Summary of Significant Accounting Policies (Details) - USD ($) $ in Thousands		9 Months Ended			12 Months Ended
		Sep. 30, 2015		Sep. 30, 2014	Dec. 31, 2014
Reconciliation of valuation and qualifying accounts
Estimated liability for appeals		$ 34,892			$ 36,799
Goodwill
Impairment of goodwill		0
Estimated liability for appeals and estimated allowance for appeals
Reconciliation of valuation and qualifying accounts
Balance at the beginning of the period		41,623	[1]	$ 55,791	55,791
Provision		9,670			16,822
Appeals found in providers' favor	[2]	(13,751)			(30,990)
Balance at the end of the period	[1]	37,542			41,623
Estimated liability for appeals		2,650			4,824
Allowance for doubtful accounts
Reconciliation of valuation and qualifying accounts
Balance at the beginning of the period		1,898		916	916
Provision		1,295			6,085
Recoveries		(100)			(17)
Charge-offs					(5,086)
Charge-offs and other		(421)
Balance at the end of the period		2,672			$ 1,898
CMS | Estimated liability for appeals and estimated allowance for appeals
Reconciliation of valuation and qualifying accounts
Appeals found in providers' favor		$ 6,000		$ 22,200

[1] Includes $2,650 and $4,824 related to estimated allowance for appeals that apply to uncollected accounts receivable as of September 30, 2015 and December 31, 2014, respectively.

[2] Includes appeals, closures or other adjustments.