Income Taxes - Operating Loss Carryforwards (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Operating loss carryforwards
Valuation allowances	$ (2,368)	$ (17,117)
Federal
Operating loss carryforwards
Operating Loss Carryforwards	38,800
Federal | AlphaCare
Operating loss carryforwards
Operating Loss Carryforwards	37,600
State
Operating loss carryforwards
Operating Loss Carryforwards	$ 93,700