Fair Value Measurements (Details) (USD $)																									3 Months Ended												3 Months Ended
	Mar. 31, 2014	Dec. 31, 2013	Mar. 31, 2013	Dec. 31, 2012	Mar. 31, 2014 Foreign Exchange Contract [Member] Level 2 [Member]	Dec. 31, 2013 Foreign Exchange Contract [Member] Level 2 [Member]	Mar. 31, 2014 Foreign Exchange Contract [Member] Level 3 [Member]	Dec. 31, 2013 Foreign Exchange Contract [Member] Level 3 [Member]	Mar. 31, 2014 Foreign Exchange Contract [Member] Gross Fair Value [Member]	Dec. 31, 2013 Foreign Exchange Contract [Member] Gross Fair Value [Member]	Mar. 31, 2014 Foreign Exchange Contract [Member] Netting [Member]	Dec. 31, 2013 Foreign Exchange Contract [Member] Netting [Member]	Mar. 31, 2014 Foreign Exchange Contract [Member] Net Fair Value [Member]	Dec. 31, 2013 Foreign Exchange Contract [Member] Net Fair Value [Member]	Mar. 31, 2014 Interest Rate Swap [Member] Level 2 [Member]	Dec. 31, 2013 Interest Rate Swap [Member] Level 2 [Member]	Mar. 31, 2014 Interest Rate Swap [Member] Level 3 [Member]	Dec. 31, 2013 Interest Rate Swap [Member] Level 3 [Member]	Mar. 31, 2014 Interest Rate Swap [Member] Gross Fair Value [Member]	Dec. 31, 2013 Interest Rate Swap [Member] Gross Fair Value [Member]	Mar. 31, 2014 Interest Rate Swap [Member] Netting [Member]	Dec. 31, 2013 Interest Rate Swap [Member] Netting [Member]	Mar. 31, 2014 Interest Rate Swap [Member] Net Fair Value [Member]	Dec. 31, 2013 Interest Rate Swap [Member] Net Fair Value [Member]	Mar. 31, 2014 Cash Convertible Notes Hedge [Member]	Mar. 31, 2014 Cash Convertible Notes Hedge [Member] Level 2 [Member]	Dec. 31, 2013 Cash Convertible Notes Hedge [Member] Level 2 [Member]	Mar. 31, 2014 Cash Convertible Notes Hedge [Member] Level 3 [Member]	Dec. 31, 2013 Cash Convertible Notes Hedge [Member] Level 3 [Member]	Mar. 31, 2014 Cash Convertible Notes Hedge [Member] Gross Fair Value [Member]	Dec. 31, 2013 Cash Convertible Notes Hedge [Member] Gross Fair Value [Member]	Mar. 31, 2014 Cash Convertible Notes Hedge [Member] Netting [Member]	Dec. 31, 2013 Cash Convertible Notes Hedge [Member] Netting [Member]	Mar. 31, 2014 Cash Convertible Notes Hedge [Member] Net Fair Value [Member]	Dec. 31, 2013 Cash Convertible Notes Hedge [Member] Net Fair Value [Member]	Mar. 31, 2014 Cash Convertible Notes [Member]	Mar. 31, 2014 Cash Conversion Derivative [Member]	Mar. 31, 2014 Cash Conversion Derivative [Member] Level 2 [Member]	Dec. 31, 2013 Cash Conversion Derivative [Member] Level 2 [Member]	Mar. 31, 2014 Cash Conversion Derivative [Member] Level 3 [Member]	Dec. 31, 2013 Cash Conversion Derivative [Member] Level 3 [Member]	Mar. 31, 2014 Cash Conversion Derivative [Member] Gross Fair Value [Member]	Dec. 31, 2013 Cash Conversion Derivative [Member] Gross Fair Value [Member]	Mar. 31, 2014 Cash Conversion Derivative [Member] Netting [Member]	Dec. 31, 2013 Cash Conversion Derivative [Member] Netting [Member]	Mar. 31, 2014 Cash Conversion Derivative [Member] Net Fair Value [Member]	Dec. 31, 2013 Cash Conversion Derivative [Member] Net Fair Value [Member]	Mar. 31, 2014 CareFirst Convertible Note [Member]
Assets [Abstract]
Assets, Fair Value					$ 52,000	$ 178,000	$ 0	$ 0	$ 52,000	$ 178,000	$ (27,000)	$ (57,000)	$ 25,000	$ 121,000												$ 0	$ 0	$ 35,497,000	$ 27,766,000	$ 35,497,000	$ 27,766,000	$ 0	$ 0	$ 35,497,000	$ 27,766,000
Liabilities [Abstract]
Liabilities, Fair Value					159,000	67,000	0	0	159,000	67,000	(27,000)	(57,000)	132,000	10,000	471,000	505,000	0	0	471,000	505,000	0	0	471,000	505,000														0	0	35,497,000	27,766,000	35,497,000	27,766,000	0	0	35,497,000	27,766,000
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Purchases, (Sales), Issuances, (Settlements) [Abstract]
Balance at beginning of period																									27,766,000												(27,766,000)
Purchases into Level 3																									0												0
Issuances into Level 3																									0												0
Gains/(Losses) included in Earnings																									7,731,000												(7,731,000)
Balance at end of period																									35,497,000												(35,497,000)
Cash and cash equivalents	2,158,000	2,584,000	2,384,000	1,759,000
Carrying Amount of Outstanding borrowings under the Fifth Amended Credit Agreement	118,300,000
Fair Value of Outstanding borrowings under the Fifth Amended Credit Agreement	117,700,000
Aggregate Principal of convertible notes																																				150,000,000
Debt Instrument, Carrying Amount																																				118,000,000												20,000,000
Debt Instrument, Fair Value																																				$ 157,400,000												$ 20,000,000