Accounts Receivable (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	$ 99,440	$ 73,999
Allowances for accounts receivable	$ 188,086		$ 167,411
Product Concentration Risk [Member] | Allowance for Doubtful Accounts [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Allowance for doubtful accounts related to fee for service patient visits	81.00%		80.00%
Ambulatory Services [Member] | Other Operating Expenses [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	$ 5,800	6,200
Physician Services [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	$ 93,608	$ 67,752