Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Document Period End Date	Jun. 30, 2015
Cash flows from operating activities:
Net income	$ 37,372	$ 28,996
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	5,167	4,993
Benefit for deferred taxes	(6,014)	(1,668)
Share based compensation	839	882
Provision for doubtful accounts	301	748
Debt discount amortization on convertible debt	8	18
Unrealized foreign exchange (gain)	(920)	517
(Gain) loss on put option	0	(315)
Reduction of acquisition earnout accruals	0	(1,762)
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	(3,662)	(2,992)
Other assets	(2,606)	917
Accounts payable and accrued expenses	(18,802)	(1,914)
Accrued payroll and related benefits	1,104	2,007
Deferred revenue	(2,036)	(1,128)
Deferred rent	(125)	(195)
Unrecognized tax benefits, period increase (decrease)	108	3,866
Loss Contingency Accrual, Period Increase (Decrease)	(690)	(4,218)
Other current liabilities	111	(128)
Net cash provided by operating activities	10,155	28,624
Cash flows from investing activities:
Purchases of marketable securities	(704)	(567)
Capital expenditures	(10,312)	(13,852)
Net cash used in investing activities	(23,496)	(22,522)
Cash flows from financing activities:
Proceeds from / (Repayments) of Lines of Credit	30,000	(15,000)
Principal payments of term loan obligation	0	(4,813)
Repurchases of common stock	(34,481)	(2,234)
Excess tax benefit from share-based compensation	63	(3,200)
Proceeds from the exercise of stock options	1,117	788
Forfeiture of certain shares to satisfy exercise costs and the recipients income tax obligations related to stock options exercised and restricted stock vested	(1,141)	(30)
Dividend payments	(5,389)	(5,793)
Principal payments of debt obligations	(623)	(321)
Payments of capital lease obligations	(1)	(103)
Net cash used in financing activities	(10,455)	(30,706)
Effect of foreign exchange rates on cash	(1,081)	833
Net change in cash and cash equivalents	(24,877)	(23,771)
Cash and cash equivalents at the beginning of the period	52,300	56,674
Cash and cash equivalents at the end of the period	27,423	32,903
Supplemental disclosures of cash flow information:
Interest paid	2,964	436
Income taxes paid	20,926	6,774
Via Media Health [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	(1,000)	0
PB Systems [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	(11,480)	0
Healthcare Magic [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	0	(5,856)
Curepet, Inc. [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	0	3
Taimma [Member]
Payment of acquisition earn-out contingency, Taimma	$ 0	$ (2,250)