CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income	$ 33,097	$ 113,402
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization	67,613	88,061
Special charges and other	8,119	24,908
Gain on sale of MCC	(16,713)
Non-cash interest expense	1,066	1,297
Non-cash stock compensation expense	19,384	18,854
Non-cash income tax (benefit) provision	13,883	(26,537)
Non-cash accretion on investments	2,271	2,371
Changes in assets and liabilities, net of effects from acquisitions of businesses:
Accounts receivable, net	(30,846)	(78,682)
Pharmaceutical inventory	3,502	7,325
Other assets	(75,253)	(66,612)
Accounts payable and accrued liabilities	(89,065)	110,710
Medical claims payable and other medical liabilities	111,063	47,478
Tax contingencies	1,478	1,914
Deferred credits and other long-term liabilities	6,936	(11,572)
Other	3,521	(965)
Net cash provided by operating activities	60,056	231,952
Net cash provided by operating activities from discontinued operations		177,800
Net cash provided by operating activities from continuing operations	60,056	54,152
Cash flows from investing activities:
Capital expenditures	(48,000)	(56,006)
Acquisitions and investments in businesses, net of cash acquired	(2,373)	(2,066)
Purchases of investments	(779,758)	(661,004)
Proceeds from maturities and sales of investments	765,468	500,660
Net cash used in investing activities	(64,663)	(218,416)
Net cash used in investing activities from discontinued operations		(164,836)
Net cash used in investing activities from continuing operations	(64,663)	(53,580)
Cash flows from financing activities:
Proceeds from borrowings on revolving line of credit		80,000
Proceeds from exercise of stock options	17,758	48,284
Payments on debt, finance lease and deferred financing obligations	(117,706)	(126,110)
Other	(1,437)	902
Net cash provided by (used in) financing activities	(101,385)	3,076
Net cash used in financing activities from discontinued operations		(32,650)
Net cash provided by (used in) financing activities from continuing operations	(101,385)	35,726
Net increase (decrease) in cash and cash equivalents from continuing operations	(105,992)	36,298
Cash and cash equivalents at beginning of period	1,144,450	115,752
Cash and cash equivalents at end of period	$ 1,038,458	152,050
Non-cash investing activities:
Assets acquired under finance leases and deferred financing obligations		$ 3,599