CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Operating activities:
Net income	$ 21,638	$ 20,406
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	5,911	5,801
Provision for bad debts	8,383	10,064
Stock-based compensation expense	2,236	2,073
Deferred income taxes	2,058	1,008
Impairment of intangibles and other		248
Loss on disposal of assets	1,247	404
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(19,758)	(12,812)
Prepaid expenses and other assets	(6,446)	(3,735)
Prepaid income taxes	(4,364)	868
Accounts payable and accrued expenses	21,867	24,341
Net amounts due to/from governmental entities	(1,900)	(715)
Net cash provided by operating activities	30,872	47,951
Investing activities:
Purchases of property, building and equipment	(13,712)	(5,205)
Cash paid for acquisitions, primarily goodwill and intangible assets	(11,515)	(566)
Other	273
Net cash used in investing activities	(24,954)	(5,771)
Financing activities:
Proceeds from line of credit	35,000	2,000
Payments on line of credit	(23,000)	(22,000)
Proceeds from employee stock purchase plan	445	389
Payments on debt	(115)	(113)
Noncontrolling interest distributions	(4,338)	(4,069)
Excess tax benefits from vesting of stock awards	1,218	811
Withholding taxes paid on stock-based compensation	(1,703)	(1,329)
Purchase of additional controlling interest		(275)
Sale of noncontrolling interest	52
Proceeds from exercise of stock options	109	145
Net cash provided by (used in) financing activities	7,668	(24,441)
Change in cash	13,586	17,739
Cash at beginning of period	6,139	531
Cash at end of period	19,725	18,270
Supplemental disclosures of cash flow information:
Interest paid	1,489	765
Income taxes paid	$ 10,635	$ 8,208