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Acquisitions - Schedules of Pro Forma Information (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Original Purchase Agreement    
Business Acquisition [Line Items]    
Total revenues $ 1,610,216 $ 1,876,494
Net loss attributable to shareholders $ (63,595) $ (71,788)
Net loss attributable to shareholders per share:    
Basic (in dollars per share) $ (1.45) $ (1.66)
Diluted (in dollars per share) $ (1.45) $ (1.66)
Discovery Benefits and Noventis    
Business Acquisition [Line Items]    
Total revenues $ 1,742,797 $ 1,604,165
Net loss attributable to shareholders $ 113,851 $ 134,564
Net loss attributable to shareholders per share:    
Basic (in dollars per share) $ 2.63 $ 3.12
Diluted (in dollars per share) $ 2.60 $ 3.09