CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash Flows from Operating Activities:
Net income	$ 117,699	$ 210,166	$ 185,184
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	24,935	30,901	28,802
Non-cash compensation	16,560	23,809	26,730
Amortization and impairment of operating lease right of use assets	46,029	40,364	39,140
Loss (gain) on disposal of property and equipment	519	(124)	(30)
(Gain) loss on equity method investments	0	(31,098)	2,980
Write-off of other comprehensive income	0	0	(15)
Deferred income taxes	23,377	44,582	(26,560)
Equity in loss (earnings) from equity method investments	45	(4,949)	(3,966)
Amortization of deferred debt issuance costs/debt discount	991	917	869
Return on equity method investments	5,163	5,343	5,444
Impairment charge	3,009	0	4,152
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable	(14,230)	(18,030)	2,114
Other current assets	(3,525)	(12,202)	(7,181)
Other assets	438	(1,017)	31
Accounts payable	4,894	(4,353)	1,941
Accrued expenses	(39,382)	(26,915)	39,839
Other long-term obligations	(8,822)	(28,796)	27,717
Operating lease liabilities	(41,175)	(36,645)	(34,695)
Operating lease right of use assets	(3,242)	(3,060)	(3,544)
Net cash provided by operating activities	133,283	188,893	288,952
Cash Flows from Investing Activities:
Proceeds from the sale of deferred compensation plan assets	252	135	101
Proceeds from the sale of property and equipment	66	144	80
Purchases of property and equipment	(6,165)	(6,302)	(5,332)
Investments in technology assets	(1,050)	(419)	0
Investment in equity method investee	(637)	(200)	(875)
Proceeds from sale of equity method investment	0	0	17,876
Purchase of cost method investment	(15,000)	(5,000)	0
Acquisitions of businesses, net of cash acquired	(71,952)	(269,965)	(298,958)
Net cash used in investing activities	(94,486)	(281,607)	(287,108)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options	2,304	2,054	6,325
Proceeds from issuance of stock to employee stock purchase plan	3,848	3,968	3,562
Shares withheld to pay taxes on non-cash compensation	(7,981)	(16,898)	(54,493)
Noncontrolling interest contributions	3,501	250	0
Noncontrolling interest distributions	(1,561)	(1,747)	(1,122)
Proceeds from sale of noncontrolling interest	5,817	0	0
Proceeds from borrowings under term loan	0	290,312	0
Proceeds from borrowings under revolving line of credit	534,500	500,700	684,200
Repayments of borrowings under revolving line of credit	(534,500)	(551,700)	(703,200)
Principal payments of long-term obligations	(13,296)	(9,143)	(10,249)
Debt issuance costs	0	(2,792)	0
Provider relief fund advance	0	(60,000)	60,000
Purchase of company stock	(17,351)	(99,878)	0
Payment of accrued contingent consideration	(5,714)	0	0
Net cash (used in) provided by financing activities	(30,433)	55,126	(14,977)
Net increase (decrease) in cash, cash equivalents and restricted cash	8,364	(37,588)	(13,133)
Cash, cash equivalents and restricted cash at beginning of period	45,769	83,357	96,490
Cash, cash equivalents and restricted cash at end of period	54,133	45,769	83,357
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	14,939	5,291	6,207
Cash Paid For Infinity ZPIC Interest	12,755	0	0
Cash paid for income taxes, net of refunds received	24,013	34,097	50,721
Accrued contingent consideration	19,195	0	0
Noncontrolling interest contribution	$ 8,900	$ 0	$ 0