Represents the number of companies in peer group considered for S&P Health Care Services Industry Index.

No definition available.

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- Definition

Represents the estimated percentage of forfeitures considered for reduction in stock compensation expense recognized during the period.

+ References

No definition available.

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- Definition

Percentage of shares to be settled as per peer group of share-based compensation awards.

+ References

No definition available.

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- Definition

Threshold number of specified trading days that common stock price to be considered for average share value for share based compensation during the performance period.

+ References

No definition available.

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- Definition

Represents the expense recognized during the period arising from equity-based compensation arrangements (for example, shares of stock, unit, stock options or other equity instruments) with employees, directors and certain consultants qualifying for treatment as employees.

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Reference 1: http://www.xbrl.org/2003/role/presentationRef
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- Definition

The total recognized tax benefit related to compensation cost for equity-based payment arrangements recognized in income during the period.

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Period which an employee's right to exercise an award is no longer contingent on satisfaction of either a service condition, market condition or a performance condition, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.

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- References

No definition available.

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- Definition

The number of grants made during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).

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The weighted average fair value at grant date for nonvested equity-based awards issued during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).

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The number of non-vested equity-based payment instruments, excluding stock (or unit) options, that validly exist and are outstanding as of the balance sheet date.

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A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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No definition available.

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The weighted average fair value of nonvested awards on equity-based plans excluding option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, revenue or profit achievement stock award plan) for which the employer is contingently obligated to issue equity instruments or transfer assets to an employee who has not yet satisfied service or performance criteria necessary to gain title to proceeds from the sale of the award or underlying shares or units.

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The number of equity-based payment instruments, excluding stock (or unit) options, that vested during the reporting period.

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The weighted average fair value as of grant date pertaining to an equity-based award plan other than a stock (or unit) option plan for which the grantee gained the right during the reporting period, by satisfying service and performance requirements, to receive or retain shares or units, other instruments, or cash in accordance with the terms of the arrangement.

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- References

No definition available.

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- Definition

The estimated dividend rate (a percentage of the share price) to be paid (expected dividends) to holders of the underlying shares over the option's term.

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The estimated measure of the percentage by which a share price is expected to fluctuate during a period. Volatility also may be defined as a probability-weighted measure of the dispersion of returns about the mean. The volatility of a share price is the standard deviation of the continuously compounded rates of return on the share over a specified period. That is the same as the standard deviation of the differences in the natural logarithms of the stock prices plus dividends, if any, over the period.

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The estimated measure of the maximum percentage by which a share price is expected to fluctuate during a period. Volatility also may be defined as a probability-weighted measure of the dispersion of returns about the mean. The volatility of a share price is the standard deviation of the continuously compounded rates of return on the share over a specified period. That is the same as the standard deviation of the differences in the natural logarithms of the stock prices plus dividends, if any, over the period.

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No definition available.

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The estimated measure of the minimum percentage by which a share price is expected to fluctuate during a period. Volatility also may be defined as a probability-weighted measure of the dispersion of returns about the mean. The volatility of a share price is the standard deviation of the continuously compounded rates of return on the share over a specified period. That is the same as the standard deviation of the differences in the natural logarithms of the stock prices plus dividends, if any, over the period.

+ References

No definition available.

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The risk-free interest rate assumption that is used in valuing an option on its own shares.

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- Definition

Weighted average expected volatility rate of share-based compensation awards.

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- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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No definition available.

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No definition available.

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- Definition

Number of options or other stock instruments for which the right to exercise has lapsed under the terms of the plan agreements.

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The number of shares under options that were cancelled during the reporting period as a result of occurrence of a terminating event specified in contractual agreements pertaining to the stock option plan.

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- Definition

Net number of share options (or share units) granted during the period.

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The weighted average grant-date fair value of options granted during the reporting period as calculated by applying the disclosed option pricing methodology.

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- Definition

Number of options outstanding, including both vested and non-vested options.

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- Definition

A roll forward is a reconciliation of a concept from the beginning of a period to the end of a period.

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No definition available.

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- Definition

Weighted average price at which grantees can acquire the shares reserved for issuance under the stock option plan.

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Number of fully vested and expected to vest exercisable options that may be converted into shares under option plan. Includes, but is not limited to, unvested options for which requisite service period has not been rendered but that are expected to vest based on achievement of performance condition, if forfeitures are recognized when they occur.

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Weighted-average exercise price, at which grantee can acquire shares reserved for issuance, for fully vested and expected to vest exercisable or convertible options. Includes, but is not limited to, unvested options for which requisite service period has not been rendered but that are expected to vest based on achievement of performance condition, if forfeitures are recognized when they occur.

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Number of fully vested and expected to vest options outstanding that can be converted into shares under option plan. Includes, but is not limited to, unvested options for which requisite service period has not been rendered but that are expected to vest based on achievement of performance condition, if forfeitures are recognized when they occur.

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Weighted-average exercise price, at which grantee can acquire shares reserved for issuance, for fully vested and expected to vest options outstanding. Includes, but is not limited to, unvested options for which requisite service period has not been rendered but that are expected to vest based on achievement of performance condition, if forfeitures are recognized when they occur.

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Weighted average price at which option holders acquired shares when converting their stock options into shares.

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No definition available.

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Weighted average price at which grantees could have acquired the underlying shares with respect to stock options of the plan that expired.

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Weighted average price at which grantees could have acquired the underlying shares with respect to stock options that were terminated.

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Weighted average per share amount at which grantees can acquire shares of common stock by exercise of options.

