CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Cash flows from operating activities:
Net income (loss)	$ 3,030	$ (2,056)	$ (66,453)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	172,390	161,011	174,263
Stock-based compensation expense	42,877	34,663	39,254
Excess tax benefits from stock-based compensation	(1,014)	(644)	0
Deferred taxes	(22,621)	(2,206)	(56)
Asset impairment charges	4,650	1,544	2,390
Write-off of unamortized deferred debt issuance costs	5,224	1,433	0
Equity in net loss of unconsolidated investments	7,501	2,100	398
Other losses (gains), net	2,579	(614)	3,553
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable, net	(17,826)	3,215	(14,644)
Prepaid expenses and other assets	13,765	17,614	(7,038)
Accounts payable	40,456	(11,953)	(1,944)
Accrued expenses	1,490	(22,974)	(22,767)
Accrued compensation and benefits	(4,106)	10,257	(29,544)
Deferred revenue	21,722	20,372	33,109
Other liabilities	(1,113)	(183)	(7,025)
Net cash provided by operating activities	269,004	211,579	103,496
Cash flows from investing activities:
Capital expenditures	(35,510)	(18,322)	(26,438)
Capitalized software	(102,472)	(49,264)	(40,661)
Cash paid for business acquisitions, net of cash acquired	(994,876)	(9,372)	(20,180)
Purchases of equity securities, other investments and related intangible assets	(21,185)	(215,786)	(21,544)
Sales and maturities of marketable securities and other investments	0	3,763	50
Proceeds received from sale of fixed assets	37	15	85
Net cash used in investing activities	(1,154,006)	(288,966)	(108,688)
Cash flows from financing activities:
Proceeds from sale or issuance of common stock	84	103,631	1,487
Proceeds from issuance of redeemable convertible preferred stock - Netsmart	333,605	0	0
Excess tax benefits from stock-based compensation	1,014	644	0
Taxes paid related to net share settlement of equity awards	(8,204)	(7,062)	(10,400)
Payments of capital lease obligations	(6,277)	(598)	(455)
Credit facility payments	(157,245)	(238,511)	(96,876)
Credit facility borrowings, net of issuance costs	823,535	284,161	101,964
Repurchase of common stock	(121,241)	0	0
Net cash provided by (used in) financing activities	865,271	142,265	(4,280)
Effect of exchange rate changes on cash and cash equivalents	(532)	(1,178)	(309)
Net (decrease) increase in cash and cash equivalents	(20,263)	63,700	(9,781)
Cash and cash equivalents, beginning of period	116,873	53,173	62,954
Cash and cash equivalents, end of period	$ 96,610	$ 116,873	$ 53,173