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Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands | Dec. 31, 2017 | Dec. 31, 2016
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Income Tax Disclosure [Abstract] |  |
Allowance for uncollectible accounts | $ 80,056 | $ 103,525
Reserves and accruals | 45,454 | 62,212
Stock-based compensation | 7,975 | 13,726
Net operating loss carryforward | 28,569 | 49,156
Property and equipment | 685 | 1,621
Other | 970 | 1,610
Deferred tax assets before valuation allowance | 163,709 | 231,850
Less: Valuation allowance | (2,615) | (4,014)
Deferred tax assets, net of valuation allowance | 161,094 | 227,836
Gross deferred tax liabilities: |  |
Amortization | (258,618) | (380,594)
Accrual to cash adjustment | (31,290) | (53,771)
Other | (4,150) | (1,023)
Total deferred tax liabilities | (294,058) | (435,388)
Net deferred tax liability | $ (132,964) | $ (207,552)

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