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Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Goodwill And Other Intangible Asset [Line Items]      
Goodwill $ 3,845,157 $ 3,366,150  
Change in goodwill carrying amount 479,000 590,000  
Goodwill deductible for tax purpose 179,800    
Intangible assets related to acquisitions 304,600    
Amortization expense for intangible assets 60,300 $ 42,000 $ 30,100
Physician And Hospital Agreements [Member]      
Goodwill And Other Intangible Asset [Line Items]      
Intangible assets related to acquisitions $ 82,400    
Weighted average amortization period 10 years    
Customer Relationships [Member]      
Goodwill And Other Intangible Asset [Line Items]      
Intangible assets related to acquisitions $ 194,400    
Weighted average amortization period 20 years    
Trade Names [Member]      
Goodwill And Other Intangible Asset [Line Items]      
Intangible assets related to acquisitions $ 14,500    
Weighted average amortization period 20 years    
Patented and Other Technology [Member]      
Goodwill And Other Intangible Asset [Line Items]      
Intangible assets related to acquisitions $ 13,300    
Weighted average amortization period 10 years