Fair Value Measurements (Details) (USD $)					3 Months Ended	9 Months Ended		3 Months Ended	9 Months Ended
	Sep. 30, 2014	Dec. 31, 2013	Sep. 30, 2013	Dec. 31, 2012	Sep. 30, 2014 Cash Convertible Notes Hedge [Member]	Sep. 30, 2014 Cash Convertible Notes Hedge [Member]	Sep. 30, 2014 Cash Convertible Notes [Member]	Sep. 30, 2014 Cash Conversion Derivative [Member]	Sep. 30, 2014 Cash Conversion Derivative [Member]	Sep. 30, 2014 CareFirst Convertible Note [Member]	Sep. 30, 2014 Recurring [Member] Foreign Exchange Contract [Member]	Dec. 31, 2013 Recurring [Member] Foreign Exchange Contract [Member]	Sep. 30, 2014 Recurring [Member] Foreign Exchange Contract [Member] Level 2 [Member]	Dec. 31, 2013 Recurring [Member] Foreign Exchange Contract [Member] Level 2 [Member]	Sep. 30, 2014 Recurring [Member] Foreign Exchange Contract [Member] Level 3 [Member]	Dec. 31, 2013 Recurring [Member] Foreign Exchange Contract [Member] Level 3 [Member]	Sep. 30, 2014 Recurring [Member] Interest Rate Swap [Member]	Dec. 31, 2013 Recurring [Member] Interest Rate Swap [Member]	Sep. 30, 2014 Recurring [Member] Interest Rate Swap [Member] Level 2 [Member]	Dec. 31, 2013 Recurring [Member] Interest Rate Swap [Member] Level 2 [Member]	Sep. 30, 2014 Recurring [Member] Interest Rate Swap [Member] Level 3 [Member]	Dec. 31, 2013 Recurring [Member] Interest Rate Swap [Member] Level 3 [Member]	Sep. 30, 2014 Recurring [Member] Cash Convertible Notes Hedge [Member]	Dec. 31, 2013 Recurring [Member] Cash Convertible Notes Hedge [Member]	Sep. 30, 2014 Recurring [Member] Cash Convertible Notes Hedge [Member] Level 2 [Member]	Dec. 31, 2013 Recurring [Member] Cash Convertible Notes Hedge [Member] Level 2 [Member]	Sep. 30, 2014 Recurring [Member] Cash Convertible Notes Hedge [Member] Level 3 [Member]	Dec. 31, 2013 Recurring [Member] Cash Convertible Notes Hedge [Member] Level 3 [Member]	Sep. 30, 2014 Recurring [Member] Cash Conversion Derivative [Member]	Dec. 31, 2013 Recurring [Member] Cash Conversion Derivative [Member]	Sep. 30, 2014 Recurring [Member] Cash Conversion Derivative [Member] Level 2 [Member]	Dec. 31, 2013 Recurring [Member] Cash Conversion Derivative [Member] Level 2 [Member]	Sep. 30, 2014 Recurring [Member] Cash Conversion Derivative [Member] Level 3 [Member]	Dec. 31, 2013 Recurring [Member] Cash Conversion Derivative [Member] Level 3 [Member]
Assets measured at fair value on a recurring basis
Gross Fair Value											$ 341,000	$ 178,000	$ 341,000	$ 178,000	$ 0	$ 0							$ 34,008,000	$ 27,766,000	$ 0	$ 0	$ 34,008,000	$ 27,766,000
Netting											(110,000)	(57,000)											0	0
Net Fair Value											231,000	121,000											34,008,000	27,766,000
Liabilities measured at fair value on a recurring basis
Gross Fair Value											163,000	67,000	163,000	67,000	0	0	361,000	505,000	361,000	505,000	0	0							34,008,000	27,766,000	0	0	34,008,000	27,766,000
Netting											(110,000)	(57,000)					0	0											0	0
Net Fair Value											53,000	10,000					361,000	505,000											34,008,000	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						6,242,000			(6,242,000)
Balance at end of period					34,008,000	34,008,000		(34,008,000)	(34,008,000)
Cash and cash equivalents	1,708,000	2,584,000	2,815,000	1,759,000
Carrying Amount of Outstanding borrowings under the Fifth Amended Credit Agreement	108,900,000
Fair Value of Outstanding borrowings under the Fifth Amended Credit Agreement	108,400,000
Aggregate Principal of convertible notes							150,000,000
Debt Instrument, Carrying Amount							121,400,000			20,000,000
Debt Instrument, Fair Value							$ 154,500,000			$ 20,000,000