Other Liabilities (Detail) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Other Liabilities [Line Items]
Payor refunds and retractions	$ 169,480	$ 163,520
Contingent earn-out consideration	6,577	142,244
Insurance and self-insurance accruals	84,882	78,073
Accrued interest	45,662	44,884
Other medical payables	31,219	39,698
Held for sale		18,440
Accrued non-income tax liabilities	18,366	17,976
Interest rate swap agreements	12,069
Other	96,167	58,530
Other liabilities	$ 464,422	$ 563,365