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Acquisitions - Acquisition of Provider Companies (Details) - USD ($)
$ in Thousands
 3 Months Ended
Dec. 31, 2016
Sep. 30, 2016
Dec. 31, 2015
 [1]
Dec. 31, 2014
Dec. 31, 2013
Business Acquisition [Line Items]          
Goodwill $ 79,147 [1]   $ 18,379 $ 0 $ 0
Provider Companies          
Business Acquisition [Line Items]          
Cash 431 $ 51      
Net working capital, net of cash acquired 812 1,229      
Goodwill 26,040 26,040      
Fair value of derivative liabilities (18,163) (18,163)      
Total 34,066 34,103      
Q4 2016 Adjustments          
Cash 380        
Net working capital, net of cash acquired (417)        
Total (37)        
Customer Relationships and Non-compete Agreements | Provider Companies          
Business Acquisition [Line Items]          
Other assets - trademarks 24,417 24,417      
Trademarks | Provider Companies          
Business Acquisition [Line Items]          
Other assets - trademarks $ 529 $ 529      
[1] See Note 4 "Equity" for disclosure of our variable interest entity in Spark HoldCo, LLC.