Income Taxes - Effective Tax Rate Reconciliation (Details)	12 Months Ended
Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Effective Income Tax Rate Reconciliation, Amount [Abstract]
Statutory income tax rate	21.00%	21.00%	21.00%
State income taxes, net of federal tax benefit	3.20%	4.00%	27.70%
Effect of the Tax Cuts and Jobs Act	0	0	(0.071)
Health insurer fee	2.20%	0.00%	2.20%
Goodwill impairments	0.00%	0.00%	89.50%
Basis difference upon disposition of subsidiary	(1.20%)	0.00%	5.00%
Other	1.10%	1.30%	4.10%
Effective income tax rate	26.30%	26.30%	142.40%

Represents the tax effect of the health care reform's non-tax deductible health insurer fee.

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- Definition

Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 12
-URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319

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Percentage of domestic federal statutory tax rate applicable to pretax income (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 6.I.Fact.4)
-URI http://asc.fasb.org/extlink&oid=116825942&loc=d3e330036-122817

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 12
-URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319

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- Definition

Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to disposition of a business not qualifying as a discontinued operation.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 6.I.Fact.4)
-URI http://asc.fasb.org/extlink&oid=116825942&loc=d3e330036-122817

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 12
-URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319

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+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 12
-URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 6.I.Fact.4)
-URI http://asc.fasb.org/extlink&oid=116825942&loc=d3e330036-122817

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- Definition

Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations applicable to state and local income tax expense (benefit), net of federal tax expense (benefit).

+ References

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- Definition

Percentage of reported income tax expense (benefit) in excess of (less than) expected income tax expense (benefit) computed by applying domestic federal statutory income tax rate to pretax income (loss) from continuing operations, attributable to Tax Cuts and Jobs Act.

+ References

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