10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C.  20549

FORM 10-Q

Quarterly Report Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

For the Quarterly Period Ended June 30, 2016

AMSURG CORP.

(Exact Name of Registrant as Specified in its Charter)

Tennessee	001-36531	62-1493316
(State or Other Jurisdiction of Incorporation)	(Commission  File Number)	(I.R.S. Employer  Identification No.)
1A Burton Hills Boulevard
Nashville, Tennessee		37215
(Address of Principal Executive Offices)		(Zip Code)

(615) 665-1283

(Registrant’s Telephone Number, Including Area Code)

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.

Yes [X] No [ ]

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).

Yes [X] No [ ]

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer  [X]	Accelerated filer                  [  ]
Non-accelerated filer   [  ]	Smaller reporting company [  ]

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).

Yes [X] No [ ]

As of August 2, 2016 there were outstanding 54,810,106 shares of the registrant’s Common Stock, no par value.

Table of Contents to Form 10-Q for the Six Months EndedJune 30, 2016

Part I	Financial Information
	Item 1.	Financial Statements	1
	Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	28
	Item 3.	Quantitative and Qualitative Disclosures About Market Risk	41
	Item 4.	Controls and Procedures	41
Part II	Other Information
	Item 1.	Legal Proceedings	42
	Item 1A.	Risk Factors	42
	Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	42
	Item 3.	Defaults Upon Senior Securities	42
	Item 4.	Mine Safety Disclosures	42
	Item 5.	Other Information	42
	Item 6.	Exhibits	43
	Signature		44

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Part I

Item 1. Financial Statements

AmSurg Corp. Consolidated Balance Sheets (unaudited) (In thousands)
	June 30,		December 31,
	2016		2015
Assets
Current assets:
Cash and cash equivalents	$	74,105	$	106,660
Restricted cash and marketable securities	12,794		13,506
Accounts receivable, net of allowance of $208,780 and $167,411, respectively	375,352		337,330
Supplies inventory	21,980		21,406
Prepaid and other current assets	74,565		75,771
Total current assets	558,796		554,673
Property and equipment, net	204,922		189,168
Investments in unconsolidated affiliates	179,056		169,170
Goodwill	4,175,008		3,970,210
Intangible assets, net	1,679,275		1,594,637
Other assets	46,263		21,450
Total assets	$	6,843,320	$	6,499,308
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	20,772	$	20,377
Accounts payable	30,721		32,561
Accrued salaries and benefits	186,908		202,537
Accrued interest	30,400		30,480
Other accrued liabilities	92,571		119,237
Total current liabilities	361,372		405,192
Long-term debt	2,581,043		2,357,956
Deferred income taxes	743,447		699,498
Other long-term liabilities	119,478		96,183
Commitments and contingencies
Noncontrolling interests – redeemable	177,845		175,732
Equity:
Preferred stock, no par value, 5,000 shares authorized, 1,725 shares issued and outstanding	166,632		166,632
Common stock, no par value, 120,000 shares authorized, 54,816 and 54,294 shares issued and outstanding, respectively	1,356,829		1,345,418
Retained earnings	853,817		781,413
Total AmSurg Corp. equity	2,377,278		2,293,463
Noncontrolling interests – non-redeemable	482,857		471,284
Total equity	2,860,135		2,764,747
Total liabilities and equity	$	6,843,320	$	6,499,308

See accompanying notes to the unaudited consolidated financial statements.

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Item 1. Financial Statements - (continued) Table of Contents

AmSurg Corp. Consolidated Statements of Earnings (unaudited) (In thousands, except earnings per share)
	Three Months Ended June 30,						Six Months Ended June 30,
	2016			2015			2016			2015
Revenues	$	859,832		$	707,733		$	1,678,118		$	1,345,930
Provision for uncollectibles	(101,333		)	(65,783		)	(194,941		)	(133,535		)
Net revenue	758,499			641,950			1,483,177			1,212,395
Operating expenses:
Salaries and benefits	404,011			320,396			813,850			622,575
Supply cost	49,703			45,790			96,666			88,374
Other operating expenses	111,145			105,002			218,827			195,572
Transaction costs	5,135			1,982			6,525			3,453
Depreciation and amortization	30,054			23,612			59,126			46,430
Total operating expenses	600,048			496,782			1,194,994			956,404
Net gain (loss) on disposals and deconsolidations	2,595			(3,035		)	2,595			(3,258		)
Equity in earnings of unconsolidated affiliates	7,351			3,989			13,930			6,640
Operating income	168,397			146,122			304,708			259,373
Interest expense, net	31,913			30,182			62,723			60,429
Earnings before income taxes	136,484			115,940			241,985			198,944
Income tax expense	33,365			25,193			54,162			39,442
Net earnings	103,119			90,747			187,823			159,502
Less net earnings attributable to noncontrolling interests	57,050			57,072			110,891			104,789
Net earnings attributable to AmSurg Corp. shareholders	46,069			33,675			76,932			54,713
Preferred stock dividends	(2,264		)	(2,264		)	(4,528		)	(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	43,805		$	31,411		$	72,404		$	50,185
Net earnings per share attributable to common shareholders:
Basic	$	0.82		$	0.66		$	1.35		$	1.05
Diluted	$	0.80		$	0.65		$	1.34		$	1.05
Weighted average number of shares and share equivalents outstanding:
Basic	53,739			47,678			53,702			47,625
Diluted	57,327			48,099			57,229			48,002

See accompanying notes to the unaudited consolidated financial statements.

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Item 1. Financial Statements - (continued) Table of Contents

AmSurg Corp. Consolidated Statements of Changes in Equity (unaudited) (In thousands)
	AmSurg Corp. Shareholders																	Noncontrolling
												Noncontrolling						Interests –
												Interests –			Total			Redeemable
	Common Stock					Preferred Stock			Retained			Non-			Equity			(Temporary
	Shares		Amount			Shares	Amount		Earnings			Redeemable			(Permanent)			Equity)
Balance at December 31, 2015	54,294		$	1,345,418		1,725	$	166,632	$	781,413		$	471,284		$	2,764,747		$	175,732
Net earnings	—		—			—	—		76,932			36,046			112,978			74,845
Issuance of restricted stock	587		—			—	—		—			—			—			—
Cancellation of restricted stock	(7	)	—			—	—		—			—			—			—
Stock options exercised	20		450			—	—		—			—			450			—
Stock repurchased	(78	)	(5,688		)	—	—		—			—			(5,688		)	—
Share-based compensation	—		15,068			—	—		—			—			15,068			—
Tax benefit related to exercise of share-based awards	—		3,734			—	—		—			—			3,734			—
Dividends paid on preferred stock	—		—			—	—		(4,528		)	—			(4,528		)	—
Acquisitions and other transactions impacting noncontrolling interests	—		780			—	—		—			13,584			14,364			4,013
Distributions to noncontrolling interests, net of capital contributions	—		—			—	—		—			(38,149		)	(38,149		)	(77,158		)
Disposals and other transactions impacting noncontrolling interests	—		(2,933		)	—	—		—			92			(2,841		)	413
Balance at June 30, 2016	54,816		$	1,356,829		1,725	$	166,632	$	853,817		$	482,857		$	2,860,135		$	177,845
Balance at January 1, 2015	48,113		$	885,393		1,725	$	166,632	$	627,522		$	418,684		$	2,098,231		$	184,099
Net earnings	—		—			—	—		54,713			33,117			87,830			71,672
Issuance of restricted stock	314		—			—	—		—			—			—			—
Cancellation of restricted stock	(7	)	—			—	—		—			—			—			—
Stock options exercised	90		2,080			—	—		—			—			2,080			—
Stock repurchased	(67	)	(3,684		)	—	—		—			—			(3,684		)	—
Share-based compensation	—		7,592			—	—		—			—			7,592			—
Tax benefit related to exercise of share-based awards	—		3,533			—	—		—			—			3,533			—
Dividends paid on preferred stock	—		—			—	—		(4,528		)	—			(4,528		)	—
Acquisitions and other transactions impacting noncontrolling interests	—		599			—	—		—			59,888			60,487			(408		)
Distributions to noncontrolling interests, net of capital contributions	—		—			—	—		—			(30,989		)	(30,989		)	(69,819		)
Disposals and other transactions impacting noncontrolling interests	—		(2,194		)	—	—		—			2,229			35			(367		)
Balance at June 30, 2015	48,443		$	893,319		1,725	$	166,632	$	677,707		$	482,929		$	2,220,587		$	185,177

See accompanying notes to the unaudited consolidated financial statements.

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Item 1. Financial Statements - (continued) Table of Contents

AmSurg Corp. Consolidated Statements of Cash Flows (unaudited) (In thousands)
	Six Months Ended June 30,
	2016			2015
Cash flows from operating activities:
Net earnings	$	187,823		$	159,502
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	59,126			46,430
Amortization of deferred loan costs	4,279			4,155
Provision for uncollectibles	207,046			144,514
Net (gain) loss on disposals and deconsolidations	(2,595		)	3,258
Share-based compensation	15,068			7,592
Excess tax benefit from share-based compensation	(3,734		)	(3,533		)
Deferred income taxes	20,987			2,699
Equity in earnings of unconsolidated affiliates	(13,930		)	(6,640		)
Net change in fair value of contingent consideration	(2,598		)	6,410
Increases (decreases) in cash and cash equivalents, net of acquisitions and dispositions:
Accounts receivable	(228,374		)	(157,056		)
Supplies inventory	(412		)	(110		)
Prepaid and other current assets	(23,744		)	30,327
Accounts payable	(3,347		)	(696		)
Accrued expenses and other liabilities	(28,204		)	12,648
Other, net	7,714			1,895
Net cash flows provided by operating activities	195,105			251,395
Cash flows from investing activities:
Acquisitions and related expenses	(281,113		)	(196,032		)
Acquisition of property and equipment	(37,618		)	(32,665		)
Proceeds from sale of interests in surgery centers	25			—
Purchases of marketable securities	(498		)	(1,245		)
Maturities of marketable securities	2,738			2,988
Other	(8,749		)	(1,987		)
Net cash flows used in investing activities	(325,215		)	(228,941		)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	317,151			7,795
Repayment on long-term borrowings and revolving credit facility	(98,763		)	(10,288		)
Distributions to noncontrolling interests	(115,589		)	(101,033		)
Proceeds from issuance of common stock upon exercise of stock options	450			2,080
Repurchase of common stock	(5,688		)	(3,684		)
Other	(6		)	886
Net cash flows provided by (used in) financing activities	97,555			(104,244		)
Net decrease in cash and cash equivalents	(32,555		)	(81,790		)
Cash and cash equivalents, beginning of period	106,660			208,079
Cash and cash equivalents, end of period	$	74,105		$	126,289
Supplemental cash flow information:
Interest payments	$	58,788		$	56,252
Income tax paid, net of refunds	$	45,726		$	7,772

See accompanying notes to the unaudited consolidated financial statements.

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Item 1. Financial Statements - (continued) Table of Contents

AmSurg Corp.

Notes to the Unaudited Consolidated Financial Statements

(1) Basis of Presentation    

These unaudited consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (GAAP) for interim financial reporting and in accordance with Rule 10-01 of Regulation S-X. In the opinion of management, the unaudited interim consolidated financial statements contained in this report reflect all normal recurring adjustments, which are necessary for a fair presentation of the financial position and the results of operations for the interim periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year. The accompanying unaudited consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in AmSurg Corp.'s (Company) Annual Report on Form 10-K for the fiscal year ended December 31, 2015.

Ambulatory Services

The Company, through its wholly-owned subsidiaries, owns interests, primarily 51%, in limited liability companies (LLCs) and limited partnerships (LPs) which own and operate ambulatory surgery centers (ASCs, surgery centers or centers). All LLCs and LPs are referred to herein as “partnerships” and “partners,” respectively. The Company has variable interests in the partnerships through its equity ownership interests. Each partnership is considered a variable interest entity (VIE) due to its structure as a limited partnership or functional equivalent under Financial Accounting Standards Board (FASB) Accounting Standard Update (ASU) No. 2015-02 “Consolidations (Topic 810) - Amendments to the Consolidation Analysis,” which was adopted effective January 1, 2016. For those partnerships in which the Company’s ownership interest is 51% or greater, the Company is considered the primary beneficiary. The Company is the primary beneficiary due to 1) ownership interest, operating agreements allowing the Company to govern the day-to-day activities, and the Company’s position as the managing member or general partner and 2) the Company's obligation to absorb losses or the right to receive returns proportionate to its equity interest in the partnerships. For the 24 partnerships in which the Company’s ownership interest is less than 51%, the Company is not deemed the primary beneficiary and therefore those partnerships are not consolidated with the exception of 2 partnerships which are consolidated because the Company holds substantive participation rights and has the obligation to absorb losses or right to receive returns proportionate to its equity interest in the partnerships. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries and the consolidated partnerships. The responsibilities of the Company’s noncontrolling partners (LPs and noncontrolling members) are to supervise the delivery of medical services, with their rights being restricted to those that protect their financial interests, such as approval of the acquisition of significant assets or the incurrence of debt which they are generally required to guarantee on a pro rata basis based upon their respective ownership interests. Intercompany profits, transactions and balances have been eliminated.

Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company’s equity. However, for instances in which certain redemption features that are not solely within the control of the Company are present, classification of noncontrolling interests outside of permanent equity is required. Consolidated net earnings attributable to the Company and to the noncontrolling interests are identified and presented on the consolidated statements of earnings; changes in ownership interests are accounted for as equity transactions when there is no change in control; and when a subsidiary is deconsolidated, any retained noncontrolling equity investment in the former subsidiary and the gain or loss on the deconsolidation of the subsidiary are measured at fair value. Certain transactions with noncontrolling interests are also classified within financing activities in the statements of cash flows. 

Center profits and losses of consolidated entities are allocated to the Company’s partners in proportion to their ownership percentages and reflected in the aggregate as net earnings attributable to noncontrolling interests. The partners of the Company’s center partnerships typically are organized as general partnerships, LPs or LLCs that are not subject to federal income tax. Each partner shares in the pre-tax earnings of the center in which it is a partner. Accordingly, the earnings attributable to noncontrolling interests in each of the Company’s consolidated partnerships are generally determined on a pre-tax basis, and total net earnings attributable to noncontrolling interests are presented after net earnings. However, the Company considers the impact of the net earnings attributable to noncontrolling interests on earnings before income taxes in order to determine the amount of pre-tax earnings on which the Company must determine its income tax expense. In addition, distributions from the partnerships are made to both the Company’s wholly-owned subsidiaries and the partners on a pre-tax basis.

Physician Services

The Company, through its wholly-owned subsidiary Sheridan Healthcare, is a national provider of multi-specialty physician and administrative services to hospitals, ambulatory surgery centers and other healthcare facilities. The Company focuses on delivering comprehensive physician services, primarily in the areas of anesthesiology, radiology, children's services and emergency medicine to

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Item 1. Financial Statements - (continued) Table of Contents

healthcare facilities. Through its contracts with healthcare facilities, the Company is authorized to bill and collect charges for fee for service medical services rendered by its healthcare professionals and employees in exchange for the provision of services to the patients of these facilities. Contract revenue is earned directly from hospital customers through a variety of payment arrangements that are established to supplement payments from third-party payors. The Company also provides physician services and manages office-based practices in the areas of pain management, gynecology, obstetrics and perinatology. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries along with the accounts of affiliated professional corporations (PCs) with which the Company has management arrangements. The Company's agreements with these PCs provide that the term of the arrangements is permanent, subject only to termination by the Company, except in the case of gross negligence, fraud or bankruptcy of the Company. The PC structure is primarily used in states which prohibit the corporate practice of medicine. The arrangements are captive in nature as a majority of the outstanding voting equity instruments of the PCs are owned by nominee shareholders appointed at the sole discretion of the Company. The nominee shareholder is a medical doctor who is generally a senior corporate employee of the Company. The Company has a contractual right to transfer the ownership of the PCs at any time to any person it designates as the nominee shareholder. The Company has the right to all assets and to receive income, both as ongoing fees and as proceeds from the sale of any interest in the PCs, in an amount that fluctuates based on the performance of the PCs and the change in the fair value of the interest in the PCs. The Company has exclusive responsibility for the provision of all non-medical services required for the day-to-day operation and management of the PCs and establishes the guidelines for the employment and compensation of the physicians and other employees of the PCs which is consistent with the operation of the Company's wholly-owned subsidiaries. Based on the provisions of these agreements, the Company has determined that the PCs are variable interest entities and that the Company is the primary beneficiary as defined in ASC 810 “Consolidations.”

