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Components of Changes in Medical Payables (Detail)
$ in Thousands
 6 Months Ended
Jun. 30, 2017
USD ($)
Health Care Costs Payable [Roll Forward]  
Health care costs payable, beginning of the period $ 336,381
Less: Claims paid  
Health care costs payable, end of the period 390,387
Healthcare Cost  
Health Care Costs Payable [Roll Forward]  
Health care costs payable, beginning of the period 214,275
Add: Components of incurred health care costs  
Current year 991,818
Prior years (6,838)
Total incurred health care costs 984,980
Less: Claims paid  
Current year 727,814
Prior years 186,623
Total claims paid 914,437
Health care costs payable, end of the period $ 284,818