CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (USD $) In Thousands, except Per Share data, unless otherwise specified	12 Months Ended
	Dec. 31, 2013		Dec. 31, 2012		Dec. 31, 2011
Net revenue:
Managed care and other	$ 3,063,049		$ 2,857,099		$ 2,551,991
PBM and dispensing revenue	483,268		350,298		247,409
Total net revenue	3,546,317		3,207,397		2,799,400
Costs and expenses:
Cost of care	2,232,976		2,071,890		1,784,724
Cost of goods sold	455,601		328,414		232,038
Direct service costs and other operating expenses	619,546	[1]	557,512	[1]	529,634	[1]
Depreciation and amortization	71,994		60,488		58,623
Interest expense	3,000		2,247		2,502
Interest and other income	(1,985)		(2,019)		(2,781)
Total costs and expenses	3,381,132		3,018,532		2,604,740
Income before income taxes	165,185		188,865		194,660
Provision for income taxes	39,924		37,838		65,037
Net income	125,261		151,027		129,623
Net income per common share -basic: (in dollars per share)	$ 4.63		$ 5.51		$ 4.25
Net income per common share -diluted: (in dollars per share)	$ 4.53		$ 5.42		$ 4.17
Other comprehensive (loss) income
Unrealized (losses) gains on available-for-sale securities	(58)	[2]	115	[2]	(159)	[2]
Comprehensive income	$ 125,203		$ 151,142		$ 129,464

[1] Includes stock compensation expense of $17,418, $17,783 and $21,252 for the years ended December 31, 2011, 2012 and 2013, respectively.

[2] Net of income tax (benefit) provision of $(102), $73 and $(38) for the years ended December 31, 2011, 2012 and 2013, respectively.