CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2020	Mar. 31, 2019
OPERATING ACTIVITIES
Net income	$ 7,109	$ 11,685
Adjustments to reconcile net income to net cash provided by operating activities:
Credit loss expense	6,020	5,148
Depreciation and amortization	10,485	10,021
Stock-based compensation	3,382	2,549
Accretion of debt discount	261	311
Deferred income taxes	4,079	(1,416)
Change in fair value of acquisition-related contingent consideration	(290)	0
Other non-cash items	1,201	32
Changes in operating assets and liabilities:
Healthcare and other accounts receivable	(12,135)	(11,397)
Inventory	(1,874)	(1,633)
Prepaid expenses and other assets	3,007	(588)
Accounts payable	1,141	8,026
Accrued and other liabilities	(9,683)	(5,194)
Net cash provided by operating activities	12,703	17,544
INVESTING ACTIVITIES
Acquisition of business, net of cash acquired	0	(44,566)
Purchases of property and equipment and investment in internally developed software	(6,984)	(5,334)
Net cash used in investing activities	(6,984)	(49,900)
FINANCING ACTIVITIES
Proceeds related to the exercising of stock options and employee stock purchase plan	1,719	4,311
Payments of tax withholdings related to vesting of share-based awards	(1,467)	(4,911)
Principal payments on long-term debt	(197,825)	(1,281)
Proceeds from borrowings on revolving credit facility	232,000	0
Payments of debt issuance costs	(1,678)	0
Principal payments on finance lease obligations	(179)	(1,163)
Net cash provided by/(used in) financing activities	32,570	(3,044)
Effect of exchange rate changes on cash	(58)	(2)
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect	38,231	(35,402)
Cash and cash equivalents - beginning of period	68,614	80,889
Cash and cash equivalents - end of period	106,845	45,487
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Non-cash purchases of property and equipment	5,045	2,584
Cash paid for interest	1,960	2,106
Cash paid for taxes	$ 50	$ 0

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Name:	us-gaap_RepaymentsOfLongTermCapitalLeaseObligations
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 15
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3291-108585

+ Details

Name:	us-gaap_RepaymentsOfLongTermDebt
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration

- Definition

Amount of noncash expense for share-based payment arrangement.

+ References

+ Details

Name:	us-gaap_ShareBasedCompensation
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	duration

- References

No definition available.

+ Details

Name:	us-gaap_SupplementalCashFlowInformationAbstract
Namespace Prefix:	us-gaap_
Data Type:	xbrli:stringItemType
Balance Type:	na
Period Type:	duration