Commitments and Contingencies (Details)			1 Months Ended		12 Months Ended
	Dec. 27, 2018 USD ($)	Sep. 07, 2018 lawsuit	Dec. 31, 2018 USD ($)	Aug. 31, 2017 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration			$ 24,600,000		$ 24,600,000	$ 41,400,000
Payment of SEC penalty	$ 100,000		100,000
Class action lawsuits | lawsuit		7
Contingent membership interest				15.00%
Credit line capacity			197,189,000		197,189,000
Fixed purchase provisions			98,500,000		98,500,000
Accrued Expenses
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration			2,400,000		2,400,000	11,800,000
Other Long-term Liabilities
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration			$ 22,200,000		22,200,000	29,600,000
BioReference
Business Acquisition, Contingent Consideration [Line Items]
Severance Costs					$ 4,900,000	$ 5,800,000	$ 17,900,000
Line of Credit | Veterans Accountable Care Group LLC
Business Acquisition, Contingent Consideration [Line Items]
Credit line capacity				$ 50,000,000.0
Line of credit facility, expiration period				5 years
Interest rate of notes payable				6.50%