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Leases - Additional Information (Detail) - USD ($)
 3 Months Ended 9 Months Ended
Sep. 30, 2019
Sep. 30, 2019
Jan. 01, 2019
Dec. 31, 2018
Lessee, Lease, Description [Line Items]        
Right-of-use assets $ 30,134,000 $ 30,134,000 $ 4,800,000  
Operating lease, liability 33,833,000 33,833,000 $ 6,400,000  
Deferred rent liabilities       $ 1,600,000
Operating leases that have not yet commenced   0    
Operating lease cost $ 1,100,000 3,800,000    
Cash paid for amounts included in the measurement of operating lease liabilities   $ 1,500,000    
Operating lease, weighted-average remaining lease term 10 years 9 months 18 days 10 years 9 months 18 days    
Operating lease, weighted-average incremental borrowing rate 6.00% 6.00%    
Nashville, TN [Member]        
Lessee, Lease, Description [Line Items]        
Right-of-use assets $ 26,500,000 $ 26,500,000    
Operating lease, liability 26,500,000 26,500,000    
Providigm, LLC [Member]        
Lessee, Lease, Description [Line Items]        
Right-of-use assets 1,200,000 1,200,000    
Operating lease, liability $ 1,200,000 $ 1,200,000