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2022
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsThe Company has evaluated events and transactions subsequent to the Company's unaudited condensed consolidated balance sheet date and prior to the date of issuance. Based on this evaluation, the Company is not aware of any events or transactions that occurred subsequent to the unaudited condensed consolidated balance sheet date and prior to the date of issuance that would require recognition or disclosure in these financial statements

Significant Accounting Polici_2

Significant Accounting Policies and Recent Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2022
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 complete 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, 2022 are not necessarily indicative of the results that may be expected for the fiscal year ending December 31, 2022. 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 unaudited condensed consolidated financial statements. The unaudited condensed consolidated balance sheet at December 31, 2021 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 complete 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, 2021.
Reclassifications	Reclassifications: Certain prior year amounts have been reclassified to conform to current year presentation.
Use of Estimates and Changes in Accounting Estimate	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. Changes in Accounting Estimate In accordance with its policy, the Company reviews the estimated useful lives of its fixed assets and intangible assets on an ongoing basis. As a result of this review, the Company adjusted the estimated useful life of the Simplura trademarks and trade names intangible asset from 10 years to 3 years and adjusted the estimated useful life of the payor network from 15 years to 10 years effective as of January 1, 2022. This change was driven by strategic shifts in the Company's personal care segment operations, partially contributed to by the acquisition of Care Finders Total Care, LLC ("Care Finders"). Based on the intangible asset values as of December 31, 2021, the effect of the change in estimate during the three and nine months ended September 30, 2022 was an increase in amortization expense of $3.6 million, a decrease in net income of $2.4 million, and a decrease in earnings per share of $0.17 per diluted common share outstanding, and an increase in amortization expense of $10.7 million, a decrease in net income of $8.4 million, and a decrease in earnings per share of $0.60 per diluted common share outstanding, respectively.
Grant Income and CARES Act Payroll Deferral	Government Grants The Company has received government grants under the CARES Act PRF and the ARPA SLFRF to provide economic relief and stimulus to combat health and economic impacts of the COVID-19 pandemic. Under these acts, the Company received distributions of approximately $1.4 million during the three months ended September 30, 2022. No distributions were received during the three months ended September 30, 2021. The Company received distributions of approximately $10.4 million and $3.5 million during the nine months ended September 30, 2022 and September 30, 2021, respectively. Distributions received under these acts are targeted to assist with incremental health care related expenses or lost revenue attributable to the COVID-19 pandemic as well as provide stimulus to support long-term growth and recovery. The payments from these acts are subject to certain restrictions and possible recoupment if not used for designated purposes. As a condition to receiving PRF distributions, providers must agree to certain terms and conditions, including that the funds are being used for healthcare related expenses and lost revenues attributable to COVID-19, 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 has submitted the required documents to meet reporting requirements through reporting period three, which ended September 30, 2022. The Company received an audit inquiry letter from HHS related to one of the business units that received PRF payments, to which the Company has responded and submitted all requested information and believes that the payments received are substantiated and within the terms and conditions defined by the HHS and continues to include these amounts as grant income. At this time, the Company is unaware of any other pending or upcoming audits or inquiries related to PRF received. As a condition to receiving SLFRF, providers must agree to use the funds to respond to the PHE or its negative economic impacts, to respond to workers performing essential work by providing premium pay to eligible workers and to offset reduction in revenue due to the COVID-19 PHE as stipulated by the states in which the funds were received. All recipients of SLFRF payments are required to comply with the reporting requirements that the state in which the funds originated has requested in order for the states to meet the requirements as described in the terms and conditions as determined by the Department of the Treasury. The Company has complied with all known reporting requirements to date. The Company recognizes distributions from government grants as grant income in line with the loss of revenues or expenses for which the grants are intended to compensate when there is reasonable assurance that it has complied with the conditions associated with the grant. 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 $12.3 million related to the deferral of employer payroll taxes as of September 30, 2022 and December 31, 2021 under the CARES Act which is recorded in accrued expenses on the unaudited condensed consolidated balance sheets. This balance is expected to be paid in the fourth quarter of 2022.
Recent Accounting Pronouncements	Recent Accounting Pronouncements The Company adopted the following accounting pronouncements during the nine months ended September 30, 2022: 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. There was no material impact to the financial statements from the adoption of this ASU. In October 2021, the FASB issued ASU 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers ("ASU 2021-08"). The new guidance requires contract assets and contract liabilities acquired in a business combination to be recognized and measured by the acquirer on the acquisition date in accordance with ASC 606, Revenue from Contracts with Customers