Variable Interest Entities

For its PCs and certain of its partnerships, the Company is considered the primary beneficiary of the variable interest entities and consolidates under the Variable Interest Model in ASC 810.The total assets of the VIEs, which are included in the accompanying consolidated balance sheets, as of June 30, 2016 and December 31, 2015, were $780.5 million and $740.1 million, respectively, and the total liabilities of the VIEs were $297.7 million and $299.0 million, respectively. Included in total assets as of June 30, 2016 and December 31, 2015, respectively, were $178.6 million and $176.8 million of assets which were restricted to use and could only be used to settle the obligations of the VIE. The creditors of the VIE have no recourse to the Company, with the exception of $18.2 million and $21.7 million of debt guaranteed by the Company at June 30, 2016 and December 31, 2015, respectively. The restricted assets and obligations, which are either restricted for use in the VIE or the creditor did not have recourse to the Company, generally consisted of the portion of assets and liabilities attributable to the Company's non-controlling partners.

The Company also has certain equity interests in unconsolidated affiliates which meet the definition of a variable interest entity. The Company has a variable interest in these investments through its equity interests; however, the Company is not the primary beneficiary of these entities as it holds 50% or less of the voting rights and does not have the power to direct the activities that most significantly impact the entities' economic performance as a result of the Company's shared or lack of control. As a result, the Company has accounted for these investments under the equity method of accounting. The Company's investment in these entities was $179.1 million and $169.2 million as of June 30, 2016 and December 31, 2015, respectively, and is reflected in the accompanying consolidated balance sheets as a component of investments in unconsolidated affiliates.

The Company has recorded its share of the earnings of these investments of $7.4 million and $4.0 million as a component of equity in earnings of the unconsolidated affiliates in the accompanying statements of earnings during the three months ended June 30, 2016 and 2015, respectively, and $13.9 million and $6.6 million during the six months ended June 30, 2016 and 2015, respectively. The Company recognized management and billing fees associated with these investments totaling $5.3 million and $3.8 million during the three months ended June 30, 2016 and 2015, respectively, and $11.6 million and $7.2 million during the six months ended June 30, 2016 and 2015, respectively, which are included in net revenue in the accompanying consolidated statements of earnings. The Company has also recorded receivables from these entities in the amount of $9.2 million and $6.0 million as of June 30, 2016 and December 31, 2015, respectively. These receivables are included in the other current assets in the accompanying consolidated balance sheets.

Restricted Cash and Marketable Securities

As of June 30, 2016 and December 31, 2015, the Company had $29.9 million and $27.4 million, respectively, of restricted cash and marketable securities in the accompanying consolidated balance sheets the majority of which is restricted for the purpose of satisfying the obligations of the Company's wholly-owned captive insurance company. The Company has reflected $17.1 million and $13.9 million as of June 30, 2016 and December 31, 2015, respectively, of its restricted cash and marketable securities as a component of other assets in the accompanying consolidated balance sheets. Restricted cash and marketable securities reflected as a component of total current assets in the accompanying consolidated balance sheets represent amounts available to satisfy the claims payments

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Item 1. Financial Statements - (continued) Table of Contents

estimated to occur in the next 12 months. As of June 30, 2016 and December 31, 2015, the Company had $0.5 million and $2.7 million, respectively, included in restricted cash and marketable securities, consisting of certificates of deposit with maturities less than 180 days, which approximates fair value.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Reclassifications

Certain prior year amounts in the accompanying consolidated financial statements have been reclassified to reflect the adoption of ASU No. 2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs” as discussed further under “Recent Accounting Pronouncements.” The impact of the reclassification made to prior period balance sheet is presented below (in thousands).

	December 31, 2015
Consolidated Balance Sheet:	Previously reported		Reclassification			Revised
Intangible assets, net	$	1,641,811	$	(47,174	)	$	1,594,637
Long-term debt	$	2,405,130	$	(47,174	)	$	2,357,956

Recent Accounting Pronouncements

In May 2014, the FASB issued ASU 2014-09 “Revenue from Contracts with Customers,” which will eliminate the transaction and industry-specific revenue recognition guidance under current GAAP and replace it with a principle-based approach using the following steps: identify the contract(s) with a customer, identify the performance obligations in the contract, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when (or as) the entity satisfies a performance obligation. In August 2015, the FASB issued ASU 2015-14 “Revenue from Contracts with Customers (Topic 606), Deferral of the Effective Date” which granted a one-year deferral of this ASU. In 2016, the FASB issued the following ASUs to provide entities further clarity on the application of ASU 2014-09:

• ASU 2016-08 “Principal versus Agent Considerations (Reporting Revenue Gross versus Net)”

• ASU 2016-10 “Identifying Performance Obligations and Licensing”

• ASU 2016-12 “Narrow-Scope Improvements and Practical Expedients”

The guidance in ASU 2014-09 and the subsequently related ASUs will now be effective for public entities for annual reporting periods beginning after December 15, 2017, including interim periods therein. Early adoption will be permitted for annual reporting periods beginning after December 15, 2016, including interim periods therein. The Company has yet to assess the impact, if any, this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

In February 2015, the FASB issued ASU No. 2015-02, “Consolidations (Topic 810) - Amendments to the Consolidation Analysis”. The new guidance made amendments to the consolidation guidance, including introducing a separate consolidation analysis specific to limited partnerships and other similar entities. Under this analysis, limited partnerships and other similar entities are considered a variable-interest entity unless the limited partners hold substantive kick-out rights or participating rights. The standard is effective for annual periods beginning after December 15, 2015. The Company adopted this standard effective January 1, 2016 and applied the adoption retrospectively. The adoption of the standard did not result in a change of consolidated subsidiaries nor did it result in any impact to the Company's consolidated financial position, results of operations or cash flows as of and for the three months ended March 31, 2016 or for any previous period.

In April 2015, the FASB issued ASU No. 2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs.” ASU 2015-03 amended current presentation guidance by requiring that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. In August 2015, the FASB issued ASU 2015-15 “Interest - Imputation of Interest (Subtopic 835-50), Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements - Amendments to Securities and Exchange Commission (SEC) Paragraphs Pursuant to Staff Announcement at June 18, 2015 EITF Meeting (SEC Update)” which incorporated into the Accounting Standards Codification an SEC staff announcement that the SEC staff will not object to an entity presenting the cost of securing a revolving line of credit as an asset, regardless of whether a balance is outstanding. The

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Item 1. Financial Statements - (continued) Table of Contents

standards were effective for annual periods beginning after December 15, 2015, and interim periods within those fiscal years. The Company adopted this ASU effective January 1, 2016 and accordingly, reclassified $47.2 million of deferred debt issuance costs from intangible assets, net to a reduction in long-term debt at December 31, 2015, in the accompanying balance sheets (see reclassification above).

In February 2016, the FASB issued ASU No. 2016-02, “Leases” which amends existing accounting standards for lease accounting, including requiring lessees to recognize most leases on the balance sheet and making changes to lessor accounting. The standard is effective for annual periods beginning after December 15, 2018 with early adoption permitted. The new standard requires a modified retrospective application for all leases existing at, or entered into, after the date of initial application, with an option to use certain transition relief. The Company has not yet determined the impact this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

In March 2016, the FASB issued ASU No. 2016-09, “Improvements to Employee Share-Based Payment Accounting” which will change how companies account for certain aspects of share-based payments to employees by requiring companies to recognize the income tax effects of awards in the income statement when the awards vest or are settled. The standard is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company has not yet determined the impact this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

(2) Business Combinations

On June 15, 2016, the Company entered into a definitive merger agreement with Envision Healthcare Holdings, Inc. (Envision). Pursuant to the merger agreement, AmSurg Corp. will change its state of incorporation from Tennessee to Delaware by merging AmSurg Corp. with and into New Amethyst Corp. (New Amethyst), a newly-formed Delaware corporation and a wholly-owned subsidiary of AmSurg Corp., with New Amethyst being the surviving corporation. AmSurg Corp. shareholders will receive one share of New Amethyst common stock for each share of AmSurg Corp. common stock owned and one share of New Amethyst mandatory convertible preferred stock for each share of AmSurg Corp. mandatory convertible preferred stock owned. Following the merger of AmSurg and New Amethyst, Envision will merge with and into New Amethyst, with New Amethyst being the surviving corporation.

If the merger is completed, Envision stockholders will receive 0.334 shares of New Amethyst common stock for each share of Envision common stock owned (the Exchange Ratio). The Exchange Ratio is fixed and will not be adjusted to reflect stock price changes prior to the closing. Upon completion of the merger, former Envision stockholders will own approximately 53% of the then outstanding New Amethyst common stock (on a fully diluted basis), including preferred shares. The value of the merger consideration to be received will fluctuate with the market value of AmSurg common stock and Envision common stock until the merger is completed. The merger is currently expected to be completed in the fourth quarter of 2016 and is subject to customary closing conditions, including obtaining regulatory approval and approval from the common shareholders of both AmSurg and Envision. Upon completion of the merger, New Amethyst will change its name to “Envision Healthcare Corporation.”

(3) Revenue Recognition

Ambulatory Services

Ambulatory services revenues consist of billing for the use of the centers’ facilities directly to the patient or third-party payor and, at certain of the Company’s centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by the Company’s centers. Such revenues are recognized when the related surgical procedures are performed. Revenues exclude any amounts billed for physicians’ surgical services, which are billed separately by the physicians to the patient or third-party payor.

Revenues from ambulatory services are recognized on the date of service, net of estimated contractual adjustments from third-party medical service payors including Medicare and Medicaid. During each of the six months ended June 30, 2016 and 2015, the Company derived approximately 26% of its ambulatory services net revenues from governmental healthcare programs, primarily Medicare and managed Medicare programs. 

Physician Services

Physician services revenues primarily consist of fee for service revenue and contract revenue and are derived principally from the provision of physician services to patients of the healthcare facilities the Company serves. Contract revenue represents income earned from the Company's hospital customers to supplement payments from third-party payors.

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The Company records revenue at the time services are provided, net of a contractual allowance and a provision for uncollectibles. Revenue less the contractual allowance represents the net revenue expected to be collected from third-party payors (including managed care, commercial and governmental payors such as Medicare and Medicaid) and patients insured by these payors. The Company also recognizes revenue for services provided during the period that have not been billed. Expected collections are estimated based on fees and negotiated payment rates in the case of third-party payors, the specific benefits provided for under each patient’s healthcare plan, mandated payment rates under the Medicare and Medicaid programs, and historical cash collections.

The Company's provision for uncollectibles includes its estimate of uncollectible balances due from uninsured patients, uncollectible co-pay and deductible balances due from insured patients and special charges, if any, for uncollectible balances due from managed care, commercial and governmental payors. The Company records net revenue from uninsured patients at its estimated realizable value, which includes a provision for uncollectible balances, based on historical cash collections (net of recoveries).

Net revenue for the physician services segment consists of the following major payors (dollars in thousands):

	Three Months Ended June 30,										Six Months Ended June 30,
	2016					2015					2016					2015
Medicare	$	61,775		14	%	$	45,967		14	%	$	120,549		14	%	$	87,296		14	%
Medicaid	30,698			7		19,298			6		61,523			7		37,878			6
Commercial and managed care	337,553			77		254,481			77		661,724			77		474,599			77
Self-pay	71,648			16		45,298			14		133,365			16		88,569			14
Net fee for service revenue	501,674			114		365,044			110		977,161			114		688,342			111
Contract and other revenue	38,411			9		31,698			10		74,076			9		62,687			10
Provision for uncollectibles	(101,333		)	(23	)	(65,783		)	(20	)	(194,941		)	(23	)	(133,535		)	(22	)
Net revenue for physician services	$	438,752		100	%	$	330,959		100	%	$	856,296		100	%	$	617,494		100	%

(4) Accounts Receivable

The Company manages accounts receivable by regularly reviewing its accounts and contracts and by providing appropriate allowances for contractual adjustments and uncollectible amounts. Some of the factors considered by management in determining the amount of such allowances are the historical trends of cash collections, contractual and bad debt write-offs, accounts receivable agings, established fee schedules, contracts with payors, changes in payor mix and procedure statistics. Actual collections of accounts receivable in subsequent periods may require changes in the estimated contractual allowance and provision for uncollectibles. The Company tests its analysis by comparing cash collections to net patient revenues and monitoring self-pay utilization. In addition, when actual collection percentages differ from expected results, on a contract by contract basis, supplemental detailed reviews of the outstanding accounts receivable balances may be performed by the Company’s billing operations to determine whether there are facts and circumstances existing that may cause a different conclusion as to the estimate of the collectability of that contract’s accounts receivable from the estimate resulting from using the historical collection experience. The Company also supplements its allowance for doubtful accounts analysis for its physician services segment quarterly using a hindsight calculation that utilizes write-off data for all payor classes during the previous twelve month period to estimate the allowance for doubtful accounts at a point in time. Changes in these estimates, if any, are charged or credited to the consolidated statements of operations in the period of change. Material changes in estimates may result from unforeseen write-offs of patient or third-party accounts receivable, unsuccessful disputes with managed care payors, adverse macro-economic conditions which limit patients’ ability to meet their financial obligations for the care provided by physicians, or broad changes to government regulations that adversely impact reimbursement rates for services provided by the Company. Significant changes in payor mix, business office operations, general economic conditions and health care coverage provided by federal or state governments or private insurers may have a significant impact on the Company’s estimates and significantly affect its results of operations and cash flows.

Due to the nature of the Company's operations, it is required to separate the presentation of its bad debt expense on the consolidated statements of earnings. The Company records the portion of its bad debts associated with its physician services segment as a component of net revenue in the accompanying consolidated statements of earnings, and the remaining portion, which is associated with its ambulatory services segment, is recorded as a component of other operating expenses in the accompanying consolidated statements of earnings. The bifurcation is a result of the Company's ability to assess the ultimate collection of the patient service revenue associated with its ambulatory services segment before services are provided. The Company's ambulatory services segment is generally able to verify a patient's insurance coverage and ability to pay before services are provided as those services are pre-scheduled and non-emergent. Bad debt expense for ambulatory services is included in other operating expenses and was $6.3 million and $12.1 million for the three and six months ended June 30, 2016, respectively, and $4.7 million and $11.0 million for the three and six months ended June 30, 2015, respectively. Bad debt expense related to physician services was $101.3 million and $194.9 million

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for the three and six months ended June 30, 2016, respectively, and $65.8 million and $133.5 million for the three and six months ended June 30, 2015, respectively.

At June 30, 2016 and December 31, 2015, allowances for doubtful accounts were $208.8 million and $167.4 million, respectively. The increase in the allowance for doubtful accounts is primarily a result of having a full quarter of operations for acquisitions completed during the fourth quarter of 2015. At June 30, 2016 and December 31, 2015, approximately 82% and 80%, respectively, of the Company’s allowance for doubtful accounts was related to fee for service patient receivables associated with the physician services segment. The principal exposure for uncollectible fee for service visits is from self-pay patients and, to a lesser extent, for co-payments and deductibles from patients with insurance. Concentration of credit risk is limited by the diversity and number of facilities, patients, payors, and by the geographic dispersion of the Company's operations.

(5) Acquisitions and Disposals

The Company accounts for its business combinations under the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any noncontrolling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method.

Ambulatory Services Activity

During each of the six months ended June 30, 2016 and 2015, the Company, through a wholly-owned subsidiary, acquired a controlling interest in four surgery centers. The aggregate amount paid for the centers and for settlement of purchase price payable obligations during the six months ended June 30, 2016 and 2015 was approximately $25.7 million and $95.4 million, respectively, and was paid in cash and funded by a combination of operating cash flow and borrowings under the Company's revolving credit agreement.

The total fair value of an acquisition includes an amount allocated to goodwill, which results from the centers’ favorable reputations in their markets, their market positions and their ability to deliver quality care with high patient satisfaction consistent with the Company’s business model.

During the six months ended June 30, 2016, the Company disposed of two surgery centers and recognized a net gain from the disposals of $3.3 million in the six months ended June 30, 2016. The Company did not dispose of any surgery centers during the six months ended June 30, 2015.

