CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Operating activities
Net income	$ 22,513	$ 25,503
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	5,958	5,801
Provision for bad debts	9,833	8,395
Stock-based compensation expense	2,879	3,398
Deferred income taxes	480	1,552
Loss on sale of assets	17	100
Other intangibles impairment charge		650
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(18,462)	(7,084)
Prepaid expenses and other assets	(1,114)	2,247
Prepaid income taxes	4,262	13,960
Accounts payable and accrued expenses	645	(6,597)
Net amounts due to/from governmental entities	(631)	135
Net cash provided by operating activities	26,380	48,060
Investing activities
Purchases of property, building and equipment	(5,997)	(6,508)
Proceeds from sale of assets		25
Cash paid for acquisitions, primarily goodwill and intangible assets	(26,920)	(6,764)
Net cash (used in) investing activities	(32,917)	(13,247)
Financing activities
Proceeds from line of credit	64,500	173,562
Payments on line of credit	(60,000)	(183,297)
Proceeds from employee stock purchase plan	570	587
Proceeds from debt issuance	1,138
Noncontrolling interest distributions	(6,286)	(6,582)
Excess tax benefits from vesting of restricted stock	11
Redemption of treasury shares	(794)
Purchase of additional controlling interest	(1,879)	(126)
Payments on repurchase of common stock		(19,017)
Sale of noncontrolling interest		80
Net cash (used in) financing activities	(2,740)	(34,793)
Change in cash	(9,277)	20
Cash at beginning of period	9,720	256
Cash at end of period	443	276
Supplemental disclosures of cash flow information
Interest paid	1,523	972
Income taxes paid	$ 18,123	$ 8,644