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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
6 Months Ended
Jun. 30, 2017
Jun. 30, 2016
Excess Tax Benefit from Share-based Compensation, Operating Activities [1]   $ 2,500
Cash Flows from Operating Activities:    
Net income $ 55,488 43,405
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 28,842 30,831
Stock-based compensation 11,561 13,458
Provision for doubtful accounts and billing adjustments 5,744 5,925
fairvalueadjustmentforcontingentconsideration 0 613
Workers’ compensation provision 1,682 1,062
Other 3,791 2,013
Changes in operating assets and liabilities:    
Accounts receivable (35,222) (34,559)
Prepaid expenses and income taxes (2,343) 4,862
Accounts payable 42 (3,180)
Accrued payroll and contract professional pay 6,302 29,961
Income taxes payable 11,679 11,054
Workers’ compensation loss reserves (1,351) (1,372)
Other Payments to Acquire Businesses 0 1,937
Other (2,622) (2,012)
Net cash provided by operating activities(1) 83,593 100,124
Cash Flows from Investing Activities:    
Cash paid for property and equipment (13,208) (13,909)
Cash received from sale of discontinued operations, net 0 6,000
Other (148) (350)
Net cash used in investing activities (13,356) (8,259)
Cash Flows from Financing Activities:    
Principal payments of long-term debt (64,000) (72,000)
Proceeds from long-term debt 2,000 7,000
Proceeds from option exercises and employee stock purchase plan 4,148 5,921
Payment of employment taxes related to release of restricted stock awards (6,863) (5,266)
Repurchase of common stock (12,136) (2,787)
Payments of Debt Issuance Costs 2,441 0
Payments of Merger Related Costs, Financing Activities 0 13,814
Net cash used in financing activities(1) (79,292) (80,946)
Effect of exchange rate changes on cash and cash equivalents 974 (6)
Net Increase (Decrease) in Cash and Cash Equivalents (8,081) 10,913
Cash and Cash Equivalents at Beginning of Year 27,044 23,869
Cash and Cash Equivalents at End of Period 18,963 34,782
Supplemental Disclosure of Cash Flow Information:    
Income taxes 20,789 10,855
Interest 12,799 14,297
Supplemental Disclosure of Non-Cash Transactions:    
Unpaid portion of additions to property and equipment 2,149 574
Unsettled repurchases of common stock $ 0 $ 802
[1] (1) Effective January 1, 2017, the Company adopted ASU No. 2016-09, Compensation - Stock Compensation (Topic 718). The Company elected to present retrospectively its gross excess tax benefits as cash flows from operating activities in the condensed consolidated statements of cash flows for all periods presented, which increased cash flows from operating activities and decreased cash flows from financing activities by $2.5 million for the six months ended June 30, 2016.