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Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Cash flows from operating activities: |  |  |
Net (loss) income | $ (1,497,702) | $ 268,629 | $ 320,372
Loss (income) from discontinued operations | 347,608 | (10,018) | (14,930)
Adjustments to reconcile net income to net cash provided from operating activities: |  |  |
Depreciation and amortization | 78,860 | 83,832 | 78,856
Goodwill impairment | 1,449,215 | 0 | 0
Amortization of premiums, discounts and issuance costs | 5,672 | 4,572 | 5,514
Stock-based compensation expense | 35,351 | 37,910 | 28,778
Deferred income taxes | (177,000) | (25,647) | (61,233)
Other | 389 | (10,903) | (3,782)
Changes in assets and liabilities: |  |  |
Accounts receivable | 7,854 | (43,408) | 10,784
Prepaid expenses and other current assets | (9,998) | (6,074) | (3,015)
Other long-term assets | 37,989 | 68 | (2,950)
Accounts payable and accrued expenses | 104,161 | 45,943 | 34,882
Income taxes payable | (24,119) | (61,256) | 73,050
Payments of contingent consideration liabilities | (1,170) | (1,093) | (750)
Long-term professional liabilities | 9,844 | (4,490) | 18,478
Other liabilities | (28,487) | (3,957) | (687)
Net cash provided by operating activities—continuing operations | 338,467 | 274,108 | 483,367
Net cash provided by operating activities—discontinued operations | 8,170 | 15,817 | 28,011
Net cash provided by operating activities | 346,637 | 289,925 | 511,378
Cash flows from investing activities: |  |  |
Acquisition payments, net of cash acquired | (111,975) | (114,491) | (531,232)
Purchases of investments | (35,101) | (15,884) | (27,723)
Proceeds from maturities or sales of investments | 51,105 | 13,710 | 25,410
Purchases of property and equipment | (31,881) | (30,479) | (26,150)
Proceeds from sales of businesses | 249,730 | 22,764 | 0
Other | 0 | 0 | 6,705
Net cash provided by (used in) investing activities—continuing operations | 121,878 | (124,380) | (552,990)
Net cash used in investing activities—discontinued operations | (19,423) | (18,389) | (23,623)
Net cash provided by (used in) investing activities | 102,455 | (142,769) | (576,613)
Cash flows from financing activities: |  |  |
Borrowings on credit agreement | 1,247,300 | 1,723,500 | 2,846,000
Payments on credit agreement | (1,986,800) | (2,094,500) | (2,699,000)
Proceeds from issuance of senior notes | 500,000 | 500,000 | 0
Payments for financing costs | (9,194) | (7,090) | (3,525)
Payments of contingent consideration liabilities | (10,120) | (5,263) | (5,449)
Payments on finance lease obligations | (234) | (1,339) | (1,659)
Proceeds from issuance of common stock | 11,258 | 16,258 | 23,276
Contribution from noncontrolling interests | 0 | 0 | 894
Repurchases of common stock | (145,280) | (302,160) | (70,192)
Net cash (used in) provided by financing activities—continuing operations | (393,070) | (170,594) | 90,345
Net cash used in financing activities—discontinued operations | 0 | (17) | (608)
Net cash (used in) provided by financing activities | (393,070) | (170,611) | 89,737
Net increase (decrease) in cash and cash equivalents | 56,022 | (23,455) | 24,502
Cash, cash equivalents and restricted cash at beginning of year | 56,745 | 80,200 | 55,698
Less cash and cash equivalents of discontinued operations at end of year | 0 | (11,254) | (13,843)
Cash and cash equivalents and restricted cash at end of year | 112,767 | 45,491 | 66,357
Supplemental disclosure of cash flow information: |  |  |
Interest | 95,444 | 82,540 | 73,837
Income taxes | 86,268 | 185,416 | 75,427
Non-cash investing and financing activities: |  |  |
Value of common stock issued for acquisitions | 0 | 0 | 2,657
Equipment financed through finance leases | 0 | 0 | 684
Property and equipment included in accounts payable | $ 2,400 | $ 2,415 | $ 1,918

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