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Summary of Significant Accounting Policies - Textual (Details)
$ in Millions
 12 Months Ended
Dec. 31, 2018
USD ($)
state
Dec. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Jan. 01, 2019
USD ($)
Finite-Lived Intangible Assets [Line Items]        
Total liabilities $ 3,356.3 $ 3,248.2    
Total assets [1] $ 5,175.0 4,864.5    
Number of states in which Entity operates | state 36      
Collection success rate of denied payments (percent) 70.00%      
Minimum accrual of loss contingency needed to accrue for related legal fees $ 5.0      
Advertising expense $ 6.7 $ 6.3 $ 7.5  
Payor Source [Member] | Revenue from Contract with Customer [Member] | Medicare [Member] | RAC Audits [Member]        
Finite-Lived Intangible Assets [Line Items]        
Percentage of Medicare patient discharges (percent) 1.00%      
Minimum [Member] | Accounting Standards Update 2016-02 [Member]        
Finite-Lived Intangible Assets [Line Items]        
Total liabilities       $ 330.0
Total assets       330.0
Maximum [Member] | Accounting Standards Update 2016-02 [Member]        
Finite-Lived Intangible Assets [Line Items]        
Total liabilities       370.0
Total assets       $ 370.0
[1] Our consolidated assets as of December 31, 2018 and December 31, 2017 include total assets of variable interest entities of $197.5 million and $264.1 million, respectively, which cannot be used by us to settle the obligations of other entities. Our consolidated liabilities as of December 31, 2018 and December 31, 2017 include total liabilities of the variable interest entities of $50.8 million and $52.5 million, respectively. See Note 3, Variable Interest Entities.