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Investments in debt and equity securities - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Available for sale investments gross pre-tax unrealized gain (loss)	$ 8,021		$ 8,021		$ 3,701
Unrealized gains on investments	863	$ 1,121	3,478	$ 1,988
Proceeds from sale of mutual funds and debt securities			5,822
Pre tax reclassification of net investment realized gain (loss) into net income			362	233
Reclassification of net investment realized gain (loss) into net income, net tax			221	143
Proceeds from sale of investments available for sale				$ 4,645
HealthCare Partners (HCP)
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Required minimum cash balance	$ 61,557		61,557
Certificates of deposit, commercial paper and money market funds due within one year
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Other Comprehensive Income (Loss), Unrealized Holding Gain (Loss) on Securities Arising During Period, before Tax			4,682
Unrealized gains on investments			$ 3,480

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