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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
6 Months Ended
Jun. 30, 2016
Jun. 30, 2015
Cash flows from operating activities:    
Net income $ 14,703 $ 11,487
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 50,587 48,518
Non-cash impairment of intangible asset 4,800  
Non-cash interest expense 204 197
Non-cash stock compensation expense 18,397 27,696
Non-cash income tax (benefit) provision 1,570 (3,323)
Non-cash amortization on investments 3,147 2,966
Cash flows from changes in assets and liabilities, net of effects from acquisitions of businesses:    
Restricted cash 53,528 84,004
Accounts receivable, net (74,430) (32,064)
Pharmaceutical inventory (12,246) (2,919)
Other assets (56,460) (31,551)
Accounts payable and accrued liabilities 14,050 (72,439)
Medical claims payable and other medical liabilities (34,460) 45,544
Contingent consideration (50,904) 36,245
Tax contingencies 647 (578)
Deferred credits and other long-term liabilities 663 (1,059)
Other 23 (48)
Net cash provided by (used in) operating activities (66,181) 112,676
Cash flows from investing activities:    
Capital expenditures (30,522) (37,653)
Acquisitions and investments in businesses, net of cash acquired (16,050) (55,943)
Purchase of investments (211,061) (293,348)
Maturity of investments 246,786 215,984
Net cash used in investing activities (10,847) (170,960)
Cash flows from financing activities:    
Proceeds from issuance of debt 225,000  
Payments to acquire treasury stock (25,458) (68,783)
Proceeds from exercise of stock options and warrants 9,691 49,170
Payments on long-term debt and capital lease obligations (9,401) (8,299)
Payments on contingent consideration (39,958) (4,439)
Tax benefit from exercise of stock options and vesting of stock awards 472 3,774
Other (94) (616)
Net cash (used in) provided by financing activities 160,252 (29,193)
Net (decrease) increase in cash and cash equivalents 83,224 (87,477)
Cash and cash equivalents at beginning of period 115,432 255,303
Cash and cash equivalents at end of period 198,656 167,826
Non-cash investing activities:    
Property and equipment acquired under capital leases $ 4,010 $ 1,987