CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash Flows from Operating Activities:
Net income	$ 210,166	$ 185,184	$ 127,907
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	30,901	28,802	18,428
Non-cash compensation	23,809	26,730	25,040
Non-cash 401(k) employer match	0	0	10,509
Amortization and impairment of operating lease right of use assets	40,364	39,140	35,905
(Gain) loss on disposal of property and equipment	(124)	(30)	141
(Gain) loss on equity method investments	(31,098)	2,980	0
Write-off of other comprehensive income	0	(15)	0
Deferred income taxes	44,582	(26,560)	13,466
Equity in earnings from equity method investments	(4,949)	(3,966)	(5,338)
Amortization of deferred debt issuance costs/debt discount	917	869	873
Return on equity method investments	5,343	5,444	4,955
Asset impairment charge	0	4,152	1,470
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(18,030)	2,114	(24,146)
Other current assets	(12,202)	(7,181)	(2,682)
Other assets	(1,017)	31	832
Accounts payable	(4,353)	1,941	(11,329)
Accrued expenses	(26,915)	39,839	42,096
Other long-term obligations	(28,796)	27,717	(329)
Operating lease liabilities	(36,645)	(34,695)	(32,295)
Operating lease right of use assets	(3,060)	(3,544)	(3,503)
Net cash provided by operating activities	188,893	288,952	202,000
Cash Flows from Investing Activities:
Proceeds from the sale of deferred compensation plan assets	135	101	448
Proceeds from the sale of property and equipment	144	80	162
Purchases of property and equipment	(6,302)	(5,332)	(7,888)
Investments in technology assets	(419)	0	0
Purchase of investment	(5,200)	(875)	(210)
Proceeds from sale of equity method investment	0	17,876	0
Acquisitions of businesses, net of cash acquired	(269,965)	(298,958)	(345,460)
Net cash used in investing activities	(281,607)	(287,108)	(352,948)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options	2,054	6,325	3,611
Proceeds from issuance of stock to employee stock purchase plan	3,968	3,562	3,187
Shares withheld to pay taxes on non-cash compensation	(16,898)	(54,493)	(9,556)
Noncontrolling interest contributions	250	0	0
Noncontrolling interest distributions	(1,747)	(1,122)	(1,062)
Proceeds from borrowings under term loan	290,312	0	175,000
Proceeds from borrowings under revolving line of credit	500,700	684,200	262,500
Repayments of borrowings under revolving line of credit	(551,700)	(703,200)	(200,000)
Principal payments of long-term obligations	(9,143)	(10,249)	(5,624)
Debt issuance costs	(2,792)	0	(847)
Provider relief fund advance	(60,000)	60,000	0
Purchase of company stock	(99,878)	0	0
Net cash provided by (used in) financing activities	55,126	(14,977)	227,209
Net (decrease) increase in cash, cash equivalents and restricted cash	(37,588)	(13,133)	76,261
Cash, cash equivalents and restricted cash at beginning of period	83,357	96,490	20,229
Cash, cash equivalents and restricted cash at end of period	45,769	83,357	96,490
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	5,291	6,207	9,628
Cash paid for income taxes, net of refunds received	$ 34,097	$ 50,721	$ 29,522