Medical Liabilities (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Balance, beginning of year	$ 63,972,318	$ 18,957,465
Medical liabilities assumed from Merger	0	39,353,540
Claims paid for previous year	(36,549,348)	(23,075,516)
Incurred health care costs	209,002,961	121,846,375
Claims paid for current year	(167,537,480)	(92,476,160)
Payment to CMS based on APAACO 2017 year settlement	(34,464,826)	0
Adjustments	(781,924)	(633,386)
Balance, end of year	$ 33,641,701	$ 63,972,318