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Cost Method Businesses (Detail) - USD ($)
12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Schedule of Cost-method Investments [Line Items]      
Carrying value of holdings in cost method companies $ 17,300,000    
Impact of subsidiary equity transactions (8,186,000) $ 5,719,000 $ (4,803,000)
Impairment of cost method investment $ 0 0 $ 0
Parchment      
Schedule of Cost-method Investments [Line Items]      
Impact of subsidiary equity transactions   700,000  
InstaMed      
Schedule of Cost-method Investments [Line Items]      
Adjustment to cost method investment   (1,600,000)  
Gain from cost method investment   $ 2,800,000