CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
OPERATING ACTIVITIES
Net income	$ 152,582	$ 180,695
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	58,505	50,149
Provision for deferred income taxes	(6,972)	4,604
Provision for bad debts	10,216	9,509
Stock-based compensation expense	10,891	10,030
Other, net	(951)	(1,920)
Benefit settlement	25,949
Changes in operating assets and liabilities	(19,902)	(39,793)
Net cash provided by operating activities	230,318	213,274
INVESTING ACTIVITIES
Cash used for acquisitions of companies, net of cash acquired	(431,249)	(71,785)
Purchases of equipment and property	(18,701)	(19,645)
Proceeds from sales of franchises	612	343
Other	1,370	1,002
Net cash used in investing activities	(447,968)	(90,085)
FINANCING ACTIVITIES
Cash paid for common stock purchased	(9,935)	(9,533)
Dividends paid	(103,093)	(91,677)
Repayment of Term Loan	(27,000)
Repayment of Revolving Commitment	(45,000)
Borrowings under Term Loan	250,000
Borrowings under Revolving Commitment	148,000
Net cash provided by/(used in) financing activities	212,972	(101,210)
Effect of exchange rate changes on cash	(6,445)	(10,377)
Net increase/(decrease) in cash and cash equivalents	(11,123)	11,602
Cash and cash equivalents at beginning of period	115,485	107,050
Cash and cash equivalents at end of period	104,362	118,652
Supplemental disclosure of cash flow information:
Non-cash additions to operating lease right-of-use assets	$ 23,415