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Schedule of intangible assets (Detail) - USD ($) | 6 Months Ended | 12 Months Ended
--- | --- | ---
Jun. 30, 2018 | Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items] |  |
Intangible Assets, Gross, Total, Beginning Balance | $ 144,476,000 | $ 144,476,000
Accumulated Amortization | (49,548,964) | (40,942,442)
Intangible Assets, Net | 94,927,036 | 103,533,558
Medicare License |  |
Finite-Lived Intangible Assets [Line Items] |  |
Intangible Assets, Gross, Total, Beginning Balance | 1,994,000 | 1,994,000
Accumulated Amortization | 0 | 0
Intangible Assets, Net | 1,994,000 | 1,994,000
Network relationships |  |
Finite-Lived Intangible Assets [Line Items] |  |
Intangible Assets, Gross, Total, Beginning Balance | 109,883,000 | 109,883,000
Accumulated Amortization | (42,332,259) | (35,842,508)
Intangible Assets, Net | $ 67,550,741 | $ 74,040,492
Network relationships | Maximum [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Weighted Average Life (Yrs) | 15 years | 15 years
Network relationships | Minimum [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Weighted Average Life (Yrs) | 11 years | 11 years
Trade name |  |
Finite-Lived Intangible Assets [Line Items] |  |
Weighted Average Life (Yrs) | 20 years | 20 years
Intangible Assets, Gross, Total, Beginning Balance | $ 1,011,000 | $ 1,011,000
Accumulated Amortization | (29,487) | (4,212)
Intangible Assets, Net | $ 981,513 | $ 1,006,788
Management contracts [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Weighted Average Life (Yrs) | 15 years | 15 years
Intangible Assets, Gross, Total, Beginning Balance | $ 22,832,000 | $ 22,832,000
Accumulated Amortization | (6,278,801) | (5,014,886)
Intangible Assets, Net | $ 16,553,199 | $ 17,817,114
Member relationships [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Weighted Average Life (Yrs) | 12 years | 12 years
Intangible Assets, Gross, Total, Beginning Balance | $ 6,696,000 | $ 6,696,000
Accumulated Amortization | (668,084) | (46,500)
Intangible Assets, Net | $ 6,027,916 | $ 6,649,500
Patient management platform [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Weighted Average Life (Yrs) | 5 years | 5 years
Intangible Assets, Gross, Total, Beginning Balance | $ 2,060,000 | $ 2,060,000
Accumulated Amortization | (240,333) | (34,336)
Intangible Assets, Net | $ 1,819,667 | $ 2,025,664

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