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Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Summary of Components of Income Tax Provision

The components of the income tax provision (benefit) are as follows (in thousands):

		December 31,
		2018				2017				2016
Federal:
Current		$	97,754			$	130,053			$	166,758
Deferred			(20,176	)			(63,038	)			15,596
			77,578				67,015				182,354
State:
Current			26,605				20,070				4,296
Deferred			(3,973	)			2,965				2,553
			22,632				23,035				6,849
Total		$	100,210			$	90,050			$	189,203

Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate

The differences between the effective rate and the United States federal income tax statutory rate are as follows:

		December 31,
		2018				2017				2016
Tax at statutory rate			21.00	%			35.00	%			35.00	%
State income tax, net of federal benefit			4.80				3.33				2.94
Non-deductible expenses			0.44				0.49				0.43
Change in accrual estimates relating to uncertain tax positions			0.05				0.02				(2.11	)
Change in valuation allowance			—				—				0.48
Other, net			1.20				0.16				0.06
Change in tax law			(0.32	)			(17.06	)			—
Income tax provision			27.17	%			21.94	%			36.80	%

Significant Components of Deferred Income Tax Assets and Liabilities

All of the Company’s deferred tax assets and liabilities are classified as long-term. The significant components of deferred income tax assets and liabilities are as follows (in thousands):

		December 31,
		2018				2017
Allowance for uncollectible accounts		$	194,876			$	80,056
Reserves and accruals			59,270				45,454
Stock-based compensation			9,201				7,975
Net operating loss carryforward			25,226				28,569
Property and equipment			26				685
Other			1,197				970
Deferred tax assets before valuation allowance			289,796				163,709
Less: Valuation allowance			(2,628	)			(2,615	)
Deferred tax assets, net of valuation allowance			287,168				161,094
Gross deferred tax liabilities:
Amortization			(286,552	)			(258,618	)
Accounting method changes			(109,418	)			(4,150	)
Accrual to cash adjustment			(39	)			(31,290	)
Other			(489	)			—
Total deferred tax liabilities			(396,498	)			(294,058	)
Net deferred tax liability		$	(109,330	)		$	(132,964	)

Schedule of Activity Related to Gross Unrecognized Tax Benefits

The following table summarizes the activity related to the Company’s liability for uncertain tax positions for the years ended December 31, 2018, 2017 and 2016 (in thousands):

		Years Ended December 31,
		2018				2017				2016
Balance at beginning of year		$	10,972			$	9,469			$	18,447
Increases related to prior year tax positions			385				2,284				301
Decreases related to prior year tax positions			—				(143	)			(3,927	)
Increases related to current year tax positions			2,900				1,430				2,258
Settlements			—				—				(5,644	)
Decreases related to lapse of statutes of limitation			(3,072	)			(2,068	)			(1,966	)
Balance at end of year		$	11,185			$	10,972			$	9,469

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Tabular disclosure of the components of income tax expense attributable to continuing operations for each year presented including, but not limited to: current tax expense (benefit), deferred tax expense (benefit), investment tax credits, government grants, the benefits of operating loss carryforwards, tax expense that results from allocating certain tax benefits either directly to contributed capital or to reduce goodwill or other noncurrent intangible assets of an acquired entity, adjustments of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity, and adjustments of the beginning-of-the-year balances of a valuation allowance because of a change in circumstances that causes a change in judgment about the realizability of the related deferred tax asset in future years.

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Tabular disclosure of the components of net deferred tax asset or liability recognized in an entity's statement of financial position, including the following: the total of all deferred tax liabilities, the total of all deferred tax assets, the total valuation allowance recognized for deferred tax assets.

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Tabular disclosure of the reconciliation using percentage or dollar amounts of the reported amount of income tax expense attributable to continuing operations for the year to the amount of income tax expense that would result from applying domestic federal statutory tax rates to pretax income from continuing operations.

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Tabular disclosure for tax positions taken in the tax returns filed or to be filed for which it is more likely than not that the tax position will not be sustained upon examination by taxing authorities and other income tax contingencies. Includes, but is not limited to, interest and penalties, reconciliation of unrecognized tax benefits, unrecognized tax benefits that would affect the effective tax rate, tax years that remain subject to examination by tax jurisdictions, and information about positions for which it is reasonably possible that amounts unrecognized will significantly change within 12 months.

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