Note 13 - Segment and Geographical Information

9 Months Ended

Sep. 30, 2013

Segment Reporting [Abstract]

Segment Reporting Disclosure [Text Block]

(13)            Segment and Geographical Information

The Company applies the provisions of ASC Topic 280, Segment Reporting, (“ASC Topic 280”). ASC 280, which is based on a management approach to segment reporting, establishes requirements to report selected segment information quarterly and to report annually entity-wide disclosures about products, major customers and the geographies in which the entity holds material assets and reports revenue. An operating segment is defined as a component that engages in business activities whose operating results are reviewed by the chief operating decision maker and for which discrete financial information is available. Based on the provisions of ASC 280, the Company has determined that it operates in one segment. The Company manages its resources and assesses its performance on an enterprise-wide basis. The Company’s product groups qualify for aggregation under ASC 280 due to their similarities in customer base, economic characteristics, and the nature of products and services provided. Additionally, for the three and nine months ended September 30, 2012 and 2013, each of the Company’s peer review, bill review, and related services, comprised less than 10% of the Company’s consolidated revenues.

Information relating to the Company’s revenues and long-lived assets by geography is as follows (in thousands):

Revenues:	For the three months ended September 30,				For the nine months ended September 30,
	2012		2013		2012		2013
United States	$	84,784	$	93,963	$	260,442	$	280,634
Canada		6,553		7,290		20,457		22,986
United Kingdom		33,521		34,604		95,474		103,645
Australia		5,227		16,497		5,227		49,940
Total	$	130,085	$	152,354	$	381,600	$	457,205

Long-lived assets: (1)	December 31, 2012		September 30, 2013
United States	$	337,831	$	321,286
Canada		34,919		26,242
United Kingdom		99,140		95,409
Australia		94,291		78,415
Total	$	566,181	$	521,352

(1)  Long-lived assets are noncurrent assets excluding deferred tax assets and deferred financing costs.