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Business Segment Information (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2015
Sep. 30, 2014
Sep. 30, 2015
Sep. 30, 2014
Operating results by business segment        
Managed care and other revenue $ 809,249 $ 703,020 $ 2,334,139 $ 2,214,885
PBM and dispensing revenue 380,833 220,150 994,518 562,774
Cost of care (596,323) (495,180) (1,686,939) (1,582,505)
Cost of goods sold (360,444) (202,180) (940,060) (520,044)
Direct service costs and other (220,586) (176,928) (616,491) (520,684)
Stock compensation expense 12,897 11,961 40,593 25,983
Changes in fair value of contingent consideration 29,738   47,274  
Less: non-controlling interest segment profit (loss) 47 (1,323) (397) (3,301)
Segment profit (loss) 55,317 62,166 173,431 183,710
Operating segments | Healthcare        
Operating results by business segment        
Managed care and other revenue 748,297 653,747 2,170,361 2,083,320
Cost of care (596,323) (495,179) (1,686,944) (1,584,264)
Direct service costs and other (106,675) (101,145) (324,695) (305,338)
Stock compensation expense 469 658 1,952 2,242
Changes in fair value of contingent consideration (809)   (638)  
Less: non-controlling interest segment profit (loss) 75 (1,323) (318) (3,301)
Segment profit (loss) 44,884 59,404 160,354 199,261
Operating segments | Pharmacy Management        
Operating results by business segment        
Managed care and other revenue 60,978 49,273 163,828 149,620
PBM and dispensing revenue 409,371 241,226 1,077,088 590,115
Cost of care   (1) 5 (16,296)
Cost of goods sold (387,834) (223,251) (1,019,200) (547,362)
Direct service costs and other (87,252) (45,535) (207,230) (122,691)
Stock compensation expense 9,410 8,122 28,282 13,981
Changes in fair value of contingent consideration 30,547   47,912  
Segment profit (loss) 35,220 29,834 90,685 67,367
Corporate and Elimination        
Operating results by business segment        
Managed care and other revenue (26)   (50) (18,055)
PBM and dispensing revenue (28,538) (21,076) (82,570) (27,341)
Cost of care       18,055
Cost of goods sold 27,390 21,071 79,140 27,318
Direct service costs and other (26,659) (30,248) (84,566) (92,655)
Stock compensation expense 3,018 3,181 10,359 9,760
Less: non-controlling interest segment profit (loss) (28)   (79)  
Segment profit (loss) $ (24,787) $ (27,072) $ (77,608) $ (82,918)