CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Operating activities:
Net income	$ 38,999	$ 33,809
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	9,680	9,024
Provision for bad debts	8,238	11,658
Stock-based compensation expense	4,522	3,518
Deferred income taxes	6,245	6,062
Gain (Loss) on disposal of assets	(23)	1,389
Goodwill and Intangible Asset Impairment	81
Changes in operating assets and liabilities, net of acquisitions:
Receivables	(19,569)	(21,175)
Prepaid expenses and other assets	(3,859)	450
Prepaid income taxes	(4,879)	(2,482)
Accounts payable and accrued expenses	26,038	17,633
Income taxes payable	(3,499)
Net amounts due to/from governmental entities	(279)	(2,043)
Net cash provided by operating activities	61,695	57,843
Investing activities:
Purchases of property, building and equipment	(7,944)	(14,576)
Cash paid for acquisitions, primarily goodwill and intangible assets	(61,247)	(20,332)
Other		273
Net cash used in investing activities	(69,191)	(34,635)
Financing activities:
Proceeds from line of credit	63,000	38,000
Payments on line of credit	(31,000)	(44,000)
Proceeds from employee stock purchase plan	776	663
Payments on debt	(192)	(156)
Noncontrolling interest distributions	(8,406)	(6,859)
Excess tax benefits from vesting of stock awards		1,293
Withholding taxes paid on stock-based compensation	(3,091)	(1,931)
Purchase of additional controlling interest	(184)
Sale of noncontrolling interest	251	52
Proceeds from exercise of stock options	0	109
Net cash (used in) provided by financing activities	21,154	(12,829)
Change in cash	13,658	10,379
Cash at beginning of period	3,264	6,139
Cash at end of period	16,922	16,518
Supplemental disclosures of cash flow information:
Interest paid	2,694	2,329
Income taxes paid	$ 22,376	$ 11,390