Fixed Assets, Net (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Property, Plant and Equipment [Line Items]
Fixed assets, gross	$ 137,409	$ 124,064
Less accumulated depreciation	(88,034)	(82,650)
Fixed assets, net	49,375	41,414
Land [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, gross	768	1,451
Building [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	30 years
Fixed assets, gross	4,587	6,107
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, gross	70,131	65,718
Computer Equipment and Software [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	3 years
Computer Equipment and Software [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	7 years
Home Medical Equipment [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	4 years
Fixed assets, gross	5,356	5,179
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	5 years
Fixed assets, gross	35,028	24,556
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, gross	18,121	18,250
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	5 years
Fixed assets, gross	2,153	2,692
Automobiles [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	5 years
Fixed assets, gross	$ 1,265	$ 111