CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Cash flows from operating activities:
Net income from continuing operations	$ 56,091	$ 43,634	$ 42,836
Net loss from discontinued operations	(184,706)	(74,952)	(48,397)
Adjustments to reconcile net income (loss) to net cash provided by operating activities, net of business acquisitions:
Depreciation and amortization	31,292	49,855	53,378
Amortization of deferred loan costs	2,209	2,520	1,855
Amortization of debt discount	7,564	7,148	6,757
Share-based employee compensation expense	17,538	10,469	8,349
Loss on sale of MeYou Health	5,325	0	0
Loss on sale of TPHS Business	192,034	0	0
Gain on sale of navvis business	0	(1,873)	0
Equity in (income) loss from joint ventures	(271)	20,229	0
Deferred income taxes	(75,942)	(5,916)	(6,972)
Excess tax benefits from share-based payment arrangements	0	0	(525)
Decrease (increase) in accounts receivable, net	8,330	16,971	(38,130)
Decrease in other current assets	2,819	2,796	1,589
(Decrease) increase in accounts payable	(3,376)	5,248	(9,343)
(Decrease) increase in accrued salaries and benefits	(8,755)	(4,345)	3,165
(Decrease) increase in other current liabilities	(4,825)	(11,764)	26,990
Other	(7,425)	940	10,546
Net cash flows provided by operating activities	37,902	60,960	52,098
Cash flows from investing activities:
Acquisition of property and equipment	(14,474)	(34,730)	(42,991)
Investment in joint ventures	(1,298)	(5,881)	(7,050)
Proceeds from sale of MeYou Health	5,156	0	0
Proceeds From sale of navvis	0	4,369	0
Payments related to sale of TPHS business	(27,469)	0	0
Other	(787)	(1,121)	(1,164)
Net cash flows used in investing activities	(38,872)	(37,363)	(51,205)
Cash flows from financing activities:
Proceeds from issuance of long-term debt	515,666	572,981	467,126
Payments of long-term debt	(527,115)	(597,837)	(481,515)
Excess tax benefits from share-based payment arrangements	0	0	525
Exercise of stock options	10,002	2,467	2,851
Repurchase of common stock	0	(1,833)	0
Deferred loan costs	(424)	(892)	(391)
Proceeds from non-controlling interest	0	1,615	0
Change in cash overdraft and other	2,834	1,648	11,227
Net cash flows provided by (used in) financing activities	963	(21,851)	(177)
Effect of exchange rate changes on cash	(261)	(1,641)	(1,535)
Less: net (decrease) increase in discontinued operations cash and cash equivalents	(1,637)	388	(347)
Net increase (decrease) in cash and cash equivalents	1,369	(283)	(472)
Cash and cash equivalents, beginning of period	233	516	988
Cash and cash equivalents, end of period	1,602	233	516
Supplemental disclosure of cash flow information:
Cash paid during the period for interest	7,474	8,303	9,503
Cash paid during the period for income taxes	1,458	262	2,399
Noncash Activities:
Issuance of CareFirst Warrants	192	2,408	1,639
Assets acquired through capital lease obligation	0	898	6,702
Conversion of CareFirst Convertible Note	$ 20,000	$ 0	$ 0