Accrued Professional Liabilities - Components of Reserves (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Payables and Accruals [Abstract]
Estimated losses under self-insured programs	$ 30,227	$ 30,748
Incurred but not reported losses	33,318	36,166
Total accrued professional liabilities	63,545	66,914
Less estimated losses payable within one year	14,319	14,362
Total	$ 49,226	$ 52,552