Physician Services Activity

The Company completed the acquisition of six physician practices in the six months ended June 30, 2016 and four physician practices in the six months ended June 30, 2015. The aggregate amount paid for the physician practices and for settlement of purchase price payable obligations during the six months ended June 30, 2016 and 2015 was approximately $255.4 million and $100.7 million, respectively, and was paid in cash and funded by a combination of operating cash flow and borrowings under the Company's revolving credit agreement. In addition to the cash paid, approximately $15.4 million of consideration for one physician practice was deferred and will be paid in the next two years, $9.7 million of which is reflected in other accrued liabilities and $5.7 million is reflected in other long-term liabilities in the accompanying consolidated balance sheets.

As a result of certain acquisitions completed during prior periods, the Company has agreed to pay as additional consideration amounts which are contingent on the acquired entities achieving future performance metrics. As of June 30, 2016 and December 31, 2015, the Company had accrued $1.0 million and $5.5 million, respectively, as a component of other accrued liabilities in the accompanying consolidated balance sheets, which represents management's estimate of the fair values of the contingent consideration. During the six months ended June 30, 2016, the Company made a cash payment of $1.9 million for one acquisition and recognized a decrease of $2.6 million associated with the change in fair value of its remaining accrued contingent consideration. As of June 30, 2016, the Company estimates it may have to pay approximately $1.0 million in future contingent payments for one acquisition made prior to December 31, 2015 based upon the current projected financial performance or anticipated achievement of other targets of the acquired operations. The current estimate of future contingent payments could increase or decrease depending upon the actual performance of the acquisition over each respective measurement period. The acquisitions completed during the six months ended June 30, 2016 did not contain provisions for contingent consideration.

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The Company utilizes Level 3 inputs, which include unobservable data, to measure the fair value of the contingent consideration. The fair value was determined utilizing future forecasts of both earnings and other performance metrics which are expected to be achieved during the performance period, in accordance with each respective purchase agreement. In estimating the fair value, management developed various scenarios and weighted the probable outcome of each scenario using a range of expected probability specific to each agreement. Management utilized a market rate to discount the results of such analysis in order to record the present value of the expected future payout. The timing of the potential remaining payments of contingent consideration is expected to occur within one year.

Purchase Price Allocations

The acquisition date fair value of the total consideration transferred and acquisition date fair value of each major financial class for both the ambulatory services and physician services acquisitions completed in the six months ended June 30, 2016, including post acquisition date adjustments recorded to purchase price allocations, are as follows (in thousands):

	Six Months Ended June 30, 2016 (1)
Accounts receivable	$	16,809
Other current assets	1,397
Property and equipment	4,258
Goodwill	209,194
Intangible assets	115,902
Other long-term assets	67
Accounts payable	(450		)
Other accrued liabilities	(20,331		)
Deferred income taxes	(20,706		)
Other long-term liabilities	(5,700		)
Long-term debt	(128		)
Total fair value	300,312
Less: Fair value attributable to noncontrolling interests	19,199
Acquisition date fair value of total consideration transferred	$	281,113

(1) Represents the preliminary allocation of fair value of acquired assets and liabilities associated with these acquisitions at June 30, 2016.

During 2016, no significant changes were made to the purchase price allocation of assets and liabilities, existing at the date of acquisition, related to individual acquisitions completed in 2015.

The total fair value of acquisitions completed by the Company include amounts allocated to goodwill, which result from the acquisitions' favorable reputations in their markets, their market positions and their ability to deliver quality care with high patient satisfaction consistent with the Company’s business model. Fair value attributable to noncontrolling interests is based on significant inputs that are not observable in the market. Key inputs used to determine the fair value include financial multiples used in the purchase of noncontrolling interests primarily from acquisitions of centers. Such multiples, based on earnings, are used as a benchmark for the discount to be applied for the lack of control or marketability. The fair value of noncontrolling interests for acquisitions where the purchase price allocation is not finalized may be subject to adjustment as the Company completes its initial accounting for acquired intangible assets. Additionally, the Company continues to obtain information relative to the fair values of assets acquired, liabilities assumed and any noncontrolling interests associated with acquisitions completed in the last 12 months. Acquired assets and assumed liabilities include, but are not limited to, fixed assets, licenses, intangible assets and professional liabilities. The valuations are based on appraisal reports, discounted cash flow analyses, actuarial analyses or other appropriate valuation techniques to determine the fair value of the assets acquired or liabilities assumed. A majority of the deferred income taxes recognized as a component of the Company's purchase price allocation is a result of the difference between the book and tax basis of the amortizable intangible assets recognized. The amount allocated to the deferred income tax liability is subject to change as a result of the final allocation of purchase price to amortizable intangibles. The Company expects to finalize the purchase price allocation for its most recent acquisitions as soon as practical.

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During the three and six months ended June 30, 2016, the Company incurred approximately $5.1 million and $6.5 million of transaction costs, respectively, and during the three and six months ended June 30, 2015, the Company incurred approximately $2.0 million and $3.5 million, respectively. The costs incurred during the three months ended June 30, 2016 were primarily associated with the definitive merger agreement with Envision Healthcare Holdings, Inc. signed on June 15, 2016. See Note 2 for additional information.

Net revenue and net earnings included in the six months ended June 30, 2016 and 2015 associated with completed acquisitions are as follows (in thousands):

	Six Months Ended June 30,
	2016		2015
Net revenue	$	12,714	$	48,042
Net earnings	$	2,198	$	9,101
Less:  Net earnings attributable to noncontrolling interests	563		2,353
Net earnings attributable to AmSurg Corp. common shareholders	$	1,635	$	6,748

The unaudited consolidated pro forma results for the six months ended June 30, 2016 and 2015, assuming all 2016 acquisitions had been consummated on January 1, 2015, and all 2015 acquisitions had been consummated on January 1, 2014 are as follows (in thousands, except earnings per share):

	Six Months Ended June 30,
	2016		2015
Net revenue	$	1,558,347	$	1,488,632
Net earnings	198,383		221,765
Amounts attributable to AmSurg Corp. common shareholders:
Net earnings	82,806		68,374
Net earnings per common share:
Basic	$	1.53	$	1.44
Diluted	$	1.52	$	1.42

(6) Investments in Unconsolidated Affiliates

Investments in unconsolidated affiliates in which the Company exerts significant influence but does not control or otherwise consolidate are accounted for using the equity method. Equity method investments are initially recorded at cost, unless such investments are a result of the Company entering into a transaction whereby the Company loses control of a previously controlled entity but retains a noncontrolling interest. Such transactions, which result in the deconsolidation of a previously consolidated entity, are measured at fair value. The fair value measurement utilizes Level 3 inputs, which include unobservable data, to measure the fair value of the retained noncontrolling interest. The fair value determination is generally based on a combination of multiple valuation methods, which can include discounted cash flow, income approach, or market value approach which incorporates estimates of future earnings and market valuation multiples for certain guideline companies. These investments are included as investments in unconsolidated affiliates in the accompanying consolidated balance sheets. The Company’s share of the profits and losses from these investments is reported in equity in earnings of unconsolidated affiliates in the accompanying consolidated statements of earnings. The Company monitors its investments for other-than-temporary impairment by considering factors such as current economic and market conditions and the operating performance of the companies and records reductions in carrying values when necessary.

As of June 30, 2016 and December 31, 2015, the Company recorded in the accompanying consolidated balance sheets its investments in unconsolidated affiliates of $179.1 million and $169.2 million, respectively. The Company's net earnings from these investments during the three months ended June 30, 2016 and 2015 were approximately $7.4 million and $4.0 million, respectively, and during the six months ended June 30, 2016 and 2015 were approximately $13.9 million and $6.6 million, respectively.

During the six months ended June 30, 2016, the Company's ambulatory services segment sold a portion of its interest in one surgery center, which resulted in the surgery center being deconsolidated and subsequently accounted for as an equity method investment. During the six months ended June 30, 2015, the Company's ambulatory services segment entered into one equity method investment. As a result of this investment, the Company contributed its controlling interest in a center and a noncontrolling interest in an entity

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that owned one ASC prior to the transaction and, after the completion of the transaction, controls the contributed center and the center it previously owned.

During the six months ended June 30, 2015, the Company's physician services segment contributed one site of service into an entity jointly owned by the Company and a health system.Therewas no deconsolidation activity for the physician services segment during the six months ended June 30, 2016.

As a result of these transactions, the Company recorded in the accompanying consolidated balance sheets, as a component of investments in unconsolidated affiliates, the fair value of the Company's investment in these entities of approximately $1.8 million and $2.3 million during the six months ended June 30, 2016 and 2015, respectively. In each of these transactions, the gain or loss on deconsolidation was determined based on the difference between the fair value of the Company’s interest, which was based on estimates of the expected future earnings, in the new entity and the carrying value of both the tangible and intangible assets of the contributed centers immediately prior to each transaction. During the three and six months ended June 30, 2016, the Company recognized a net loss on deconsolidation related to this center in the accompanying consolidated statements of earnings of approximately $0.7 million, respectively. During the three and six months ended June 30, 2015, the Company recognized a net loss on deconsolidation in the accompanying consolidated statements of earnings of approximately $3.0 million and $3.3 million, respectively.

(7) Prepaid and Other Current Assets

The following table presents a summary of items comprising prepaid and other current assets in the accompanying consolidated balance sheets as of June 30, 2016 and December 31, 2015 (in thousands):

	June 30,		December 31,
	2016		2015
Income taxes receivable	$	16,241	$	7,908
Prepaid expenses	22,104		18,900
Deferred compensation plan assets	23,530		16,623
Other	12,690		32,340
Total prepaid and other current assets	$	74,565	$	75,771

(8) Goodwill and Intangible Assets

The changes in the carrying amount of goodwill for the six months ended June 30, 2016 are as follows (in thousands):

Balance at December 31, 2015	$	3,970,210
Goodwill acquired, including post acquisition adjustments	207,333
Goodwill disposed, including impact of deconsolidation transactions	(2,535		)
Balance at June 30, 2016	$	4,175,008

As of June 30, 2016, the ambulatory services segment and the physician services segment each had approximately $2.1 billion of goodwill. During the six months ended June 30, 2016, goodwill increased $38.4 million for the ambulatory services segment primarily due to the acquisition of four centers, net of one deconsolidation. During the six months ended June 30, 2016, goodwill increased by $166.4 million for the physician services segment, primarily due to the acquisition of six physician practices and post-acquisition adjustments associated with acquisitions completed during 2015. For the six months ended June 30, 2016 and 2015, respectively, approximately $100.9 million and $107.6 million of goodwill recorded was deductible for tax purposes.

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Intangible assets at June 30, 2016 and December 31, 2015 consisted of the following (in thousands):

	June 30, 2016							December 31, 2015
	Gross							Gross
	Carrying		Accumulated					Carrying		Accumulated
	Amount		Amortization			Net		Amount		Amortization			Net
Amortizable intangible assets:
Customer relationships with hospitals	$	1,494,790	$	(109,444	)	$	1,385,346	$	1,379,977	$	(74,490	)	$	1,305,487
Capitalized software	81,595		(33,500		)	48,095		71,462		(28,125		)	43,337
Agreements, contracts and other	12,358		(3,519		)	8,839		11,267		(2,449		)	8,818
Total amortizable intangible assets	1,588,743		(146,463		)	1,442,280		1,462,706		(105,064		)	1,357,642
Non-amortizable intangible assets:
Trade name	228,000		—			228,000		228,000		—			228,000
Restrictive covenant arrangements	8,995		—			8,995		8,995		—			8,995
Total non-amortizable intangible assets	236,995		—			236,995		236,995		—			236,995
Total intangible assets	$	1,825,738	$	(146,463	)	$	1,679,275	$	1,699,701	$	(105,064	)	$	1,594,637

Amortization of intangible assets for the three months ended June 30, 2016 and 2015 was $21.1 million and $14.7 million, respectively, and $41.5 million and $29.2 million for the six months ended June 30, 2016 and 2015, respectively. Estimated amortization of intangible assets for the remainder of 2016 and each of the following five years and thereafter is $44.9 million, $88.6 million, $87.4 million, $84.7 million, $82.4 million, $78.0 million and $976.3 million, respectively. The Company expects to recognize amortization of all intangible assets over a weighted average period of 17.9 years with no expected residual values.

(9) Other Accrued Liabilities

The following table presents a summary of items comprising other accrued liabilities in the accompanying consolidated balance sheets as of June 30, 2016 and December 31, 2015 (in thousands):

	June 30,		December 31,
	2016		2015
Accrued professional liabilities	$	14,541	$	14,362
Contingent purchase price payable	1,000		5,509
Current income taxes payable	—		7,892
Refunds payable	29,626		48,415
Other	47,404		43,059
Total other accrued liabilities	$	92,571	$	119,237

(10) Accrued Professional Liabilities

The Company maintains professional liability insurance policies with third-party insurers generally on a claims-made basis, subject to self-insured retention, exclusions and other restrictions. A substantial portion of the professional liability loss risks are being provided by a third-party insurer, which is fully reinsured by the Company's wholly-owned captive insurance subsidiary. The Company records an estimate of liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss patterns, which are not discounted.

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At June 30, 2016 and December 31, 2015, the Company's accrued professional liabilities are presented in the accompanying consolidated balance sheets as a component of other accrued liabilities and other long-term liabilities as follows (in thousands):

	June 30, 2016		December 31, 2015
Estimated losses under self-insured programs	$	32,652	$	30,748
Incurred but not reported losses	35,955		36,166
Total accrued professional liabilities	68,607		66,914
Less estimated losses payable within one year	14,541		14,362
Total	$	54,066	$	52,552

The changes to the Company's estimated losses under self-insured programs as of June 30, 2016 were as follows (in thousands):

Balance at December 31, 2015	$	66,914
Assumed liabilities through acquisitions	1,862
Provision related to current period reserves	10,037
Payments for current period reserves	(39		)
Benefit related to changes in prior period reserves	(249		)
Payments for prior period reserves	(6,307		)
Other, net including post-acquisition adjustments	(3,611		)
Balance at June 30, 2016	$	68,607

(11)Long-term Debt

Long-term debt at June 30, 2016 and December 31, 2015 consisted of the following (in thousands):

	June 30,		December 31,
	2016		2015
Revolving credit agreement	$	400,000	$	175,000
Term loan	852,600		856,950
5.625% Senior Unsecured Notes due 2020	250,000		250,000
5.625% Senior Unsecured Notes due 2022	1,100,000		1,100,000
Other debt due through 2025	23,920		24,944
Capitalized lease arrangements due through 2026	18,202		18,613
	2,644,722		2,425,507
Less current portion	20,772		20,377
Less net deferred financing costs	42,907		47,174
Long-term debt	$	2,581,043	$	2,357,956

The fair value of fixed rate long-term debt, with a carrying value of $1,391.1 million, was $1,438.2 million at June 30, 2016. The fair value of variable rate long-term debt approximates its carrying value of $1,253.6 million at June 30, 2016. With the exception of the Company’s 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes (each defined below), the fair value of fixed rate debt (Level 2) is determined based on an estimation of discounted future cash flows of the debt at rates currently quoted or offered to the Company for similar debt instruments of comparable maturities by its lenders. The fair value of the Company’s 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes (Level 1) is determined based on quoted prices in an active market.

a. Term Loan and Credit Facility

The Company has a credit facility that is comprised of an $870.0 million term loan and a $500.0 million revolving credit facility. On October 21, 2015, the Company exercised the accordion feature of its revolving credit facility and increased the Company's borrowing capacity by $200.0 million to $500.0 million. As of June 30, 2016, the Company had available $100.0 million under the revolving credit facility.

The term loan matures on July 16, 2021 and bears interest at a rate equal to, at the Company’s option, the alternative base rate as defined in the agreement (ABR) plus 1.75% to 2.00% or LIBOR plus 2.75% to 3.00%, with a LIBOR floor of 0.75%, or a

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combination thereof (3.50% on June 30, 2016). The term loan requires quarterly principal payments of 0.25% of the face amount totaling $8.7 million annually.

