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General (Detail) - USD ($) | 3 Months Ended | 9 Months Ended |
--- | --- | --- | ---
Sep. 30, 2015 | Sep. 30, 2014 | Sep. 30, 2015 | Sep. 30, 2014 | Sep. 01, 2015
Organization And Description Of Business [Line Items] |  |  |  |  |
Revenue from Medicaid programs | $ 2,439,071,000 | $ 2,196,513,000 | $ 7,271,852,000 | $ 6,570,732,000 |
Increase (decrease) in net revenue |  | 21,000,000 |  |  |
Increase (decrease) in other operating expense |  |  |  | 71,000,000 |
Impairment of goodwill or indefinite-lived intangible assets |  |  |  |  | $ 0
State Medicaid programs |  |  |  |  |
Organization And Description Of Business [Line Items] |  |  |  |  |
Revenue from Medicaid programs | 62,000,000 | 53,000,000 | 221,000,000 | 180,000,000 |
Revenue offset amount | $ 30,000,000 | $ 21,000,000 | $ 97,000,000 | $ 71,000,000 |

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