CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities:
Net income	$ 17,469	$ 13,391
Adjustments to reconcile net income to net cash used in operating activities:
Depreciation and amortization	26,976	25,007
Non-cash interest expense	253	102
Non-cash stock compensation expense	10,140	8,887
Non-cash income tax benefit	(1,010)	(538)
Non-cash amortization on investments	1,112	1,844
Cash flows from changes in assets and liabilities, net of effects from acquisitions of businesses:
Accounts receivable, net	(27,699)	(13,538)
Pharmaceutical inventory	(3,379)	(5,121)
Other assets	(1,172)	(35,839)
Accounts payable and accrued liabilities	(52,838)	11,406
Medical claims payable and other medical liabilities	(5,160)	(38,292)
Contingent consideration	(49)	734
Tax contingencies	506	289
Deferred credits and other long-term liabilities	4,150	(227)
Other	(421)	34
Net cash used in operating activities	(31,122)	(31,861)
Cash flows from investing activities:
Capital expenditures	(10,939)	(15,611)
Acquisitions and investments in businesses, net of cash acquired	(200)	(15,641)
Purchase of investments	(141,432)	(157,020)
Maturity of investments	131,840	144,902
Net cash used in investing activities	(20,731)	(43,370)
Cash flows from financing activities:
Proceeds from issuance of debt	200,000
Payments to acquire treasury stock		(7,992)
Proceeds from exercise of stock options and warrants	4,945	7,784
Payments on debt and capital lease obligations	(182,738)	(4,154)
Payments on contingent consideration		(2,000)
Other	(1,275)	(72)
Net cash (used in) provided by financing activities	20,932	(6,434)
Net decrease in cash and cash equivalents	(30,921)	(81,665)
Cash and cash equivalents at beginning of period	304,508	249,029
Cash and cash equivalents at end of period	273,587	167,364
Non-cash investing activities:
Property and equipment acquired under capital leases	$ 906	$ 1,293