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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2016 | Dec. 31, 2015
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Income Tax Disclosure [Abstract] |  |
Allowance for uncollectible accounts | $ 103,525 | $ 82,928
Reserves and accruals | 62,212 | 66,655
Stock-based compensation | 13,726 | 13,662
Net operating loss carryforward | 49,156 | 51,505
Property and equipment | 1,621 | 3,116
Other | 1,610 | 2,723
Deferred tax assets before valuation allowance | 231,850 | 220,589
Less: Valuation allowance | (4,014) | (1,552)
Total deferred tax assets | 227,836 | 219,037
Gross deferred tax liabilities: |  |
Amortization | (380,594) | (311,303)
Accrual to cash adjustment | (53,771) | (55,046)
Other | (1,023) | (6,693)
Total deferred tax liabilities | (435,388) | (373,042)
Net deferred tax liability | $ (207,552) | $ (154,005)

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