Segment Reporting (Details) $ in Thousands	3 Months Ended
Mar. 31, 2016 USD ($) segment	Mar. 31, 2015 USD ($)
Segment Reporting [Abstract]
Number of reportable segments \| segment	2
Segment Reporting Information [Line Items]
Net revenue	$ 724,678	$ 570,445
Adjusted EBITDA	120,100	93,755
Earnings from continuing operations attributable to noncontrolling interests	53,841	47,717
Interest expense, net	(30,810)	(30,247)
Depreciation and amortization	(29,072)	(22,818)
Share-based compensation	(7,168)	(3,709)
Transaction costs	(1,390)	(1,471)
Net loss on deconsolidation	0	(223)
Earnings before income taxes	105,501	83,004
Acquisition and Capital Expenditures	18,681	141,361
Ambulatory Services [Member]
Segment Reporting Information [Line Items]
Net revenue	307,134	283,910
Adjusted EBITDA	53,626	47,308
Acquisition and Capital Expenditures	8,371	54,096
Physician Services [Member]
Segment Reporting Information [Line Items]
Net revenue	417,544	286,535
Adjusted EBITDA	66,474	46,447
Acquisition and Capital Expenditures	$ 10,310	$ 87,265

Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization

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- Definition

Business Acquisitions and Capital Expenditures

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Represents the expense recognized during the period arising from equity-based compensation arrangements (for example, shares of stock, unit, stock options or other equity instruments) with employees, directors and certain consultants qualifying for treatment as employees.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 718
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 14.F)
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-Name Staff Accounting Bulletin (SAB)
-Number Topic 14
-Section F

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This element represents acquisition-related costs incurred to effect a business combination which costs have been expensed during the period. Such costs include finder's fees; advisory, legal, accounting, valuation, and other professional or consulting fees; general administrative costs, including the costs of maintaining an internal acquisitions department; and may include costs of registering and issuing debt and equity securities.

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-Section 25
-Paragraph 23
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The amount of the gain (loss) recognized by the parent and included in its attributable portion of net income for the period due to deconsolidation of a subsidiary or derecognition of a group of assets. The gain (loss) recognized and included in the net income attributable to the parent for the period is generally computed as the difference between: (a) the aggregate of: (1) the fair value of any consideration received; (2) the fair value of any retained noncontrolling investment in the former subsidiary at the date the subsidiary was deconsolidated; and (3) the carrying amount of any noncontrolling interest in the former subsidiary (including any accumulated other comprehensive income attributable to the noncontrolling interest) at the date the subsidiary was deconsolidated and (b) the carrying amount of the former subsidiary's assets and liabilities.

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The current period expense charged against earnings on long-lived, physical assets not used in production, and which are not intended for resale, to allocate or recognize the cost of such assets over their useful lives; or to record the reduction in book value of an intangible asset over the benefit period of such asset; or to reflect consumption during the period of an asset that is not used in production.

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Amount of income (loss) from continuing operations attributable to the noncontrolling interest. Also defined as revenue less expenses and taxes from ongoing operations before extraordinary items but after deduction of those portions of income or loss from continuing operations that are allocable to noncontrolling interests.

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This element represents the income or loss from continuing operations attributable to the economic entity which may also be defined as revenue less expenses from ongoing operations, after income or loss from equity method investments, but before income taxes, extraordinary items, and noncontrolling interest.

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-Publisher SEC
-Name Regulation S-X (SX)
-Number 210
-Section 03
-Paragraph 10
-Article 5

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The net amount of operating interest income (expense).

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Number of segments reported by the entity. A reportable segment is a component of an entity for which there is an accounting requirement to report separate financial information on that component in the entity's financial statements.

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Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

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Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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