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Investments in Debt and Equity Securities - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Available for sale investments gross pre-tax unrealized gain (loss)	$ 4,934		$ 4,934		$ 2,589
Unrealized gain (losses) on investments, net of tax	1,121	$ (1,651)	1,988	$ (1,368)
Proceeds from sale of investments available for sale debt securities			4,645
Proceeds from sale of investments available for sale				1,961
Pre tax reclassification of net investment realized gain (loss) into net income			233	617
Reclassification of net investment realized gain (loss) into net income, net of tax			143	$ 376
HealthCare Partners (HCP)
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Required minimum cash balance	$ 58,127		58,127
Certificates of deposit, commercial paper and money market funds
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Unrealized gain (losses) on investments, pre tax			2,578
Unrealized gain (losses) on investments, net of tax			$ 1,781