The revolving credit facility matures on July 16, 2019 and permits the Company to borrow up to $500.0 million at an interest rate equal to, at the Company’s option, the ABR plus 1.75% to 2.00% or LIBOR plus 2.75% to 3.00%, or a combination thereof, and provides for a fee of 0.375% of unused commitments. The Company has the option to increase borrowings under the senior secured credit facility by an unlimited amount as long as certain financial covenants are met and lender approval is obtained. The senior credit facility contains certain covenants relating to the ratio of debt to operating performance measurements and interest coverage ratios and is secured by a pledge of the stock of the Company’s wholly-owned subsidiaries and certain of the Company’s less than wholly-owned subsidiaries. As of June 30, 2016, the Company was in compliance with the covenants contained in the term loan and credit facility.

b. Senior Unsecured Notes

2020 Senior Unsecured Notes

The Company has $250.0 million aggregate principal amount of 5.625% senior unsecured notes due 2020 (the 2020 Senior Unsecured Notes). The 2020 Senior Unsecured Notes are unsecured obligations of the Company and are guaranteed by its existing and subsequently acquired or organized wholly-owned domestic subsidiaries. The 2020 Senior Unsecured Notes are pari passu in right of payment with all the existing and future senior debt of the Company and senior to all existing and future subordinated debt of the Company. Interest on the 2020 Senior Unsecured Notes accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on May 30 and November 30, through the maturity date of November 30, 2020.

The Company may redeem the 2020 Senior Unsecured Notes in whole or in part. The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve month period beginning on November 30 of the years indicated below:  

Period	Redemption Price
2015	104.219	%
2016	102.813	%
2017	101.406	%
2018 and thereafter	100.000	%

The 2020 Senior Unsecured Notes contain certain covenants which, among other things, limit, but may not restrict the Company’s ability to enter into or guarantee additional borrowings, sell preferred stock, pay dividends and repurchase stock. Based on the terms of the 2020 Senior Unsecured Notes, the Company has adequate ability to meet its obligations to pay dividends as required under the terms of its mandatory convertible preferred stock. The Company was in compliance with the covenants contained in the indenture relating to the 2020 Senior Unsecured Notes at June 30, 2016.

2022 Senior Unsecured Notes

The Company has $1.1 billion aggregate principal amount of 5.625% senior unsecured notes due 2022 (the 2022 Senior Unsecured Notes). The 2022 Senior Unsecured Notes are unsecured obligations of the Company and are guaranteed by the Company and existing and subsequently acquired or organized wholly-owned domestic subsidiaries. The 2022 Senior Unsecured Notes are pari passu in right of payment with all the existing and future senior debt of the Company and senior to all existing and future subordinated debt of the Company. Interest on the 2022 Senior Unsecured Notes accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on January 15 and July 15, through the maturity date of July 15, 2022.

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Prior to July 15, 2017, the Company may redeem up to 35% of the aggregate principal amount of the 2022 Senior Unsecured Notes at a redemption price of 105.625% of the principal amount thereof, plus accrued and unpaid interest and liquidated damages, if any, using proceeds of one or more equity offerings. On or after July 15, 2017, the Company may redeem the 2022 Senior Unsecured Notes in whole or in part. The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve month period beginning on July 15 of the years indicated below:

Period	Redemption Price
2017	104.219	%
2018	102.813	%
2019	101.406	%
2020 and thereafter	100.000	%

The 2022 Senior Unsecured Notes contain certain covenants which, among other things, limit, but may not restrict the Company’s ability to enter into or guarantee additional borrowings, sell preferred stock, pay dividends and repurchase stock. Based on the terms of the 2022 Senior Unsecured Notes, the Company has adequate ability to meet its obligations to pay dividends as required under the terms of its mandatory preferred stock. The Company was in compliance with the covenants contained in the indenture relating to the 2022 Senior Unsecured Notes at June 30, 2016.

(12) Other Long-Term Liabilities

Other long-term liabilities consist of the following (in thousands):

	June 30,		December 31,
	2016		2015
Accrued professional liabilities	$	54,066	$	52,552
Deferred rent	27,330		18,958
Tax-effected unrecognized benefits	3,426		3,426
Other	34,656		21,247
Other long-term liabilities	$	119,478	$	96,183

(13) Shareholders’ Equity

a. Common Stock

During December 2015, the Company issued 5,835,000 shares of its common stock in a public offering, at $80.00 per share, prior to underwriting discounts, commissions, and other related offering expenses of approximately $19.1 million. Proceeds were used to repay a portion of the Company's revolving credit facility, to fund a portion of the acquisitions completed during the three months ended December 31, 2015 and for general corporate purposes.

In addition, the Company repurchases shares by withholding a portion of employee restricted stock that vests to cover payroll withholding taxes in accordance with the restricted stock agreements. During the six months ended June 30, 2016 and 2015, the Company repurchased 77,780 shares and 67,000 shares, respectively, of common stock for approximately $5.7 million and $3.7 million, respectively.

b. Preferred Stock

The Company has 1,725,000 shares outstanding of its mandatory convertible preferred stock. The mandatory convertible preferred stock pays dividends at an annual rate of 5.25% of the initial liquidation preference of $100 per share. Dividends accrue and cumulate and, to the extent lawful and declared by the Company's Board of Directors, will be paid on each January 1, April 1, July 1 and October 1 in cash or, at the Company's election (subject to certain limitations), by delivery of any combination of cash and shares of common stock. Each share of the mandatory convertible preferred stock has a liquidation preference of $100, plus an amount equal to accrued and unpaid dividends. Each share of the mandatory convertible preferred stock will automatically convert on July 1, 2017 (subject to postponement in certain cases), into between 1.8141 and 2.2222 shares of common stock (the “minimum conversion rate” and “maximum conversion rate,” respectively), each subject to adjustment. The number of shares of common stock issuable on conversion will be determined based on the average volume weighted average price per share of the Company's common stock over the 20 consecutive trading day period commencing on and including the 22nd scheduled trading day prior to July 1, 2017. At any time

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prior to July 1, 2017, holders may elect to convert all or a portion of their shares of mandatory convertible preferred stock into shares of common stock at the minimum conversion rate. If any holder elects to convert shares of mandatory convertible preferred stock during a specified period beginning on the effective date of a fundamental change the conversion rate will be adjusted under certain circumstances and such holder will also be entitled to a fundamental change dividend make-whole amount.

During each of the six months ended June 30, 2016 and 2015, the Company's Board of Directors declared two dividends each of $1.3125 per share in cash, or $2.3 million, for the Company’s mandatory convertible preferred stock. As ofJune 30, 2016, the dividend declared in May 2016 was funded to the paying agent to be paid to shareholders of record as of June 15, 2016.

c. Stock Incentive Plans

In May 2014, the Company adopted the AmSurg Corp. 2014 Equity and Incentive Plan (the “2014 Plan”), which was amended in May 2016. The amendment increased the number of shares that may be awarded under the 2014 Plan from 1,200,000 to 3,200,000. The Company also has unvested restricted stock and fully vested options outstanding under the AmSurg Corp. 2006 Stock Incentive Plan, as amended, under which no additional awards may be granted. Under these plans, the Company has granted restricted stock and non-qualified options to purchase shares of common stock to employees and outside directors from its authorized but unissued common stock. At June 30, 2016, 3,200,000 shares were authorized for grant under the 2014 Plan and 2,396,435 shares were available for future equity grants. Restricted stock granted to outside directors vests on the first anniversary of the date of grant. Restricted stock granted to employees generally vests over four years in three equal installments beginning on the second anniversary of the date of grant. The fair value of restricted stock is determined based on the closing bid price of the Company’s common stock on the grant date. Under Company policy, shares held by outside directors and senior management are subject to certain holding requirements and restrictions.

The Company has not issued options subsequent to 2008, and all outstanding options are fully vested. Options were granted at market value on the date of the grant and vested over four years. Outstanding options have a term of ten years from the date of grant.

Other information pertaining to share-based activity during the three and six months ended June 30, 2016 and 2015 was as follows (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2016		2015		2016		2015
Share-based compensation expense	$	7,900	$	3,883	$	15,068	$	7,592
Fair value of shares vested	1,282		1,746		18,243		13,220
Cash received from option exercises	174		334		450		2,080
Tax benefit from exercises of share based awards	129		216		3,734		3,533

As of June 30, 2016, the Company had total unrecognized compensation cost of approximately $45.6 million related to non-vested awards, which the Company expects to recognize through 2020 and over a weighted average period of 1.2 years. For the three and six months ended June 30, 2016 and 2015, there were no options that were anti-dilutive.

A summary of the status of non-vested restricted shares at June 30, 2016 and changes during the six months ended June 30, 2016 is as follows:

			Weighted
	Number		Average
	of Shares		Grant Price
Non-vested shares at December 31, 2015	734,101		$	44.73
Shares granted	586,791		74.00
Shares vested	(249,421	)	38.61
Shares forfeited	(5,407	)	55.40
Non-vested shares at June 30, 2016	1,066,064		$	62.22

In addition to the non-vested restricted shares, during the six months ended June 30, 2016, the Company granted 74,752 performance-based restricted stock units (RSUs) to certain of its officers and physician employees. The weighted average fair value of the Company's common stock on the grant date of these RSUs was $74.09. Subject to achieving applicable performance thresholds, the RSUs will vest ratably over a three year period from the grant date. The conversion of the RSUs to restricted stock is contingent on the Company’s achievement of a specified one-year financial performance goal for the year ended December 31, 2016 and, if achieved,

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would occur during the first quarter of 2017. If the financial performance goal is not achieved, the RSUs will be forfeited. The number of RSUs that will ultimately be received by the holders range from 0% to 150% of the units granted, depending on the Company’s level of achievement with respect to the financial performance goal. At June 30, 2016, the Company believes the RSUs will vest at approximately 150%.

A summary of stock option activity for the six months ended June 30, 2016 is summarized as follows:

					Weighted
			Weighted		Average
			Average		Remaining
	Number		Exercise		Contractual
	of Shares		Price		Term (in years)
Outstanding at December 31, 2015	33,751		$	22.98	1.1
Options exercised with total intrinsic value of $1.0 million	(19,718	)	22.84
Options terminated	(4,200	)	21.07
Outstanding, Vested and Exercisable at June 30, 2016 with an aggregate intrinsic value of $0.5 million	9,833		$	24.09	0.5

The aggregate intrinsic value represents the total pre-tax intrinsic value received by the option holders on the exercise date or that would have been received by the option holders had all holders of in-the-money outstanding options at June 30, 2016 exercised their options at the Company’s closing stock price on June 30, 2016.

d. Earnings per Share

Basic net earnings attributable to AmSurg Corp. common stockholders, per common share, excludes dilution and is computed by dividing net earnings attributable to AmSurg Corp. common stockholders by the weighted-average number of common shares outstanding during the period. Diluted net earnings attributable to AmSurg common stockholders, per common share is computed by dividing net earnings attributable to AmSurg Corp. common stockholders by the weighted-average number of common shares outstanding during the period plus any potential dilutive common share equivalents, including shares issuable (1) upon the vesting of restricted stock awards as determined under the treasury stock method and (2) upon conversion of the Company's mandatory convertible preferred stock as determined under the if-converted method. For purposes of calculating diluted earnings per share, preferred stock dividends have been subtracted from both net earnings from continuing operations attributable to AmSurg Corp. and net earnings attributable to AmSurg Corp. common shareholders in periods in which utilizing the if-converted method would be anti-dilutive. For the three and six months ended June 30, 2015, approximately 3.1 million common share equivalents related to the mandatory convertible preferred stock were anti-dilutive and therefore are excluded from the dilutive weighted average number of shares outstanding.

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The following is a reconciliation of the numerator and denominators of basic and diluted earnings per share (in thousands, except per share amounts):

	Three Months Ended June 30,					Six Months Ended June 30,
	Earnings		Shares	Per Share		Earnings		Shares	Per Share
	(Numerator)		(Denominator)	Amount		(Numerator)		(Denominator)	Amount
2016:
Net earnings attributable to AmSurg Corp. common shareholders (basic)	$	43,805	53,739	$	0.82	$	72,404	53,702	$	1.35
Preferred stock dividends	2,264		—			4,528		—
Effect of dilutive securities, options and non-vested shares	—		3,588			—		3,527
Net earnings attributable to AmSurg Corp. common shareholders (diluted)	$	46,069	57,327	$	0.80	$	76,932	57,229	$	1.34
2015:
Net earnings attributable to AmSurg Corp. common shareholders (basic)	$	31,411	47,678	$	0.66	$	50,185	47,625	$	1.05
Effect of dilutive securities, options and non-vested shares	—		421			—		377
Net earnings attributable to AmSurg Corp. common shareholders (diluted)	$	31,411	48,099	$	0.65	$	50,185	48,002	$	1.05

(14) Income Taxes

The Company files a consolidated federal income tax return. Income taxes are accounted for under the asset and liability method.  Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date.

The Company applies recognition thresholds and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return as it relates to accounting for uncertainty in income taxes. In addition, it is the Company’s policy to recognize interest accrued and penalties, if any, related to unrecognized benefits as income tax expense in its consolidated statements of earnings. The Company does not expect significant changes to its tax positions or liability for tax uncertainties during the next 12 months.

The Company and its subsidiaries file U.S. federal and various state tax returns. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2012.

During the six months ended June 30, 2016 and 2015 the Company had net income tax payments of $45.7 million and $7.8 million, respectively. The increase in net payments made is primarily due to lower taxes paid in the six months ended June 30, 2015 due to the tax benefit resulting from significant transaction costs incurred in association with the Sheridan acquisition completed during 2014.

(15) Commitments and Contingencies

Litigation

From time to time the Company is named as a party to legal claims and proceedings in the ordinary course of business. The Company's management is not aware of any claims or proceedings that are expected to have a material adverse impact on the Company's consolidated financial condition, results of operations or cash flows.

Insurance Programs

Given the nature of the services provided, the Company and its subsidiaries are subject to professional and general liability claims and related lawsuits in the ordinary course of business. The Company maintains professional insurance with third-party insurers generally on a claims-made basis, subject to self-insured retentions, exclusions and other restrictions. A substantial portion of the professional

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liability loss risks are being provided by a third-party insurer, which is fully reinsured by the Company's wholly-owned captive insurance subsidiary. In addition, the captive provides stop loss coverage for the Company’s self-insured employee health program. The assets, liabilities and results of operations of the wholly-owned captive are consolidated in the accompanying consolidated financial statements. The liabilities for self-insurance in the accompanying consolidated balance sheets include estimates of the ultimate costs related to both reported claims on an individual and aggregate basis and unreported claims. The Company also obtains professional liability insurance on a claims-made basis from third-party insurers for its surgery centers and certain of its owned practices and employed physicians.

The Company’s reserves for professional liability claims within the self-insured retention are based upon periodic actuarial calculations. These actuarial estimates consider historical claims frequency and severity, loss development patterns and other actuarial assumptions and are not discounted to present value.

The Company also maintains insurance for director and officer liability, workers’ compensation liability and property damage. Certain policies are subject to deductibles. In addition to the insurance coverage provided, the Company indemnifies its officers and directors for actions taken on behalf of the Company and its subsidiaries. 

Redeemable Noncontrolling Interests

Certain of the Company’s wholly-owned subsidiaries are responsible for all debts incurred but unpaid by the Company's less than wholly-owned partnerships as these subsidiaries are the general partner. As manager of the operations of these partnerships, the Company has the ability to limit potential liabilities by curtailing operations or taking other operating actions. In the event of a change in current law that would prohibit the physicians’ current form of ownership in the partnerships, the Company would be obligated to purchase the physicians’ interests in a substantial majority of the Company’s partnerships. The purchase price to be paid in such event would be determined by a predefined formula, as specified in the partnership agreements. The Company believes the likelihood of a change in current law that would trigger such purchases was remote as of June 30, 2016. As a result, the noncontrolling interests that are subject to this redemption feature are not included as part of the Company’s equity and are classified as noncontrolling interests – redeemable on the Company’s consolidated balance sheets.

Physician Services Operating Lease

On January 16, 2015, the Company entered into an agreement to lease approximately 222,000 square feet of office space in Plantation, Florida, which will be utilized by its physician services segment. The Company took possession of the space in the fourth quarter of 2015 and began tenant improvements on approximately 167,000 square feet of space, which it intends to begin to occupy during the third quarter of 2016. In addition, the Company plans to begin tenant improvements on an additional 55,000 square feet of space during the third quarter of 2016, which it intends to occupy during the first quarter of 2017. Annual rent expense is expected to be approximately $2.9 million. The initial term of this lease agreement expires in February 2029.