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Schedule of Purchase Price Allocation	The following table summarizes information from 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 $ 11,424 Accounts receivable (1) 14,708 Prepaid expenses and other (2) 2,625 Property and equipment (3) 2,527 Inventories (4) 231 Operating right of use asset (5) 1,939 Intangibles (6) 100,750 Goodwill (7) 232,103 Other assets (8) 226 Accounts payable (9) (2,720) Accrued expenses and other accrued liabilities (9) (14,344) Operating lease liability (5) (1,939) Deferred tax liabilities (10) (2,327) Other liabilities (9) (378) Total of assets acquired less liabilities assumed $ 344,825 (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. (2) Given the short-term nature of the balance of prepaid expenses, the carrying value represents the fair value. (3) The acquired property and equipment consists primarily of capitalized software, computer equipment, and automobiles. (4) Given the short-term nature of the balance of inventories, the carrying value represents the fair value. (5) The fair value of the operating lease liability and corresponding right-of-use asset (current and long-term) was recorded at $1.9 million based on market rates available to the Company during the purchase price allocation. (6) The allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 97,200 Trade name Amortizable 3 years 1,950 Non-compete agreement Amortizable 5 years 1,600 $ 100,750 The Company valued the payor network utilizing the multi-period excess earnings method, trade names utilizing the relief-from-royalty method and the non-compete agreement utilizing the with/without method. (7) The acquisition initially resulted in $232.2 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 home care solutions. In the third quarter of 2022, goodwill decreased by $0.1 million as a result of changes to accounts payable and deferred tax liabilities, as discussed in detail below. All of the acquired goodwill is deductible for tax purposes. (8) Included in other assets are security deposits with a value of $0.2 million. (9) Due to the short-term nature of the accounts, the carrying value is assumed to represent the fair value for accounts payable as well as certain other current and non-current liabilities as of the acquisition date. In the third quarter of 2022, it was determined that an additional $0.2 million of accounts payable existed as of the acquisition date, and therefore, the initial balance of $2.5 million was increased to $2.7 million. The following table summarizes 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) 6,800 Inventory (2) 1,684 Prepaid expenses and other (3) 805 Property and equipment (4) 14,908 Intangible assets (5) 75,590 Goodwill (6) 236,317 Accounts payable and accrued liabilities (7) (1,884) Accrued expense (7) (2,487) Deferred revenue (7) (67) Deferred tax liabilities (8) (17,070) Total of assets acquired less liabilities assumed $ 317,518 (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. (2) Given the short-term nature of the balance of inventories, the carrying value represents the fair value. (3) Given the short-term nature of the balance of prepaid expenses, the carrying value represents the fair value. (4) The acquired property and equipment consists primarily of personal emergency response system devices, with the remainder consisting of computer equipment, buildings and other equipment. The Company valued the personal emergency response system devices, computer equipment and other equipment utilizing the cost approach at $12.7 million. The carrying value of the remainder of the property, plant and equipment, consisting primarily of buildings and land, is assumed to represent the fair value. (5) The allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 72,150 Trade name Amortizable 3 years 890 Developed technology Amortizable 3 years 2,550 $ 75,590 The Company valued the payor network utilizing the multi-period excess earnings method, trade names utilizing the relief-from-royalty method and developed technology utilizing the cost approach. (6) The acquisition initially resulted in $236.7 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. In the third quarter of 2022, goodwill decreased by $0.4 million due to a decrease in deferred tax liabilities, as discussed in more detail below. The related goodwill is not deductible for tax purposes. (7) Due to the short-term nature of the accounts, the carrying value is assumed to represent the fair value for accounts payable as well as certain other current and non-current liabilities as of the acquisition date. (8) 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 basis. In the third quarter of 2022, deferred tax liabilities of $17.5 million decreased by $0.4 million due to tax impacts of the acquisition. The following is a preliminary estimate of the allocation of the consideration transferred to acquired identifiable assets and assumed liabilities, net of cash acquired, as of the acquisition date of May 11, 2022 (in thousands): Cash $ 327 Accounts receivable (1) 2,548 Prepaid expenses and other (2) 770 Property and equipment (3) 2,744 Intangible assets (4) 21,950 Goodwill (5) 44,113 Accounts payable (6) (281) Accrued expenses and other current liabilities (6) (577) Total of assets acquired less liabilities assumed $ 71,594 The acquisition method of accounting requires us to record the assets acquired and liabilities assumed at their fair values as of the date of acquisition, which requires management to use currently available information to make estimates and assumptions. The Company believes that the available information provides a reasonable basis for estimating the fair values of assets acquired and liabilities assumed, however, if new information becomes available related to facts that existed at the acquisition date, preliminary estimates may be adjusted. Upon finalization of the preliminary items noted below, there may be related adjustments to certain of such items and to goodwill and income taxes. (1) Management has valued accounts receivable based on the estimated future collectability of the receivables portfolio. In the third quarter of 2022, it was determined that $0.4 million of the initial accounts receivable balance was uncollectible, and therefore, the initial balance of $2.9 million was decreased to $2.5 million. 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 and other assets, the carrying value represents the fair value. (3) The acquired property and equipment consists primarily of personal emergency response system devices, with the remainder consisting of computer equipment and furniture and fixtures. The Company valued the personal emergency response system devices utilizing the cost approach. The carrying value of the remainder of the property, plant and equipment, consisting primarily of computer equipment and furniture and fixtures, is assumed to represent the fair value. Management's assessment of the fair value for PP&E is ongoing. (4) The preliminary allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 21,600 Trade name Amortizable 2 years 350 $ 21,950 The Company valued the payor network utilizing the multi-period excess earnings method and trade names utilizing the relief-from-royalty method.
Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination	The allocation of consideration exchanged for intangible assets acquired is as follows (in thousands): Type Useful Life Value Payor network Amortizable 7 years $ 97,200 Trade name Amortizable 3 years 1,950 Non-compete agreement Amortizable 5 years 1,600 $ 100,750 Type Useful Life Value Payor network Amortizable 7 years $ 72,150 Trade name Amortizable 3 years 890 Developed technology Amortizable 3 years 2,550 $ 75,590
Pro Forma Information	Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 Revenue $ 647,782 $ 552,342 $ 1,850,472 $ 1,616,115 Income (loss) from continuing operations, net (9,714) (13,442) (7,242) 12,439 Diluted earnings (loss) per share $ (0.69) $ (0.96) $ (0.52) $ 0.87

