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Goodwill and Other Intangible Assets
 3 Months Ended
Mar. 31, 2026
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Other Intangible Assets Goodwill and Other Intangible Assets
Other intangible assets consisted of the following (in thousands):
March 31, 2026December 31, 2025
Weighted-average amortization period
Gross Carrying
Amount
Accumulated
Amortization
Net Carrying
Value
Gross Carrying
Amount
Accumulated
Amortization
Net Carrying
Value
Client relationships15 years$4,199,517 $(2,721,405)$1,478,112 $4,199,517 $(2,651,110)$1,548,407 
Provider network15 years896,800 (586,906)309,894 896,800 (571,959)324,841 
Technology6 years21,850 (12,766)9,084 21,850 (12,213)9,637 
Trade names9 years2,670 (1,484)1,186 2,670 (1,421)1,249 
Non-compete5 years1,000 (580)420 1,000 (530)470 
Total$5,121,837 $(3,323,141)$1,798,696 $5,121,837 $(3,237,233)$1,884,604 
Goodwill was as follows (in thousands):
March 31, 2026December 31, 2025
Gross goodwill$4,489,636 $4,489,636 
Accumulated impairment(2,083,783)(2,083,783)
Total goodwill$2,405,853 $2,405,853 
No impairment loss related to goodwill or indefinite-lived intangible assets was recorded during the three months ended March 31, 2026 and 2025.