CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Cash flows from operating activities:
Net income	$ 3,726	$ 54,485
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	75,239	66,665
Non-cash interest expense	297	3,888
Non-cash stock compensation expense	40,593	25,983
Non-cash income tax expense (benefit)	(1,018)	813
Non-cash amortization on investments	5,106	3,620
Cash flows from changes in assets and liabilities, net of effects from acquisitions of businesses:
Restricted cash	79,959	71,530
Accounts receivable, net	(41,428)	(19,492)
Pharmaceutical inventory	(5,277)	8,710
Other assets	(48,653)	(22,378)
Accounts payable and accrued liabilities	1,230	(28,461)
Medical claims payable and other medical liabilities	59,819	39,940
Tax contingencies	(2,290)	(15,179)
Deferred credits and other long-term liabilities	10,848	3,940
Other	(26)	178
Net cash provided by operating activities	178,125	194,242
Cash flows from investing activities:
Capital expenditures	(54,604)	(50,597)
Acquisitions and investments in businesses, net of cash acquired	(55,818)	(132,210)
Purchase of investments	(391,785)	(216,958)
Maturity of investments	283,619	220,191
Net cash used in investing activities	(218,588)	(179,574)
Cash flows from financing activities:
Proceeds from issuance of debt		250,000
Payments to acquire treasury stock	(150,763)	(139,316)
Proceeds from exercise of stock options and warrants	50,074	41,685
Payments on long-term debt and capital lease obligations	(12,665)	(2,606)
Payments on contingent consideration	(8,932)
Tax benefit from exercise of stock options and vesting of stock awards	3,887	2,805
Other	408	(2,150)
Net cash provided by (used in) financing activities	(117,991)	150,418
Net increase (decrease) in cash and cash equivalents	(158,454)	165,086
Cash and cash equivalents at beginning of period	255,303	203,187
Cash and cash equivalents at end of period	96,849	368,273
Non-cash investing activities:
Property and equipment acquired under capital leases	$ 3,415	$ 216