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Financial Information Attributable to the Company's Business Segments	The following table sets forth certain financial information from continuing operations attributable to the Company’s business segments for the three and nine months ended September 30, 2022 and 2021 (in thousands): Three months ended September 30, 2022 NEMT Personal Care RPM Corporate and Other Total Service revenue, net $ 459,796 $ 169,226 $ 18,760 $ — $ 647,782 Grant income (1) — 789 — — 789 Service expense 394,981 132,746 6,836 — 534,563 General and administrative expense 31,815 22,057 5,816 16,201 75,889 Depreciation and amortization 7,079 12,919 5,467 207 25,672 Operating income (loss) $ 25,921 $ 2,293 $ 641 $ (16,408) $ 12,447 Equity in net loss (income) of investee, net of tax $ (208) $ — $ — $ 26,656 $ 26,448 Equity investment $ 208 $ — $ — $ 43,269 $ 43,477 Goodwill (2) $ 135,186 $ 552,775 $ 280,429 $ 30 $ 968,420 Total assets $ 517,930 $ 962,425 $ 402,929 $ 106,561 $ 1,989,845 Nine months ended September 30, 2022 NEMT Personal Care RPM Corporate and Other Total Service revenue, net $ 1,309,449 $ 491,661 $ 49,362 $ — $ 1,850,472 Grant income (1) — 4,587 — — 4,587 Service expense 1,100,801 379,423 17,884 — 1,498,108 General and administrative expense 102,736 68,536 17,520 43,316 232,108 Depreciation and amortization 21,576 37,976 14,201 623 74,376 Operating income (loss) $ 84,336 $ 10,313 $ (243) $ (43,939) $ 50,467 Equity in net loss (income) of investee, net of tax $ (143) $ — $ — $ 28,163 $ 28,020 Equity investment $ 208 $ — $ — $ 43,269 $ 43,477 Goodwill (2) $ 135,186 $ 552,775 $ 280,429 $ 30 $ 968,420 Total assets $ 517,930 $ 962,425 $ 402,929 $ 106,561 $ 1,989,845 (1) Grant income for the Personal Care segment includes funding received on a periodic basis from the PRF in relation to relief under the CARES Act and funding received from the SLFRF under ARPA in relation to economic recovery to combat health and economic impacts of the COVID-19 pandemic. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements. (2) In May 2022, the Company completed the acquisition of GMM which is included within the RPM segment. The Company recorded goodwill of $43.7 million related to the acquisition during the second quarter of 2022. During the third quarter of 2022, the Company recorded an increase in GMM goodwill of $0.4 million and a decrease in VRI goodwill of $0.4 million related to measurement period adjustments as discussed in Note 3, Acquisitions, for a total GMM goodwill balance of $44.1 million and a total VRI goodwill balance of $236.3 million. Additionally, during the third quarter of 2022, the Company recorded a net decrease in goodwill of $0.1 million in the Personal Care segment related to measurement period adjustments at the Care Finders subsidiary as discussed in Note 3, Acquisitions . Three months ended September 30, 2021 NEMT Personal Care RPM Corporate and Other 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 29,875 15,802 216 22,312 68,205 Depreciation and amortization 7,496 4,912 200 — 12,608 Operating income (loss) $ 31,223 $ 3,682 $ 381 $ (22,312) $ 12,974 Equity in net loss of investee, net of tax $ — $ — $ — $ 4,845 $ 4,845 Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,186 $ 565,886 $ 228,884 $ 30 $ 929,986 Total assets $ 552,912 $ 1,037,886 $ 343,277 $ 201,078 $ 2,135,153 Nine months ended September 30, 2021 NEMT Personal Care RPM Corporate and Other 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 85,961 45,606 216 47,812 179,595 Depreciation and amortization 21,744 14,723 200 — 36,667 Operating income (loss) $ 103,993 $ 12,623 $ 381 $ (47,812) $ 69,185 Equity in net loss of investee, net of tax $ — $ — $ — $ 1,424 $ 1,424 Equity investment $ — $ — $ — $ 134,353 $ 134,353 Goodwill $ 135,186 $ 565,886 $ 228,884 $ 30 $ 929,986 Total assets $ 552,912 $ 1,037,886 $ 343,277 $ 201,078 $ 2,135,153

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following table summarizes disaggregated revenue from contracts with customers by contract type for the three and nine months ended September 30, 2022 and September 30, 2021 (in thousands): Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 NEMT capitated contracts $ 399,859 $ 311,913 $ 1,145,694 $ 916,976 NEMT FFS contracts 59,937 61,079 163,755 164,192 Total NEMT revenue 459,796 372,992 1,309,449 1,081,168 Personal Care FFS contracts 169,226 118,503 491,661 338,385 RPM PMPM contracts 18,760 1,564 49,362 1,564 Total service revenue, net $ 647,782 $ 493,059 $ 1,850,472 $ 1,421,117 Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 State and Managed Medicaid contracts $ 547,423 $ 441,802 $ 1,565,738 $ 1,274,660 Managed Medicare contracts 92,228 44,074 254,835 125,571 Private pay and other contracts 8,131 7,183 29,899 20,886 Total service revenue, net $ 647,782 $ 493,059 $ 1,850,472 $ 1,421,117
Schedule of Accounts Receivable	The following table provides information about accounts receivable, net (in thousands): September 30, 2022 December 31, 2021 Accounts receivable $ 208,787 $ 210,937 Reconciliation contracts receivable (1) 60,060 24,480 Allowance for doubtful accounts (2,670) (2,296) Accounts receivable, net $ 266,177 $ 233,121 (1) Reconciliation contracts receivable primarily represent underpayments and receivables on certain contracts with reconciliation and risk corridor provisions. See the contract payables and receivables activity below.
Other Account Liabilities	The following table provides information about other revenue related accounts included on the accompanying unaudited condensed consolidated balance sheets (in thousands): September 30, 2022 December 31, 2021 Accrued contract payables (1) $ 243,800 $ 281,586 Deferred revenue, current $ 2,213 $ 2,714 (1) Accrued contract payables primarily represent overpayments and liability reserves on certain risk corridor, profit rebate and reconciliation contracts. The following table provides the summary activity of total contract payables and receivables as reported within the unaudited condensed consolidated balance sheets (in thousands): December 31, 2021 Additional Amounts Recorded Amounts Paid or Settled September 30, 2022 Reconciliation contract payables $ 22,035 $ 15,675 $ (13,011) $ 24,699 Profit rebate/corridor contract payables 246,424 59,129 (99,123) 206,430 Overpayments and other cash items 13,127 7,529 (7,985) 12,671 Total contract payables $ 281,586 $ 82,333 $ (120,119) $ 243,800 Reconciliation contract receivables $ 24,403 $ 37,838 $ (15,848) $ 46,393 Corridor contract receivables 77 13,590 — 13,667 Total reconciliation contract receivables $ 24,480 $ 51,428 $ (15,848) $ 60,060

