Commitments and Contingencies (Details) (USD $)	12 Months Ended
	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Future minimum payments under operating leases
2012	$ 17,900,000
2013	10,300,000
2014	8,300,000
2015	6,900,000
2016	5,400,000
2017 and beyond	11,000,000
Future minimum rentals to be received under operating subleases
2012	700,000
2013	600,000
2014	500,000
2015	300,000
2016 and beyond	0
Rent expense	19,300,000	19,800,000	20,300,000
Specialty Pharmaceutical Management
Insurance
Period for which insurance policies have been renewed (in years)	1
General liability
Insurance
Period for which insurance policies have been renewed (in years)	1
Insurance coverage per claim for un-aggregated self-insured retention	50,000
General liability | Specialty Pharmaceutical Management
Insurance
Insurance coverage per claim for un-aggregated self-insured retention	25,000
Professional liability
Insurance
Period for which insurance policies have been renewed (in years)	1
Insurance coverage per claim for un-aggregated self-insured retention	50,000
Professional liability | Specialty Pharmaceutical Management
Insurance
Insurance coverage per claim for un-aggregated self-insured retention	50,000
Professional liability | Behavioral health direct care facilities
Insurance
Period for which insurance policies have been renewed (in years)	5
Insurance coverage per claim for un-aggregated self-insured retention	50,000
Managed care liability
Insurance
Period for which insurance policies have been renewed (in years)	1
Insurance coverage per claim for un-aggregated self-insured retention	1,000,000
Insurance coverage per class action claim for un-aggregated self-insured retention	$ 10,000,000