Note 2 - Revenue Recognition - Revenues Disaggregated by Revenue Source and Market (Details) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2019	Mar. 31, 2018
Revenues	$ 147,953	$ 141,425
Sales Channel, Commercial [Member]
Revenues	76,259	71,785
Sales Channel, State [Member]
Revenues	61,742	54,620
Sales Channel, Federal [Member]
Revenues	9,952	15,020
Coordination of Benefits [Member]
Revenues	105,851	91,752
Payment Integrity [Member]
Revenues	27,726	38,641
Total Population Management [Member]
Revenues	$ 14,376	$ 11,032

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=118956577&loc=SL49130545-203045

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=118956577&loc=SL49130543-203045

Name:	us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration