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Segment Information - Adjusted EBITDA (Details) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2020
Mar. 31, 2019
Segment Reporting Information [Line Items]    
Adjusted EBITDA $ 24,403 $ 262,349
Less adjustments:    
Depreciation and amortization of property and equipment 69,513 75,348
Amortization of capitalized implementation costs 9,547 12,111
Acquisition-related amortization 16,801 15,984
Amortization of upfront incentive consideration 18,213 19,128
Interest expense, net 37,442 38,013
Other, net 47,486 1,870
Restructuring and other costs 25,281 0
Acquisition-related costs 17,827 11,706
Litigation costs, net 1,741 1,438
Stock-based compensation 17,577 15,694
Provision for income taxes (27,254) 11,843
(Loss) Income from continuing operations (209,771) $ 59,214
Workforce reduction    
Less adjustments:    
Restructuring and other costs 25,000  
Department Of Justice Lawsuit    
Less adjustments:    
Litigation charge $ 46,000  
Minimum    
Less adjustments:    
Average expected life of the service contract to cost of revenue 3 years  
Maximum    
Less adjustments:    
Average expected life of the service contract to cost of revenue 10 years