Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2016

Goodwill And Intangible Assets Disclosure [Abstract]

Summary of Changes in Goodwill

The following table provides a summary of the changes in goodwill (in thousands):

	December 31,
	2016			2015
Balance at beginning of period	$	541,704		$	534,916
Acquisitions		129			6,788
Impairment		(125,000	)		—
Balance at end of period	$	416,833		$	541,704

Summary of the Components of Intangible Assets

The following table provides a summary of the components of intangible assets (in thousands):

	December 31,
	2016			2015
Finite-lived intangible assets:
Capitalized software costs:
Cost	$	180,855		$	194,941
Accumulated amortization		(118,391	)		(98,004	)
Capitalized software costs, net		62,464			96,937
Physician guarantee contracts:
Cost		11,355			16,594
Accumulated amortization		(6,329	)		(9,560	)
Physician guarantee contracts, net		5,026			7,034
Other finite-lived intangible assets:
Cost		44,342			43,275
Accumulated amortization		(33,059	)		(29,351	)
Other finite-lived intangible assets, net		11,283			13,924
Total finite-lived intangible assets
Cost		236,552			254,810
Accumulated amortization		(157,779	)		(136,915	)
Total finite-lived intangible assets, net	$	78,773		$	117,895
Indefinite-lived intangible assets:
Tradenames	$	4,000		$	4,000
Medical licenses and other indefinite-lived intangible assets		2,209			7,355
Total indefinite-lived intangible assets	$	6,209		$	11,355
Total intangible assets:
Cost	$	242,761		$	266,165
Accumulated amortization		(157,779	)		(136,915	)
Total intangible assets, net	$	84,982		$	129,250

Summary of the Components of Amortization Expense

The following table provides a summary of the components of amortization expense (in thousands):

	Year Ended December 31,
	2016		2015		2014
Amortization of finite-lived intangible assets:
Capitalized software costs	$	25,193	$	27,317	$	26,991
Physician guarantee contracts		3,108		3,951		5,149
Other finite-lived intangible assets		2,866		3,334		3,585
Total amortization expense related to finite-lived intangible assets		31,167		34,602		35,725
Amortization of leasehold improvements and property and equipment assets held under capital lease obligations		3,111		2,496		2,610
Total amortization expense	$	34,278	$	37,098	$	38,335

Summary of Future Estimated Amortization Expense

Total estimated future amortization expense for the next five years and thereafter related to intangible assets follows (in thousands):

2017	$	23,217
2018		16,810
2019		12,813
2020		9,212
2021		8,812
Thereafter		7,909
Total estimated future amortization expense	$	78,773