CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Net revenue:
Net revenue	$ 1,739,489	$ 1,805,077
Costs and expenses:
Cost of care	941,961	928,661
Cost of goods sold	489,793	559,665
Direct service costs and other operating expenses	271,924	269,077
Depreciation and amortization	30,708	30,407
Interest expense	9,107	8,366
Interest and other income	(4,974)	(2,476)
Total costs and expenses	1,738,519	1,793,700
Income before income taxes	970	11,377
(Benefit) provision for income taxes	539	(75)
Net income	$ 431	$ 11,452
Net income per common share:
Basic (in dollars per share)	$ 0.02	$ 0.47
Diluted (in dollars per share)	$ 0.02	$ 0.45
Other comprehensive income:
Unrealized (losses) gains on available-for-sale securities	$ 320	$ (319)
Comprehensive income	751	11,133
Managed care and other
Net revenue:
Net revenue	1,223,979	1,219,763
PBM
Net revenue:
Net revenue	$ 515,510	$ 585,314