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Components of Changes in Health Care Costs Payable (Detail)
$ in Thousands
 6 Months Ended
Jun. 30, 2016
USD ($)
Medical Expense And Medical Claims Payable [Line Items]  
Health care costs payable, beginning of the period $ 332,102
Less: Claims paid  
Health care costs payable, end of the period 300,564
Healthcare Cost  
Medical Expense And Medical Claims Payable [Line Items]  
Health care costs payable, beginning of the period 212,641
Add: Components of incurred health care costs  
Current year 857,955
Prior years 6,424
Total incurred health care costs 864,379
Less: Claims paid  
Current year 665,499
Prior years 194,385
Total claims paid 859,884
Health care costs payable, end of the period $ 217,136