Equity Investment (Tables)

Equity Investment (Tables)	9 Months Ended
	Sep. 30, 2022
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, 2022 December 31, 2021 Current assets $ 110,892 $ 124,081 Long-term assets $ 381,096 $ 482,063 Current liabilities $ 44,557 $ 57,048 Long-term liabilities $ 330,794 $ 340,448 Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 Revenue $ 76,461 $ 78,458 $ 235,582 $ 316,830 Operating income (loss) $ (79,992) $ (16,833) $ (81,604) $ 3,324 Net loss $ (85,081) $ (15,627) $ (93,211) $ (7,143)

Prepaid Expenses and Other Cu_2

Prepaid Expenses and Other Current Assets (Tables)	9 Months Ended
	Sep. 30, 2022
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets were comprised of the following (in thousands): September 30, 2022 December 31, 2021 Prepaid insurance $ 8,331 $ 9,487 Deferred ERP implementation costs 6,390 3,003 Deferred financing costs on credit facility 3,249 1,480 Prepaid income taxes 2,709 13,848 Inventory 1,864 1,458 Other prepaid expenses 14,138 9,275 Total prepaid expenses and other current assets $ 36,681 $ 38,551

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	9 Months Ended
	Sep. 30, 2022
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses and other current liabilities were comprised of the following (in thousands): September 30, 2022 December 31, 2021 Accrued compensation and related liabilities (1) $ 52,107 $ 54,564 Accrued interest 24,239 12,826 Accrued operating expenses 16,378 14,457 Insurance reserves 15,972 10,152 Accrued legal fees 11,016 5,081 Accrued government grants (2) 5,439 1,514 Union pension obligation 4,952 6,629 Deferred revenue 2,213 2,714 Deferred acquisition payments 50 3,578 Other 12,851 12,276 Total accrued expenses and other current liabilities $ 145,217 $ 123,791 (1) Accrued compensation and related liabilities include deferred payroll taxes, which are deferred as a result of the CARES Act. The CARES Act provides for certain federal income and other tax changes, including the deferral of the employer portion of Social Security payroll taxes. See Note 2, Significant Accounting Policies and Recent Accounting Pronouncements. (2) Accrued government grants include payments received from government entities in relation to the PRF and SLFRF to offset lost revenue or increased expenditures for which the related expenditure has not yet been incurred and thus the related payments are deferred as of as of September 30, 2022 and December 31, 2021.

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	Senior unsecured notes as of September 30, 2022 and December 31, 2021 consisted of the following (in thousands): Senior Unsecured Note Date of Issuance September 30, 2022 December 31, 2021 $500.0 million 5.875% due November 15, 2025 11/4/2020 $ 490,399 $ 488,368 $500.0 million 5.000% due October 1, 2029 8/24/2021 $ 487,902 $ 486,857

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Schedule of Earnings (Loss) Per Share	The following table details the computation of basic and diluted earnings (loss) per share (in thousands, except share and per share data): Three months ended September 30, Nine months ended September 30, 2022 2021 2022 2021 Numerator: Net income (loss) $ (28,505) $ (7,572) $ (24,859) $ 24,940 Denominator: Denominator for basic earnings per share -- weighted-average shares 14,051,794 13,993,438 14,041,224 14,102,371 Effect of dilutive securities: Common stock options — — — 130,221 Restricted stock — — — 45,739 Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion 14,051,794 13,993,438 14,041,224 14,278,331 Earnings (loss) per share: Basic earnings (loss) per share $ (2.03) $ (0.54) $ (1.77) $ 1.77 Diluted earnings (loss) per share $ (2.03) $ (0.54) $ (1.77) $ 1.75
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, 2022 2021 2022 2021 Stock options to purchase common stock 115,686 49,158 123,534 53,550

Organization and Basis of Pre_2

Organization and Basis of Presentation (Details)	Sep. 30, 2022
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 ($)			3 Months Ended						9 Months Ended
	Jan. 01, 2022	Dec. 31, 2021	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021
Disaggregation of Revenue [Line Items]
Net income (loss)			$ (28,505,000)	$ 3,328,000	$ 318,000	$ (7,572,000)	$ 13,672,000	$ 18,840,000	$ (24,859,000)	$ 24,940,000
Diluted earnings per share (in dollars per share)			$ (2.03)			$ (0.54)			$ (1.77)	$ 1.75
Grant income			$ 789,000			$ 0			$ 4,587,000	$ 3,500,000
Accrued cash benefit, due from deferral of payroll taxes		$ 12,300,000	12,300,000						12,300,000
Intangible Assets, Amortization Period
Disaggregation of Revenue [Line Items]
Amortization			3,600,000						10,700,000
Net income (loss)			$ (2,400,000)						$ (8,400,000)
Diluted earnings per share (in dollars per share)			$ 0.17						$ 0.60
Minimum | Trade name
Disaggregation of Revenue [Line Items]
Finite-lived intangible asset, useful life	3 years	10 years
Maximum | Payor network
Disaggregation of Revenue [Line Items]
Finite-lived intangible asset, useful life	10 years	15 years
Grant income
Disaggregation of Revenue [Line Items]
Grant income			$ 1,400,000			$ 0			$ 10,400,000	$ 3,500,000

