Summary of Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Significant Accounting Policies [Line Items]
Interest income	$ 0.2	$ 0.4	$ 0.1
Outstanding standby letters of credit as collateral	18.1	18.8
Equity compensation	3.4	3.6	4.1
Advertising costs	7.9	6.7	7.6
Cumulative impact of currency fluctuations	1.3	1.3
Net change in derivative instruments		0.2
Income tax expense related to deferred tax asset			$ 0.2
Claims-Based Liability Insurance
Significant Accounting Policies [Line Items]
Self insured retention per claim	0.5
Claims-Based Liability Insurance | MDA Holdings Inc
Significant Accounting Policies [Line Items]
Letter of credit for malpractice claims	$ 1.8	$ 1.8
Minimum
Significant Accounting Policies [Line Items]
Threshold period, past due for payment of services provided	30 days
Short term leases period	3 months
Estimated useful life of assets	3 years
Intangible assets- useful life	3 years
Minimum | Computer software
Significant Accounting Policies [Line Items]
Estimated useful life of assets	3 years
Maximum
Significant Accounting Policies [Line Items]
Threshold period, past due for payment of services provided	60 days
Short term leases period	6 months
Estimated useful life of assets	7 years
Intangible assets- useful life	16 years
Maximum | Computer software
Significant Accounting Policies [Line Items]
Estimated useful life of assets	10 years