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Business Acquisitions - Additional Information (Detail) (USD $) | 12 Months Ended
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Dec. 31, 2013 Company | Dec. 31, 2012 Company
Business Acquisition [Line Items] |  |
Number of physician group practices acquired | 11 | 16
Business acquisition, total consideration | $ 250,100,000 | $ 451,100,000
Cash consideration | 236,700,000 | 436,400,000
Contingent consideration | 13,400,000 | 14,700,000
Goodwill recorded in connection with acquisitions | 2,393,731,000 | 2,165,672,000
Other intangible assets | 29,600,000 | 48,200,000
Other liabilities | 8,100,000 | 12,000,000
Contingent consideration payments related to prior-period acquisitions | 13,400,000 |
Assumed payment probability of contingent consideration payment | 100.00% |
Range of the undiscounted amount under contingent consideration agreement, low | 0 |
Range of the undiscounted amount under contingent consideration agreement, high | 14,600,000 |
Time period for achievement of certain performance measures for payment of contingent consideration, years | 5 years |
Contingent consideration increase in fair value | 2,700,000 |
Contingent consideration decrease in fair value | 900,000 |
Contingent consideration Net change in fair value | 1,800,000 |
Eleven Physician Group Practices Acquisition [Member] |  |
Business Acquisition [Line Items] |  |
Goodwill recorded in connection with acquisitions | 228,600,000 |
Prior-Period Acquisition [Member] |  |
Business Acquisition [Line Items] |  |
Contingent consideration payments related to prior-period acquisitions | 13,000,000 |
Prior-period acquisition of other assets | 500,000 |
Sixteen Physician Group Practices Acquisition [Member] |  |
Business Acquisition [Line Items] |  |
Goodwill recorded in connection with acquisitions |  | 414,300,000
Fixed assets |  | 600,000
Prior-Period Acquisitions [Member] |  |
Business Acquisition [Line Items] |  |
Contingent consideration | 43,000,000 |
Contingent consideration payments related to prior-period acquisitions | $ 45,400,000 |
Minimum [Member] |  |
Business Acquisition [Line Items] |  |
Assumed discount rates for acquisition-date fair value | 2.50% |
Eligibility criteria for payments of contingent purchase price (in years) | 3 years |
Maximum [Member] |  |
Business Acquisition [Line Items] |  |
Assumed discount rates for acquisition-date fair value | 4.00% |
Eligibility criteria for payments of contingent purchase price (in years) | 5 years |

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- Definition Amount of consideration transferred, consisting of acquisition-date fair value of assets transferred by the acquirer, liabilities incurred by the acquirer, and equity interest issued by the acquirer. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 30 -Paragraph 7 -URI http://asc.fasb.org/extlink&oid=6911251&loc=d3e6578-128477 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 30 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6911251&loc=d3e6613-128477 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=7488404&loc=d3e6927-128479 + Details
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- Definition Amount of other liabilities due after one year or the normal operating cycle, if longer, assumed at the acquisition date. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 805 -SubTopic 20 -Section 50 -Paragraph 1 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=6910749&loc=d3e4845-128472 + Details
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