HMS (HMSY) 10-Q 9 Nov 20 2020 Q3 Quarterly report Financial data

COVER PAGE

COVER PAGE - shares	9 Months Ended
	Sep. 30, 2020	Nov. 03, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2020
Document Transition Report	false
Entity File Number	000-50194
Entity Registrant Name	HMS HOLDINGS CORP
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	11-3656261
Entity Address, Address Line One	5615 High Point Drive
Entity Address, City or Town	Irving,
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	75038
City Area Code	214
Local Phone Number	453-3000
Title of 12(b) Security	Common Stock $0.01 par value
Trading Symbol	HMSY
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		88,551,634
Entity Central Index Key	0001196501
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Amendment Flag	false

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 211,034	$ 139,268
Accounts receivable, net	234,418	223,443
Prepaid expenses and other current assets	19,430	30,925
Income tax receivable	1,032	3,210
Deferred financing costs, net	564	564
Total current assets	466,478	397,410
Property and equipment, net	82,829	86,947
Goodwill	594,561	599,351
Intangible assets, net	120,755	131,849
Operating lease right-of-use assets	14,725	17,493
Deferred financing costs, net	686	1,109
Other assets	17,065	10,117
Total assets	1,297,099	1,244,276
Current liabilities:
Accounts payable, accrued expenses and other liabilities	93,956	97,747
Liability for appeals	5,179	3,570
Total current liabilities	99,135	101,317
Long-term liabilities:
Revolving credit facility	240,000	240,000
Operating lease liabilities	11,976	14,881
Net deferred tax liabilities	25,075	25,587
Other liabilities	8,974	7,626
Total long-term liabilities	286,025	288,094
Total liabilities	385,160	389,411
Commitments and contingencies
Shareholders' equity:
Preferred stock -- $0.01 par value; 5,000,000 shares authorized; none issued	0	0
Common stock -- $0.01 par value; 175,000,000 shares authorized;102,207,020 shares issued and 88,542,342 shares outstanding at September 30, 2020; 101,766,468 shares issued and 88,103,566 shares outstanding at December 31, 2019	1,022	1,018
Capital in excess of par value	499,704	479,964
Retained earnings	546,789	509,459
Treasury stock, at cost: 13,663,194 shares at September 30, 2020 and December 31, 2019	(135,576)	(135,576)
Total shareholders' equity	911,939	854,865
Total liabilities and shareholders' equity	$ 1,297,099	$ 1,244,276

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	175,000,000	175,000,000
Common stock, shares issued (in shares)	102,207,020	101,766,468
Common stock, shares outstanding (in shares)	88,542,342	88,103,566
Treasury cost, shares (in shares)	13,663,194	13,663,194

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Statement [Abstract]
Revenue	$ 165,236	$ 146,815	$ 479,302	$ 462,950
Cost of services:
Compensation	63,829	56,258	193,678	172,033
Direct project and other operating expenses	23,335	22,751	71,214	63,693
Information technology	15,160	14,207	45,188	39,627
Occupancy	3,965	4,144	12,517	12,275
Amortization of acquisition related software and intangible assets	5,506	4,158	16,575	12,490
Total cost of services	111,795	101,518	339,172	300,118
Selling, general and administrative expenses	26,241	28,232	88,861	85,514
Total operating expenses	138,036	129,750	428,033	385,632
Operating income	27,200	17,065	51,269	77,318
Interest expense	(1,926)	(2,677)	(6,135)	(8,379)
Interest income	8	1,210	266	3,291
Other (expense)/income	(1,127)	7,697	1,744	7,697
Income before income taxes	24,155	23,295	47,144	79,927
Income taxes	6,120	2,159	9,814	10,049
Net income	$ 18,035	$ 21,136	$ 37,330	$ 69,878
Basic income per common share:
Net income per common share -- basic (in dollars per share)	$ 0.20	$ 0.24	$ 0.42	$ 0.79
Diluted income per common share:
Net income per common share -- diluted (in dollars per share)	$ 0.20	$ 0.24	$ 0.42	$ 0.77
Weighted average shares:
Basic (in shares)	88,531	86,324	88,397	88,190
Diluted (in shares)	90,228	88,324	89,976	90,441

Consolidated Statement of Share

Consolidated Statement of Shareholders' Equity - USD ($) $ in Thousands	Total	Common Stock and paid-in capital	Retained earnings	Treasury stock	Shares issued
Balance, beginning of period at Dec. 31, 2018		$ 426,737	$ 422,235	$ (135,576)
Balance, beginning of period (in shares) at Dec. 31, 2018				13,663,194	98,924,501
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options		39,175
Stock-based compensation expense		18,715
Vesting of restricted stock units, net of shares withheld for employee tax		(6,970)
Net income	$ 69,878		69,878
Exercise of stock options (in shares)	2,427,156				2,427,156
Vesting of restricted stock units, net of shares withheld for employee tax (in shares)					405,022
Balance, end of period at Sep. 30, 2019	$ 834,194	477,657	492,113	$ (135,576)
Balance, end of period (in shares) at Sep. 30, 2019				13,663,194	101,756,679
Balance, beginning of period at Jun. 30, 2019		462,569	470,977	$ (135,576)
Balance, beginning of period (in shares) at Jun. 30, 2019				13,663,194	101,014,406
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options		12,177
Stock-based compensation expense		2,934
Vesting of restricted stock units, net of shares withheld for employee tax		(23)
Net income	$ 21,136		21,136
Exercise of stock options (in shares)	740,748				740,748
Vesting of restricted stock units, net of shares withheld for employee tax (in shares)					1,525
Balance, end of period at Sep. 30, 2019	$ 834,194	477,657	492,113	$ (135,576)
Balance, end of period (in shares) at Sep. 30, 2019				13,663,194	101,756,679
Balance, beginning of period at Dec. 31, 2019	854,865	480,982	509,459	$ (135,576)
Balance, beginning of period (in shares) at Dec. 31, 2019				13,663,194	101,766,468
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options		2,145
Stock-based compensation expense		21,083
Vesting of restricted stock units, net of shares withheld for employee tax		(3,484)
Net income	$ 37,330		37,330
Exercise of stock options (in shares)	119,991				119,991
Vesting of restricted stock units, net of shares withheld for employee tax (in shares)					320,561
Balance, end of period at Sep. 30, 2020	$ 911,939	500,726	546,789	$ (135,576)
Balance, end of period (in shares) at Sep. 30, 2020				13,663,194	102,207,020
Balance, beginning of period at Jun. 30, 2020		497,091	528,754	$ (135,576)
Balance, beginning of period (in shares) at Jun. 30, 2020				13,663,194	102,173,154
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of stock options		526
Stock-based compensation expense		3,133
Vesting of restricted stock units, net of shares withheld for employee tax		(24)
Net income	$ 18,035		18,035
Exercise of stock options (in shares)	28,402				28,402
Vesting of restricted stock units, net of shares withheld for employee tax (in shares)					5,464
Balance, end of period at Sep. 30, 2020	$ 911,939	$ 500,726	$ 546,789	$ (135,576)
Balance, end of period (in shares) at Sep. 30, 2020				13,663,194	102,207,020

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Operating activities:
Net income	$ 37,330	$ 69,878
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization of property, equipment and software	24,121	24,719
Amortization of intangible assets	11,094	7,009
Amortization of deferred financing costs	423	423
Gain on sale of cost basis investment	0	(7,697)
Stock-based compensation expense	21,083	18,715
Deferred income taxes	(512)	6,327
Noncash lease expense	2,768	2,955
Release of estimated liability for appeals, net	0	(10,478)
Changes in operating assets and liabilities:
Accounts receivable	(8,678)	508
Prepaid expenses and other current assets	11,495	72
Other assets	(6,948)	(1,746)
Income taxes receivable	2,178	9,926
Accounts payable, accrued expenses and other liabilities	(91)	(3,976)
Operating lease liabilities	(2,905)	(3,927)
Liability for appeals	1,609	211
Net cash provided by operating activities	92,967	112,919
Investing activities:
Acquisition of a business, net of cash acquired	1,529	(36,554)
Proceeds from sale of cost basis investment	0	9,776
Purchases of property and equipment	(8,396)	(5,840)
Investment in capitalized software	(12,766)	(10,763)
Net cash used in investing activities	(19,633)	(43,381)
Financing activities:
Proceeds from exercise of stock options	2,145	39,175
Payments of tax withholdings on behalf of employees for net-share settlements	(3,484)	(6,970)
Payments on capital lease obligations	(229)	(93)
Net cash (used in)/provided by financing activities	(1,568)	32,112
Net increase in cash and cash equivalents	71,766	101,650
Cash and Cash Equivalents
Cash and cash equivalents at beginning of year	139,268	178,946
Cash and cash equivalents at end of period	211,034	280,596
Supplemental disclosure of cash flow information:
Cash paid for income taxes/(refunds received), net of refunds	7,035	(5,303)
Cash paid for interest	3,422	8,118
Supplemental disclosure of non-cash activities:
Change in balance of accrued property and equipment purchases	$ 1,159	$ 2,291

