Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income	$ 19,298	$ 109,254
Less: Loss from discontinued operations, net of tax	(17,456)	(175)
Net income from continuing operations	36,754	109,429
Adjustments to reconcile net income from continuing operations to net cash provided by operating activities:
Depreciation and amortization	142,042	141,948
Amortization of debt issuance costs	3,836	4,103
Amortization of operating lease assets	11,675	0
Impairment loss	47,912	82
Provision for bad debt and claim losses	11,546	11,113
Share-based compensation	26,863	29,574
Equity in earnings of affiliates, net of taxes	(497)	(2,909)
Gain on sale of property and equipment	(3)	(19)
Loss on early extinguishment of debt	1,453	0
Deferred income tax	(10,642)	10,279
Loss/(gain) on investments and other, net	473	(5,124)
Tax indemnification release	13,394	0
Change in operating assets and liabilities, net of acquisitions:
Accounts receivable	(33,071)	2,619
Prepaid expenses and other current assets	(7,132)	(7,617)
Accounts payable and other accrued expenses	(18,023)	(22,037)
Contract liabilities	19,629	(18,406)
Income taxes	31,239	7,847
Dividends received from investments in affiliates	0	775
Other assets and other liabilities	(29,208)	(9,353)
Net cash provided by operating activities - continuing operations	248,240	252,304
Net cash used in operating activities - discontinued operations	(1,148)	(4)
Total cash provided by operating activities	247,092	252,300
Cash flows from investing activities:
Purchases of property and equipment	(63,196)	(41,020)
Purchases of capitalized data and other intangible assets	(29,443)	(25,013)
Cash paid for acquisitions, net of cash acquired	(13,280)	(140,977)
Purchases of investments	(658)	0
Cash received from sale of business-lines	4,109	3,245
Proceeds from sale of property and equipment	3	198
Proceeds from investments	5,591	980
Net cash used in investing activities - continuing operations	(96,874)	(202,587)
Net cash provided by investing activities - discontinued operations	0	0
Total cash used in investing activities	(96,874)	(202,587)
Cash flows from financing activities:
Proceeds from long-term debt	1,770,000	120,095
Debt issuance costs	(9,621)	0
Repayment of long-term debt	(1,844,155)	(114,626)
Proceeds from issuance of shares in connection with share-based compensation	8,391	19,585
Payment of tax withholdings related to net share settlements	(9,645)	(12,623)
Shares repurchased and retired	(61,607)	(87,028)
Contingent consideration payments subsequent to acquisitions	(612)	0
Net cash used in financing activities - continuing operations	(147,249)	(74,597)
Net cash provided by financing activities - discontinued operations	0	0
Total cash used in financing activities	(147,249)	(74,597)
Effect of exchange rate on cash, cash equivalents and restricted cash	637	2,039
Net change in cash, cash equivalents and restricted cash	3,606	(22,845)
Cash, cash equivalents and restricted cash at beginning of period	98,250	132,154
Less: Change in cash, cash equivalents and restricted cash - discontinued operations	(1,148)	(4)
Plus: Cash swept from discontinued operations	(1,148)	(4)
Cash, cash equivalents and restricted cash at end of period	101,856	109,309
Supplemental disclosures of cash flow information:
Cash paid for interest	53,202	50,108
Cash paid for income taxes	11,558	25,406
Cash refunds from income taxes	16,812	3,271
Non-cash investing activities:
Capital expenditures included in accounts payable and other accrued expenses	$ 11,286	$ 16,911