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Acquisitions and divestitures (Tables)
9 Months Ended
Sep. 30, 2021
Business Combinations [Abstract]  
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]
The following table summarizes the assets acquired and liabilities assumed in these transactions and recognized at their acquisition dates at estimated fair values, as well as the estimated fair value of the noncontrolling interests assumed in these transactions:
Current assets$5,655 
Property and equipment4,154 
Noncompetition agreements and other long-term assets4,451 
Indefinite-lived licenses2,448 
Goodwill53,619 
Liabilities assumed(9,456)
Noncontrolling interests(3,921)
$56,950 
Schedule of Business Acquisitions by Acquisition, Contingent Consideration
The following is a reconciliation of changes in contingent earn-out obligations for the three and nine months ended September 30, 2021:
Three months ended
September 30, 2021
Nine months ended
September 30, 2021
Beginning balance $28,342 $30,248 
Acquisitions487 3,181 
Foreign currency translation(1,954)(979)
Fair value remeasurements(1,166)(1,320)
Payments(2,952)(8,373)
Ending balance$22,757 $22,757