CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2017	Jun. 30, 2016
Cash flows from operating activities:
Net income	$ 22,396	$ 14,703
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization	54,707	50,587
Non-cash impairment of intangible assets		4,800
Non-cash interest expense	578	204
Non-cash stock compensation expense	21,511	18,397
Non-cash income tax expense (benefit)	(1,520)	1,570
Non-cash amortization on investments	2,094	3,147
Changes in assets and liabilities, net of effects from acquisitions of businesses:
Accounts receivable, net	(21,859)	(74,430)
Pharmaceutical inventory	(1,188)	(12,246)
Other assets	(21,974)	(56,460)
Accounts payable and accrued liabilities	(59,372)	14,522
Medical claims payable and other medical liabilities	5,978	(34,460)
Contingent consideration	203	(50,904)
Tax contingencies	764	647
Deferred credits and other long-term liabilities	1,882	663
Other	(364)	23
Net cash (used in) provided by operating activities	3,836	(119,237)
Cash flows from investing activities:
Capital expenditures	(26,797)	(30,522)
Acquisitions and investments in businesses, net of cash acquired	(3,200)	(15,477)
Purchase of investments	(238,814)	(211,061)
Maturity of investments	233,143	246,786
Net cash used in investing activities	(35,668)	(10,274)
Cash flows from financing activities:
Proceeds from issuance of debt	200,000	225,000
Payments to acquire treasury stock	(5,000)	(25,458)
Proceeds from exercise of stock options and warrants	5,946	9,691
Payments on debt and capital lease obligations	(190,978)	(9,401)
Payments on contingent consideration		(39,958)
Other	(1,311)	(94)
Net cash provided by financing activities	8,657	159,780
Net increase (decrease) in cash and cash equivalents	(23,175)	30,269
Cash and cash equivalents at beginning of period	304,508	249,029
Cash and cash equivalents at end of period	281,333	279,298
Non-cash investing activities:
Property and equipment acquired under capital leases	$ 2,418	$ 4,010