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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 $ (49,480) $ (62,315)
Net loss attributable to shareholders per share:    
Basic (in dollars per share) $ (1.13) $ (1.44)
Diluted (in dollars per share) $ (1.13) $ (1.44)
Discovery Benefits and Noventis    
Business Acquisition [Line Items]    
Total revenues   $ 1,742,797
Net loss attributable to shareholders   $ 113,851
Net loss attributable to shareholders per share:    
Basic (in dollars per share)   $ 2.63
Diluted (in dollars per share)   $ 2.60