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CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands
6 Months Ended
Jun. 30, 2011
Jun. 30, 2010
Cash flows from operating activities:    
Net income $ 68,529 $ 60,947
Adjustments to reconcile net income to net cash provided by (used in) operating activities:    
Depreciation and amortization 28,219 27,657
Non-cash interest expense 213 361
Non-cash stock compensation expense 8,983 8,234
Non-cash income tax expense 6,885 18,039
Cash flows from changes in assets and liabilities, net of effects from acquisitions of businesses:    
Restricted cash 13,697 35,956
Accounts receivable, net (77,031) (2,445)
Other assets (21,141) 5,674
Accounts payable and accrued liabilities (27,098) (25,050)
Medical claims payable and other medical liabilities (12,390) (7,638)
Other 9,246 4,454
Net cash provided by (used in) operating activities (1,888) 126,189
Cash flows from investing activities:    
Capital expenditures (26,693) (21,681)
Acquisitions and investments in businesses, net of cash acquired (274)  
Purchase of investments (187,807) (96,515)
Maturity of investments 123,043 84,959
Net cash used in investing activities (91,731) (33,237)
Cash flows from financing activities:    
Payments on long-term debt and capital lease obligations   (588)
Payments to acquire treasury stock (211,451) (74,427)
Proceeds from issuance of equity 20,000  
Proceeds from exercise of stock options and warrants 28,842 17,148
Other 391 (1,504)
Net cash used in financing activities (162,218) (59,371)
Net increase (decrease) in cash and cash equivalents (255,837) 33,581
Cash and cash equivalents at beginning of period 337,179 196,507
Cash and cash equivalents at end of period $ 81,342 $ 230,088