Restructuring - Rollforward (Details) - USD ($) $ in Thousands	3 Months Ended			6 Months Ended	9 Months Ended
	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2020	Sep. 30, 2020	Sep. 30, 2019
Restructuring Reserve [Roll Forward]
Expenses recorded					$ 4,880	$ 0
Operation Simplification and Optimization Program
Restructuring Reserve [Roll Forward]
Beginning balance	$ 13,731	$ 10,613	$ 9,506	$ 9,506	9,506
Expenses recorded	1,833	7,614	7,754
Payments made	(5,387)	(4,496)	(6,647)
Ending balance	10,177	13,731	10,613	13,731	10,177
DRG Acquisition Integration Program
Restructuring Reserve [Roll Forward]
Beginning balance	2,072		0	0	0
Expenses recorded	1,359			3,324	4,683
Payments made	(1,157)			(1,252)
Ending balance	2,274	2,072		2,072	2,274
Severance and Related Benefit Costs | Operation Simplification and Optimization Program
Restructuring Reserve [Roll Forward]
Beginning balance	10,001	9,433	9,506	9,506	9,506
Expenses recorded	472	4,865	6,574
Payments made	(2,939)	(4,297)	(6,647)
Ending balance	7,534	10,001	9,433	10,001	7,534
Severance and Related Benefit Costs | DRG Acquisition Integration Program
Restructuring Reserve [Roll Forward]
Beginning balance	2,060		0	0	0
Expenses recorded	1,210			3,312	4,522
Payments made	(1,013)			(1,252)
Ending balance	2,257	2,060		2,060	2,257
Exit and Disposal Costs | Operation Simplification and Optimization Program
Restructuring Reserve [Roll Forward]
Beginning balance	3,730	1,180	0	0	0
Expenses recorded	1,361	2,749	1,180
Payments made	(2,448)	(199)	0
Ending balance	2,643	3,730	1,180	3,730	2,643
Exit and Disposal Costs | DRG Acquisition Integration Program
Restructuring Reserve [Roll Forward]
Beginning balance	12		$ 0	0	0
Expenses recorded	149			12	161
Payments made	(144)			0
Ending balance	$ 17	$ 12		$ 12	$ 17