Merger with Envision Healthcare Holdings, Inc.

On June 15, 2016, the Company signed a definitive merger agreement with Envision as previously mentioned in Note 2. If the Company were to terminate the merger agreement, under certain circumstances, it would be required to pay Envision a termination fee of $180.0 million and would be obligated to provide reimbursement for up to $15.0 million of expenses.

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(16) Segment Reporting

The Company operates in two major lines of business - ambulatory surgery centers and outsourced physician services, which have been identified as its operating and reportable segments. Through the ambulatory services segment, the Company acquires, develops and operates ambulatory surgery centers in partnership with physicians. Through the physician services segment, the Company provides outsourced physician services in multiple specialties to hospitals, ambulatory surgery centers and other healthcare facilities, primarily in the areas of anesthesiology, radiology, children’s services, and emergency medicine.

The Company’s financial information by operating segment is prepared on an internal management reporting basis and includes allocations of corporate overhead to each segment. This financial information is used by the chief operating decision maker to allocate resources and assess the performance of the operating segments. The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker which is its Chief Executive Officer.

The following table presents financial information for each reportable segment (in thousands):

	Three Months Ended June 30,						Six Months Ended June 30,
	2016			2015			2016			2015
Net Revenue:
Ambulatory Services	$	319,747		$	310,991		$	626,881		$	594,901
Physician Services	438,752			330,959			856,296			617,494
Total	$	758,499		$	641,950		$	1,483,177		$	1,212,395
Adjusted EBITDA:
Ambulatory Services	$	61,746		$	60,304		$	115,372		$	107,612
Physician Services	87,497			67,668			153,971			114,115
Total	$	149,243		$	127,972		$	269,343		$	221,727
Adjusted EBITDA:	$	149,243		$	127,972		$	269,343		$	221,727
Net earnings attributable to noncontrolling interests	57,050			57,072			110,891			104,789
Interest expense, net	(31,913		)	(30,182		)	(62,723		)	(60,429		)
Depreciation and amortization	(30,054		)	(23,612		)	(59,126		)	(46,430		)
Share-based compensation	(7,900		)	(3,883		)	(15,068		)	(7,592		)
Net change in fair value of contingent consideration	2,598			(6,410		)	2,598			(6,410		)
Transaction costs	(5,135		)	(1,982		)	(6,525		)	(3,453		)
Net gain (loss) on disposals and deconsolidations	2,595			(3,035		)	2,595			(3,258		)
Earnings before income taxes	$	136,484		$	115,940		$	241,985		$	198,944
Acquisition and Capital Expenditures:
Ambulatory Services	$	35,031		$	64,514		$	43,401		$	118,610
Physician Services	265,019			22,822			275,330			110,087
Total	$	300,050		$	87,336		$	318,731		$	228,697

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(17) Financial Information for the Company and Its Subsidiaries

The 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes are senior unsecured obligations of the Company and are guaranteed by its existing and subsequently acquired or organized 100% owned domestic subsidiaries. The 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes are guaranteed on a full and unconditional and joint and several basis, with limited exceptions considered customary for such guarantees, including the release of the guarantee when a subsidiary's assets are sold. The following condensed consolidating financial statements present the Company (as parent issuer), the subsidiary guarantors, the subsidiary non-guarantors and consolidating adjustments. These condensed consolidating financial statements have been prepared and presented in accordance with Rule 3-10 of Regulation S-X “Financial Statements of Guarantors and Issuers of Guaranteed Securities Registered or Being Registered.” The operating and investing activities of the separate legal entities are fully interdependent and integrated. Accordingly, the results of the separate legal entities are not representative of what the operating results would be on a stand-alone basis.

Condensed Consolidating Balance Sheet - June 30, 2016 (In thousands)
	Parent Issuer		Guarantor Subsidiaries		Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Assets
Current assets:
Cash and cash equivalents	$	4,591	$	16,215	$	53,299	$	—		$	74,105
Restricted cash and marketable securities	—		—		12,794		—			12,794
Accounts receivable, net	—		258,863		116,489		—			375,352
Supplies inventory	—		—		21,980		—			21,980
Prepaid and other current assets	45,542		24,074		26,261		(21,312		)	74,565
Total current assets	50,133		299,152		230,823		(21,312		)	558,796
Property and equipment, net	11,877		27,822		165,223		—			204,922
Investments in and receivables from unconsolidated affiliates	5,219,975		1,807,424		—		(6,848,343		)	179,056
Goodwill	—		2,123,067		—		2,051,941			4,175,008
Intangible assets, net	13,037		1,664,313		1,925		—			1,679,275
Other assets	7,186		20,825		20,251		(1,999		)	46,263
Total assets	$	5,302,208	$	5,942,603	$	418,222	$	(4,819,713	)	$	6,843,320
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	8,700	$	20	$	12,052	$	—		$	20,772
Accounts payable	3,073		1,640		29,569		(3,561		)	30,721
Accrued salaries and benefits	29,533		140,149		17,226		—			186,908
Accrued interest	30,386		—		14		—			30,400
Other accrued liabilities	5,171		69,166		35,985		(17,751		)	92,571
Total current liabilities	76,863		210,975		94,846		(21,312		)	361,372
Long-term debt	2,550,996		36		56,065		(26,054		)	2,581,043
Deferred income taxes	288,503		456,942		—		(1,998		)	743,447
Other long-term liabilities	8,568		76,144		34,766		—			119,478
Intercompany payable	—		1,228,157		—		(1,228,157		)	—
Noncontrolling interests – redeemable	—		—		60,886		116,959			177,845
Equity:
Total AmSurg Corp. equity	2,377,278		3,967,431		125,450		(4,092,881		)	2,377,278
Noncontrolling interests – non-redeemable	—		2,918		46,209		433,730			482,857
Total equity	2,377,278		3,970,349		171,659		(3,659,151		)	2,860,135
Total liabilities and equity	$	5,302,208	$	5,942,603	$	418,222	$	(4,819,713	)	$	6,843,320

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Condensed Consolidating Balance Sheet - December 31, 2015 (In thousands)
	Parent Issuer		Guarantor Subsidiaries		Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Assets
Current assets:
Cash and cash equivalents	$	20,437	$	27,507	$	58,716	$	—		$	106,660
Restricted cash and marketable securities	—		—		13,506		—			13,506
Accounts receivable, net	—		223,434		113,896		—			337,330
Supplies inventory	—		—		21,406		—			21,406
Prepaid and other current assets	28,739		39,046		16,062		(8,076		)	75,771
Total current assets	49,176		289,987		223,586		(8,076		)	554,673
Property and equipment, net	12,515		14,601		162,052		—			189,168
Investments in and receivables from unconsolidated affiliates	4,901,026		1,775,272		—		(6,507,128		)	169,170
Goodwill	—		1,956,741		—		2,013,469			3,970,210
Intangible assets, net	12,780		1,579,537		2,320		—			1,594,637
Other assets	4,653		1,717		17,078		(1,998		)	21,450
Total assets	$	4,980,150	$	5,617,855	$	405,036	$	(4,503,733	)	$	6,499,308
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	8,700	$	—	$	11,677	$	—		$	20,377
Accounts payable	2,816		3,760		29,837		(3,852		)	32,561
Accrued salaries and benefits	31,510		158,705		12,322		—			202,537
Accrued interest	30,463		—		17		—			30,480
Other accrued liabilities	13,962		76,590		32,909		(4,224		)	119,237
Total current liabilities	87,451		239,055		86,762		(8,076		)	405,192
Long-term debt	2,326,103		—		55,249		(23,396		)	2,357,956
Deferred income taxes	268,573		432,923		—		(1,998		)	699,498
Other long-term liabilities	4,560		71,509		20,114		—			96,183
Intercompany payable	—		1,228,157		—		(1,228,157		)	—
Noncontrolling interests – redeemable	—		—		63,060		112,672			175,732
Equity:
Total AmSurg Corp. equity	2,293,463		3,646,211		132,267		(3,778,478		)	2,293,463
Noncontrolling interests – non-redeemable	—		—		47,584		423,700			471,284
Total equity	2,293,463		3,646,211		179,851		(3,354,778		)	2,764,747
Total liabilities and equity	$	4,980,150	$	5,617,855	$	405,036	$	(4,503,733	)	$	6,499,308

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Condensed Consolidating Statement of Operations - For the Three Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	7,700		$	437,042		$	324,047		$	(10,290	)	$	758,499
Operating expenses:
Salaries and benefits	22,246			305,173			76,727			(135		)	404,011
Supply cost	—			1,145			48,578			(20		)	49,703
Other operating expenses	6,034			44,213			71,033			(10,135		)	111,145
Transaction costs	2,099			3,036			—			—			5,135
Depreciation and amortization	1,103			21,192			7,759			—			30,054
Total operating expenses	31,482			374,759			204,097			(10,290		)	600,048
Net gain (loss) on disposals and deconsolidations	—			2,857			(262		)	—			2,595
Equity in earnings of unconsolidated affiliates	87,700			68,939			—			(149,288		)	7,351
Operating income	63,918			134,079			119,688			(149,288		)	168,397
Interest expense (income), net	(4,215		)	35,528			600			—			31,913
Earnings before income taxes	68,133			98,551			119,088			(149,288		)	136,484
Income tax expense	22,064			10,858			443			—			33,365
Net earnings	46,069			87,693			118,645			(149,288		)	103,119
Less net earnings (loss) attributable to noncontrolling interests	—			(7		)	57,057			—			57,050
Net earnings attributable to AmSurg Corp. shareholders	46,069			87,700			61,588			(149,288		)	46,069
Preferred stock dividends	(2,264		)	—			—			—			(2,264		)
Net earnings attributable to AmSurg Corp. common shareholders	$	43,805		$	87,700		$	61,588		$	(149,288	)	$	43,805

Condensed Consolidating Statement of Operations - For the Six Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	16,244		$	852,872		$	634,659		$	(20,598	)	$	1,483,177
Operating expenses:
Salaries and benefits	46,341			614,753			153,024			(268		)	813,850
Supply cost	—			2,152			94,547			(33		)	96,666
Other operating expenses	13,652			87,552			137,920			(20,297		)	218,827
Transaction costs	2,276			4,249			—			—			6,525
Depreciation and amortization	2,175			41,528			15,423			—			59,126
Total operating expenses	64,444			750,234			400,914			(20,598		)	1,194,994
Net gain (loss) on disposals and deconsolidations	—			2,857			(262		)	—			2,595
Equity in earnings of unconsolidated affiliates	156,742			134,375			—			(277,187		)	13,930
Operating income	108,542			239,870			233,483			(277,187		)	304,708
Interest expense (income), net	(7,034		)	68,504			1,253			—			62,723
Earnings before income taxes	115,576			171,366			232,230			(277,187		)	241,985
Income tax expense	38,644			14,632			886			—			54,162
Net earnings	76,932			156,734			231,344			(277,187		)	187,823
Less net earnings (loss) attributable to noncontrolling interests	—			(7		)	110,898			—			110,891
Net earnings attributable to AmSurg Corp. shareholders	76,932			156,741			120,446			(277,187		)	76,932
Preferred stock dividends	(4,528		)	—			—			—			(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	72,404		$	156,741		$	120,446		$	(277,187	)	$	72,404

25

Item 1. Financial Statements - (continued) Table of Contents

Condensed Consolidating Statement of Operations - For the Three Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Net revenue	$	7,079		$	329,579		$	314,780	$	(9,488	)	$	641,950
Operating expenses:
Salaries and benefits	15,511			228,618			76,391		(124		)	320,396
Supply cost	—			489			45,335		(34		)	45,790
Other operating expenses	5,783			42,099			66,450		(9,330		)	105,002
Transaction costs	324			1,658			—		—			1,982
Depreciation and amortization	1,056			14,617			7,939		—			23,612
Total operating expenses	22,674			287,481			196,115		(9,488		)	496,782
Net gain (loss) on disposals and deconsolidations	—			(3,035		)	—		—			(3,035		)
Equity in earnings of unconsolidated affiliates	76,931			64,513			—		(137,455		)	3,989
Operating income	61,336			103,576			118,665		(137,455		)	146,122
Interest expense, net	11,978			17,624			580		—			30,182
Earnings before income taxes	49,358			85,952			118,085		(137,455		)	115,940
Income tax expense	15,683			9,021			489		—			25,193
Net earnings	33,675			76,931			117,596		(137,455		)	90,747
Less net earnings attributable to noncontrolling interests	—			—			57,072		—			57,072
Net earnings attributable to AmSurg Corp. shareholders	33,675			76,931			60,524		(137,455		)	33,675
Preferred stock dividends	(2,264		)	—			—		—			(2,264		)
Net earnings attributable to AmSurg Corp. common shareholders	$	31,411		$	76,931		$	60,524	$	(137,455	)	$	31,411

Condensed Consolidating Statement of Operations - For the Six Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	14,170		$	615,158		$	601,409		$	(18,342	)	$	1,212,395
Operating expenses:
Salaries and benefits	33,154			440,219			149,454			(252		)	622,575
Supply cost	—			885			87,523			(34		)	88,374
Other operating expenses	12,417			71,710			129,501			(18,056		)	195,572
Transaction costs	592			2,861			—			—			3,453
Depreciation and amortization	1,890			28,924			15,616			—			46,430
Total operating expenses	48,053			544,599			382,094			(18,342		)	956,404
Net gain (loss) on disposals and deconsolidations	(188		)	(3,223		)	(35		)	188			(3,258		)
Equity in earnings of unconsolidated affiliates	137,318			119,096			—			(249,774		)	6,640
Operating income	103,247			186,432			219,280			(249,586		)	259,373
Interest expense, net	23,864			35,378			1,187			—			60,429
Earnings before income taxes	79,383			151,054			218,093			(249,586		)	198,944
Income tax expense	24,670			13,924			848			—			39,442
Net earnings	54,713			137,130			217,245			(249,586		)	159,502
Less net earnings attributable to noncontrolling interests	—			—			104,789			—			104,789
Net earnings attributable to AmSurg Corp. shareholders	54,713			137,130			112,456			(249,586		)	54,713
Preferred stock dividends	(4,528		)	—			—			—			(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	50,185		$	137,130		$	112,456		$	(249,586	)	$	50,185

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Item 1. Financial Statements - (continued) Table of Contents

Condensed Consolidating Statement of Cash Flows - For the Six Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Cash flows from operating activities:
Net cash flows provided by operating activities	$	39,294		$	131,227		$	255,297		$	(230,713	)	$	195,105
Cash flows from investing activities:
Acquisitions and related expenses	(265,258		)	(284,010		)	—			268,155			(281,113		)
Acquisition of property and equipment	(1,676		)	(19,916		)	(16,026		)	—			(37,618		)
Proceeds from sale of interests in surgery centers	—			25			—			—			25
Purchases of marketable securities	—			—			(498		)	—			(498		)
Maturities of marketable securities	—			—			2,738			—			2,738
Other	—			(4,057		)	(4,692		)	—			(8,749		)
Net cash flows used in investing activities	(266,934		)	(307,958		)	(18,478		)	268,155			(325,215		)
Cash flows from financing activities:
Proceeds from long-term borrowings	313,000			—			4,151			—			317,151
Repayment on long-term borrowings	(92,350		)	(9		)	(6,404		)	—			(98,763		)
Distributions to owners, including noncontrolling interests	—			(102,330		)	(243,972		)	230,713			(115,589		)
Capital contributions	—			265,258			—			(265,258		)	—
Changes in intercompany balances with affiliates, net	(2,657		)	—			2,657			—			—
Other, net	(6,199		)	2,520			1,332			(2,897		)	(5,244		)
Net cash flows provided by (used in) financing activities	211,794			165,439			(242,236		)	(37,442		)	97,555
Net decrease in cash and cash equivalents	(15,846		)	(11,292		)	(5,417		)	—			(32,555		)
Cash and cash equivalents, beginning of period	20,437			27,507			58,716			—			106,660
Cash and cash equivalents, end of period	$	4,591		$	16,215		$	53,299		$	—		$	74,105

Condensed Consolidating Statement of Cash Flows - For the Six Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Cash flows from operating activities:
Net cash flows provided by (used in) operating activities	$	(27,553	)	$	172,907		$	232,423		$	(126,382	)	$	251,395
Cash flows from investing activities:
Acquisitions and related expenses	(51,852		)	(197,718		)	—			53,538			(196,032		)
Acquisition of property and equipment	(4,490		)	(9,424		)	(18,751		)	—			(32,665		)
Purchases of marketable securities	—			—			(1,245		)	—			(1,245		)
Maturities of marketable securities	—			—			2,988			—			2,988
Other	—			(1,441		)	(546		)	—			(1,987		)
Net cash flows used in investing activities	(56,342		)	(208,583		)	(17,554		)	53,538			(228,941		)
Cash flows from financing activities:
Proceeds from long-term borrowings	—			—			7,795			—			7,795
Repayment on long-term borrowings	(4,350		)	—			(5,938		)	—			(10,288		)
Distributions to owners, including noncontrolling interests	—			(15,108		)	(212,307		)	126,382			(101,033		)
Capital contributions	—			51,852			—			(51,852		)	—
Changes in intercompany balances with affiliates, net	444			—			(444		)	—			—
Other financing activities, net	(2,892		)	2,573			1,287			(1,686		)	(718		)
Net cash flows provided by (used in) financing activities	(6,798		)	39,317			(209,607		)	72,844			(104,244		)
Net increase (decrease) in cash and cash equivalents	(90,693		)	3,641			5,262			—			(81,790		)
Cash and cash equivalents, beginning of period	134,351			23,471			50,257			—			208,079
Cash and cash equivalents, end of period	$	43,658		$	27,112		$	55,519		$	—		$	126,289

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Forward-Looking Statements

This report contains certain forward-looking statements (all statements other than with respect to historical fact) within the meaning of the federal securities laws, which are intended to be covered by the safe harbors created thereby.  Investors are cautioned that all forward-looking statements involve known and unknown risks and uncertainties including, without limitation, those described in this report and in our Annual Report on Form 10-K for the year ended December 31, 2015.  Although we believe that the assumptions underlying the forward-looking statements contained herein are reasonable, any of the assumptions could be inaccurate.  Therefore there can be no assurance that the forward-looking statements included in this report will prove to be accurate.  Actual results could differ materially and adversely from those contemplated by any forward-looking statement.  In light of the significant risks and uncertainties inherent in the forward-looking statements included herein, the inclusion of such information should not be regarded as a representation by us or any other person that our objectives and plans will be achieved.  We undertake no obligation to publicly release any revisions to any forward-looking statements in this discussion to reflect events and circumstances occurring after the date hereof or to reflect unanticipated events.

