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Acquisitions - Fair Value of Identifiable Net Assets and Goodwill (Details) - USD ($)
$ in Thousands
Sep. 30, 2019
Dec. 31, 2018
Feb. 01, 2018
Business Acquisition [Line Items]      
Goodwill $ 3,382,656 $ 3,320,726  
U.S. HealthWorks      
Business Acquisition [Line Items]      
Accounts receivable     $ 68,934
Other current assets     10,810
Property and equipment     69,712
Identifiable intangible assets     140,406
Other assets     25,435
Goodwill     540,067
Total assets     855,364
Accounts payable and other current liabilities     49,925
Deferred income taxes and other long-term liabilities     51,851
Total liabilities     101,776
Consideration given     $ 753,588