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Held for Sale and Discontinued Operations Additional Information (Details) $ in Thousands		1 Months Ended	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 01, 2018 USD ($)	Dec. 31, 2017 USD ($)	Jun. 30, 2018 USD ($)	Jun. 30, 2017 USD ($)	Jun. 30, 2018 USD ($) clinic	Jun. 30, 2017 USD ($)	Dec. 31, 2017 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from Divestiture of Businesses		$ 4,900,000
Payments to Acquire Businesses, Gross					$ 89,465	$ 619,839
Goodwill impairment charges			$ 3,106	$ 10,498	3,106	34,696	$ 36,196
Series of Individually Immaterial Business Acquisitions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payments to Acquire Businesses, Gross					$ 88,185
DMG held for sale | Series of Individually Immaterial Business Acquisitions [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of businesses acquired | clinic					2
Payments to Acquire Businesses, Gross					$ 1,280
Business Combination, Consideration Transferred, Other					99
Discontinued Operations, Held-for-sale | DMG held for sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill impairment charges			$ 0	$ 50,619	$ 0	$ 50,619
Tandigm Health
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale of Stock, Percentage of Ownership before Transaction	19.00%
Gain (Loss) on Disposition of Business, Net of Tax	$ 18,636

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Amount of tangible or intangible assets, including a business or subsidiary of the acquirer transferred by the entity to the former owners of the acquiree. Excludes cash.

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