CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Operating activities:
Net income	$ 31,516	$ 21,020
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	8,685	6,874
Provision for bad debts	14,873	11,699
Stock-based compensation expense	3,150	3,086
Deferred income taxes	1,125	522
Impairment of intangibles	248	0
Loss on disposal of assets	680	21
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(24,643)	(12,868)
Prepaid expenses and other assets	(3,660)	280
Prepaid income taxes	779	4,005
Accounts payable and accrued expenses	19,071	(1,283)
Net amounts due to/from governmental entities	(205)	95
Net cash provided by operating activities	51,619	33,451
Investing activities:
Purchases of property, building and equipment	(11,401)	(4,872)
Cash paid for acquisitions. primarily goodwill and intangible assets	(4,359)	(73,194)
Net cash (used in) investing activities	(15,760)	(78,066)
Financing activities:
Proceeds from line of credit	64,000	72,000
Payments on line of credit	(32,000)	(30,000)
Proceeds from employee stock purchase plan	569	575
Payments on debt	(172)	(147)
Noncontrolling interest distributions	(6,372)	(5,086)
Payment of deferred financing fees	0	(900)
Excess tax benefits from vesting of stock awards	897	124
Redemption of treasury shares	(1,449)	(923)
Purchase of additional controlling interest	(275)	(359)
Proceeds from exercise of stock options	145	0
Sale of noncontrolling interest	0	193
Net cash provided by (used in) financing activities	25,343	35,477
Change in cash	61,202	(9,138)
Cash at beginning of period	531	14,014
Cash at end of period	61,733	4,876
Supplemental disclosures of cash flow information:
Interest paid	1,227	1,827
Income taxes paid	$ 14,242	$ 6,946