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Business Combinations - Goodwill (Details) - USD ($)
$ in Thousands
Jun. 30, 2016
Dec. 31, 2015
Aug. 17, 2015
Nov. 12, 2014
Business Combinations        
Goodwill not deductible for tax $ 639,484 $ 639,188    
Acquisitions        
Business Combinations        
Goodwill not deductible for tax 639,500      
CBR Acquisition Holdings Corp        
Business Combinations        
Goodwill not deductible for tax 441,400   $ 441,371  
Lumara Health        
Business Combinations        
Goodwill not deductible for tax $ 198,100     $ 198,113