+ References

No definition available.

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Period from grant date that an equity-based award expires, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.

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Number of share options (or share units) exercised during the current period.

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-Paragraph 1
-Subparagraph (SX 210.5-02(28))
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-URI http://asc.fasb.org/extlink&oid=27012166&loc=d3e187085-122770

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)(2)
-URI http://asc.fasb.org/extlink&oid=96867065&loc=d3e5070-113901

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General - Stock Compensation (Details) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018 USD ($) $ / shares shares	Jun. 30, 2017 USD ($)	Jun. 30, 2018 USD ($) company $ / shares shares	Jun. 30, 2017 USD ($)
Stock options, Non vested restricted stock awards and nonvested restricted stock units
Stock compensation expense \| $	$ 10,439	$ 11,371	$ 18,085	$ 21,511
Benefits of tax deductions in excess of recognized stock compensation expense \| $			$ 4,900	$ 1,000
Minimum
Stock options, Non vested restricted stock awards and nonvested restricted stock units
Estimated forfeitures (as a percent)	0.00%	0.00%	0.00%	0.00%
Maximum
Stock options, Non vested restricted stock awards and nonvested restricted stock units
Estimated forfeitures (as a percent)	4.00%	4.00%	4.00%	4.00%
Stock options
Stock options, Non vested restricted stock awards and nonvested restricted stock units
Grants in period, weighted average grant date fair value (in dollars per share)			$ 25.67
Expected volatility (as a percent)			28.21%
Stock option activity
Outstanding, beginning of period (in shares) \| shares			2,458,237
Granted (in shares) \| shares			425,456
Forfeited (in shares) \| shares			(44,651)
Exercised (in shares) \| shares			(379,589)
Outstanding, end of period (in shares) \| shares	2,459,453		2,459,453
Vested and expected to vest end of period (in shares) \| shares	2,440,741		2,440,741
Exercisable, end of period (in shares) \| shares	1,483,866		1,483,866
Weighted average exercise price of stock options
Outstanding, beginning of period (in dollars per share)			$ 61.50
Granted (in dollars per share)			99.02
Forfeited (in dollars per share)			74.78
Exercised (in dollars per share)			56.58
Outstanding, end of period (in dollars per share)	$ 68.51		68.51
Vested and expected to vest end of period (in dollars per share)	68.38		68.38
Exercisable, end of period (in dollars per share)	$ 59.99		$ 59.99
Assumptions used for estimating value of awards granted
Vesting period			3 years
Life of options (Expiration period)			10 years
Restricted stock awards
Nonvested restricted stock awards and units
Outstanding, beginning of period (in shares) \| shares			31,102
Awarded (in shares) \| shares			11,795
Vested (in shares) \| shares			(31,102)
Outstanding, end of period (in shares) \| shares	11,795		11,795
Weighted average exercise price of nonvested restricted stock award and units
Outstanding, beginning of period (in dollars per share)			$ 68.00
Awarded (in dollars per share)			89.05
Vested (in dollars per share)			68.00
Outstanding, end of period (in dollars per share)	$ 89.05		$ 89.05
Restricted stock awards \| Minimum
Assumptions used for estimating value of awards granted
Vesting period			12 months
Restricted stock awards \| Maximum
Assumptions used for estimating value of awards granted
Vesting period			24 months
Restricted Stock Units (RSUs)
Nonvested restricted stock awards and units
Outstanding, beginning of period (in shares) \| shares			163,289
Awarded (in shares) \| shares			109,348
Vested (in shares) \| shares			(82,207)
Forfeited (in shares) \| shares			(13,082)
Outstanding, end of period (in shares) \| shares	177,348		177,348
Weighted average exercise price of nonvested restricted stock award and units
Outstanding, beginning of period (in dollars per share)			$ 66.46
Awarded (in dollars per share)			99.45
Vested (in dollars per share)			65.54
Forfeited (in dollars per share)			80.95
Outstanding, end of period (in dollars per share)	$ 86.16		$ 86.16
Assumptions used for estimating value of awards granted
Vesting period			3 years
Performance Based Restricted Stock Units (“PSUs”)
Nonvested restricted stock awards and units
Outstanding, beginning of period (in shares) \| shares			202,315
Awarded (in shares) \| shares			80,502
Vested (in shares) \| shares			(33,592)
Forfeited (in shares) \| shares			(1,865)
Outstanding, end of period (in shares) \| shares	247,360		247,360
Weighted average exercise price of nonvested restricted stock award and units
Outstanding, beginning of period (in dollars per share)			$ 84.63
Awarded (in dollars per share)			141.61
Vested (in dollars per share)			85.00
Forfeited (in dollars per share)			97.25
Outstanding, end of period (in dollars per share)	$ 103.03		$ 103.03
Assumptions used for estimating value of awards granted
Vesting period			3 years
Expected dividend yield (as a percent)			0.00%
Risk-free interest rate (as a percent)			2.37%
Expected volatility, minimum (as a percent)			20.00%
Expected volatility, maximum (as a percent)			82.00%
Expected volatility, average (as a percent)			35.00%
Number of trading days considered for average share value			30 days
Number of companies in peer group \| company			49
Performance Based Restricted Stock Units (“PSUs”) \| Minimum
Assumptions used for estimating value of awards granted
Percentage of shares to be settled			0.00%
Performance Based Restricted Stock Units (“PSUs”) \| Maximum
Assumptions used for estimating value of awards granted
Percentage of shares to be settled			200.00%