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) - USD ($) $ in Thousands						3 Months Ended		9 Months Ended
	May 30, 2022	May 18, 2022	May 11, 2022	Sep. 22, 2021	Sep. 14, 2021	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Business Acquisition [Line Items]
Cash acquired								$ 327	$ 14,885
Payments for asset acquisitions	$ 7,600
Customer Contracts | Personal Care
Business Acquisition [Line Items]
Useful Life		6 years
CareFinders Total Care
Business Acquisition [Line Items]
Percentage of voting interests acquired					100%
Purchase price					$ 333,400
Consideration transferred, net of cash from acquisition excluded					344,800
Cash acquired					$ 11,400
Pro forma interest expense							$ 1,100		3,700
VRI Intermediate Holdings, LLC
Business Acquisition [Line Items]
Percentage of voting interests acquired				100%
Purchase price				$ 314,600
Consideration transferred, net of cash from acquisition excluded				317,500
Cash acquired				$ 2,900
Pro forma interest expense							$ 1,000		$ 3,200
Guardian Medical Monitoring
Business Acquisition [Line Items]
Percentage of voting interests acquired			100%
Purchase price			$ 71,300
Consideration transferred, net of cash from acquisition excluded			71,600
Cash acquired			$ 300
Acquisition related costs						$ 400		$ 2,000

Acquisitions - Purchase Price A

Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	3 Months Ended
	Sep. 30, 2022	May 11, 2022	Dec. 31, 2021	Sep. 30, 2021	Sep. 22, 2021	Sep. 14, 2021
Business Acquisition [Line Items]
Goodwill	$ 968,420		$ 924,787	$ 929,986
CareFinders Total Care
Business Acquisition [Line Items]
Cash						$ 11,424
Accounts receivable						14,708
Prepaid expenses and other						2,625
Property and equipment						2,527
Inventories						231
Operating right of use asset						1,939
Intangibles						100,750
Goodwill						232,103
Other assets						226
Accounts payable and accrued liabilities	(2,720)					(2,500)
Accrued expenses and other accrued liabilities						(14,344)
Operating lease liabilities						(1,939)
Deferred tax liabilities	(2,600)					(2,327)
Other liabilities						(378)
Total of assets acquired and liabilities assumed						344,825
Present value of minimum lease payments						1,900
Increase (decrease) to goodwill	(100)
Security deposit						200
Increase (decrease) in accounts payable	200
Deferred tax liabilities, decreased amount	300
CareFinders Total Care | Pro Forma
Business Acquisition [Line Items]
Goodwill						$ 232,200
VRI Intermediate Holdings, LLC
Business Acquisition [Line Items]
Cash					$ 2,922
Accounts receivable					6,800
Prepaid expenses and other					805
Property and equipment					14,908
Inventories					1,684
Intangibles					75,590
Goodwill	236,317				236,700
Intangible assets					75,590
Accounts payable and accrued liabilities					(1,884)
Accrued expenses and other accrued liabilities					(2,487)
Deferred tax liabilities	(17,500)				(17,070)
Deferred revenue					(67)
Total of assets acquired and liabilities assumed					317,518
Increase (decrease) to goodwill	(400)
Deferred tax liabilities, decreased amount	(400)
VRI Intermediate Holdings, LLC | Personal Emergency Response System Devices, Computer Equipment and Other Equipment
Business Acquisition [Line Items]
Property and equipment					12,700
VRI Intermediate Holdings, LLC | Pro Forma
Business Acquisition [Line Items]
Goodwill					$ 236,300
Guardian Medical Monitoring
Business Acquisition [Line Items]
Cash		$ 327
Accounts receivable	2,900	2,548
Prepaid expenses and other		770
Property and equipment		2,744
Goodwill	44,113
Intangible assets		21,950
Accounts payable and accrued liabilities		(281)
Accrued expenses and other accrued liabilities		(577)
Total of assets acquired and liabilities assumed		71,594
Increase (decrease) to goodwill	400
Initial accounts receivable balance deemed uncollectable		400
Initial accounts receivable, increased amount	(2,500)
Guardian Medical Monitoring | Pro Forma
Business Acquisition [Line Items]
Goodwill	$ 44,100	$ 43,700

Acquisitions - Intangible Asset

Acquisitions - Intangible Assets Acquired (Details) - USD ($) $ in Thousands	May 11, 2022	Sep. 22, 2021	Sep. 14, 2021
CareFinders Total Care
Business Acquisition [Line Items]
Finite-lived intangibles			$ 100,750
CareFinders Total Care | Payor network
Business Acquisition [Line Items]
Useful Life			7 years
Finite-lived intangibles			$ 97,200
CareFinders Total Care | Trade name
Business Acquisition [Line Items]
Useful Life			3 years
Finite-lived intangibles			$ 1,950
CareFinders Total Care | Non-compete agreement
Business Acquisition [Line Items]
Useful Life			5 years
Finite-lived intangibles			$ 1,600
VRI Intermediate Holdings, LLC
Business Acquisition [Line Items]
Finite-lived intangibles		$ 75,590
Intangible assets		$ 75,590
VRI Intermediate Holdings, LLC | Payor network
Business Acquisition [Line Items]
Useful Life		7 years
Finite-lived intangibles		$ 72,150
VRI Intermediate Holdings, LLC | Trade name
Business Acquisition [Line Items]
Useful Life		3 years
Finite-lived intangibles		$ 890
VRI Intermediate Holdings, LLC | Developed technology
Business Acquisition [Line Items]
Useful Life		3 years
Finite-lived intangibles		$ 2,550
Guardian Medical Monitoring
Business Acquisition [Line Items]
Intangible assets	$ 21,950
Guardian Medical Monitoring | Payor network
Business Acquisition [Line Items]
Useful Life	7 years
Finite-lived intangibles	$ 21,600
Guardian Medical Monitoring | Trade name
Business Acquisition [Line Items]
Useful Life	2 years
Finite-lived intangibles	$ 350

