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Goodwill and Other Intangible Assets
 6 Months Ended
Jun. 30, 2026
Intangible Asset, Goodwill and Other [Abstract]  
Goodwill and Other Intangible Assets Goodwill and Other Intangible Assets
Other intangible assets consisted of the following (in thousands):
June 30, 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 $(2,791,701)$1,407,816 $4,199,517 $(2,651,110)$1,548,407 
Provider network15 years896,800 (601,852)294,948 896,800 (571,959)324,841 
Technology6 years21,850 (13,320)8,530 21,850 (12,213)9,637 
Trade names9 years2,670 (1,546)1,124 2,670 (1,421)1,249 
Non-compete5 years1,000 (630)370 1,000 (530)470 
Total$5,121,837 $(3,409,049)$1,712,788 $5,121,837 $(3,237,233)$1,884,604 
Goodwill was as follows (in thousands):
June 30, 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 was recorded during the three and six months ended June 30, 2026 and 2025.