Investments in Other Entities - Equity Method - Summarized Balance Sheets and Statements of Income (Details) - USD ($)	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
LaSalle Medical Associates – IPA Line of Business
Assets
Cash and cash equivalents	$ 3,237,833		$ 18,444,702
Receivables, net	7,778,735		2,897,337
Other current assets	3,526,319		5,459,442
Loan receivable	2,250,000		1,250,000
Restricted cash	680,216		667,414
Total assets	17,473,103		28,718,895
Liabilities and Stockholders' (Deficit) Equity
Current liabilities	22,953,961		26,837,814
Stockholders’ (deficit) equity	(5,480,858)		1,881,081
Total liabilities and stockholders’ (deficit) equity	17,473,103		28,718,895
Statements of Operations
Revenues	144,569,818	$ 177,696,760
Expenses	155,581,757	180,445,655
Net loss	(11,011,939)	(2,748,895)
Universal Care, Inc.
Assets
Cash and cash equivalents	29,568,915		27,812,520
Receivables, net	62,787,671		46,978,703
Other current assets	33,786,968		18,670,350
Other assets	10,799,827		661,621
Property and equipment, net	3,319,680		2,786,996
Total assets	140,263,061		96,910,190
Liabilities and Stockholders' (Deficit) Equity
Current liabilities	120,698,226		89,731,133
Other liabilities	25,067,577		25,024,043
Stockholders’ (deficit) equity	(5,502,742)		(17,844,986)
Total liabilities and stockholders’ (deficit) equity	140,263,061		96,910,190
Statements of Operations
Revenues	372,181,425	240,633,955
Expenses	370,597,312	246,765,335
Income (loss) before benefit from income taxes	1,584,113	(6,131,380)
Provision for income taxes	(11,010,394)	(130,023)
Net loss	12,594,507	(6,001,357)
WCollege LLC
Assets
Cash and cash equivalents	31,986		158,088
Other current assets	24,750		16,137
Other assets	70,000		70,000
Property and equipment, net	33,412,652		33,394,792
Total assets	33,539,388		33,639,017
Liabilities and Stockholders' (Deficit) Equity
Current liabilities	1,261,243		1,007,413
Stockholders’ (deficit) equity	32,278,145		32,631,604
Total liabilities and stockholders’ (deficit) equity	33,539,388		$ 33,639,017
Statements of Operations
Revenues	0	0
Expenses	779,958	181,359
Income (loss) before benefit from income taxes	(779,958)	(181,359)
Other Income	426,500	25,650
Net loss	$ (353,458)	$ (155,709)