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, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Pro forma:
Revenue	$ 647,782	$ 552,342	$ 1,850,472	$ 1,616,115
Income (loss) from continuing operations, net	$ (9,714)	$ (13,442)	$ (7,242)	$ 12,439
Diluted earnings per share (in dollars per share)	$ (0.69)	$ (0.96)	$ (0.52)	$ 0.87

Segments - Narrative (Details)

Segments - Narrative (Details)	9 Months Ended
	Sep. 30, 2022 segment
Segment Reporting [Abstract]
Number of reportable segments	4

Segments - Segments (Details)

Segments - Segments (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	May 11, 2022	Dec. 31, 2021	Sep. 22, 2021	Sep. 14, 2021
Segment Reporting Information [Line Items]
Service revenue, net	$ 647,782	$ 493,059	$ 1,850,472	$ 1,421,117
Grant income	789	0	4,587	3,500
Service expense	534,563	399,272	1,498,108	1,139,170
General and administrative expense	75,889	68,205	232,108	179,595
Depreciation and amortization	25,672	12,608	74,376	36,667
Operating income	12,447	12,974	50,467	69,185
Equity in net loss (income) of investee, net of tax	26,448	(4,845)	28,020	(1,424)
Equity investment	43,477	134,353	43,477	134,353		$ 83,069
Goodwill	968,420	929,986	968,420	929,986		924,787
Total assets	1,989,845	2,135,153	1,989,845	2,135,153		$ 2,027,425
Guardian Medical Monitoring
Segment Reporting Information [Line Items]
Goodwill	44,113		44,113
Increase (decrease) to goodwill	400
Guardian Medical Monitoring | Pro Forma
Segment Reporting Information [Line Items]
Goodwill	44,100		44,100		$ 43,700
CareFinders Total Care
Segment Reporting Information [Line Items]
Goodwill								$ 232,103
Increase (decrease) to goodwill	(100)
CareFinders Total Care | Pro Forma
Segment Reporting Information [Line Items]
Goodwill								$ 232,200
VRI Intermediate Holdings, LLC
Segment Reporting Information [Line Items]
Goodwill	236,317		236,317				$ 236,700
Increase (decrease) to goodwill	(400)
VRI Intermediate Holdings, LLC | Pro Forma
Segment Reporting Information [Line Items]
Goodwill							$ 236,300
NEMT
Segment Reporting Information [Line Items]
Service revenue, net	459,796	372,992	1,309,449	1,081,168
Grant income	0	0	0	0
Service expense	394,981	304,398	1,100,801	869,470
General and administrative expense	31,815	29,875	102,736	85,961
Depreciation and amortization	7,079	7,496	21,576	21,744
Operating income	25,921	31,223	84,336	103,993
Equity in net loss (income) of investee, net of tax	208	0	143	0
Equity investment	208	0	208	0
Goodwill	135,186	135,186	135,186	135,186
Total assets	517,930	552,912	517,930	552,912
Personal Care
Segment Reporting Information [Line Items]
Service revenue, net	169,226	118,503	491,661	338,385
Grant income	789	0	4,587	3,500
Service expense	132,746	94,107	379,423	268,933
General and administrative expense	22,057	15,802	68,536	45,606
Depreciation and amortization	12,919	4,912	37,976	14,723
Operating income	2,293	3,682	10,313	12,623
Equity in net loss (income) of investee, net of tax	0	0	0	0
Equity investment	0	0	0	0
Goodwill	552,775	565,886	552,775	565,886
Total assets	962,425	1,037,886	962,425	1,037,886
Personal Care | CareFinders Total Care
Segment Reporting Information [Line Items]
Increase (decrease) to goodwill	(100)
RPM
Segment Reporting Information [Line Items]
Service revenue, net	18,760	1,564	49,362	1,564
Grant income	0	0	0	0
Service expense	6,836	767	17,884	767
General and administrative expense	5,816	216	17,520	216
Depreciation and amortization	5,467	200	14,201	200
Operating income	641	381	(243)	381
Equity in net loss (income) of investee, net of tax	0	0	0	0
Equity investment	0	0	0	0
Goodwill	280,429	228,884	280,429	228,884
Total assets	402,929	343,277	402,929	343,277
Corporate and Other
Segment Reporting Information [Line Items]
Service revenue, net	0	0	0	0
Grant income	0	0	0	0
Service expense	0	0	0	0
General and administrative expense	16,201	22,312	43,316	47,812
Depreciation and amortization	207	0	623	0
Operating income	(16,408)	(22,312)	(43,939)	(47,812)
Equity in net loss (income) of investee, net of tax	(26,656)	(4,845)	(28,163)	(1,424)
Equity investment	43,269	134,353	43,269	134,353
Goodwill	30	30	30	30
Total assets	$ 106,561	$ 201,078	$ 106,561	$ 201,078

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation of Revenue (NET Services) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Disaggregation of Revenue [Line Items]
Total service revenue, net	$ 647,782	$ 493,059	$ 1,850,472	$ 1,421,117
State and Managed Medicaid contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	547,423	441,802	1,565,738	1,274,660
Managed Medicare contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	92,228	44,074	254,835	125,571
Private pay and other contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	8,131	7,183	29,899	20,886
NEMT
Disaggregation of Revenue [Line Items]
Total service revenue, net	459,796	372,992	1,309,449	1,081,168
NEMT | Capitated contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	399,859	311,913	1,145,694	916,976
NEMT | FFS contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	59,937	61,079	163,755	164,192
Personal Care
Disaggregation of Revenue [Line Items]
Total service revenue, net	169,226	118,503	491,661	338,385
Personal Care | FFS contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	169,226	118,503	491,661	338,385
Personal Care | PMPM Contracts
Disaggregation of Revenue [Line Items]
Total service revenue, net	$ 18,760	$ 1,564	$ 49,362	$ 1,564