Business and Summary of Signifi

Business and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Business and Summary of Significant Accounting Policies	Business and Summary of Significant Accounting Policies (a) Business The terms “HMS,” “Company,” “we,” “us,” and “our” refer to HMS Holdings Corp. and its consolidated subsidiaries unless the context clearly indicates otherwise. HMS is an industry-leading provider of cost containment and analytical solutions in the healthcare marketplace. Our mission is to make healthcare work better for everyone. We use data, technology and analytics to deliver payment accuracy and population health management solutions that help healthcare organizations reduce costs, improve health outcomes and enhance consumer experiences. We currently operate as one business segment with a single management team that reports to the Chief Executive Officer. The Consolidated Financial Statements and accompanying Notes in this Form 10-Q are unaudited. Accordingly, they do not include all of the information and notes required by generally accepted accounting principles (“U.S. GAAP”) for complete financial statements. The results reported in these unaudited Consolidated Financial Statements are not necessarily indicative of the results that may be expected for any subsequent interim period or the entire year. These unaudited Consolidated Financial Statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 (“2019 Form 10-K”). The consolidated balance sheet as of December 31, 2019 included herein was derived from audited financial statements, but does not include all disclosures required by U.S. GAAP. The preparation of the Company’s unaudited Consolidated Financial Statements requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent liabilities at the date of the unaudited Consolidated Financial Statements and the reported amounts of revenue and expenses during the reporting periods. Actual results could differ from those estimates. These estimates and assumptions were considered and made in context with the information reasonably available to the Company and the unknown future impacts of the novel coronavirus (COVID-19) as of September 30, 2020 and through the date of this Form 10-Q. The statements include all adjustments (which include only normal recurring adjustments, except as disclosed) that management considers necessary to present a fair statement of the Company’s results for such interim periods. These unaudited Consolidated Financial Statements include HMS accounts and transactions and those of the Company’s wholly owned subsidiaries. All significant intercompany balances and transactions have been eliminated in consolidation. (b) Summary of Significant Accounting Policies There have been no material changes to the Company’s significant accounting policies that are referenced in the 2019 Form 10-K. Recently Adopted Accounting Pronouncements In June 2016, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") No. 2016-13, Financial Instruments – Credit Losses (“ASU 2016-13”). ASU 2016-13 introduces the current expected credit losses methodology for estimating allowances for credit losses. ASU 2016-13 applies to all financial instruments carried at amortized cost and off-balance-sheet credit exposures not accounted for as insurance, including loan commitments, standby letters of credit, and financial guarantees. The new accounting standard does not apply to trading assets, loans held for sale, financial assets for which the fair value option has been elected, or loans and receivables between entities under common control. ASU 2016-13 is effective for public entities for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted this guidance on January 1, 2020. When developing an estimate of the Company's expected credit losses, the Company considers all relevant information regarding the collectability of cash flows including historical information, customers' credit history and current financial conditions, industry trends and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued ASU 2018-15, Intangibles - Goodwill and Other - Internal Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract ("ASU 2018-15"). The standard aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal use software. ASU 2018-15 is effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. The Company adopted this guidance on January 1, 2020. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurements ("ASU 2018-13"). The objective of the ASU is to improve the disclosures related to fair value measurement by removing, modifying, or adding disclosure requirements related to recurring and non-recurring fair value measurements. ASU 2018-13 is effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. The Company adopted this guidance on January 1, 2020. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. Recently Issued Accounting Pronouncements Not Yet Adopted In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes ("ASU 2019-12"). The guidance eliminates certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period, and the recognition of deferred tax liabilities for outside basis differences related to changes in ownership of equity method investments and foreign subsidiaries. The guidance also simplifies aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, and interim periods within those fiscal years. Early adoption is permitted, including adoption in any interim period for which financial statements have not been issued. This guidance is not expected to have a material impact on the Company’s financial position, results of operations or internal control framework. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting ("ASU 2020-04"). The objective of ASU 2020-04 is to provide optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The guidance is effective for all entities as of March 12, 2020 through December 31, 2022. The Company is evaluating the impact, but does not expect this guidance to have a material impact on the Company’s consolidated financial statements.

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2020
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition The Company’s revenue disaggregated by solution for the three and nine months ended September 30, 2020 and 2019 was as follows (in thousands) : Three Months Ended Nine Months Ended 2020 2019 2020 2019 Coordination of Benefits $ 113,870 $ 94,619 $ 338,661 $ 305,564 Payment Integrity 37,987 37,016 101,704 113,863 Population Health Management 13,379 15,180 38,937 43,523 Total $ 165,236 $ 146,815 $ 479,302 $ 462,950 Coordination of benefits revenue is derived from contracts with state governments, Medicaid managed care plans, and commercial entities that can span years with the option to renew. Types of service contracts could include: (a) the identification of erroneously paid claims; (b) the delivery of verified commercial insurance coverage information; (c) the identification of paid claims where another third party is liable; and (d) the identification and enrollment of Medicaid members who have access to employer insurance. Most of these types of service contracts contain multiple promises, all of which are not distinct within the context of the contract. Therefore, the promises represent a single, distinct performance obligation for the types of services we offer. Revenue derived from these performance obligations is largely based on variable consideration where, based on the number of claims or amount of findings the Company identified, a contingent or fixed transaction price/recovery percentage is allocated to each distinct performance obligation. The Company utilizes the expected value method to estimate the variable consideration related to the transaction price for its service contracts. Key inputs and assumptions in determining variable consideration include identified pricing and expected recoveries and/or savings. The expected recoveries and/or savings are based on historical experience of information received from our customers. Revenue is primarily recognized at a point in time when our customers realize economic benefits from our services when our services are completed. However, we have a limited number of fixed fee arrangements where revenue is recognized over time as performance obligations are satisfied within one within the respective contract; however, payment is typically due on demand and there is a clear and distinct history of customers making consistent payments. Payment integrity services revenue is derived from contracts with federal and state governments, commercial health plans and other at-risk entities that can span years with the option to renew. Types of service contracts could include: (a) services designed to ensure that healthcare payments are accurate and appropriate; and (b) the identification of over/under payments or inaccurate charges based on a review of medical records. Most of these types of service contracts contain multiple promises, all of which are not distinct within the context of the contract. Therefore, the promises represent a single, distinct performance obligation for the types of services we offer. Revenue derived from these performance obligations is largely based on variable consideration where, based on the amount of recovery findings the Company identifies, a contingent or fixed transaction price/recovery percentage is allocated to each distinct performance obligation. The Company utilizes the expected value method to estimate the variable consideration related to the transaction price for its service contracts. Key inputs and assumptions in determining variable consideration include identified pricing and expected recoveries and/or savings. The expected recoveries and/or savings are based on historical experience of information received from our customers. Revenue is primarily recognized at a point in time when our customers realize economic benefits from our services when our services are completed. However, we have a limited number of fixed fee arrangements where revenue is recognized over time as performance obligations are satisfied within one Payment accuracy revenue consists of revenue for our coordination of benefits and payment integrity services. Population health management revenue is derived from contracts with health plans and other risk-bearing entities that can span years with the option to renew. Types of service contracts could include: (a) programs designed to improve member engagement; and (b) outreach services designed to improve clinical outcomes. Most of these types of service contracts contain multiple promises, all of which are not distinct within the context of the contract. Therefore, the promises represent a single, distinct performance obligation for the types of services we offer. Revenue derived from these services is largely based on consideration associated with prices per order/transfer and PMPM/PMPY fees. The Company believes the output method is a reasonable measure of progress for the satisfaction of our performance obligations, which are satisfied over time, as it provides a faithful depiction of (1) our performance toward complete satisfaction of the performance obligation under the contract and (2) the value transferred to the customer of the services performed under the contract. The Company has elected the right to invoice practical expedient for recognition of revenue related to its performance obligations when the amount we have the right to invoice the customer corresponds directly with the value to the customer. Additionally, we have a limited number of fixed fee arrangements where revenue is recognized over time as performance obligations are satisfied within one The Company's accounts receivable balance is net of estimated variable consideration of $16.6 million and $17.1 million as of September 30, 2020 and December 31, 2019, respectively, related to revenue recognized based on expected recoveries and/or savings. The Company’s revenue disaggregated by market for the three and nine months ended September 30, 2020 and 2019 was as follows ( in thousands ): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Commercial $ 87,001 $ 69,711 $ 250,064 $ 225,014 State 62,233 62,830 195,046 189,752 Federal 16,002 14,274 34,192 48,184 Total $ 165,236 $ 146,815 $ 479,302 $ 462,950 A portion of the Company’s services are deferred and revenue is recognized at a later time. Deferred revenue was approximately $6.9 million and $4.2 million as of September 30, 2020 and December 31, 2019, respectively, and is included in Accounts payable, accrued expenses and other liabilities in the Consolidated Balance Sheets. Approximately $3.1 million of the December 31, 2019 balance was recognized in revenue during the nine months ended September 30, 2020. Contract modifications are routine in nature and often done to account for changes in the contract specifications or requirements. In most instances, contract modifications are for services that are not distinct, and, therefore, modifications are accounted for as part of the existing contract. The Company has elected to use the practical expedient to expense the incremental costs of obtaining a contract if the amortization period of the asset that the Company would have otherwise recognized is one year or less.

