Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities
Consolidated net (loss) income	$ (1,718)	$ 19,186
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	2,191	2,412
Amortization of debt discount and debt issuance costs	354	470
Provision for allowances	1,038	798
Deferred income tax expense	597	471
Gain on derivative liability	(1,581)	(16,436)
Acquisition-related contingent consideration	270	287
Loss on early extinguishment of debt	4,969	0
Equity compensation	737	648
Other non-cash costs	11	0
Changes in operating assets and liabilities:
Accounts receivable	10,817	2,500
Prepaid expenses and other assets	(264)	(105)
Accounts payable and accrued expenses	(16,087)	(6,068)
Other liabilities	76	(1,599)
Net cash provided by operating activities	1,410	2,564
Cash flows from investing activities
Acquisition-related settlements - Mediscan	0	277
Purchases of property and equipment	(1,090)	(982)
Net cash used in investing activities	(1,090)	(705)
Cash flows from financing activities
Repayments of debt	(6,005)	(59,227)
Borrowings on debt	0	57,200
Extinguishment fees	(578)	0
Other	(1,000)	(403)
Net cash used in financing activities	(7,583)	(2,430)
Effect of exchange rate changes on cash	34	(6)
Change in cash and cash equivalents	(7,229)	(577)
Cash and cash equivalents at beginning of period	20,630	2,453
Cash and cash equivalents at end of period	$ 13,401	$ 1,876