Fixed Assets, Net (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011
Property, Plant and Equipment [Line Items]
Fixed assets, gross	$ 124,064	$ 124,272
Less accumulated depreciation	(82,650)	(78,026)
Fixed assets, net	41,414	46,246
Land [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, gross	1,451	1,451
Building [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	30 years
Fixed assets, gross	6,107	6,107
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, gross	65,718	58,270
Computer Equipment and Software [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	3 years
Computer Equipment and Software [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	7 years
Home Medical Equipment [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	4 years
Fixed assets, gross	5,179	4,671
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	5 years
Fixed assets, gross	24,556	31,501
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, gross	18,250	19,318
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Fixed assets, useful lives	5 years
Fixed assets, gross	$ 2,803	$ 2,954