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Acquisitions	Acquisitions (a) Accent On December 23, 2019, HMS acquired West Claims Recovery Services, LLC (“Accent”), a payment accuracy and cost containment business, for aggregate consideration of cash in the amount of $157.6 million, net of post-closing adjustments, which was funded through cash on hand. Estimates and assumptions for which the Company is still obtaining or evaluating information are subject to change up to one year from the acquisition date as additional information becomes available and adjustments may require a change in the amounts allocated to goodwill during the periods in which the adjustments are determined. As of September 30, 2020, HMS has not finalized the determination of fair values allocated to various assets and liabilities, including, but not limited to: receivables; accounts payable; and goodwill. The intangible assets are valued using various methods which require several judgments, including growth rates, discount rates, customer attrition rates, and expected levels of revenues, earnings, cash flows and tax rates. The intangible assets are amortized over their estimated useful lives on a straight-line basis. Goodwill was determined based on the difference between the purchase price and the fair values of the tangible and intangible assets acquired. Goodwill recognized from the acquisition was the result of synergies to be realized from future revenue growth. Goodwill is deductible for tax purposes, has an indefinite useful life and will be included in the Company’s annual impairment testing or between annual tests if an indicator of impairment exists. The preliminary allocation of the purchase price to the fair value of the assets acquired and the liabilities assumed as of December 23, 2019, the effective date of the acquisition, as adjusted during the nine months ended September 30, 2020, is as follows ( in thousands ): Cash and cash equivalents $ 9,916 Accounts receivable 11,485 Prepaid expenses 129 Property and equipment 2,878 Intangible assets 68,400 Goodwill 76,755 Other assets 489 Accounts payable and accrued liabilities (12,431) Total purchase price $ 157,621 As of the nine months ended September 30, 2020, the Company made refinements to the December 23, 2019 preliminary purchase price allocation as reported at December 31, 2019. These refinements, primarily related to working capital, resulted in an increase in accounts receivable of $2.3 million, an increase in cash and cash equivalents of $0.5 million, a decrease in accounts payable and accrued liabilities of $1.0 million, a decrease in goodwill of approximately $4.8 million and an overall decrease in the total consideration paid due to post-closing adjustments of $1.0 million. Substantially all the receivables acquired are expected to be collectible. The purchase price allocated to the intangible assets acquired was as follows ( in thousands, except for useful life ): Useful Life Customer relationships 12 $ 67,000 Trade name 3 1,400 Fair value of intangibles acquired $ 68,400 We incurred $2.1 million of acquisition related costs related to the Accent acquisition for the year ended December 31, 2019. The costs include consulting, legal and transaction costs, and have been recorded in selling, general and administrative expenses. The financial results of Accent's operations since the date of acquisition have been included in the Company’s consolidated financial statements. For the three and nine months ended September 30, 2020, Accent contributed approximately $10.8 million and $32.4 million in revenue to HMS's results of operations, respectively. (b) VitreosHealth On September 16, 2019, HMS acquired VitreosHealth, Inc. ("VitreosHealth"), a company that offers predictive and prescriptive health insights utilized by population risk models, for aggregate consideration of $36.6 million, which was funded with cash on hand. The purchase price was subject to certain post-closing purchase price adjustments and the initial purchase price allocation as of the date of acquisition was based on a preliminary valuation. The Company's allocation of consideration exchanged to the net tangible and intangible assets acquired and liabilities assumed in the acquisition is based on estimated fair values as of September 16, 2019. The Company allocated the purchase price, net of cash acquired, to the following significant assets: intellectual property subject to amortization of $6.0 million, and goodwill of $30.2 million which represents the excess purchase price over the net identifiable tangible and intangible assets. There were no additional material allocations to assets and liabilities. The intangible assets are valued using various methods which require several judgments, including growth rates, discount rates, expected levels of revenues, earnings, cash flows and tax rates. The intangible assets are amortized over their estimated useful lives on a straight-line basis and are not expected to be deductible for tax purposes. The goodwill recognized from the acquisition was a result of expected synergies to be realized from future revenue growth, is not expected to be deductible for tax purposes, has an indefinite useful life and will be included in the Company’s annual impairment testing. The results of VitreosHealth's operations since the date of acquisition have been included in the Company's consolidated financial statements and are not considered material.

Intangible Assets, Goodwill and

Intangible Assets, Goodwill and Other Assets	9 Months Ended
	Sep. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Goodwill and Other Assets	Intangible Assets, Goodwill and Other Assets (a) Intangible Assets Intangible assets consisted of the following ( in thousands, except for weighted average amortization period ): Gross Carrying Amount Accumulated Net Carrying Amount Weighted Average Amortization Period in Years September 30, 2020 Customer relationships $ 125,423 $ (18,968) $ 106,455 11.3 Trade names 1,400 (361) 1,039 2.2 Intellectual property 27,700 (14,439) 13,261 3.5 Total $ 154,523 $ (33,768) $ 120,755 Gross Carrying Amount Accumulated Net Carrying Amount Weighted Average Amortization Period in Years December 31, 2019 Customer relationships $ 135,290 $ (21,637) $ 113,653 12.1 Trade names 1,536 (147) 1,389 3.0 Intellectual property 27,700 (10,893) 16,807 3.7 Total $ 164,526 $ (32,677) $ 131,849 Amortization expense of intangible assets is expected to approximate the following (in thousands): Year ending December 31, Amortization 2020 (excluding the nine months ended September 30, 2020) $ 3,562 2021 14,247 2022 14,235 2023 11,405 2024 10,330 Thereafter 66,976 Total $ 120,755 For the three months ended September 30, 2020 and 2019, amortization expense related to intangible assets was $3.7 million and $2.3 million, respectively. (b) Goodwill As a result of adjustments relating to the Accent acquisition, the changes in the carrying amount of goodwill were as follows ( in thousands ): Balance at December 31, 2019 $ 599,351 Accent acquisition - Adjustment (4,790) Balance at September 30, 2020 $ 594,561 (c) Other Assets Included in Other assets is a Level 1 investment in equity securities with a cost basis of $7.4 million. As of September 30, 2020 and December 31, 2019, the fair value measurement of the equity instrument was $9.6 million and $7.9 million, respectively. There were no sales, settlements issuances or transfers related to this level 1 instrument. The Company recorded a net unrealized loss of $1.2 million and an unrealized gain of $1.7 million for the three and nine months ended September 30, 2020, respectively. There were no realized or unrealized gains in the three and nine months ended September 30, 2019. These gains and losses are reflected as a component of Other (expense)/income in the accompanying Consolidated Statements of Income. During the three months ended September 30, 2019, a third party acquired one hundred percent of the outstanding stock of InstaMed Holdings, Inc. ("InstaMed") including the Company's cost based investment in Instamed of $2.1 million. As a result, the Company received proceeds of $9.8 million from the sale of the investment and recognized a $7.7 million gain in other income for the three and nine months ended September 30, 2019.