Forward-looking statements and our liquidity, financial condition and results of operations, may be affected by the following risks and uncertainties and the other risks and uncertainties discussed in this report, in our Annual Report on Form 10-K for the year ended December 31, 2015 under “Item 1A. – Risk Factors” as well as other unknown risks and uncertainties:

• the risk that we may face challenges managing our physician services segment as a new business and may not realize anticipated benefits;

• the risk of becoming subject to investigations by federal and state entities;

• the risks associated with unpredictable impacts of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (the Health Reform Law);

• the risk of governmental or commercial health changes designed to reduce the number of surgical procedures;

• our failure to comply with applicable laws and regulations, including the federal Anti-Kickback Statue and similar state laws;

• our ability to successfully maintain effective internal controls over financial reporting;

• our ability to implement our business strategy, manage the growth in our business, and integrate acquired businesses;

• the risk of making acquisitions that could divert the attention of management;

• the risk that our substantial indebtedness and restrictions in our debt instruments could adversely affect our business or our ability to implement our growth strategy or limit our ability to react to changes in the economy or our industry;

• our ability to generate sufficient cash to service all of our indebtedness, including any future indebtedness;

• restrictive covenants in our indenture documents that may restrict our business strategies or that could result in an acceleration of our debt;

• the risk of regulatory changes that may obligate us to buy out interests of physicians who are minority owners of our surgery centers;

• our failure to successfully maintain numerous complex information systems and processes, implement new systems and processes, and maintain the security of those systems and processes;

• our ability and the ability of third-party payors to transition to the ICD-10 coding system;

• our ability to effectively manage and implement security measures protecting our information technology systems to protect confidential data;

• the risk of disruptions in our disaster recovery systems or management continuity plan;

• the risk of shortages or quality control issues of products, equipment, and medical supplies could adversely affect our operations and profitability;

• the risk of enforcement authorities concluding that our market share in any particular market is too concentrated or our clients' commercial payor contract negotiating practices are illegal;

• the risk of litigation and investigations, and liability claims for damages and other expenses not covered by insurance;

• potential write-offs of the impaired portion of intangible assets;

• the risk that payments from third-party payors, including government healthcare programs, may decrease or not increase as costs increase;

• adverse developments affecting the medical practices of our physician partners;

• our ability to maintain favorable relations with our physician partners;

• failure of our physician partners to perform on their pro rata share of any indebtedness or lease agreements;

• our ability to grow revenues by increasing procedure volume while maintaining operating margins and profitability at our existing surgery centers;

• our ability to compete for physician partners, managed care contracts, patients and strategic relationships;

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Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations - (continued) Table of Contents

• adverse weather and other factors beyond our control that may affect our surgery centers;

• our legal responsibility to minority owners of our surgery centers, which may conflict with our interests and prevent us from acting solely in our best interests;

• the risk of changes in patient volume and patient mix;

• the risk related to revenue concentration resulting from several significant client relationships;

• the risk that contracts are cancelled or not renewed or that we are not able to enter into additional contracts under terms that are acceptable to us;

• the risk of potential decreases in our reimbursement rates, revenue and profit margin under our fee for service payor contracts;

• failure to timely or accurately bill for services;

• the risk that laws and regulations that regulate payments for medical services made by government healthcare programs could cause our revenues to decrease;

• our ability to enroll our providers in the Medicare and Medicaid programs on a timely basis;

• the risk that our strategic partnerships with certain healthcare providers are not successful;

• the high level of competition in our segments of the market for medical services;

• our ability to successfully recruit and retain physicians, nurses and other clinical providers with the qualifications and attributes desired by us and our clients;

• our ability to accurately assess the costs we will incur under new contracts;

• the risk that margins may be negatively impacted by cross-selling to existing clients or selling bundled services to new clients;

• our ability in some jurisdictions to enforce non-compete agreements with our physicians and other clinical employees;

• the risk of unfavorable changes in regulatory, economic and other conditions in the states where we operate;

• the risk that legislative or regulatory action may make our captive insurance company arrangement less feasible or otherwise reduce our profitability; and

• the inherent uncertainties relating to the reserves we establish with respect to our losses covered under our insurance programs.

Executive Overview

We are one of the largest owners and operators of ambulatory surgery centers (ASCs, surgery centers, or centers) in the United States based upon total number of facilities, and are a leading provider of outsourced physician services. Through our ambulatory services segment, we acquire, develop and operate ASCs in partnership with physicians. Through our physician services segment, we are one of the largest providers of outsourced physician services in multiple specialties to hospitals, ambulatory surgery centers and other healthcare facilities, primarily in the areas of anesthesiology, radiology, children’s services and emergency medicine.

Our operations consist primarily of two major segments: ambulatory services and physician services.

Ambulatory Services Overview

We acquire, develop and operate surgery centers in partnership primarily with physicians. Our surgery centers are typically located adjacent to or in close proximity to the medical practices of our partner physicians. At June 30, 2016, we operated 258 ASCs in 34 states and the District of Columbia in partnership with approximately 2,000 physicians. We generally own a majority interest, primarily 51%, in the surgery centers we operate. We also own a minority interest in certain surgery centers in partnership with leading health systems and physicians, and currently intend to continue to pursue such partnerships.

Physician Services Overview

At June 30, 2016, we delivered physician services, primarily in the areas of anesthesiology, radiology, children’s services, and emergency medical services, to more than 530 healthcare facilities in 32 states, with a significant presence in Florida, New Jersey, Arizona and California. At June 30, 2016, we employed more than 4,200 physicians and other healthcare professionals in our physician services business. We receive reimbursement from third-party payors for fee for service medical services rendered by our affiliated healthcare professionals and other employees to the patients who receive medical treatment at these facilities. In addition to this primary form of reimbursement, in certain cases, we also receive contract revenue directly from the facilities where we perform our services through a variety of payment arrangements that are established to supplement payments from third-party payors. We also provide physician services and manage office-based practices in the areas of pain management, gynecology, obstetrics and perinatology.

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Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations - (continued) Table of Contents

Merger with Envision Healthcare Holdings, Inc.

On June 15, 2016, we entered into an Agreement and Plan of Merger (the Merger Agreement) with Envision Healthcare Holdings, Inc. (Envision). Pursuant to the Merger Agreement, AmSurg Corp. will change its state of incorporation from Tennessee to Delaware by merging AmSurg Corp. with and into New Amethyst Corp. (New Amethyst), a newly-formed Delaware corporation and a wholly-owned subsidiary of AmSurg Corp., with New Amethyst being the surviving corporation. AmSurg Corp. shareholders will receive one share of New Amethyst common stock for each share of AmSurg Corp. common stock owned and one share of New Amethyst mandatory convertible preferred stock for each share of AmSurg Corp. mandatory convertible preferred stock owned. Following the merger of AmSurg and New Amethyst, Envision will merge with and into New Amethyst, with New Amethyst being the surviving corporation.

If the merger is completed, Envision stockholders will receive 0.334 shares of New Amethyst common stock for each share of Envision common stock owned (the Exchange Ratio). The Exchange Ratio is fixed and will not be adjusted to reflect stock price changes prior to the closing. Upon completion of the merger, former Envision stockholders will own approximately 53% of the then outstanding New Amethyst common stock (on a fully diluted basis), including preferred shares. The value of the merger consideration to be received will fluctuate with the market value of AmSurg common stock and Envision common stock until the merger is completed. The merger is currently expected to be completed in the fourth quarter of 2016 and is subject to customary closing conditions, including obtaining regulatory approval and approval from the common shareholders of both AmSurg and Envision. Upon completion of the merger, New Amethyst will change its name to “Envision Healthcare Corporation.”

Operating Environment

Our ASCs and physician practices depend upon third-party reimbursement programs, including governmental and private insurance programs, to pay for substantially all of the services rendered to patients. For the six months ended June 30, 2016, we derived approximately 26% and 19%, respectively, of our ambulatory services and physician services net revenue from governmental healthcare programs, primarily Medicare and managed Medicare programs, and the remainder from a wide mix of commercial payors and patient co-pays and deductibles. The Medicare program currently reimburses physician services and ASCs in accordance with predetermined fee schedules. We are not required to file cost reports for our centers or physician services and, accordingly, we have no unsettled amounts from governmental third-party payors.

ASCs are paid under the Medicare program based upon a percentage of the payments to hospital outpatient departments pursuant to the hospital outpatient prospective patient system and reimbursement rates for ASCs are increased annually based on increases in the consumer price index (CPI). The Health Reform Law provides for the annual CPI increases applicable to ASCs to be reduced by a productivity adjustment, which is based on historical nationwide productivity gains. In 2015, ASC reimbursement rates increased by 1.9%, which positively impacted our 2015 ambulatory services revenues by approximately $9.0 million and our net earnings per diluted share by $0.10. For 2016, the Centers for Medicare and Medicaid Services (CMS) increased ASC reimbursement rates by 0.3%, which we estimate will not have a significant impact our 2016 ambulatory services revenues. We estimate that proposed ASC reimbursement rates for 2017 recently announced by the CMS, which are subject to final approval in November 2016, would negatively impact our 2017 revenue by approximately $5.0 million. There can be no assurance that CMS will not revise the ASC payment system or that any annual CPI increases will be material. 

Physician practices are paid under the Medicare program based upon the Medicare Physician Fee Schedule, under which CMS has assigned a national relative value unit (RVU) to most medical procedures and services that reflects the various resources required by a physician to provide the services relative to all other services. Each RVU is calculated based on a combination of work required in terms of time and intensity of effort for the service, practice expense (overhead) attributable to the service and malpractice insurance expense attributable to the service. These three elements are each modified by a geographic adjustment factor to account for local practice costs and then aggregated. Historically, the aggregated amount was multiplied by a conversion factor calculated by the sustainable growth rate (SGR) to arrive at the payment amount for each service. In April 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the SGR physician payment methodology. Instead of tying payments to the SGR, MACRA provides for a 0.5% payment update for each calendar year thereafter through 2019. In addition, MACRA requires the establishment of the Merit-Based Incentive Payment System (MIPS) beginning in 2019, under which physicians will receive performance-based payment incentives or payment reductions based on their performance with respect to clinical quality, resource use, clinical improvement activities, and meaningful use of electronic health records. MIPS will consolidate certain existing physician incentive programs, including payments to physicians for the meaningful use of electronic health records. MACRA also requires CMS beginning in 2019 to provide incentive payments for physicians and other eligible professionals that participate in alternative payment models, such as accountable care organizations.

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Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations - (continued) Table of Contents

In November 2012, CMS adopted a rule under the Health Reform Law that generally allows physicians in certain specialties who provide eligible primary care services to be paid at the Medicare reimbursement rates in effect in calendar years 2013 and 2014 instead of state-established Medicaid reimbursement rates (Medicaid-Medicare Parity). Generally, state Medicaid reimbursement rates are lower than federally established Medicare rates. Legislation was passed in certain states to extend Medicaid-Medicare Parity for calendar year 2015. Accordingly, our 2015 Medicaid program revenues were reduced by approximately $3.2 million compared to fiscal 2014. We do not expect further reduction in reimbursement rates in 2016 in those states which previously extended Medicaid-Medicare Parity.

The Budget Control Act of 2011 (BCA) requires automatic spending reductions of $1.2 trillion for federal fiscal years (FFY) 2013 through 2021, minus any deficit reductions enacted by Congress and debt service costs. The percentage reduction for Medicare may not be more than 2% for a FFY, with a uniform percentage reduction across all Medicare programs. These BCA-mandated spending cuts are commonly referred to as “sequestration.” Sequestration began on March 1, 2013, and CMS imposed a 2% reduction on Medicare claims as of April 1, 2013. These reductions have been extended through FFY 2025. We cannot predict with certainty what other deficit reduction initiatives may be proposed by Congress, whether Congress will attempt to restructure or suspend sequestration or the impact sequestration may have on our business. 

The Health Reform Law represents significant change across the healthcare industry and contains a number of provisions designed to reduce Medicare program spending. However, the Health Reform Law also expands coverage of uninsured individuals through a combination of public program expansion and private sector health insurance reforms. For example, the Health Reform Law has expanded eligibility under existing Medicaid programs in states that have not opted out of the expansion, created financial penalties on individuals who fail to carry insurance coverage, established affordability credits for those not enrolled in an employer-sponsored health plan, resulted in the establishment of, or participation in, a health insurance exchange for each state and allowed states to create federally funded, non-Medicaid plans for low-income residents not eligible for Medicaid. The Health Reform Law also established a number of private health insurance market reforms, including a ban on lifetime limits and pre-existing condition exclusions, new benefit mandates and increased dependent coverage.

Many health plans are required to cover, without cost-sharing, certain preventive services designated by the U.S. Preventive Services Task Force, including screening colonoscopies. Medicare now covers these preventive services without cost-sharing, and states that provide Medicaid coverage of these preventive services without cost-sharing receive a one percentage point increase in their federal medical assistance percentage for these services.

We believe health insurance market reforms that expand insurance coverage have resulted in an increased volume of certain procedures at our centers. Most of the provisions of the Health Reform Law that are reducing the number of uninsured individuals are in effect including, as of January 1, 2016, the employer mandate, which requires firms with 50 or more full-time employees to offer health insurance or pay fines. Because of the many variables involved, including the law’s complexity, lack of implementing definitive regulations or interpretive guidance, gradual or partially delayed implementation, court challenges, amendments, repeal, or further implementation delays, we are unable to predict the net effect of the reductions in Medicare spending, the expected increases in revenues from increased procedure volumes, and numerous other provisions in the law that may affect us. We are further unable to foresee how individuals and employers will respond to the choices afforded them by the Health Reform Law. Thus, we cannot predict the full impact of the Health Reform Law on us at this time.

Critical Accounting Policies

A summary of significant accounting policies is disclosed in our 2015 Annual Report on Form 10-K under the caption “Critical Accounting Policies” in Management’s Discussion and Analysis of Financial Condition and Results of Operations. There have been no material changes in the nature of our critical accounting policies or the application of those policies since December 31, 2015.

