Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Document Period End Date	Sep. 30, 2016
Cash flows from operating activities:
Net Income (Loss) Attributable to Parent	$ 69,218	$ 57,604
Net Income (Loss) Attributable to Noncontrolling Interest	133	0
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	8,088	7,932
Benefit for deferred taxes	(6,250)	(5,749)
Share based compensation	2,078	1,244
Provision for doubtful accounts	700	1,950
Debt discount amortization on convertible debt	0	13
Unrealized foreign exchange gain	(328)	(2,008)
Business Combination, Bargain Purchase, Gain Recognized, Amount	(1,162)	0
Capitalized Computer Software, Amortization	1,040	0
Reduction of acquisition earnout accruals	(1,726)	(1,533)
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	(11,205)	(6,328)
Other assets	(3,402)	(3,606)
Accounts payable and accrued expenses	(4,499)	(21,448)
Accrued payroll and related benefits	79	1,100
Deferred revenue	(290)	(3,096)
Deferred rent	(168)	(111)
Unrecognized tax benefits, period increase (decrease)	700	594
Loss Contingency Accrual, Period Increase (Decrease)	0	(690)
Other current liabilities	44	(205)
Net cash provided by operating activities	53,050	25,663
Cash flows from investing activities:
Payments to Develop Software	(1,034)	0
Payments to Acquire Interest in Joint Venture, net of cash acquired	(696)	(6,000)
Purchases of marketable securities	(1,078)	(940)
Capital expenditures	(4,420)	(12,713)
Net cash used in investing activities	(7,228)	(32,128)
Cash flows from financing activities:
Proceeds from (Repayments of) Lines of Credit	(72,436)	66,000
Proceeds from Issuance of Other Long-term Debt	125,000	0
Repurchases of common stock	(43,775)	(67,780)
Excess tax benefit from share-based compensation	0	63
Proceeds from the exercise of stock options	29	1,117
Forfeiture of certain shares to satisfy exercise costs and the recipients income tax obligations related to stock options exercised and restricted stock vested	(147)	(1,141)
Dividend payments	(7,401)	(7,989)
Principal payments of debt obligations	(600)	(638)
Repayments of Long-term Capital Lease Obligations	4	3
Net cash used in financing activities	(2,459)	(10,371)
Repayments of Other Long-term Debt	3,125	0
Effect of foreign exchange rates on cash	(736)	(2,264)
Net change in cash and cash equivalents	42,627	(19,100)
Cash and cash equivalents at the beginning of the period	57,179	52,300
Cash and cash equivalents at the end of the period	99,806	33,200
Supplemental disclosures of cash flow information:
Interest paid	5,318	4,002
Income taxes paid	14,068	24,663
Via Media Health [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	0	(1,000)
PB Systems [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	$ 0	$ (11,475)