Accounts Payable, Accrued Expen

Accounts Payable, Accrued Expenses and Other Liabilities	9 Months Ended
	Sep. 30, 2020
Payables and Accruals [Abstract]
Accounts Payable, Accrued Expenses and Other Liabilities	Accounts Payable, Accrued Expenses and Other Liabilities Accounts payable, accrued expenses and other liabilities consisted of the following (in thousands) : September 30, December 31, Accounts payable, trade $ 18,190 $ 12,246 Accrued compensation and other 27,261 36,827 Accrued operating expenses 42,035 42,045 Current portion of lease liabilities 6,470 6,629 Total accounts payable, accrued expenses and other liabilities $ 93,956 $ 97,747

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company’s effective tax rate increased to 20.8% for the nine months ended September 30, 2020 from 12.6% for the nine months ended September 30, 2019. The effective tax rate for the nine months ended September 30, 2020 includes discrete tax benefits primarily related to a prior year R&D credit true-up and net equity compensation deductions. For the nine months ended September 30, 2020, the differences between the federal statutory rate and our effective tax rate are tax expense items related to state taxes, equity compensation impacts, unrecognized tax benefits, including interest, officer compensation deduction limits, research and development tax credits, and other permanent differences. The Company has current period foreign income tax expense and includes global intangible low-taxed income as current period income tax expense, both of which are not material to the overall financial statements. Included in Other liabilities on the Consolidated Balance Sheets, are the total amount of unrecognized tax benefits (net of the federal benefit for state issues) of approximately $5.3 million and $4.2 million, as of September 30, 2020 and December 31, 2019, respectively, that, if recognized, would favorably affect the Company’s future effective tax rate. Also included in Other liabilities on the Consolidated Balance Sheets, are accrued liabilities for interest expense and penalties related to unrecognized tax benefits of $0.9 million and $0.7 million as of September 30, 2020 and December 31, 2019, respectively. HMS includes interest expense and penalties in the provision for income taxes in the unaudited Consolidated Statements of Income. The amount of interest expense (net of federal and state income tax benefits) and penalties in the unaudited Consolidated Statements of Income for the nine months ended September 30, 2020 and 2019 was $0.2 million and $0.03 million, respectively. The Company believes it is reasonably possible that the amount of unrecognized tax benefits may decrease by $1.6 million over the next twelve months, due to the expiration of the statute of limitations in federal and various state jurisdictions. HMS files income tax returns with the U.S. Federal government and various state and local jurisdictions and will file income tax returns in certain foreign jurisdictions in future periods as a result of its acquisition of VitreosHealth. HMS is generally no longer subject to U.S. Federal income tax examinations for years before 2016. HMS operates in a number of state, local and foreign jurisdictions. Accordingly, HMS is subject to state, local and foreign income tax examinations based on the various statutes of limitations in each jurisdiction.

Liability for Appeals

Liability for Appeals	9 Months Ended
	Sep. 30, 2020
Other Liabilities Disclosure [Abstract]
Liability for Appeals	Liability For AppealsUnder the Company’s contracts with certain commercial health plan customers and its Medicare Recovery Audit Contractor (“RAC”) contract with the Centers for Medicare & Medicaid Services (“CMS”) (included within the Company’s payment integrity services revenue), providers have the right to appeal HMS claim findings and to pursue additional appeals if the initial appeal is found in favor of HMS’s customer. To the extent the amount to be returned to providers following a successful appeal exceeds or is less than the amount recorded, revenue in the applicable period would be reduced or increased by such amount. The liability for appeals balance was approximately $5.2 million and $3.6 million as of September 30, 2020 and December 31, 2019, respectively.

