v2.4.0.8
Components of Change in Health Care Costs Payable (Detail) (USD $)
In Thousands, unless otherwise specified
 12 Months Ended
Dec. 31, 2013
Dec. 31, 2012
Dec. 31, 2013
Healthcare Cost
Medical Expense And Medical Claims Payable [Line Items]      
Health care costs payable, beginning of the year $ 287,452 $ 238,964 $ 119,512
Acquisitions and other adjustments     26,575
Add: Components of incurred health care costs      
Current year     1,329,887
Prior years     (16,587)
Total incurred health care costs     1,313,300
Less: Claims paid      
Current year     1,169,455
Prior years     117,622
Total claims paid     1,287,077
Health care costs payable, end of the year $ 287,452 $ 238,964 $ 172,310