CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Operating activities:
Net income	$ 15,802	$ 16,341
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization of property and equipment	23,228	24,459
Amortization of intangible assets	15,226	15,572
Amortization of deferred financing costs	1,563	1,563
Stock-based compensation expense	10,208	9,095
Excess tax benefit from exercised stock options	(1,477)	(870)
Deferred income taxes	(8,925)	(9,322)
Allowance for doubtful accounts and bad debt write-offs	(31)	(6,549)
Loss on disposal of fixed assets	40	191
Change in fair value of contingent consideration		17
Changes in operating assets and liabilities:
Accounts receivable	(23,964)	(14,054)
Prepaid expenses	1,186	2,666
Prepaid income taxes	6,619	7,662
Other current assets	162	(2,189)
Other assets	(229)	125
Accounts payable, accrued expenses and other liabilities	(8,174)	8,978
Income taxes payable	4,182	9,841
Estimated liability for appeals	5,037	16,269
Net cash provided by operating activities	40,453	79,795
Investing activities:
Purchases of land, property and equipment	(5,903)	(16,594)
Investment in capitalized software	(1,985)	(2,726)
Net cash used in investing activities	(7,888)	(19,320)
Financing activities:
Repayment of revolving credit facility		(35,000)
Purchase of treasury stock	(25,000)
Proceeds from exercise of stock options	4,188	3,279
Excess tax benefit from exercised stock options	1,477	870
Payments of tax withholdings on behalf of employees for net-share settlement for restricted stock awards and units	(635)	(1,128)
Payments on capital lease obligations	(907)	(1,241)
Payments on contingent consideration		(428)
Net cash used in financing activities	(20,877)	(33,648)
Net increase in cash and cash equivalents	11,688	26,827
Cash and cash equivalents at beginning of period	133,116	93,366
Cash and cash equivalents at end of period	144,804	120,193
Supplemental disclosure of cash flow information:
Cash paid for income taxes	13,619	3,541
Cash paid for interest	5,295	4,438
Supplemental disclosure of noncash activities:
Accrued property and equipment purchases	392	974
Equipment purchased through capital leases		20
Decrease in appeals liability for lost appeals offset with a reduction in accounts receivable	$ 6,944	$ 23,206