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Business Segment Information - Operating Results by Segment (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2017
Jun. 30, 2016
Jun. 30, 2017
Jun. 30, 2016
Operating results by business segment        
Managed care and other revenue $ 821,699 $ 699,861 $ 1,551,039 $ 1,376,322
PBM and dispensing revenue 597,440 464,484 1,173,723 905,045
Cost of care (583,264) (472,529) (1,065,318) (930,160)
Cost of goods sold (562,355) (436,930) (1,104,988) (852,389)
Direct service costs and other [1],[2],[3] (231,372) (214,077) (452,858) (406,533)
Stock compensation expense 11,371 9,510 21,511 18,397
Changes in fair value of contingent consideration 252 463 203 197
Impairment of intangible assets   4,800   4,800
Less: non-controlling interest segment profit (loss) (569) (1,312) (847) (1,147)
Segment profit (loss) 54,340 56,894 124,159 116,826
Operating segments | Healthcare        
Operating results by business segment        
Managed care and other revenue 755,270 637,970 1,420,646 1,256,898
Cost of care (583,264) (472,529) (1,065,318) (930,160)
Direct service costs and other (145,914) (139,965) (284,882) (265,582)
Stock compensation expense 3,106 2,451 5,765 4,470
Changes in fair value of contingent consideration 252 390 203 70
Impairment of intangible assets   4,800   4,800
Less: non-controlling interest segment profit (loss) (568) (1,305) (845) (1,136)
Segment profit (loss) 30,018 34,422 77,259 71,632
Operating segments | Pharmacy Management        
Operating results by business segment        
Managed care and other revenue 66,659 61,975 130,839 119,552
PBM and dispensing revenue 631,932 495,399 1,238,678 965,633
Cost of goods sold (595,446) (466,637) (1,167,283) (910,586)
Direct service costs and other (74,953) (64,086) (150,806) (124,927)
Stock compensation expense 5,684 5,548 11,414 10,970
Changes in fair value of contingent consideration   73   127
Segment profit (loss) 33,876 32,272 62,842 60,769
Corporate and Elimination        
Operating results by business segment        
Managed care and other revenue (230) (84) (446) (128)
PBM and dispensing revenue (34,492) (30,915) (64,955) (60,588)
Cost of goods sold 33,091 29,707 62,295 58,197
Direct service costs and other (10,505) (10,026) (17,170) (16,024)
Stock compensation expense 2,581 1,511 4,332 2,957
Less: non-controlling interest segment profit (loss) (1) (7) (2) (11)
Segment profit (loss) $ (9,554) $ (9,800) $ (15,942) $ (15,575)
[1] Includes changes in fair value of contingent consideration of $463 and $252 for the three months ended June 30, 2016 and 2017, respectively, and $197 and $203 for the six months ended June 30, 2016 and 2017, respectively.
[2] Includes impairment of intangible assets of $4,800 for the three and six months ended June 30, 2016.
[3] Includes stock compensation expense of $9,510 and $11,371 for the three months ended June 30, 2016 and 2017, respectively, and $18,397 and $21,511 for the six months ended June 30, 2016 and 2017, respectively