Credit Agreement

Credit Agreement	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Credit Agreement	Credit Agreement In May 2013, we entered into a credit agreement (as amended and restated, the "Credit Agreement") with certain lenders and Citibank, N.A. as administrative agent. The Credit Agreement originally provided for an initial $500 million five-year revolving credit facility maturing on May 3, 2018. On December 19, 2017, the Company entered into an amendment to the Credit Agreement, which, among other things, extended the maturity of its then existing $500 million revolving credit facility by five years to December 2022 (the "Amended Revolving Facility").The availability of funds under the Amended Revolving Facility includes sublimits for (a) up to $50 million for the issuance of letters of credit and (b) up to $25 million for swingline loans. In addition, the Company may increase the commitments under the Amended Revolving Facility and/or add one or more incremental term loan facilities, provided that such incremental facilities do not exceed in the aggregate the sum of (i) the greater of $120 million and 100% of Consolidated EBITDA (as defined in the Credit Agreement) and (ii) an additional amount so long as our first lien leverage ratio (as defined in the Credit Agreement) on a pro forma basis is not greater than 3.00:1.00, subject to obtaining commitments from the lenders and meeting certain other conditions. As of September 30, 2020 and December 31, 2019, the outstanding principal balance due on the Amended Revolving Facility was $240 million. No principal payments were made against the Amended Revolving Facility during the nine months ended September 30, 2020. Borrowings under the Amended Revolving Facility bear interest at a rate equal to, at the Company’s election (except with respect to swingline borrowings, which will accrue interest based only at the base rate), either: ▪ a base rate determined by reference to the greatest of (a) the prime or base commercial lending rate of the administrative agent as in effect on the relevant date, (b) the federal funds effective rate plus 0.50% and (c) the one-month London Interbank Offered Rate (or any successor rate determined in accordance with the Credit Agreement) (“LIBO Rate”) plus 1.00%, plus an interest margin ranging from 0.50% to 1.00% based on the Company’s consolidated leverage ratio for the applicable period; or ▪ an adjusted LIBO Rate, equal to the LIBO Rate for the applicable interest period multiplied by the statutory reserve rate (equal to (x) one divided by (y) one minus the aggregate of the maximum reserve percentage (including any marginal, special, emergency or supplemental reserves) established by the Board of Governors of the Federal Reserve System of the United States), plus an interest margin ranging from 1.50% to 2.00% based on the Company’s consolidated leverage ratio for the applicable period. In addition to paying interest on the outstanding principal, the Company is required to pay unused commitment fees on the Amended Revolving Facility during the term of the Credit Agreement ranging from 0.375% to 0.250% per annum based on the Company’s consolidated leverage ratio and letter of credit fees equal to 0.125% per annum on the aggregate face amount of each letter of credit, as well as customary agency fees. As part of a contractual agreement with a customer, the Company has an outstanding irrevocable letter of credit for $6.5 million, which is issued against the Amended Revolving Facility and expires June 30, 2021. The Amended Revolving Facility is secured, subject to certain customary carve-outs and exceptions, by a first priority lien and security interest in substantially all tangible and intangible assets of the Company and certain subsidiaries of the Company. The Amended Revolving Facility contains certain restrictive covenants, which affect, among other things, the ability of the Company and its subsidiaries to incur indebtedness, create liens, make investments, sell or otherwise dispose of assets, engage in mergers or consolidations with other entities, and pay dividends or repurchase stock. The Company is also required to comply, on a quarterly basis, with two financial covenants: (i) a minimum interest coverage ratio of 3:00:1:00, and (ii) a maximum consolidated leverage ratio of 4.25:1.00 from and after January 2020. The consolidated leverage ratio is subject to a step-up to 5.25:1.00 for four full consecutive fiscal quarters following a permitted acquisition or similar investment. As of September 30, 2020, the Company was in compliance with all terms of the Credit Agreement. Interest expense and the commitment fees on the unused portion of the Company’s Amended Revolving Facility were as follows ( in thousands ): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Interest expense $ 1,594 $ 2,342 $ 5,111 $ 7,392 Commitment fees 162 157 482 473 As of September 30, 2020 and December 31, 2019, the unamortized balance of deferred origination fees and debt issuance costs was $1.3 million and $1.7 million, respectively. For the nine month periods ended September 30, 2020 and 2019, HMS amortized $0.4 million and $0.4 million, respectively, of interest expense related to the Company’s deferred origination fees and debt issue costs.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table reconciles the basic to diluted weighted average common shares outstanding using the treasury stock method (in thousands, except per share amounts) : Three Months Ended Nine Months Ended 2020 2019 2020 2019 Net income $ 18,035 $ 21,136 $ 37,330 $ 69,878 Weighted average common shares outstanding-basic 88,531 86,324 88,397 88,190 Plus: net effect of dilutive stock options and restricted stock units 1,697 2,000 1,579 2,251 Weighted average common shares outstanding-diluted 90,228 88,324 89,976 90,441 Net income per common share -- basic $ 0.20 $ 0.24 $ 0.42 $ 0.79 Net income per common share -- diluted $ 0.20 $ 0.24 $ 0.42 $ 0.77 For the three months ended September 30, 2020 and 2019, (i) 1,227,140 and 625,573 stock options, respectively, and (ii) restricted stock units representing 807 and 1,693 shares of the Company's common stock, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive. For the nine months ended September 30, 2020 and 2019, (i) 1,126,976 and 472,627 stock options, respectively, and (ii) restricted stock units representing 2,297 and 2,791 shares of common stock, respectively, were not included in the diluted earnings per share calculation because the effect would have been anti-dilutive.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation (a) Long-Term Incentive Award Plans The Company grants stock options and restricted stock units to HMS employees and non-employee directors of the Company under the HMS Holdings Corp. 2019 Omnibus Incentive Plan (the “2019 Omnibus Plan”), as approved by the Company’s shareholders on May 22, 2019. The 2019 Omnibus Plan replaces and supersedes the HMS Holdings Corp. 2016 Omnibus Incentive Plan. (b) Stock-Based Compensation Expense Total stock-based compensation expense in the Company’s unaudited Consolidated Statements of Income related to the Company’s long-term incentive award plans was as follows (in thousands): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Cost of services-compensation $ 922 $ 982 $ 5,897 $ 7,825 Selling, general and administrative 2,211 1,952 15,186 10,890 Total $ 3,133 $ 2,934 $ 21,083 $ 18,715 (c) Stock Options For the three months ended September 30, 2020 and 2019, stock-based compensation expense related to stock options was approximately $1.0 million and $0.9 million, respectively. For the nine months ended September 30, 2020 and 2019, stock-based compensation expense related to stock options was approximately $8.0 million and $7.8 million, respectively. Presented below is a summary of stock option activity for the nine months ended September 30, 2020 ( in thousands, except for weighted average exercise price and weighted average remaining contractual terms ): Number of Options Weighted Weighted Aggregate Outstanding balance at December 31, 2019 2,411 $ 23.43 Granted 1,073 27.47 Exercised (120) 17.88 Forfeitures (47) 28.06 Expired (6) 29.24 Outstanding balance at September 30, 2020 3,311 $ 24.88 7.51 $ 9,564 Expected to vest at September 30, 2020 1,303 $ 28.85 8.92 $ 832 Exercisable at September 30, 2020 1,579 $ 20.69 6.04 $ 8,376 During the three months ended September 30, 2020 and 2019, the Company received proceeds of $0.5 million and $12.2 million, respectively, for the issuance of 28,402 and 740,748 shares of common stock upon the exercise of outstanding stock options, respectively. The total intrinsic value of stock options exercised during the three months ended September 30, 2020 and 2019 was $0.3 million and $16.0 million, respectively. During the nine months ended September 30, 2020 and 2019, the Company received proceeds of $2.1 million and $39.2 million, respectively, for the issuance of 119,991 and 2,427,156 shares of common stock upon the exercise of outstanding stock options, respectively. The total intrinsic value of stock options exercised during the nine months ended September 30, 2020 and 2019 was $1.2 million and $45.5 million, respectively. As of September 30, 2020, there was approximately $5.6 million of total unrecognized compensation cost related to stock options outstanding, which is expected to be recognized over a weighted average period of 1.2 years. The weighted-average grant date fair value per share of the stock options granted during the nine months ended September 30, 2020 and 2019 was $9.06 and $13.87, respectively. HMS estimated the fair value of each stock option grant on the date of grant using a Black-Scholes option pricing model and weighted–average assumptions set forth in the following table: Nine Months Ended 2020 2019 Expected dividend yield 0 % 0 % Risk-free interest rate 1.1 % 2.5 % Expected volatility 41.1 % 40.9 % Expected life (years) 6.3 6.4 The total tax benefits recognized on stock-based compensation related to stock options for the nine months ended September 30, 2020 and 2019 was $3.2 million and $16.1 million, respectively. (d) Restricted Stock Units For the three months ended September 30, 2020 and 2019, stock-based compensation expense related to restricted stock units was approximately $2.1 million and $1.9 million, respectively. For the nine months ended September 30, 2020 and 2019, stock-based compensation expense related to restricted stock units was approximately $13.1 million and $10.9 million, respectively. Presented below is a summary of restricted stock units activity for the nine months ended September 30, 2020 (in thousands, except for weighted average grant date fair value per unit): Number of Weighted Average Outstanding balance at December 31, 2019 1,239 $ 21.37 Granted 747 24.22 Vesting of restricted stock units, net of units withheld for taxes (321) 23.47 Units withheld for taxes (147) 23.47 Forfeitures (63) 24.41 Outstanding balance at September 30, 2020 1,455 $ 25.41 For the three months ended September 30, 2020 and 2019, HMS granted 7,538 and 12,687 restricted stock units, respectively, with an aggregate fair market value of $0.2 million and $0.5 million, respectively. For the nine months ended September 30, 2020 and 2019, HMS granted 746,502 and 474,520 restricted stock units, respectively, with an aggregate fair market value of $18.1 million and $16.2 million, respectively. As of September 30, 2020, 1,147,469 restricted stock units remained unvested and there was approximately $13.3 million of unrecognized compensation cost related to restricted stock units, which is expected to be recognized over a weighted average vesting period of 1.1 years.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies In February 2018, the Company received a Civil Investigative Demand (“CID”) from the Texas Attorney General, purporting to investigate possible unspecified violations of the Texas Medicaid Fraud Prevention Act. In March 2018, the Company provided certain documents and information in response to the CID. HMS has not received any further requests from the government in connection with this CID. In September 2018, a former employee filed an action in the New York County Supreme Court entitled Christopher Frey v. Health Management Systems, Inc. alleging retaliation under New York law. The complaint seeks recovery of an unspecified amount of monetary damages, including back pay and other compensatory and equitable relief. In May 2019, the Court heard oral arguments on the Company's motion to dismiss the complaint, and in July 2020, the Court granted the motion to dismiss the complaint in its entirety. On August 26, 2020, the plaintiff filed a notice of appeal with the New York Supreme Court Appellate Division, First Judicial Department. From time to time, HMS may be subject to investigations, legal proceedings and other disputes arising in the ordinary course of the Company’s business, including but not limited to regulatory audits, billing and contractual disputes, employment-related matters and post-closing disputes related to acquisitions. Due to the Company’s contractual relationships, including those with federal and state government entities, HMS’s operations, billing and business practices are subject to scrutiny and audit by those entities and other multiple agencies and levels of government, as well as to frequent transitions and changes in the personnel responsible for oversight of the Company’s contractual performance. HMS may have contractual disputes with its customers arising from differing interpretations of contractual provisions that define the Company’s rights, obligations, scope of work or terms of payment, and with associated claims of liability for inaccurate or improper billing for reimbursement of contract fees, or for sanctions or damages for alleged performance deficiencies. Resolution of such disputes may involve litigation or may require that HMS accept some amount of loss or liability in order to avoid customer abrasion, negative marketplace perceptions and other disadvantageous results that could affect the Company’s business, financial condition, results of operations and cash flows. HMS records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss contingency is not both probable and estimable, HMS does not establish an accrued liability.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2020
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsIn connection with the preparation of these unaudited Consolidated Financial Statements, an evaluation of subsequent events was performed through the date of filing and there were no events that have occurred that would require adjustments to the financial statements or disclosures.