Revenue Recognition - Narrative

Revenue Recognition - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
NEMT
Disaggregation of Revenue [Line Items]
Performance obligation satisfied in previous period	$ 1.7	$ (0.1)	$ 6.5	$ 0.2
One US State | Revenue Benchmark | Government Contracts Concentration Risk | NEMT | Continuing Operations
Disaggregation of Revenue [Line Items]
Concentration risk, percentage	10.40%	10.80%	11%	9.70%
One US State | Revenue Benchmark | Government Contracts Concentration Risk | Personal Care | Continuing Operations
Disaggregation of Revenue [Line Items]
Concentration risk, percentage	12.10%	12%	12%	13%
One US State | Revenue Benchmark | Government Contracts Concentration Risk | RPM | Continuing Operations
Disaggregation of Revenue [Line Items]
Concentration risk, percentage	18.40%		20.40%

Revenue Recognition - Schedule

Revenue Recognition - Schedule of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Accounts receivable	$ 208,787	$ 210,937
Reconciliation contracts receivable	60,060	24,480
Allowance for doubtful accounts	(2,670)	(2,296)
Accounts receivable, net	$ 266,177	$ 233,121

Revenue Recognition - Schedul_2

Revenue Recognition - Schedule of Other Accounts (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2021	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Revenue recognized	$ 243,800	$ 281,586
Deferred revenue, current		$ 2,714	$ 2,213

Revenue Recognition - Summary o

Revenue Recognition - Summary of Contract Payables and Receivables (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2022 USD ($)
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	$ 281,586
Contract with customer, liability, additional amounts recorded	82,333
Contract with customer, liability, cumulative catch-up adjustment to revenue, modification of contract	(120,119)
Contract with customer, liability end of period	243,800
Summary of Receivables [Roll Forward]
Contract with customer, asset, after allowance for credit loss beginning of period	24,480
Contract with customer, asset, additional amounts recorded	51,428
Contract with customer, asset, cumulative catch-up adjustment to revenue, modification of contract	(15,848)
Contract with customer, asset, after allowance for credit loss end of period	60,060
Reconciliation Contract
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	22,035
Contract with customer, liability, additional amounts recorded	15,675
Contract with customer, liability, cumulative catch-up adjustment to revenue, modification of contract	(13,011)
Contract with customer, liability end of period	24,699
Summary of Receivables [Roll Forward]
Contract with customer, asset, after allowance for credit loss beginning of period	24,403
Contract with customer, asset, additional amounts recorded	37,838
Contract with customer, asset, cumulative catch-up adjustment to revenue, modification of contract	(15,848)
Contract with customer, asset, after allowance for credit loss end of period	46,393
Profit Rebate Contract Payable
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	246,424
Contract with customer, liability, additional amounts recorded	59,129
Contract with customer, liability, cumulative catch-up adjustment to revenue, modification of contract	(99,123)
Contract with customer, liability end of period	206,430
Summary of Receivables [Roll Forward]
Contract with customer, asset, after allowance for credit loss beginning of period	77
Contract with customer, asset, additional amounts recorded	13,590
Contract with customer, asset, cumulative catch-up adjustment to revenue, modification of contract	0
Contract with customer, asset, after allowance for credit loss end of period	13,667
Overpayments and Other Cash Items
Summary of Contract Payables [Roll Forward]
Contract with customer, liability beginning of period	13,127
Contract with customer, liability, additional amounts recorded	7,529
Contract with customer, liability, cumulative catch-up adjustment to revenue, modification of contract	(7,985)
Contract with customer, liability end of period	$ 12,671

Equity Investment - Narrative (

Equity Investment - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Schedule of Equity Method Investments [Line Items]
Operating income (loss)	$ 12,447,000	$ 12,974,000	$ 50,467,000	$ 69,185,000
Net income	(28,505,000)	(7,572,000)	(24,859,000)	24,940,000
Equity investment	43,477,000	134,353,000	43,477,000	134,353,000	$ 83,069,000
Matrix
Schedule of Equity Method Investments [Line Items]
Net income	$ (26,700,000)	(4,800,000)	$ (28,200,000)	(1,400,000)
Matrix
Schedule of Equity Method Investments [Line Items]
Equity method investment, ownership percentage	43.60%		43.60%		43.60%
Impairment	$ 82,200,000	0	$ 82,200,000	0	$ 111,400,000
Operating income (loss)	(36,100,000)	$ (6,700,000)	(39,000,000)	$ (2,000,000)
Equity investment	$ 43,500,000		$ 43,500,000		$ 83,100,000

Equity Investment - Summary of

Equity Investment - Summary of Financial Information for Matrix (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Schedule of Investments [Line Items]
Current assets	$ 381,706						$ 381,706		$ 409,834
Current liabilities	533,507						533,507		527,234
Revenue	647,782			$ 493,059			1,850,472	$ 1,421,117
Operating income (loss)	12,447			12,974			50,467	69,185
Net loss	(28,505)	$ 3,328	$ 318	(7,572)	$ 13,672	$ 18,840	(24,859)	24,940
Matrix
Schedule of Investments [Line Items]
Current assets	110,892						110,892		124,081
Long-term assets	381,096						381,096		482,063
Current liabilities	44,557						44,557		57,048
Long-term liabilities	330,794						330,794		$ 340,448
Revenue	76,461			78,458			235,582	316,830
Operating income (loss)	(79,992)			(16,833)			(81,604)	3,324
Net loss	$ (85,081)			$ (15,627)			$ (93,211)	$ (7,143)

