CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Operating activities:
Net income	$ 20,406	$ 13,167
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	5,801	4,413
Provision for bad debts	10,064	7,725
Stock-based compensation expense	2,073	2,069
Deferred income taxes	1,008	844
Impairment of intangibles	248	0
Loss on sale of assets	404	144
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(12,812)	(8,625)
Prepaid expenses and other assets	(3,735)	(301)
Prepaid income taxes	868	512
Accounts payable and accrued expenses	24,341	4,249
Net amounts due to/from governmental entities	(715)	(401)
Net cash provided by operating activities	47,951	23,796
Investing activities:
Purchases of property, building and equipment	(5,205)	(3,419)
Cash paid for acquisitions, primarily goodwill and intangible assets	(566)	(65,103)
Net cash (used in) investing activities	(5,771)	(68,522)
Financing activities:
Proceeds from line of credit	2,000	68,000
Payments on line of credit	(22,000)	(21,000)
Proceeds from employee stock purchase plan	389	391
Payments on debt	(113)	(91)
Noncontrolling interest distributions	(4,069)	(3,122)
Payment of deferred financing fees	0	(799)
Excess tax benefits from vesting of stock awards	811	112
Redemption of treasury shares	(1,329)	(850)
Purchase of additional controlling interest	(275)	(95)
Proceeds from exercise of stock options	145	0
Sale of noncontrolling interest	0	193
Net cash provided by (used in) financing activities	(24,441)	42,739
Change in cash	17,739	(1,987)
Cash at beginning of period	531	14,014
Cash at end of period	18,270	12,027
Supplemental disclosures of cash flow information:
Interest paid	765	1,177
Income taxes paid	$ 8,208	$ 6,064