CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Operating activities
Net income (loss)	$ 29,146	$ 35,428	$ (3,651)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization expense	8,325	7,806	7,521
Provision for bad debts	13,929	11,875	12,320
Stock-based compensation expense	3,886	4,390	4,092
Deferred income taxes	2,351	2,204	4,378
Loss on sale of assets	20	105
Other intangibles impairment charge	500	650
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(18,961)	(4,497)	(21,024)
Prepaid expenses and other assets	(749)	1,780	6,247
Prepaid income taxes	3,299	18,855	(17,926)
Accounts payable and accrued expenses	4,395	(4,288)	4,478
Net amounts due to/from governmental entities	(226)	464	189
Net cash provided by (used in) operating activities	45,915	74,772	(3,376)
Investing activities
Cash paid for acquisitions, primarily goodwill and intangible assets	(26,920)	(6,758)	(11,680)
Proceeds from sale of assets		33
Purchases of property, building and equipment	(8,343)	(8,415)	(7,945)
Net cash (used in) investing activities	(35,263)	(15,140)	(19,625)
Financing activities
Proceeds from line of credit	73,000	188,561	142,995
Payments on line of credit	(70,500)	(203,881)	(108,175)
Payments on capital leases			(14)
Excess tax benefits from vesting of restricted stock	18		320
Proceeds from issuance of common stock under ESPP	786	783	860
Proceeds from debt issuance	1,212
Noncontrolling interest distributions	(8,126)	(8,444)	(11,857)
Purchase of additional controlling interest	(1,879)	(309)	(891)
Sale of noncontrolling interest		80	308
Redemption of treasury stock to pay income tax	(869)
Repurchase of common stock		(26,958)	(577)
Net cash provided by (used in) financing activities	(6,358)	(50,168)	22,969
Change in cash	4,294	9,464	(32)
Cash at beginning of period	9,720	256	288
Cash at end of period	14,014	9,720	256
Supplemental disclosures of cash flow information
Interest paid	1,961	1,550	1,018
Income taxes paid	$ 21,606	$ 8,645	$ 11,363