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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