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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Operating activities:      
Net income $ 52 $ 143 $ 62
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 182 126 134
Deferred income taxes 22 (7) (2)
Share-based compensation 26 23 22
Amortization of convertible senior notes and lease financing obligations 31 30 27
Other, net 16 19 7
Changes in operating assets and liabilities:      
Receivables (348) 56 (298)
Prepaid expenses and other current assets (69) (35) (20)
Medical claims and benefits payable 226 482 531
Amounts due government agencies 473 202 470
Accounts payable and accrued liabilities (4) 84 11
Deferred revenue 92 24 74
Income taxes (26) (22) 42
Net cash provided by operating activities 673 1,125 1,060
Investing activities:      
Purchases of investments (1,929) (1,923) (953)
Proceeds from sales and maturities of investments 1,966 1,126 633
Purchases of property, equipment and capitalized software (176) (132) (115)
Change in restricted investments 4 (6) (34)
Net cash paid in business combinations (48) (450) (44)
Other, net (19) (35) (23)
Net cash used in investing activities (202) (1,420) (536)
Financing activities:      
Proceeds from senior notes offerings, net of issuance costs 0 689 123
Proceeds from common stock offering, net of issuance costs 0 373 0
Contingent consideration liabilities settled 0 0 (50)
Proceeds from employee stock plans 18 18 14
Principal payments on convertible senior notes 0 0 (10)
Other, net 1 5 2
Net cash provided by financing activities 19 1,085 79
Net increase in cash and cash equivalents 490 790 603
Cash and cash equivalents at beginning of period 2,329 1,539 936
Cash and cash equivalents at end of period 2,819 2,329 1,539
Supplemental cash flow information:      
Income taxes 153 197 30
Interest 66 38 29
Schedule of non-cash investing and financing activities:      
Convertible senior notes exchange transaction 0 0 177
Increase in non-cash lease financing obligation 0 0 14
Common stock used for stock-based compensation (8) (15) (9)
Details of business combinations:      
Fair value of assets acquired (186) (389) (52)
Fair value of liabilities assumed 28 41 0
Payable to seller 8 0 8
Amounts advanced for acquisitions 102 (102) 0
Net cash paid in business combinations (48) (450) (44)
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net 0 0 0
(Loss) gain on 1.125% Notes Call Option      
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net (107) 45 143
Gain (loss) on 1.125% Notes Conversion Option      
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net $ 107 $ (45) $ (143)