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Basis of Presentation - Additional Information (Detail) - USD ($) |  | 1 Months Ended | 3 Months Ended |
--- | --- | --- | --- | ---
Oct. 01, 2018 | Jan. 31, 2018 | Mar. 31, 2019 | Mar. 31, 2018 | Dec. 31, 2018
Summary Of Significant Accounting Policies [Line Items] |  |  |  |  |
Cash, Uninsured Amount |  |  | $ 110,000,000 |  |
Marketable Securities, Current |  |  | 1,143,006 |  | $ 1,127,102
Allowance for Doubtful Accounts Receivable, Current |  |  | 5,200,000 |  | 4,300,000
Goodwill, Impairment Loss |  |  | $ 0 | $ 0 |
Equity Method Investment, Significant Influence Description |  |  | Significant influence is generally deemed to exist if the Company has an ownership interest in the voting stock of the investee of between 20% and 50%, although other factors, such as representation on the investee’s board of directors, are considered in determining whether the equity method of accounting is appropriate. |  |
Payment Of Revenue | $ 8,300,000 | $ 7,300,000 |  |  |
All-Inclusive Population-Based Payments to be Received | 5,500,000 |  |  |  |
Deferred Revenue, Current |  |  | $ 33,200,000 |  | 9,100,000
Operating Lease, Right-of-Use Asset |  |  | 8,528,159 |  | $ 0
Contract with Customer, Liability, Revenue Recognized |  |  | 100,000 |  |
Payment of revenue reduce | $ 5,500,000 |  |  |  |
Impairment of Intangible Assets, Finite-lived |  |  | $ 0 | $ 0 |
Variable Interest Entity Percentage |  |  | 50.00% |  |
Operating Lease, Liability |  |  | $ 8,439,069 |  |
New Accounting Adoption 842 [Member] |  |  |  |  |
Summary Of Significant Accounting Policies [Line Items] |  |  |  |  |
Operating Lease, Right-of-Use Asset |  |  | 9,000,000 |  |
Operating Lease, Liability |  |  | 8,900,000 |  |
Pacific Ambulatory Surgery Center, LLC [Member] |  |  |  |  |
Summary Of Significant Accounting Policies [Line Items] |  |  |  |  |
Equity Method Investment, Impairment |  |  | 300,000 |  |
Accounts Payable And Accrued Expenses [Member] |  |  |  |  |
Summary Of Significant Accounting Policies [Line Items] |  |  |  |  |
Payment Of Revenue |  |  | 24,800,000 |  |
Other Receivables [Member] |  |  |  |  |
Summary Of Significant Accounting Policies [Line Items] |  |  |  |  |
Reinsurance Recoverables, Including Reinsurance Premium Paid |  |  | $ 11,200,000 |  |

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