Goodwill and Intangible Assets (Details 1) (USD $) In Thousands, unless otherwise specified	3 Months Ended	6 Months Ended
	Dec. 31, 2011	Jun. 30, 2012
Schedule of intangible assets
Average Life in Years
Gross Carrying Amount, Finite Intangible assets	$ 55,333	$ 16,396
Accumulated Amortization, Finite Intangible assets	(11,567)	(4,053)
Impairment Charge, Finite Intangible assets	(30,400)
Net Book Value, Finite Intangible assets	13,366	12,343
Gross Carrying Amount, Indefinite Intangible assets	532,000	472,000
Impairment Charge, Indefinite Lived Intangible assets	(60,000)
Net Book Value, Indefinite Lived Intangible assets	472,000	472,000
Gross Carrying Amount, Intangible assets	587,333	488,396
Impairment Charge, Intangible assets	(90,400)
Net Book Value	485,366	484,343
Capitated relationships [Member]
Schedule of intangible assets
Average Life in Years		20 years
Gross Carrying Amount, Finite Intangible assets	40,000	4,400
Accumulated Amortization, Finite Intangible assets	(6,333)	(1,230)
Impairment Charge, Finite Intangible assets	(30,400)
Net Book Value, Finite Intangible assets	3,267	3,170
Payor relationships [Member]
Schedule of intangible assets
Average Life in Years		20 years
Gross Carrying Amount, Finite Intangible assets	11,000	11,000
Accumulated Amortization, Finite Intangible assets	(1,742)	(2,017)
Impairment Charge, Finite Intangible assets
Net Book Value, Finite Intangible assets	9,258	8,983
Net favorable leasehold interest [Member]
Schedule of intangible assets
Average Life in Years		3 years 6 months
Gross Carrying Amount, Finite Intangible assets	3,210
Accumulated Amortization, Finite Intangible assets	(2,904)
Impairment Charge, Finite Intangible assets
Net Book Value, Finite Intangible assets	306
Customer list [Member]
Schedule of intangible assets
Average Life in Years		1 year 1 month 6 days
Gross Carrying Amount, Finite Intangible assets	1,123	996
Accumulated Amortization, Finite Intangible assets	(588)	(806)
Impairment Charge, Finite Intangible assets
Net Book Value, Finite Intangible assets	535	190
Trade names [Member]
Schedule of intangible assets
Average Life in Years
Gross Carrying Amount, Indefinite Intangible assets	525,000	465,000
Impairment Charge, Indefinite Lived Intangible assets	(60,000)
Net Book Value, Indefinite Lived Intangible assets	465,000	465,000
Accreditations with commissions [Member]
Schedule of intangible assets
Average Life in Years
Gross Carrying Amount, Indefinite Intangible assets	7,000	7,000
Impairment Charge, Indefinite Lived Intangible assets
Net Book Value, Indefinite Lived Intangible assets	$ 7,000	$ 7,000