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General (Details 3) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 9 Months Ended
Sep. 30, 2013
Sep. 30, 2012
Sep. 30, 2013
Sep. 30, 2012
Concentration of Business        
Net revenue $ 873,598 $ 798,437 $ 2,538,107 $ 2,377,123
Minimum
       
Concentration of Business        
Term of Contract     1 year  
Term of renewed contract     1 year  
Notice period for termination of contract     60 days  
Maximum
       
Concentration of Business        
Term of Contract     3 years  
Term of renewed contract     2 years  
Notice period for termination of contract     180 days  
Pennsylvania Counties
       
Concentration of Business        
Net revenue     269,100 269,800
Florida Areas
       
Concentration of Business        
Net revenue     $ 97,800 $ 100,600