Business and Summary of Signi_2

Business and Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Accounting	The Consolidated Financial Statements and accompanying Notes in this Form 10-Q are unaudited. Accordingly, they do not include all of the information and notes required by generally accepted accounting principles (“U.S. GAAP”) for complete financial statements. The results reported in these unaudited Consolidated Financial Statements are not necessarily indicative of the results that may be expected for any subsequent interim period or the entire year. These unaudited Consolidated Financial Statements should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 (“2019 Form 10-K”). The consolidated balance sheet as of December 31, 2019 included herein was derived from audited financial statements, but does not include all disclosures required by U.S. GAAP.
Use of Estimates	The preparation of the Company’s unaudited Consolidated Financial Statements requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent liabilities at the date of the unaudited Consolidated Financial Statements and the reported amounts of revenue and expenses during the reporting periods. Actual results could differ from those estimates. These estimates and assumptions were considered and made in context with the information reasonably available to the Company and the unknown future impacts of the novel coronavirus (COVID-19) as of September 30, 2020 and through the date of this Form 10-Q. The statements include all adjustments (which include only normal recurring adjustments, except as disclosed) that management considers necessary to present a fair statement of the Company’s results for such interim periods.
Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Adopted Accounting Pronouncements In June 2016, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") No. 2016-13, Financial Instruments – Credit Losses (“ASU 2016-13”). ASU 2016-13 introduces the current expected credit losses methodology for estimating allowances for credit losses. ASU 2016-13 applies to all financial instruments carried at amortized cost and off-balance-sheet credit exposures not accounted for as insurance, including loan commitments, standby letters of credit, and financial guarantees. The new accounting standard does not apply to trading assets, loans held for sale, financial assets for which the fair value option has been elected, or loans and receivables between entities under common control. ASU 2016-13 is effective for public entities for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted this guidance on January 1, 2020. When developing an estimate of the Company's expected credit losses, the Company considers all relevant information regarding the collectability of cash flows including historical information, customers' credit history and current financial conditions, industry trends and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued ASU 2018-15, Intangibles - Goodwill and Other - Internal Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract ("ASU 2018-15"). The standard aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal use software. ASU 2018-15 is effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. The Company adopted this guidance on January 1, 2020. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurements ("ASU 2018-13"). The objective of the ASU is to improve the disclosures related to fair value measurement by removing, modifying, or adding disclosure requirements related to recurring and non-recurring fair value measurements. ASU 2018-13 is effective for public business entities for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. The Company adopted this guidance on January 1, 2020. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. Recently Issued Accounting Pronouncements Not Yet Adopted In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes ("ASU 2019-12"). The guidance eliminates certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period, and the recognition of deferred tax liabilities for outside basis differences related to changes in ownership of equity method investments and foreign subsidiaries. The guidance also simplifies aspects of accounting for franchise taxes and enacted changes in tax laws or rates, and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. ASU 2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, and interim periods within those fiscal years. Early adoption is permitted, including adoption in any interim period for which financial statements have not been issued. This guidance is not expected to have a material impact on the Company’s financial position, results of operations or internal control framework. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting ("ASU 2020-04"). The objective of ASU 2020-04 is to provide optional expedients and exceptions for applying U.S. GAAP to contracts, hedging relationships and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The guidance is effective for all entities as of March 12, 2020 through December 31, 2022. The Company is evaluating the impact, but does not expect this guidance to have a material impact on the Company’s consolidated financial statements.

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2020
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue by Solution	The Company’s revenue disaggregated by solution for the three and nine months ended September 30, 2020 and 2019 was as follows (in thousands) : Three Months Ended Nine Months Ended 2020 2019 2020 2019 Coordination of Benefits $ 113,870 $ 94,619 $ 338,661 $ 305,564 Payment Integrity 37,987 37,016 101,704 113,863 Population Health Management 13,379 15,180 38,937 43,523 Total $ 165,236 $ 146,815 $ 479,302 $ 462,950
Disaggregation Of Revenue by Market	The Company’s revenue disaggregated by market for the three and nine months ended September 30, 2020 and 2019 was as follows ( in thousands ): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Commercial $ 87,001 $ 69,711 $ 250,064 $ 225,014 State 62,233 62,830 195,046 189,752 Federal 16,002 14,274 34,192 48,184 Total $ 165,236 $ 146,815 $ 479,302 $ 462,950

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Allocation of Purchase Price	The preliminary allocation of the purchase price to the fair value of the assets acquired and the liabilities assumed as of December 23, 2019, the effective date of the acquisition, as adjusted during the nine months ended September 30, 2020, is as follows ( in thousands ): Cash and cash equivalents $ 9,916 Accounts receivable 11,485 Prepaid expenses 129 Property and equipment 2,878 Intangible assets 68,400 Goodwill 76,755 Other assets 489 Accounts payable and accrued liabilities (12,431) Total purchase price $ 157,621
Purchase Price Allocated to Intangibles Acquired	The purchase price allocated to the intangible assets acquired was as follows ( in thousands, except for useful life ): Useful Life Customer relationships 12 $ 67,000 Trade name 3 1,400 Fair value of intangibles acquired $ 68,400

Intangible Assets, Goodwill a_2

Intangible Assets, Goodwill and Other Assets (Tables)	9 Months Ended
	Sep. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	Intangible assets consisted of the following ( in thousands, except for weighted average amortization period ): Gross Carrying Amount Accumulated Net Carrying Amount Weighted Average Amortization Period in Years September 30, 2020 Customer relationships $ 125,423 $ (18,968) $ 106,455 11.3 Trade names 1,400 (361) 1,039 2.2 Intellectual property 27,700 (14,439) 13,261 3.5 Total $ 154,523 $ (33,768) $ 120,755 Gross Carrying Amount Accumulated Net Carrying Amount Weighted Average Amortization Period in Years December 31, 2019 Customer relationships $ 135,290 $ (21,637) $ 113,653 12.1 Trade names 1,536 (147) 1,389 3.0 Intellectual property 27,700 (10,893) 16,807 3.7 Total $ 164,526 $ (32,677) $ 131,849
Amortization Expense of Intangible Assets	Amortization expense of intangible assets is expected to approximate the following (in thousands): Year ending December 31, Amortization 2020 (excluding the nine months ended September 30, 2020) $ 3,562 2021 14,247 2022 14,235 2023 11,405 2024 10,330 Thereafter 66,976 Total $ 120,755
Goodwill	As a result of adjustments relating to the Accent acquisition, the changes in the carrying amount of goodwill were as follows ( in thousands ): Balance at December 31, 2019 $ 599,351 Accent acquisition - Adjustment (4,790) Balance at September 30, 2020 $ 594,561

Accounts Payable, Accrued Exp_2

Accounts Payable, Accrued Expenses and Other Liabilities (Tables)	9 Months Ended
	Sep. 30, 2020
Payables and Accruals [Abstract]
Accounts Payable, Accrued Expenses, and Other Liabilities	Accounts payable, accrued expenses and other liabilities consisted of the following (in thousands) : September 30, December 31, Accounts payable, trade $ 18,190 $ 12,246 Accrued compensation and other 27,261 36,827 Accrued operating expenses 42,035 42,045 Current portion of lease liabilities 6,470 6,629 Total accounts payable, accrued expenses and other liabilities $ 93,956 $ 97,747

Credit Agreement (Tables)

Credit Agreement (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Schedule of Interest Expense and Commitment Fees	Interest expense and the commitment fees on the unused portion of the Company’s Amended Revolving Facility were as follows ( in thousands ): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Interest expense $ 1,594 $ 2,342 $ 5,111 $ 7,392 Commitment fees 162 157 482 473

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Schedule of Earnings Per Share	The following table reconciles the basic to diluted weighted average common shares outstanding using the treasury stock method (in thousands, except per share amounts) : Three Months Ended Nine Months Ended 2020 2019 2020 2019 Net income $ 18,035 $ 21,136 $ 37,330 $ 69,878 Weighted average common shares outstanding-basic 88,531 86,324 88,397 88,190 Plus: net effect of dilutive stock options and restricted stock units 1,697 2,000 1,579 2,251 Weighted average common shares outstanding-diluted 90,228 88,324 89,976 90,441 Net income per common share -- basic $ 0.20 $ 0.24 $ 0.42 $ 0.79 Net income per common share -- diluted $ 0.20 $ 0.24 $ 0.42 $ 0.77

