Medical Liabilities (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Balance, beginning of year	$ 18,957,465	$ 16,011,519
Medical liabilities assumed from Merger	39,353,540	0
Claims paid for previous year	(23,075,516)	(14,501,482)
Incurred health care costs	121,846,375	98,906,764
Claims paid for current year	(92,476,160)	(84,520,493)
Adjustments	(633,386)	3,061,157
Balance, end of year	$ 63,972,318	$ 18,957,465