Recent Accounting Pronouncements

See Note 1 in the Notes to the Unaudited Consolidated Financial Statements.

Results of Operations

Our consolidated statements of earnings include the results of both our ambulatory services segment and our physician services segment. Our consolidated revenues consist of both facility fees charged for surgical procedures performed in our ASCs and fee for service revenue, contract revenue and other revenue derived principally from the provision of physician services to patients of the healthcare facilities we serve through our physician services segment. Additionally, at certain of our centers (primarily centers that

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perform gastrointestinal endoscopy procedures), we charge for anesthesia services provided by medical professionals employed or contracted by our centers. As it relates to our ambulatory services segment, we generally own a controlling interest, primarily 51%, in our centers, and our consolidated statements of earnings include 100% of the results of operations of each of our consolidated entities, reduced by the noncontrolling partners’ share of the net earnings or loss of the centers. The noncontrolling ownership interest in each LP or LLC is generally held directly or indirectly by physicians who perform procedures at the center. We generally own 100% of the entities included in our physician services segment with the exception of our affiliated professional corporations, which we consolidate as they are variable interest entities and we are the primary beneficiary. On a consolidated basis, our share of the profits and losses of non-consolidated entities is reported in equity in earnings of unconsolidated affiliates in our consolidated statements of earnings.

Our revenues are influenced by national surgery trends, hospital-specific factors, and other factors affecting patient needs for medical services. National surgery trends can change based on changes in patient utilization, population growth and demographics, weather related disruptions, as well as general economic factors. Hospital-specific factors include changes in local availability of alternative sites of care to the patient, changes in surgeon utilization of the facility, construction and regulations that affect patient flow through the hospital. We believe patient utilization can also be affected by changes in the portion of medical costs for which the patients themselves bear financial responsibility, by general economic conditions, and by other factors.

Our ambulatory services revenues are directly related to the number of procedures performed at our centers. Our overall growth in ASC procedure volume is impacted directly by the number of centers in operation and the procedure volume at existing centers. We increase our number of centers through acquisitions, joint venture partnerships and developments. Procedure growth at an existing center may result from additional contracts entered into with third-party payors, increased numbers of procedures performed by our physician partners, additional physicians utilizing the center and/or scheduling and operating efficiencies gained at the surgery center.

Our physician services revenues consist of fee for service revenue, contract revenue and other revenue. Fee for service revenue is primarily generated through the provision of anesthesiology, radiology, children's services, and emergency medical services at the facilities we serve. Contract revenue reflects payments received or receivable directly from certain of the facilities where we provide medical services to supplement payments from third-party payors. We also earn other revenue for certain ancillary services performed.

Expenses associated with our ambulatory services segment relate directly and indirectly to procedures performed and include: clinical and administrative salaries and benefits, supply cost and other operating expenses such as linen cost, repair and maintenance of equipment, billing fees and bad debt expense. The majority of our salary and benefits cost is associated directly with the number of centers we own and manage and tends to grow in proportion to the growth in our number of centers in operation. We also incur operating expenses resulting from our corporate oversight, which includes salaries and benefits of our operators and administrative support infrastructure. Our centers also incur costs that are more fixed in nature, such as lease expense, legal fees, property taxes, utilities and depreciation and amortization.

Salaries and benefits expense is a significant component of the total expenses associated with our physician services segment and includes compensation and benefits for our employed physicians and other professional providers as well as the salaries and benefits of our administrative support staff. Other operating expenses of our physician services segment includes professional liability costs, costs of business development and marketing, information technology, dues and licenses, occupancy costs and other administrative functions that are indirectly related to the operations of our physician group practices. Our professional liability costs include provisions for paid and estimated losses for actual claims and estimates of claims likely to be incurred in the period, based on our past loss experience and actuarial analysis provided by a third-party, as well as actual direct costs, including investigation and defense costs, and other costs related to provider professional liability. We plan to continue to expand our investment in administrative support initiatives as a result of our planned future growth from new contracts and acquisitions.

Our depreciation expense primarily relates to charges for equipment and leasehold improvements. Amortization expense primarily relates to intangible assets recorded for customer relationships, computer software, and other technologies arising from acquisitions that we have made.

Our interest expense results primarily from our borrowings used to fund acquisition and development activity, as well as interest incurred on capital leases and the amortization of deferred financing costs.

The effective tax rate on pre-tax earnings as presented is approximately 22% for the six months ended June 30, 2016. However, after removing the earnings attributable to non-controlling interest, our adjusted effective tax rate generally increases to approximately 40%. We file a consolidated federal income tax return and numerous state income tax returns with varying tax rates which reflects the blending of these rates.

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Profits and losses are allocated to our noncontrolling partners, all of which relate to our ambulatory services segment, in proportion to their individual ownership percentages and reflected in the aggregate as total net earnings attributable to noncontrolling interests. The noncontrolling partners are typically organized as LLCs, LPs or general partnerships that are not subject to federal income tax. Each noncontrolling partner shares in the pre-tax earnings or loss of the entity of which it is a partner. Accordingly, net earnings attributable to the noncontrolling interests in each of our LLCs and LPs are generally determined on a pre-tax basis, and pre-tax earnings are presented before net earnings attributable to noncontrolling interests have been subtracted.

Consolidated Operations

The following table shows certain statement of operations items expressed as a percentage of net revenues for the three and six months ended June 30, 2016 and 2015.

	Three Months Ended June 30,				Six Months Ended June 30,
	2016		2015		2016		2015
Net revenue	100.0	%	100.0	%	100.0	%	100.0	%
Operating expenses:
Salaries and benefits	53.3		49.9		54.9		51.4
Supply cost	6.6		7.1		6.5		7.3
Other operating expenses	14.7		16.4		14.8		16.1
Transaction costs	0.7		0.3		0.4		0.3
Depreciation and amortization	4.0		3.7		4.0		3.8
Total operating expenses	79.1		77.4		80.6		78.9
Net gain (loss) on disposals and deconsolidations	0.3		(0.5	)	0.2		(0.3	)
Equity in earnings of unconsolidated affiliates	1.0		0.6		0.9		0.5
Operating income	22.2		22.8		20.5		21.4
Interest expense, net	4.2		4.7		4.2		5.0
Earnings from operations before income taxes	18.0		18.1		16.3		16.4
Income tax expense	4.4		3.9		3.7		3.3
Net earnings	13.6		14.1		12.7		13.2
Net earnings attributable to noncontrolling interests	7.5		8.9		7.5		8.6
Net earnings attributable to AmSurg Corp. shareholders	6.1	%	5.2	%	5.2	%	4.5	%

Three and Six Months Ended June 30, 2016 compared to Three and Six Months Ended June 30, 2015

Net revenue increased $116.5 million, or 18.2%, to $758.5 million in the three months ended June 30, 2016 from $642.0 million in the three months ended June 30, 2015. Net revenue increased $270.8 million, or 22.3%, to $1,483.2 million in the six months ended June 30, 2016 from $1,212.4 million in the six months ended June 30, 2015. Our net revenue was impacted primarily due to the following:

• an increase of $107.8 million and $238.8 million during the three and six months ended June 30, 2016 associated with our physician services segment driven primarily from completed acquisitions in 2015 and 2016 and increases in our same-contract growth; and

• an increase of $8.8 million and $32.0 million during the three and six months ended June 30, 2016 associated with our ambulatory services segment driven primarily from completed acquisitions in 2015 and 2016 and increases in our same-center growth.

Operating income increased $22.3 million, or 15.2%, to $168.4 million during the three months ended June 30, 2016, from $146.1 million in the three months ended June 30, 2015. Operating income increased $45.3 million, or 17.5%, to $304.7 million during the six months ended June 30, 2016, from $259.4 million in the six months ended June 30, 2015. Our operating income was impacted during the three and six months ended June 30, 2016 primarily due to the following:

• an increase of $22.5 million and $34.9 million during the three and six months ended June 30, 2016 associated with results from our physician services segment primarily due to acquisitions during 2015;

• a decrease of $0.2 million and an increase of $10.5 million during the three and six months ended June 30, 2016 associated with results from our ambulatory services segment due to same-contract growth offset by deconsolidation activity; and

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• we incurred approximately $5.1 million and $6.5 million of transaction costs and during the three and six months ended June 30, 2016, respectively. The majority of the costs incurred during the three and six months ended June 30, 2016 were primarily due to the proposed merger with Envision.

As a percentage of our consolidated net revenue our physician services segment represents 57.8% and 57.7% for the three and six months ended June 30, 2016 as compared to 51.6% and 50.9% for the three and six months ended June 30, 2015. As a result, our consolidated operations compared to prior periods has experienced a shift as a percent of net revenue in both individual operating expense categories as well as in our net earnings attributable to noncontrolling interests. See further discussion of specific operating expense categories within our discussion of each of our operating segments.

Net interest expense increased $1.7 million, or 5.7%, to $31.9 million in the three months ended June 30, 2016, from $30.2 million in the three months ended June 30, 2015 and increased $2.3 million, or 3.8%, to $62.7 million in the six months ended June 30, 2016, from $60.4 million in the six months ended June 30, 2015, primarily as a result of increased borrowings which were used to fund recent acquisitions. See “- Liquidity and Capital Resources” for additional information.

We recognized income tax expense of $33.4 million and $54.2 million for the three and six months ended June 30, 2016, respectively, compared to $25.2 million and $39.4 million in the three and six months ended June 30, 2015, respectively. Our effective tax rate during the three and six months ended June 30, 2016 was approximately 24% and 22%, respectively, of earnings from continuing operations. This differs from the federal statutory income tax rate of 35% primarily due to the exclusion of the noncontrolling interests’ share of pre-tax earnings and the impact of state income taxes. However, excluding the earnings attributable to non-controlling interest, our adjusted effective tax rate generally increases to approximately 40%. For the six months ended June 30, 2016 and 2015, our adjusted effective tax rate was approximately 41%, which reflects the impact of valuation allowances recorded against capital loss carryforwards associated with disposed centers.

Noncontrolling interests in net earnings for six months ended June 30, 2016 increased $6.1 million from the six months ended June 30, 2015, primarily as a result of noncontrolling interests in earnings at surgery centers added to operations during 2015. The change in noncontrolling interests in net earnings for the three months ended June 30, 2016 as compared to the prior year period was not significant.

Ambulatory Services Operations

The following table presents certain operating data at our ambulatory services segment for the three and six months ended June 30, 2016 and 2015. An ASC is deemed to be under development when a LP or LLC has been formed with the physician partners to develop the ASC.

	Three Months Ended June 30,						Six Months Ended June 30,
	2016			2015			2016			2015
Procedures performed during the period at consolidated centers	436,940			441,302			853,524			845,821
Centers in operation, end of period (consolidated)	236			239			236			239
Centers in operation, end of period (unconsolidated)	22			11			22			11
Average number of continuing centers in operation (consolidated)	237			238			236			237
New centers added, during period	4			2			4			4
Centers merged into existing centers, during period	—			—			1			—
Centers discontinued, during period	2			—			2			—
Centers under development, end of period	1			2			1			2
Centers under letter of intent, end of period	4			6			4			6
Average revenue per consolidated center (in thousands)	$	1,352		$	1,308		$	2,655		$	2,515
Same center revenues increase (consolidated)	4.2		%	5.1		%	6.6		%	4.4		%
Surgical hospitals in operation at end of period (unconsolidated)	1			—			1			—

Of the continuing centers in operation at June 30, 2016, 154 centers performed gastrointestinal endoscopy procedures, 57 centers performed procedures in multiple specialties, 38 centers performed ophthalmology procedures and 9 centers performed orthopaedic procedures.

A significant measurement of how much our ambulatory service revenues grow from year to year is the change in our same-center revenue. We define our same-center group each year as those centers that contain full year-to-date operations in both comparable

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reporting periods, including the expansion of the number of operating centers associated with a LLC or LP. Ambulatory services revenues at our 2016 same-center group, constituting approximately 95% of our total number of consolidated centers, increased by 4.2% and 6.6% during the three and six months ended June 30, 2016, respectively, comprised of a 3.3% and 4.3% increase in procedures, and a 0.9% and 1.5% increase in revenue per procedure as compared to the prior year period and a 0.8% increase due to an additional working day in the six months ended June 30, 2016.

The following table presents selected statement of operations data expressed in dollars (in thousands) and as a percentage of net revenue for our ambulatory services segment.

	Three Months Ended June 30,								Six Months Ended June 30,
	2016				2015				2016				2015
Net revenue	$	319,747	100.0	%	$	310,991	100.0	%	$	626,881	100.0	%	$	594,901		100.0	%
Operating expenses:
Salaries and benefits	97,596		30.5		90,662		29.2		196,494		31.3		180,458			30.3
Supply cost	48,558		15.2		45,301		14.6		94,514		15.1		87,489			14.7
Other operating expenses	64,747		20.2		60,713		19.5		128,003		20.4		121,072			20.4
Transaction costs	2,099		0.7		324		0.1		2,276		0.4		592			0.1
Depreciation and amortization	8,862		2.8		8,995		2.9		17,598		2.8		17,506			2.9
Total operating expenses	221,862		69.4		205,995		66.2		438,885		70.0		407,117			68.4
Net gain (loss) on disposals and deconsolidations	2,595		0.8		—		—		2,595		0.4		(223		)	—
Equity in earnings of unconsolidated affiliates	5,256		1.6		952		0.3		9,056		1.4		1,631			0.3
Operating income	$	105,736	33.1	%	$	105,948	34.1	%	$	199,647	31.8	%	$	189,192		31.8	%

Three and Six Months Ended June 30, 2016 compared to Three and Six Months Ended June 30, 2015

The number of procedures performed in our consolidated ASCs decreased by 4,362, or 1.0%, to 436,940 and increased by 7,703, or 0.9% to 853,524 in the three and six months ended June 30, 2016, respectively, from 441,302 and 845,821 in the three and six months ended June 30, 2015, respectively. Ambulatory services revenues increased $8.8 million, or 2.8%, to $319.7 million and $32.0 million, or 5.4%, to $626.9 million in the three and six months ended June 30, 2016, respectively, from $311.0 million and $594.9 million in the three and six months ended June 30, 2015, respectively. Our ambulatory services revenues were impacted during the three and six months ended June 30, 2016 as compared to the prior periods primarily due to the following:

• revenue growth of $11.9 million and $35.7 million for the three and six months ended June 30, 2016, respectively, recognized by our 2016 same-center group of 4.2% and 6.6% during the three and six months ended June 30, 2016;

• centers acquired in 2015, which contributed $12.5 million and $27.8 million of additional revenues in the three and six months ended June 30, 2016, respectively, due to having a full period of operations in 2016;

• centers acquired in 2016, which contributed $2.4 million of additional revenues in each of the three and six months ended June 30, 2016, respectively; and

• reduced revenue recognized during the three and six months ended June 30, 2016 of $18.4 million and $34.7 million, respectively, resulting from the deconsolidation of centers that were consolidated in the prior periods. The deconsolidated centers represented 28,621 and 54,694 procedures reported during the three and six months ended June 30, 2015, respectively. Our share of the results of operations from the deconsolidated centers is reflected in equity in earnings of unconsolidated affiliates in our consolidated statements of earnings.

Salaries and benefits increased by $6.9 million, or 7.6%, to $97.6 million and $16.0 million, or 8.9%, to $196.5 million in the three and six months ended June 30, 2016, respectively, from $90.7 million and $180.5 million in the three and six months ended June 30, 2015, respectively. Salaries and benefits increased as a result of additional corporate overhead, as well as additional staffing at newly acquired and developed centers.

Supply cost increased $3.3 million, or 7.2%, to $48.6 million and $7.0 million, or 8.0%, to $94.5 million in the three and six months ended June 30, 2016, respectively, from $45.3 million and $87.5 million in the three and six months ended June 30, 2015, respectively. Increased supply costs for the three and six months ended June 30, 2016 are primarily due to the increase in procedures performed by our same center group offset by the reduction in expense from the deconsolidated centers that were consolidated in the prior period.

