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General (Detail) - Entity [Domain] - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended
--- | --- | ---
Jun. 30, 2015 | Jun. 30, 2014 | Jun. 30, 2015 | Jun. 30, 2014
Organization And Description Of Business [Line Items] |  |  |  |
Revenue from Medicaid programs | $ 2,452,680 | $ 2,227,721 | $ 4,832,781 | $ 4,374,219
Increase (decrease) in net revenue |  | 32,000 |  |
Increase (decrease) in other operating expense |  |  |  | 50,000
State Medicaid programs |  |  |  |
Organization And Description Of Business [Line Items] |  |  |  |
Revenue from Medicaid programs | 92,000 | 75,000 | 159,000 | 124,000
Revenue offset amount | $ 39,000 | $ 32,000 | $ 67,000 | $ 50,000

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