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Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Detail) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017
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Finite-Lived Intangible Assets [Line Items] |  |
Gross Carrying Value | $ 910,888 | $ 906,681
Accumulated Amortization | (322,576) | (266,753)
Net Carrying Value | 588,312 | 639,928
Physician And Hospital Agreements [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross Carrying Value | 376,871 | 381,635
Accumulated Amortization | (223,589) | (203,915)
Net Carrying Value | 153,282 | 177,720
Customer Relationships [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross Carrying Value | 443,300 | 443,300
Accumulated Amortization | (71,870) | (48,837)
Net Carrying Value | 371,430 | 394,463
Trade Names [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross Carrying Value | 43,156 | 43,156
Accumulated Amortization | (4,630) | (2,933)
Net Carrying Value | 38,526 | 40,223
Patented and Other Technology [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross Carrying Value | 47,561 | 38,590
Accumulated Amortization | (22,487) | (11,068)
Net Carrying Value | $ 25,074 | $ 27,522

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