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Significant Accounting Policies Significant Accounting Policies - Revenue Recognition (Details) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Dec. 31, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Net service revenue $ 291,054 $ 244,249  
Provision for bad debts   $ 0  
Allowance for uncollectible accounts     $ 0
Accounting Standards Update 2014-09      
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Net service revenue 4,900    
Allowance for uncollectible accounts $ 26,000