Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Accrued Liabilities, Current [Abstract]
Accrued professional liabilities	$ 14,362	$ 11,983
Contingent purchase price payable	5,509	12,213
Current income taxes payable	7,892	0
Refunds payable	48,415	17,752
Other	43,059	26,038
Total other accrued liabilities	$ 119,237	$ 67,986