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Selected Quarterly Financial Data (unaudited) Selected Quarterly Financial Data - Additional Information (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended
--- | --- | --- | ---
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Jun. 30, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Business Combination, Step Acquisition, Equity Interest in Acquiree, Remeasurement Gain | $ (28,152) |  |  |  |  |  |  |  | $ (28,152) |  |
Income tax expense |  |  |  |  |  |  |  |  | 258,400 | $ 323,859 | $ 431,761
Valuation adjustment on disposal group |  |  |  |  |  |  |  |  | 316,840 | 0 | 0
Equity investment (loss) income |  |  |  |  |  |  |  |  | (4,484) | (8,640) | 16,874
Restructuring Charges |  |  |  |  | $ 9,569 |  |  |  |  |  |
Loss Contingency Accrual, Period Increase (Decrease) |  |  |  |  | 11,100 | $ 3,600 |  |  |  |  |
Investment and other asset impairments |  |  |  |  |  |  |  |  | 17,338 | 295,234 | 14,993
Share-based Compensation Arrangement by Share-based Payment Award, Plan Modification, Incremental Compensation Cost |  | $ 23,470 |  |  |  |  |  |  | 14,704 |  |
Goodwill impairment charges |  |  |  |  |  |  |  |  | 3,106 | 36,196 | 28,415
Gain (loss) related to litigation settlement |  |  |  |  |  |  |  |  | 0 | 526,827 | 0
APAC JV - Deconsolidated Noncontrolling Entity |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Equity Method Investment, Realized Gain (Loss) on Disposal |  |  |  |  |  |  | $ (6,273) |  |  |  |
Equity investment (loss) income | 1,530 | 5,995 |  |  | 6,293 |  |  |  | (4,484) | (8,640) | 16,874
Equity Method Investment, Other than Temporary Impairment |  |  |  | $ 280,066 |  |  |  |  |  |  |
Paladina - Direct Primary Care |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Equity Method Investment, Realized Gain (Loss) on Disposal |  | 1,506 | $ 35,205 |  |  |  |  |  |  |  |
Tandigm Health |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Equity Method Investment, Realized Gain (Loss) on Disposal |  |  | 25,096 |  |  |  |  |  |  |  |
Business Combination, Bargain Purchase, Gain Recognized, Amount |  |  |  |  | (17,129) |  |  |  |  |  |
INDIA | APAC JV - Deconsolidated Noncontrolling Entity |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Equity investment (loss) income | 8,715 |  |  |  |  |  |  |  |  |  |
GERMANY |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Goodwill impairment charges |  |  | 3,106 |  |  |  |  |  | 3,106 |  |
DaVita Rx - Pharmacy |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Restructuring Charges |  | 11,366 |  |  |  |  |  |  |  |  |
Investment and other asset impairments |  | 6,093 |  |  |  |  |  |  |  |  |
Asset Impairment Charges |  |  | 11,245 |  |  |  | 15,168 |  |  |  |
International Operations |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Equity Method Investment, Realized Gain (Loss) on Disposal |  |  | $ 1,248 |  |  |  |  |  |  |  |
Restructuring Charges |  |  |  |  | 2,700 |  |  |  |  |  |
Goodwill impairment charges |  |  |  |  |  |  |  |  |  | 1,500 |
Vascular access |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Goodwill impairment charges |  |  |  |  |  |  | 24,198 | $ 10,498 |  | 34,696 | 28,415
U.S. Department of Veterans Affairs (VA) |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Gain (loss) related to litigation settlement |  |  |  |  |  |  | $ (529,504) |  |  | 527,000 |
DMG - Held for sale |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Goodwill impairment charges |  |  |  |  | $ 601,040 | $ 50,619 |  |  |  |  |
DMG - Held for sale | Discontinued Operations, Held-for-sale |  |  |  |  |  |  |  |  |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |  |  |  |  |  |  |  |  |
Income tax expense |  |  |  | $ 163,555 |  |  |  |  |  |  |
Valuation adjustment on disposal group | 218,639 | 98,201 |  |  |  |  |  |  | 316,840 |  |
Goodwill impairment charges | 41,537 |  |  |  |  |  |  |  | 41,537 | $ 651,659 | $ 253,000
Tax expense related to valuation adjustment, disposal group, including discontinued operation | $ 8,318 | 117,946 |  |  |  |  |  |  | 109,628 |  |
Valuation Charge To Record Valuation Allowance And Related Tax Expense, Disposal Group, Including Discontinued Operations |  | $ 216,147 |  |  |  |  |  |  | $ 468,005 |  |

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