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Total Stock-Based Compensation Expense	Total stock-based compensation expense in the Company’s unaudited Consolidated Statements of Income related to the Company’s long-term incentive award plans was as follows (in thousands): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Cost of services-compensation $ 922 $ 982 $ 5,897 $ 7,825 Selling, general and administrative 2,211 1,952 15,186 10,890 Total $ 3,133 $ 2,934 $ 21,083 $ 18,715
Summary of Stock Option Activity	Presented below is a summary of stock option activity for the nine months ended September 30, 2020 ( in thousands, except for weighted average exercise price and weighted average remaining contractual terms ): Number of Options Weighted Weighted Aggregate Outstanding balance at December 31, 2019 2,411 $ 23.43 Granted 1,073 27.47 Exercised (120) 17.88 Forfeitures (47) 28.06 Expired (6) 29.24 Outstanding balance at September 30, 2020 3,311 $ 24.88 7.51 $ 9,564 Expected to vest at September 30, 2020 1,303 $ 28.85 8.92 $ 832 Exercisable at September 30, 2020 1,579 $ 20.69 6.04 $ 8,376
Schedule of Estimated Fair Value of Stock Option Grants	HMS estimated the fair value of each stock option grant on the date of grant using a Black-Scholes option pricing model and weighted–average assumptions set forth in the following table: Nine Months Ended 2020 2019 Expected dividend yield 0 % 0 % Risk-free interest rate 1.1 % 2.5 % Expected volatility 41.1 % 40.9 % Expected life (years) 6.3 6.4
Summary of Restricted Stock Units Activity	Presented below is a summary of restricted stock units activity for the nine months ended September 30, 2020 (in thousands, except for weighted average grant date fair value per unit): Number of Weighted Average Outstanding balance at December 31, 2019 1,239 $ 21.37 Granted 747 24.22 Vesting of restricted stock units, net of units withheld for taxes (321) 23.47 Units withheld for taxes (147) 23.47 Forfeitures (63) 24.41 Outstanding balance at September 30, 2020 1,455 $ 25.41

Business and Summary of Signi_3

Business and Summary of Significant Accounting Policies (Details)	9 Months Ended
	Sep. 30, 2020segment
Accounting Policies [Abstract]
Number of business segments	1

Revenue Recognition (Details)

Revenue Recognition (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Disaggregation of Revenue [Line Items]
Accounts receivable allowance	$ 16.6	$ 17.1
Deferred revenue	6.9	4.2
Revenue recognized	3.1
Customer cash held in company bank accounts	$ 19.4	$ 21.9
Minimum
Disaggregation of Revenue [Line Items]
Term, contracts with customers	1 year
Amortization period	1 year
Maximum
Disaggregation of Revenue [Line Items]
Term, contracts with customers	3 years

Revenue Recognition - Revenues

Revenue Recognition - Revenues Disaggregated by Revenue Source and Market (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	$ 165,236	$ 146,815	$ 479,302	$ 462,950
Commercial
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	87,001	69,711	250,064	225,014
State
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	62,233	62,830	195,046	189,752
Federal
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	16,002	14,274	34,192	48,184
Coordination of Benefits
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	113,870	94,619	338,661	305,564
Payment Integrity
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	37,987	37,016	101,704	113,863
Population Health Management
Disaggregation of Revenue [Line Items]
Revenue from contract with customer	$ 13,379	$ 15,180	$ 38,937	$ 43,523

Acquisitions (Details)

Acquisitions (Details) - USD ($) $ in Thousands	Dec. 23, 2019	Sep. 16, 2019	Sep. 30, 2020	Sep. 30, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill			$ 594,561	$ 594,561	$ 599,351
Accent
Business Acquisition [Line Items]
Acquisition of a business, net of cash acquired	$ 157,600
Change in value of accounts receivable			2,300
Change in value of cash and cash equivalents			500
Change in value of accounts payable and accrued liabilities			(1,000)
Change in carrying value of goodwill			(4,800)
Change in value of total consideration paid			(1,000)
Acquisition related costs					$ 2,100
Revenue contributed			10,800	32,400
Intangible assets			68,400	68,400
Goodwill			$ 76,755	$ 76,755
VitreosHealth, Inc.
Business Acquisition [Line Items]
Aggregate consideration		$ 36,600
Intangible assets		6,000
Goodwill		$ 30,200

Acquisitions - Allocation of Pu

Acquisitions - Allocation of Purchase Price (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill	$ 594,561	$ 599,351
Accent
Business Acquisition [Line Items]
Cash and cash equivalents	9,916
Accounts receivable	11,485
Prepaid expenses	129
Property and equipment	2,878
Intangible assets	68,400
Goodwill	76,755
Other assets	489
Accounts payable and accrued liabilities	(12,431)
Total purchase price	$ 157,621

Acquisitions - Purchase Price A

Acquisitions - Purchase Price Allocated to Intangibles Acquired (Details) - Accent $ in Thousands	Dec. 23, 2019USD ($)
Business Acquisition [Line Items]
Finite-lived intangible assets acquired	$ 68,400
Customer relationships
Business Acquisition [Line Items]
Useful Life (in years)	12 years
Finite-lived intangible assets acquired	$ 67,000
Trade name
Business Acquisition [Line Items]
Useful Life (in years)	3 years
Finite-lived intangible assets acquired	$ 1,400

Intangible Assets, Goodwill a_3

Intangible Assets, Goodwill and Other Assets - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 154,523	$ 164,526
Accumulated Amortization	(33,768)	(32,677)
Net Carrying Amount	120,755	131,849
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	125,423	135,290
Accumulated Amortization	(18,968)	(21,637)
Net Carrying Amount	$ 106,455	$ 113,653
Weighted Average Amortization Period in Years	11 years 3 months 18 days	12 years 1 month 6 days
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,400	$ 1,536
Accumulated Amortization	(361)	(147)
Net Carrying Amount	$ 1,039	$ 1,389
Weighted Average Amortization Period in Years	2 years 2 months 12 days	3 years
Intellectual property
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 27,700	$ 27,700
Accumulated Amortization	(14,439)	(10,893)
Net Carrying Amount	$ 13,261	$ 16,807
Weighted Average Amortization Period in Years	3 years 6 months	3 years 8 months 12 days

Intangible Assets, Goodwill a_4

Intangible Assets, Goodwill and Other Assets - Estimated Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
2020 (excluding the nine months ended September 30, 2020)	$ 3,562
2021	14,247
2022	14,235
2023	11,405
2024	10,330
Thereafter	66,976
Net Carrying Amount	$ 120,755	$ 131,849

Intangible Assets, Goodwill a_5

Intangible Assets, Goodwill and Other Assets (Details) - USD ($)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Amortization of intangible assets	$ 3,700,000	$ 2,300,000	$ 11,094,000	$ 7,009,000
Sales related to financial instrument			0		$ 0
Settlements related to financial instrument			0		0
Issuances related to financial instrument			0		0
Unrealized gains (losses)	$ (1,200,000)		1,700,000
Net unrealized gains		0		0
Realized gains		0		0
Proceeds from sale of cost basis investment			0	9,776,000
Gain on sale of cost basis investment			0	7,697,000
Insta Med Holdings Inc.
Business Acquisition [Line Items]
Percentage acquired	100.00%
Cost-based investment		2,100,000		2,100,000
Proceeds from sale of cost basis investment		9,800,000
Gain on sale of cost basis investment		$ 7,700,000		$ 7,700,000
Fair Value, Inputs, Level 1
Business Acquisition [Line Items]
Cost basis of investment	$ 7,400,000		7,400,000
Fair value measurement in relation to equity instrument	$ 9,600,000		$ 9,600,000		$ 7,900,000

Intangible Assets, Goodwill a_6

Intangible Assets, Goodwill and Other Assets - Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Goodwill [Roll Forward]
Balance at December 31, 2019	$ 599,351
Balance at September 30, 2020	594,561
Accent acquisition - Adjustment
Goodwill [Roll Forward]
Accent acquisition - Adjustment	(4,790)
Balance at September 30, 2020	$ 76,755

Accounts Payable, Accrued Exp_3

Accounts Payable, Accrued Expenses and Other Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Accounts payable, trade	$ 18,190	$ 12,246
Accrued compensation and other	27,261	36,827
Accrued operating expenses	42,035	42,045
Current portion of lease liabilities	6,470	6,629
Total accounts payable, accrued expenses and other liabilities	$ 93,956	$ 97,747

