CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Net revenue:
Net revenue	$ 1,788,336	$ 1,810,923	$ 3,527,825	$ 3,616,000
Costs and expenses:
Cost of care	1,001,886	935,814	1,943,847	1,864,475
Cost of goods sold	461,187	558,419	950,980	1,118,084
Direct service costs and other operating expenses	266,434	259,152	538,358	528,229
Depreciation and amortization	33,490	33,848	64,198	64,255
Interest expense	9,141	8,678	18,248	17,044
Interest and other income	(5,021)	(3,363)	(9,995)	(5,839)
Total costs and expenses	1,767,117	1,792,548	3,505,636	3,586,248
Income before income taxes	21,219	18,375	22,189	29,752
Provision for income taxes	7,606	4,824	8,145	4,749
Net income	$ 13,613	$ 13,551	$ 14,044	$ 25,003
Net income per common share:
Basic (in dollars per share)	$ 0.56	$ 0.55	$ 0.58	$ 1.02
Diluted (in dollars per share)	$ 0.56	$ 0.53	$ 0.58	$ 0.98
Other comprehensive income:
Unrealized gains (losses) on available-for-sale securities	$ 419	$ 132	$ 739	$ (187)
Comprehensive income	14,032	13,683	14,783	24,816
Managed care and other
Net revenue:
Net revenue	1,283,143	1,215,340	2,507,122	2,435,103
PBM
Net revenue:
Net revenue	$ 505,193	$ 595,583	$ 1,020,703	$ 1,180,897