Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Cash flows from operating activities:
Net earnings	$ 84,704	$ 68,755
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	29,072	22,818
Amortization of deferred loan costs	2,140	2,074
Provision for uncollectibles	99,440	73,999
Net loss on deconsolidations	0	223
Share-based compensation	7,168	3,709
Excess tax benefit from share-based compensation	(3,605)	(3,317)
Deferred income taxes	6,602	3,334
Equity in earnings of unconsolidated affiliates	(6,579)	(2,651)
Increases (decreases) in cash and cash equivalents, net of acquisitions and dispositions:
Accounts receivable	(114,523)	(74,214)
Supplies inventory	(178)	(30)
Prepaid and other current assets	(8,423)	13,842
Accounts payable	(6,108)	(2,526)
Accrued expenses and other liabilities	(11,056)	(7,886)
Other, net	3,119	697
Net cash flows provided by operating activities	81,773	98,827
Cash flows from investing activities:
Acquisitions and related expenses	(2,990)	(126,578)
Acquisition of property and equipment	(15,691)	(14,783)
Maturities of marketable securities	2,240	0
Other	(1,509)	(220)
Net cash flows used in investing activities	(17,950)	(141,581)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	16,197	2,227
Repayment on long-term borrowings and revolving credit facility	(40,332)	(5,213)
Distributions to noncontrolling interests	(56,801)	(47,202)
Proceeds from issuance of common stock upon exercise of stock options	276	1,746
Repurchase of common stock	(5,688)	(3,684)
Other	1,748	2,957
Net cash flows used in financing activities	(84,600)	(49,169)
Net decrease in cash and cash equivalents	(20,777)	(91,923)
Cash and cash equivalents, beginning of period	106,660	208,079
Cash and cash equivalents, end of period	85,883	116,156
Supplemental cash flow information:
Interest payments	41,250	40,043
Income tax paid, net of refunds	$ 8,897	$ (88)