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Schedule of intangible assets (Detail) - USD ($) | 9 Months Ended | 12 Months Ended
--- | --- | ---
Sep. 30, 2018 | Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items] |  |
Intangible Assets, Gross | $ 144,476,000 | $ 144,476,000
Accumulated Amortization | (53,713,020) | (40,942,442)
Intangible Assets, Net | 90,762,980 | 103,533,558
Medicare License [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Intangible Assets, Gross | 1,994,000 | 1,994,000
Accumulated Amortization | 0 | 0
Intangible Assets, Net | 1,994,000 | 1,994,000
Network relationships [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Intangible Assets, Gross | 109,883,000 | 109,883,000
Accumulated Amortization | (45,485,494) | (35,842,508)
Intangible Assets, Net | $ 64,397,506 | $ 74,040,492
Network relationships [Member] | Maximum [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Useful Life (Years) | 15 years | 15 years
Network relationships [Member] | Minimum [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Useful Life (Years) | 11 years | 11 years
Management contracts [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Useful Life (Years) | 15 years | 15 years
Intangible Assets, Gross | $ 22,832,000 | $ 22,832,000
Accumulated Amortization | (6,863,192) | (5,014,886)
Intangible Assets, Net | $ 15,968,808 | $ 17,817,114
Member relationships [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Useful Life (Years) | 12 years | 12 years
Intangible Assets, Gross | $ 6,696,000 | $ 6,696,000
Accumulated Amortization | (978,876) | (46,500)
Intangible Assets, Net | $ 5,717,124 | $ 6,649,500
Patient management platform [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Useful Life (Years) | 5 years | 5 years
Intangible Assets, Gross | $ 2,060,000 | $ 2,060,000
Accumulated Amortization | (343,333) | (34,336)
Intangible Assets, Net | $ 1,716,667 | $ 2,025,664
Trade name[Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Useful Life (Years) | 20 years | 20 years
Intangible Assets, Gross | $ 1,011,000 | $ 1,011,000
Accumulated Amortization | (42,125) | (4,212)
Intangible Assets, Net | $ 968,875 | $ 1,006,788

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