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Accrued Professional Liability - Schedule of Accrued Professional Liability (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2015
Dec. 31, 2014
Dec. 31, 2013
Payables and Accruals [Abstract]      
Balance at beginning of year $ 168,369 $ 158,691 $ 137,036
Assumed liabilities through acquisition 35,968    
Provision (adjustment) for losses related to Current year 39,204 39,386 41,235
Provision (adjustment) for losses related to Prior years (25,797) (16,125) (8,100)
Total provision for losses 13,407 23,261 33,135
Claim payments related to Current year (1,382) (293) (741)
Claim payments related to Prior years (13,835) (13,290) (10,739)
Total payments (15,217) (13,583) (11,480)
Balance at end of year $ 202,527 $ 168,369 $ 158,691