Summary of Goodwill and Acquired Intangible Assets (Details 1) (USD $) In Thousands, unless otherwise specified	Dec. 31, 2011	Dec. 31, 2010
Finite lived intangible assets
Gross Carrying Amount	$ 29,117	$ 29,117
Accumulated Amortization	(27,540)	(27,052)
Membership rights and provider contracts [Member]
Finite lived intangible assets
Gross Carrying Amount	28,171	28,171
Accumulated Amortization	(26,594)	(26,106)
Non-compete agreements and trademarks [Member]
Finite lived intangible assets
Gross Carrying Amount	946	946
Accumulated Amortization	$ (946)	$ (946)

Sum of the gross carrying amounts before accumulated amortization as of the balance sheet date of all intangible assets having statutory or estimated useful lives. The aggregate gross carrying amount (including any previously recognized impairment charges) of a major finite-lived intangible asset class. A major class is composed of intangible assets that can be grouped together because they are similar, either by their nature or by their use in the operations of a company.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Statement of Financial Accounting Standard (FAS)

-Number 142

-Paragraph 45

-Subparagraph a(1)

-LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy.

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 350

-SubTopic 30

-Section 50

-Paragraph 2

-Subparagraph (a)(1)

-URI http://asc.fasb.org/extlink&oid=6905858&loc=d3e16323-109275

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Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	debit
Period Type:	instant