Prepaid Expenses and Other Cu_3

Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Prepaid Expense and Other Assets, Current [Abstract]
Prepaid insurance	$ 8,331	$ 9,487
Deferred ERP implementation costs	6,390	3,003
Deferred financing costs on credit facility	3,249	1,480
Prepaid income taxes	2,709	13,848
Inventory	1,864	1,458
Other prepaid expenses	14,138	9,275
Total prepaid expenses and other current assets	$ 36,681	$ 38,551

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Payables and Accruals [Abstract]
Accrued compensation and related liabilities	$ 52,107	$ 54,564
Accrued interest	24,239	12,826
Accrued operating expenses	16,378	14,457
Insurance reserves	15,972	10,152
Accrued legal fees	11,016	5,081
Accrued government grants	5,439	1,514
Union pension obligation	4,952	6,629
Deferred revenue	2,213	2,714
Deferred acquisition payments	50	3,578
Other	12,851	12,276
Total accrued expenses and other current liabilities	$ 145,217	$ 123,791

Debt - Long Term Debt Instrumen

Debt - Long Term Debt Instruments (Details) - Senior Notes - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Unsecured Notes Due 2025
Debt Instrument [Line Items]
Long-term debt	$ 500,000
Interest rate, stated percentage	5.875%
Long-term debt, gross	$ 490,399	$ 488,368
Unsecured Notes Due 2029
Debt Instrument [Line Items]
Long-term debt	$ 500,000
Interest rate, stated percentage	5%
Long-term debt, gross	$ 487,902	$ 486,857

Debt - Narrative (Details)

Debt - Narrative (Details) - USD ($)	9 Months Ended
	Sep. 30, 2022	Feb. 03, 2022	Dec. 31, 2021
Line of Credit Facility [Line Items]
Deferred financing fees	$ 21,699,000		$ 24,775,000
Letters of credit outstanding, amount	38,000,000
Line of credit facility additional maximum borrowing capacity	$ 175,000,000
Debt instrument, covenant, maximum indebtedness principal amount		$ 40,000,000
Revolving Credit Facility
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity		325,000,000
Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage	3.50%
Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage	1.75%
Bridge Loan
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity		25,000,000
Letter of Credit
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity		60,000,000
Letter of Credit | Maximum
Line of Credit Facility [Line Items]
Debt instrument, pro forma net leverage ratio	350%
Alternative Currency Loan
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity		$ 75,000,000
Senior Notes
Line of Credit Facility [Line Items]
Unamortized debt issuance expense	$ 21,700,000
New Credit Agreement | Maximum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage	0.50%
New Credit Agreement | Maximum | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Basis spread on variable rate	3.50%
New Credit Agreement | Maximum | Alternate Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate	2.50%
New Credit Agreement | Minimum
Line of Credit Facility [Line Items]
Unused capacity, commitment fee percentage	0.30%
New Credit Agreement | Minimum | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Basis spread on variable rate	1.75%
New Credit Agreement | Minimum | Alternate Base Rate
Line of Credit Facility [Line Items]
Basis spread on variable rate	0.75%
2025 Senior Notes | Senior Notes
Line of Credit Facility [Line Items]
Deferred financing fees	$ 14,500,000
2029 Senior Notes | Senior Notes
Line of Credit Facility [Line Items]
Deferred financing fees	$ 13,500,000

Stock-Based Compensation and _2

Stock-Based Compensation and Similar Arrangements - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period for recognition			3 years
Common stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation	$ (0.3)	$ 0.5	$ 1	$ 1.5
Stock options outstanding (in shares)	209,075		209,075
Weighted-average exercise price (in dollars per share)	$ 97.30		$ 97.30
Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation	$ 0.7	0.7	$ 3.5	3.5
Shares of unvested RSAs outstanding (in shares)	13,137		13,137
Weighted-average grant date fair value (in dollars per share)	$ 94.44		$ 94.44
Restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation	$ 1	$ 1	$ 2.5	$ 2.5
Shares of unvested RSAs outstanding (in shares)	85,369		85,369
Weighted-average grant date fair value (in dollars per share)	$ 113.19		$ 113.19
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation	$ (0.2)		$ 0.6
Shares of unvested RSAs outstanding (in shares)	18,663		18,663
Weighted-average grant date fair value (in dollars per share)	$ 153.17		$ 153.17

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, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021
Numerator:
Net income (loss)	$ (28,505)	$ 3,328	$ 318	$ (7,572)	$ 13,672	$ 18,840	$ (24,859)	$ 24,940
Denominator:
Denominator for basic earnings per share -- weighted-average shares (in shares)	14,051,794			13,993,438			14,041,224	14,102,371
Effect of dilutive securities:
Denominator for diluted earnings per share -- adjusted weighted-average shares assumed conversion (in shares)	14,051,794			13,993,438			14,041,224	14,278,331
Earnings (loss) per share:
Basic earnings (loss) per share (in dollars per share)	$ (2.03)			$ (0.54)			$ (1.77)	$ 1.77
Diluted earnings (loss) per share (in dollars per share)	$ (2.03)			$ (0.54)			$ (1.77)	$ 1.75
Common stock options
Effect of dilutive securities:
Common stock options (in shares)	0			0			0	130,221
Restricted stock
Effect of dilutive securities:
Common stock options (in shares)	0			0			0	45,739

Earnings (Loss) Per Share - S_2

Earnings (Loss) Per Share - Schedule of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Stock options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	115,686	49,158	123,534	53,550

Earnings (Loss) Per Share - Nar

Earnings (Loss) Per Share - Narrative (Details) - USD ($)	3 Months Ended		19 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Mar. 08, 2021
Earnings Per Share [Abstract]
Stock repurchase program, authorized amount				$ 75,000,000
Stock repurchase plan (in shares)			269,407
Treasury stock, value, acquired, cost method	$ 24,590,000	$ 14,450,000	$ 39,000,000

Income Taxes (Details)

Income Taxes (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Effective income tax rate	33.90%	42.30%	21.70%	24.20%