Basis of Presentation - Additional Information (Details)			3 Months Ended	8 Months Ended	9 Months Ended
	Mar. 31, 2019 USD ($)	Oct. 01, 2018 USD ($)	Sep. 30, 2019 USD ($)	Sep. 30, 2018 USD ($)	Sep. 30, 2019 USD ($) segment unit	Sep. 30, 2018 USD ($)	Sep. 01, 2019 USD ($)	Jan. 01, 2019 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segments | segment					1
Number of reportable segments | segment					1
Amount deposit accounts exceeded FDIC insured limit			$ 248,700,000		$ 248,700,000
Amount of short-term marketable securities			1,154,480		1,154,480				$ 1,127,102
Allowance for doubtful accounts			2,900,000		2,900,000				4,300,000
Impairment of finite-lived intangible assets					0	$ 0
Impairment of long-lived assets					$ 0	0
Number of main reporting units | unit					3
Impairment of goodwill					$ 0	0
Impairment of indefinite-lived intangible assets					$ 0	$ 0
Expected period of payment upon termination of agreement					30 days
Payments received		$ 5,500,000		$ 7,300,000	$ 8,300,000
AIPBP payments							$ 3,700,000
Accrued contract liability recognized					500,000
Contract liability balance			17,000,000		$ 17,000,000				$ 9,100,000
Voting rights held (more than)					50.00%
Right-of-use assets			13,540,129		$ 13,540,129			$ 9,000,000
Lease liabilities			13,506,374		13,506,374			$ 8,900,000
Pacific Ambulatory Surgery Center, LLC
Summary Of Significant Accounting Policies [Line Items]
Impairment of investments	$ 300,000
Accounts Payable and Accrued Expenses
Summary Of Significant Accounting Policies [Line Items]
Payments received					45,000,000
Accrued contract liability recognized					36,500,000
Other Receivables
Summary Of Significant Accounting Policies [Line Items]
Recoverable claims paid			$ 11,400,000		$ 11,400,000					$ 3,000,000
PMPM Managed Care Contract
Summary Of Significant Accounting Policies [Line Items]
General term of contracts			1 year		1 year
Participation Agreement
Summary Of Significant Accounting Policies [Line Items]
General term of contracts			2 years		2 years				2 years
Management Fee Income Contract
Summary Of Significant Accounting Policies [Line Items]
General term of contracts			10 years		10 years
CMS
Summary Of Significant Accounting Policies [Line Items]
Expected period of payment upon termination of agreement					30 days
Medicare license
Summary Of Significant Accounting Policies [Line Items]
Indefinite-lived assets written off			$ 2,000,000