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Schedule of Disaggregates Revenue by Major Source (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  | $ 2,754,496 | $ 2,648,913 | $ 2,681,353 | $ 2,687,516 | $ 2,642,787 | $ 2,541,864 | $ 2,612,356 | $ 2,612,858 | $ 10,772,278 | $ 10,409,865 | $ 9,766,210
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 100.00% | 100.00% | 100.00%
Medicare |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 1,875,875 | $ 1,816,840 | $ 1,729,093
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 17.00% | 17.00% | 18.00%
Managed Medicare |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 929,390 | $ 791,403 | $ 679,778
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 9.00% | 8.00% | 7.00%
Medicaid |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 1,183,618 | $ 1,206,364 | $ 1,180,160
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 11.00% | 12.00% | 12.00%
Managed Medicaid |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 1,530,005 | $ 1,388,751 | $ 1,237,398
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 14.00% | 13.00% | 13.00%
Managed Care (HMO and PPOs) |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 3,489,870 | $ 3,361,521 | $ 3,253,029
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 32.00% | 32.00% | 33.00%
UK Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 504,721 | $ 426,575 | $ 241,098
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 5.00% | 4.00% | 2.00%
Other Patient Revenue and Adjustments, Net |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 650,987 | $ 717,971 | $ 741,222
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 6.00% | 7.00% | 8.00%
Other Non-patient Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 607,812 | $ 700,440 | $ 704,432
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 6.00% | 7.00% | 7.00%
Acute Care Hospital Services |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 5,719,905 | $ 5,484,683 | $ 5,112,950
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 100.00% | 100.00% | 100.00%
Acute Care Hospital Services | Medicare |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 1,296,152 | $ 1,223,150 | $ 1,114,911
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 23.00% | 22.00% | 22.00%
Acute Care Hospital Services | Managed Medicare |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 730,387 | $ 630,083 | $ 536,224
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 13.00% | 11.00% | 10.00%
Acute Care Hospital Services | Medicaid |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 487,197 | $ 482,820 | $ 424,934
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 9.00% | 9.00% | 8.00%
Acute Care Hospital Services | Managed Medicaid |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 554,438 | $ 511,844 | $ 444,164
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 10.00% | 9.00% | 9.00%
Acute Care Hospital Services | Managed Care (HMO and PPOs) |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 2,093,890 | $ 1,949,435 | $ 1,845,571
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 37.00% | 36.00% | 36.00%
Acute Care Hospital Services | UK Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 0 | $ 0 | $ 0
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 0.00% | 0.00% | 0.00%
Acute Care Hospital Services | Other Patient Revenue and Adjustments, Net |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 167,570 | $ 219,056 | $ 284,872
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 3.00% | 4.00% | 6.00%
Acute Care Hospital Services | Other Non-patient Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 390,271 | $ 468,295 | $ 462,274
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 7.00% | 9.00% | 9.00%
Behavioral Health Services |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues | [1] |  |  |  |  |  |  |  |  | $ 5,038,874 | $ 4,906,719 | $ 4,645,007
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 100.00% | 100.00% | 100.00%
Behavioral Health Services | Medicare |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 579,723 | $ 593,690 | $ 614,182
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 12.00% | 12.00% | 13.00%
Behavioral Health Services | Managed Medicare |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 199,003 | $ 161,320 | $ 143,554
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 4.00% | 3.00% | 3.00%
Behavioral Health Services | Medicaid |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 696,421 | $ 723,544 | $ 755,226
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 14.00% | 15.00% | 16.00%
Behavioral Health Services | Managed Medicaid |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 975,567 | $ 876,907 | $ 793,234
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 19.00% | 18.00% | 17.00%
Behavioral Health Services | Managed Care (HMO and PPOs) |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 1,395,980 | $ 1,412,086 | $ 1,407,458
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 28.00% | 29.00% | 30.00%
Behavioral Health Services | UK Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 504,721 | $ 426,575 | $ 241,098
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 10.00% | 9.00% | 5.00%
Behavioral Health Services | Other Patient Revenue and Adjustments, Net |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 483,417 | $ 498,915 | $ 456,350
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 10.00% | 10.00% | 10.00%
Behavioral Health Services | Other Non-patient Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 204,042 | $ 213,682 | $ 233,905
Percentage of Net Revenue |  |  |  |  |  |  |  |  |  | 4.00% | 4.00% | 5.00%
Other |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 13,499 | $ 18,463 | $ 8,253
Other | Other Non-patient Revenue |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Net revenues |  |  |  |  |  |  |  |  |  | $ 13,499 | $ 18,463 | $ 8,253
[1] | Includes net revenues generated from our behavioral health care facilities located in the U.K. amounting to approximately $505 million in 2018, $429 million in 2017 and $241 million in 2016. Total assets at our U.K. behavioral health care facilities were approximately $1.224 billion as of December 31, 2018, $1.098 billion as of December 31, 2017 and $965 million as of December 31, 2016. In addition, included in our 2018 Behavioral Health Services operating segment Income (loss) before allocation of corporate overhead and income taxes is a pre-tax $49 million provision for asset impairment to reduce the carrying value of a tradename intangible asset.

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