XML 45 R5.htm IDEA: XBRL DOCUMENT v3.2.0.727
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2015
Jun. 30, 2014
Cash flows from operating activities:    
Net income $ 152,637 $ 142,685
Adjustments to reconcile net income to net cash provided from operating activities:    
Depreciation and amortization 29,161 20,732
Net change in fair value of contingent consideration liabilities (261) 460
Stock-based compensation expense 15,764 15,849
Equity in earnings of unconsolidated affiliate (1,566) (150)
Distribution of earnings from unconsolidated affiliate 2,062  
Deferred income taxes 17,535 7,492
Changes in assets and liabilities:    
Accounts receivable (2,125) (42,013)
Prepaid expenses and other assets (2,680) (3,055)
Other assets 3,859 632
Accounts payable and accrued expenses (119,527) (64,349)
Income taxes payable (12,135) 3,009
Payments of contingent consideration liabilities (792) (3,767)
Long-term professional liabilities 5,289 4,424
Other liabilities 5,228 2,472
Net cash provided from operating activities 92,449 84,421
Cash flows from investing activities:    
Acquisition payments, net of cash acquired (569,465) (135,497)
Purchases of investments (10,948) (9,726)
Proceeds from sales or maturities of investments 14,028 8,050
Purchases of property and equipment (12,669) (7,753)
Net cash used in investing activities (579,054) (144,926)
Cash flows from financing activities:    
Borrowings on credit facility 1,414,500 634,000
Payments on credit facility (690,500) (482,500)
Payments for credit facility amendment (1,227)  
Payments of contingent consideration liabilities (4,647) (6,910)
Payments on capital lease obligations (455) (42)
Excess tax benefit from vesting of restricted stock and exercises of stock options 8,973 9,816
Proceeds from issuance of common stock 10,956 18,388
Contribution from noncontrolling interests   1,025
Repurchases of common stock (233,601) (126,696)
Net cash provided from financing activities 503,999 47,081
Net increase (decrease) in cash and cash equivalents 17,394 (13,424)
Cash and cash equivalents at beginning of period 47,928 31,137
Cash and cash equivalents at end of period $ 65,322 $ 17,713