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Effective income tax rate, percent	20.80%	12.60%
Unrecognized tax benefits that would impact effective tax rate	$ 5,300		$ 4,200
Unrecognized tax benefits, income tax penalties and interest accrued	900		$ 700
Unrecognized tax benefits, income tax penalties and interest expense	200	$ 30
Possible decrease in unrecognized tax benefits	$ 1,600

Liability for Appeals (Details)

Liability for Appeals (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Other Liabilities Disclosure [Abstract]
Liability for appeals	$ 5,179	$ 3,570

Credit Agreement (Details)

Credit Agreement (Details)	Dec. 19, 2017USD ($)	May 31, 2013USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)
Line of Credit Facility [Line Items]
Letters of credit outstanding, amount			$ 6,500,000
Amortization of interest expense			423,000	$ 423,000
Credit Agreement
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity	$ 500,000,000	$ 500,000,000
Line of credit facility, expiration period	5 years	5 years
Debt agreement, maximum borrowing capacity	$ 120,000,000
Debt agreement, maximum borrowing capacity percent of consolidated EBITDA	100.00%
Credit Agreement | Letter of Credit
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity	$ 50,000,000
Line of credit facility, unused capacity, commitment fee percentage	0.125%
Credit Agreement | Swingline Loans
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity	$ 25,000,000
Credit Agreement | Revolving Credit Facility
Line of Credit Facility [Line Items]
Debt instrument, covenant, interest coverage ratio	5.25
Long-term line of credit, total			240,000,000		$ 240,000,000
Repayments of long-term lines of credit			0
Debt issuance costs, net			1,300,000		$ 1,700,000
Amortization of interest expense			$ 400,000	$ 400,000
Credit Agreement | Revolving Credit Facility | Fed Funds Effective Rate Overnight Index Swap Rate
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	0.50%
Credit Agreement | Revolving Credit Facility | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	1.00%
Credit Agreement | Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Line of credit facility, unused capacity, commitment fee percentage	0.375%
Debt instrument, secured leverage ratio	3
Credit Agreement | Revolving Credit Facility | Minimum | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	0.50%
Credit Agreement | Revolving Credit Facility | Minimum | One-month LIBOR Rate
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	1.50%
Credit Agreement | Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Debt instrument, covenant, interest coverage ratio	3
Line of credit facility, unused capacity, commitment fee percentage	0.25%
Credit Agreement | Revolving Credit Facility | Maximum | From and After January 2020
Line of Credit Facility [Line Items]
Debt instrument, covenant, interest coverage ratio	4.25
Credit Agreement | Revolving Credit Facility | Maximum | London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	1.00%
Credit Agreement | Revolving Credit Facility | Maximum | One-month LIBOR Rate
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	2.00%

Credit Agreement - Summary of I

Credit Agreement - Summary of Interest Expense and Commitment Fees on Unused Portion of Revolving Credit Facility (Details) - Revolving Credit Facility - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Line of Credit Facility [Line Items]
Interest expense	$ 1,594	$ 2,342	$ 5,111	$ 7,392
Commitment fees	$ 162	$ 157	$ 482	$ 473

Earnings Per Share - Summary of

Earnings Per Share - Summary of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Earnings Per Share [Abstract]
Net income	$ 18,035	$ 21,136	$ 37,330	$ 69,878
Weighted average common shares outstanding-basic (in shares)	88,531	86,324	88,397	88,190
Plus: net effect of dilutive stock options and restricted stock units (in shares)	1,697	2,000	1,579	2,251
Weighted average common shares outstanding-diluted (in shares)	90,228	88,324	89,976	90,441
Net income per common share -- basic (in dollars per share)	$ 0.20	$ 0.24	$ 0.42	$ 0.79
Net income per common share -- diluted (in dollars per share)	$ 0.20	$ 0.24	$ 0.42	$ 0.77

Earnings Per Share (Details)

Earnings Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Share-based Payment Arrangement, Option
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	1,227,140	625,573	1,126,976	472,627
Restricted Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	807	1,693	2,297	2,791

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 3,133	$ 2,934	$ 21,083	$ 18,715
Cost of services-compensation
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	922	982	5,897	7,825
Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 2,211	$ 1,952	$ 15,186	$ 10,890

Stock-Based Compensation (Detai

Stock-Based Compensation (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 3,133	$ 2,934	$ 21,083	$ 18,715
Proceeds from stock options exercised	$ 500	$ 12,200	$ 2,145	$ 39,175
Shares issued upon exercise of stock options (in shares)	28,402	740,748	119,991	2,427,156
Total intrinsic value of stock options exercised	$ 300	$ 16,000	$ 1,200	$ 45,500
Unrecognized compensation cost related to stock options outstanding	5,600		$ 5,600
Recognition period for compensation cost related to awards outstanding			1 year 2 months 12 days
Weighted-average grant date fair value per share of stock options (in dollars per share)			$ 9.06	$ 13.87
Total income tax benefits	6,120	2,159	$ 9,814	$ 10,049
Share-based Payment Arrangement, Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	1,000	900	8,000	7,800
Total income tax benefits			3,200	16,100
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 2,100	$ 1,900	$ 13,100	$ 10,900
Recognition period for compensation cost related to awards outstanding			1 year 1 month 6 days
Restricted stock units granted (in shares)	7,538	12,687	746,502	474,520
Fair market value of restricted stock units	$ 200	$ 500	$ 18,100	$ 16,200
Number of unvested restricted stock units (in shares)	1,147,469		1,147,469
Unrecognized compensation cost related to restricted stock units	$ 13,300		$ 13,300

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Number of Options
Outstanding, beginning balance (in shares)			2,411,000
Granted (in shares)			1,073,000
Exercised (in shares)	(28,402)	(740,748)	(119,991)	(2,427,156)
Forfeitures (in shares)			(47,000)
Expired (in shares)			(6,000)
Outstanding, ending balance (in shares)	3,311,000		3,311,000
Number of options, expected to vest (in shares)	1,303,000		1,303,000
Number of options, exercisable (in shares)	1,579,000		1,579,000
Weighted Average Exercise Price
Outstanding, beginning balance (in dollars per share)			$ 23.43
Granted (in dollars per share)			27.47
Exercised (in dollars per share)			17.88
Forfeitures (in dollars per share)			28.06
Expired (in dollars per share)			29.24
Outstanding, ending balance (in dollars per share)	$ 24.88		24.88
Weighted average exercise price, expected to vest (in dollars per share)	28.85		28.85
Weighted average exercise price, exercisable (in dollars per share)	$ 20.69		$ 20.69
Weighted Average- Remaining Contractual Terms
Outstanding, ending balance			7 years 6 months 3 days
Vested and expected to vest			8 years 11 months 1 day
Exercisable			6 years 14 days
Aggregate Intrinsic Value
Outstanding, ending balance	$ 9,564		$ 9,564
Vested and expected to vest	832		832
Exercisable	$ 8,376		$ 8,376

Stock-Based Compensation - Weig

Stock-Based Compensation - Weighted Average Assumptions Used in Valuation of Stock Options (Details) - Black Scholes Model - Share-based Payment Arrangement, Option	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividend yield	0.00%	0.00%
Risk-free interest rate	1.10%	2.50%
Expected volatility	41.10%	40.90%
Expected life (years)	6 years 3 months 18 days	6 years 4 months 24 days

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Restricted Stock Units (Details) - Restricted Stock Units (RSUs) - $ / shares	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Number of Units
Outstanding, beginning balance (in shares)			1,239,000
Granted (in shares)	7,538	12,687	746,502	474,520
Vesting of restricted stock units, net of units withheld for taxes (in shares)			(321,000)
Units withheld for taxes (in shares)			(147,000)
Forfeitures (in shares)			(63,000)
Outstanding, ending balance (in shares)	1,455,000		1,455,000
Weighted Average Grant Date Fair Value per Unit
Outstanding, beginning balance (in dollars per share)			$ 21.37
Granted (in dollars per share)			24.22
Vesting of restricted stock units, net of units withheld for taxes (in dollars per share)			23.47
Units withheld for taxes (in dollars per share)			23.47
Forfeitures (in dollars per share)			24.41
Outstanding, ending balance (in dollars per share)	$ 25.41		$ 25.41