Other operating expenses increased $4.0 million, or 6.6%, to $64.7 million and $6.9 million, or 5.7%, to $128.0 million in the three and six months ended June 30, 2016, respectively, from $60.7 million and $121.1 million in the three and six months ended June 30,

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2015, respectively. The additional expense in the three and six months ended June 30, 2016 resulted primarily from:

• an increase of $5.5 million and $9.3 million, respectively, in other operating expenses at our 2016 same-center group;

• centers acquired or opened during 2015, which resulted in an increase of $1.9 million and $4.2 million, respectively;

• centers acquired during 2016, which resulted in an increase of $0.5 million in each of the three and six months ended June 30, 2016, respectively; and

• deconsolidation of centers in the prior period, which resulted in a decrease of $3.8 million and $7.1 million, respectively.

Transaction costs was approximately $2.1 million and $2.3 million for the three and six months ended June 30, 2016, respectively, and $0.3 million and $0.6 million for the three and six months ended June 30, 2015, respectively, resulting primarily from our acquisition of surgery centers and the proposed merger with Envision.

Depreciation and amortization expense decreased $0.1 million, or 1.5%, to $8.9 million and increased $0.1 million, or 0.5%, to $17.6 million in the three and six months ended June 30, 2016, respectively, from $9.0 million and $17.5 million in the three and six months ended June 30, 2015 primarily as a result of centers deconsolidated and disposed during 2016 and 2015 offset from centers acquired during the same periods.

Equity in earnings of unconsolidated affiliates was $5.3 million and $9.1 million during the three and six months ended June 30, 2016, respectively, and $1.0 million and $1.6 million during the three and six months ended June 30, 2015, respectively. The increase in our earnings from equity method investments during the three and six months ended June 30, 2016 is due to the consummation of five equity method investments during 2015 whereby we contributed nine ASCs to joint ventures generally with health systems which were not fully reflected in 2015 results. Additionally, in 2016, we entered into one equity method investment in which we contributed one ASC into a joint venture with a health system.

Physician Services Operations

We utilize certain measures for our physician segment operations to monitor our net revenue growth, which includes same contract revenue, new contract revenue and acquired contract revenue. Our same contract revenue reflects revenue that contain full year-to-date operations in both comparable reporting periods. Our new contract revenue reflects revenue from contracts that have not been in effect for both the entire current and comparable periods less the amount of revenue relating to contracts terminated during such periods. Acquired contract revenue reflects the revenue from acquisitions that were completed during the periods. The following table presents the percentage change related to our net revenue growth and same contract growth during the three and six months ended June 30, 2016 and 2015.

	Three Months Ended June 30,				Six Months Ended June 30,
	2016		2015		2016		2015
Contribution to Net Revenue Growth:
Same contract	4.5	%	10.9	%	7.0	%	8.1	%
New contract	0.6		1.6		0.9		2.0
Acquired contract and other	27.5		11.8		30.8		9.3
Total net revenue growth	32.6	%	24.3	%	38.7	%	19.4	%
Same contract revenue growth	5.5	%	14.3	%	8.4	%	10.5	%

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The following table shows selected statement of operations data expressed in dollars (in thousands) and as a percentage of net revenue for our physician services segment.

	Three Months Ended June 30,									Six Months Ended June 30,
	2016				2015					2016				2015
Net revenue	$	438,752	100.0	%	$	330,959		100.0	%	$	856,296	100.0	%	$	617,494		100.0	%
Operating expenses:
Salaries and benefits	306,415		69.8		229,734			69.4		617,356		72.1		442,117			71.6
Supply cost	1,145		0.3		489			0.1		2,152		0.3		885			0.1
Other operating expenses	46,398		10.6		44,289			13.4		90,824		10.6		74,500			12.1
Transaction costs	3,036		0.7		1,658			0.5		4,249		0.5		2,861			0.5
Depreciation and amortization	21,192		4.8		14,617			4.4		41,528		4.8		28,924			4.7
Total operating expenses	378,186		86.2		290,787			87.9		756,109		88.3		549,287			89.0
Net gain (loss) on disposals and deconsolidations	—		—		(3,035		)	(0.9	)	—		—		(3,035		)	(0.5	)
Equity in earnings of unconsolidated affiliates	2,095		0.5		3,037			0.9		4,874		0.6		5,009			0.8
Operating income	$	62,661	14.3	%	$	40,174		12.1	%	$	105,061	12.3	%	$	70,181		11.4	%

Three and Six Months Ended June 30, 2016 compared to Three and Six Months Ended June 30, 2015

Physician services revenues increased $107.8 million, or 32.6%, to $438.8 million and $238.8 million, or 38.7%, to $856.3 million in the three and six months ended June 30, 2016, respectively, from $331.0 million and $617.5 million in the three and six months ended June 30, 2015, respectively. During the three and six months ended June 30, 2016, compared to the prior year periods, our total growth in net revenue of our physician services segment resulted primarily from physician practices acquired in 2016 and 2015, which contributed approximately $89.2 million and $184.7 million, respectively. In addition during the three and six months ended June 30, 2016, we experienced an increase in net revenue as a result of same contract growth which contributed approximately $14.9 million and $43.3 million, respectively. Our same contract revenue growth was 5.5% and 8.4% for the three and six months ended June 30, 2016, respectively, which is reflective of a 5.1% and 5.9% increase in patient encounters, a 0.4% and 1.8% increase in revenue per patient encounter, and a 0.7% increase due to an additional working day in the six months ended June 30, 2016.

We evaluate our physician services revenue net of contractual adjustments and provisions for uncollectible charges. Payors generally receive discounts from standard charges, which we refer to as contractual adjustments. In addition, patients our physicians serve may be personally responsible for the payment of the medical services they receive. Our contracts with hospitals and other facilities typically require us to provide care to all patients who present at our locations. While we seek to bill for all medical services we provide, a portion of our medical services are delivered to patients that have no insurance and from whom we cannot collect full compensation. As a result, we establish a provision for uncollectible charges. Our net revenue from our physician services operations represents gross billings after provisions for contractual allowances and uncollectibles.

The following table summarizes our approximate payor mix as a percentage of net revenue and our approximate payor mix based on patient encounters for the periods indicated.

	Percentage of Net Revenue								Percentage of Total Volume
	Three Months Ended June 30,				Six Months Ended June 30,				Three Months Ended June 30,				Six Months Ended June 30,
	2016		2015		2016		2015		2016		2015		2016		2015
Medicare	13	%	13	%	13	%	13	%	34	%	34	%	34	%	34	%
Medicaid	6		5		6		5		21		22		21		22
Commercial and managed care	71		72		71		71		36		36		36		36
Self-pay	1		1		1		1		9		8		9		8
Net fee for service revenue	91	%	91	%	91	%	90	%	100	%	100	%	100	%	100	%
Contract and other revenue	9		9		9		10
Net revenue for physician services	100	%	100	%	100	%	100	%

Included in total operating expenses for the three and six months ended June 30, 2016 is approximately $321.8 million and $641.9 million, respectively, and for the three and six months ended June 30, 2015 is approximately $236.7 million and $457.1 million,

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respectively, incurred for direct practice expenses, which primarily includes salaries and benefits costs of our physicians and other professional medical personnel. As a percentage of physician services revenue, direct practice expense was 73.3% and 75.0% for the three and six months ended June 30, 2016, respectively, and 71.5% and 74.0% for the three and six months ended June 30, 2015, respectively. During the three and six months ended June 30, 2016, we recognized income of approximately $2.6 million in other operating expenses associated with the net change in fair value of contingent consideration. During the three and six months ended June 30, 2015, we recognized expense of approximately $6.4 million in other operating expenses associated with the net change in fair value of contingent consideration.

Transaction costs was approximately $3.0 million and $4.2 million for the three and six months ended June 30, 2016, respectively, and $1.7 million and $2.9 million for the three and six months ended June 30, 2015, respectively, resulting primarily from our acquisition of physician practices and the proposed merger with Envision.

Depreciation and amortization for our physician services segment includes approximately $20.3 million and $39.9 million of amortization for the three and six months ended June 30, 2016, respectively, and $14.0 million and $27.7 million for the three and six months ended June 30, 2015, respectively, resulting primarily from amortizable intangible assets related to our customer relationships with hospitals. The increase in amortization associated with customer relationships with hospitals during the three and six months ended June 30, 2016 compared to the prior year period is a result of acquisitions completed in 2015 and 2016.

Equity in earnings of unconsolidated affiliates decreased to $2.1 million and $4.9 million in the three and six months ended June 30, 2016, respectively, compared to $3.0 million and $5.0 million for the three and six months ended June 30, 2015, respectively.

Liquidity and Capital Resources

Cash and cash equivalents at June 30, 2016 and December 31, 2015 were $74.1 million and $106.7 million, respectively. The change is primarily due to increased accounts receivable within our physician services segment and a change in our current income tax position from a payable to a receivable. Cash flow from operations for the six months ended June 30, 2016 generated $195.1 million compared to $251.4 million for the six months ended June 30, 2015. Additionally, net cash flow provided by operating activities, net of distributions to noncontrolling interests, for the six months ended June 30, 2016 was $79.5 million, compared to $150.4 million for the six months ended June 30, 2015. The decrease is primarily due to increased tax payments resulting from higher net earnings in the current period and lower taxes paid in the prior period due to the tax benefit resulting from significant transaction costs incurred in association with the Sheridan acquisition completed during 2014. In addition, we experienced an increase in net accounts receivable associated with our acquisitions completed during the six months ended June 30, 2016 and the latter half of 2015. For our ambulatory services segment, positive operating cash flows of individual centers are the sole source of cash used to make distributions to our wholly-owned subsidiaries, as well as to our physician partners, which we are obligated to make on a monthly basis in accordance with each partnership’s operating or partnership agreement. Distributions to noncontrolling interests, which is considered a financing activity, were $115.6 million and $101.0 million during the six months ended June 30, 2016 and 2015, respectively.

The principal source of our operating cash flow is the collection of accounts receivable from governmental payors, commercial payors and individuals. We bill for services as delivered, usually within a few days following the date the service is rendered for our ambulatory services segment and within 5 to 15 days following the date the service is rendered for our physician services segment. Generally, unpaid amounts that are 30 to 45 days past due are rebilled based on a standard set of procedures. If amounts remain uncollected after 60 days, we proceed with a series of late-notice notifications until amounts are either collected, contractually written off in accordance with contracted rates or determined to be uncollectible, typically after 90 to 120 days. Receivables determined to be uncollectible are written off and such amounts are applied to our estimate of allowance for bad debts as previously established in accordance with our policy for bad debt expense. The amount of actual write-offs of account balances for each of our subsidiaries is continuously compared to established allowances for bad debt to ensure that such allowances are adequate. At June 30, 2016 and December 31, 2015, our ambulatory services segment net accounts receivable represented 38 days of revenue outstanding, respectively. At June 30, 2016, our physician services segment net accounts receivable represented 55 days of revenue outstanding which is an increase in the days outstanding since December 31, 2015. The increase is primarily due to the volume of acquisitions completed toward the end of the fourth quarter of 2015 and those acquisitions completed during the six months ended June 30, 2016 as it is not unusual for us to experience delays in our ability to bill for procedures until certain administrative procedures are finalized.

During the six months ended June 30, 2016, we had total acquisition and capital expenditures of $318.7 million, which included:

• $255.4 million for the acquisition of physician practices;

• $25.7 million for the acquisition of interests in surgery centers; and

• $38.3 million for new or replacement property, including $0.7 million in new capital leases.

38

Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations - (continued) Table of Contents

At June 30, 2016, we had unfunded construction and equipment purchase commitments for our new physician services segment headquarters and for surgery centers under development or under renovation of approximately $17.8 million, which we intend to fund through additional borrowings from our revolving credit facility and operating cash flow.

As of June 30, 2016, we had $29.9 million of restricted cash and marketable securities the majority of which is restricted for the purpose of satisfying the obligations of our wholly-owned captive insurance company. Approximately $12.8 million is reflected as a component of total current assets in the accompanying consolidated balance sheets which is expected to be utilized to satisfy the claims payments estimated to occur in the next 12 months.

During the six months ended June 30, 2016, we received approximately $0.5 million from the exercise of stock options under our employee stock incentive plans. During the six months ended June 30, 2016, we repurchased 77,780 shares of our common stock by withholding a portion of employee restricted stock that vested, with a value of approximately $5.7 million, to cover payroll withholding taxes in accordance with the restricted stock agreements. The excess tax benefit received from the exercise of options and the vesting of restricted stock was approximately $3.7 million.

During December 2015, we issued 5,835,000 shares of our common stock in a public offering, at $80.00 per share, prior to underwriting discounts, commissions and other related offering expenses of approximately $19.1 million. Proceeds were used to repay a portion of our revolving credit facility, to fund a portion of the acquisitions completed during the three months ended December, 31, 2015 and for general corporate purposes.

Our mandatory convertible preferred stock pays dividends at an annual rate of 5.25% of the initial liquidation preference of $100 per share. Dividends, to the extent lawful and declared by our board of directors, are paid on each January 1, April 1, July 1 and October 1 in cash or, at our election (subject to certain limitations), by delivery of any combination of cash and shares of common stock. At any time prior to July 1, 2017, holders may elect to convert all or a portion of their shares of mandatory convertible preferred stock into shares of common stock at the minimum conversion rate of 1.8141 shares of common stock. On July 1, 2017, all outstanding shares of our mandatory convertible preferred stock will convert into common stock. During each of the six months ended June 30, 2016 and 2015, the Board of Directors declared two dividends each totaling $1.3125 per share in cash, or $2.3 million, respectively, for our mandatory convertible preferred stock. The dividend declared in May 2016 has been funded to the paying agent and was paid on July 1, 2016 to shareholders of record as of June 15, 2016.

For the six months ended June 30, 2016, we had net borrowings on long-term debt of $218.4 million. At June 30, 2016, we had $100.0 million available under our revolving credit agreement, $250.0 million outstanding pursuant to our 2020 Senior Unsecured Notes, $1.1 billion outstanding pursuant to our 2022 Senior Unsecured Notes and $852.6 million outstanding pursuant to our term loan.

Our $870.0 million term loan matures on July 16, 2021 and bears interest equal to, at our option, the alternative base rate as defined in the agreement (ABR) plus 1.75% to 2.00% or LIBOR plus 2.75% to 3.00%, with a LIBOR floor of 0.75%, or a combination thereof (3.50% on June 30, 2016). Our revolving credit facility, which matures on July 16, 2019, permits us to borrow up to $500.0 million, at an interest rate equal to, at our option, the ABR plus 1.75% to 2.00% or LIBOR plus 2.75% to 3.00%, or a combination thereof and provides for a fee of 0.375% of unused commitments. In accordance with the terms of the senior secured credit facility, principal payments are required quarterly in installments of an amount equal to 0.25% of the aggregate initial principal amount of the term loan. We have the option to increase borrowings under the senior secured credit facility beyond the initial term under both the term loan and revolver as long as certain financial covenants are met and lender approval is obtained.

We have $1.1 billion aggregate principal amount of 5.625% senior unsecured notes due 2022 (the 2022 Senior Unsecured Notes). Interest on the 2022 Senior Unsecured Notes accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on January 15 and July 15 through the maturity date on July 15, 2022. At June 30, 2016, we had approximately $28.5 million in accrued interest associated with the 2022 Senior Unsecured Notes reflected in other accrued liabilities, which was paid in July 2016.

We have $250.0 million aggregate principal amount of 5.625% senior unsecured notes due 2020 (the 2020 Senior Unsecured Notes). Interest accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on May 30 and November 30, through the maturity date on November 30, 2020. At June 30, 2016, we had approximately $1.2 million in accrued interest associated with the 2020 Senior Unsecured Notes reflected in other accrued liabilities which will be paid in November 2016. The 2020 Senior Unsecured Notes contain certain covenants which, among other things, limit our ability to enter into or guarantee additional borrowing, sell preferred stock, pay dividends and repurchase stock, in each case subject to certain exceptions.

As of June 30, 2016, we were in compliance with all covenants contained in our credit agreement, the indenture governing our 2020 Senior Unsecured Notes, and the indenture governing our 2022 Senior Unsecured Notes.

39

Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations - (continued) Table of Contents

On January 16, 2015, we entered into an agreement to lease approximately 222,000 square feet of office space in Plantation, Florida which we intend to utilize for our physician services segment. We took possession of the space in the fourth quarter of 2015 and began tenant improvements on approximately 167,000 square feet of space, which we intend to begin to occupy during the third quarter of 2016. In addition, we plan to begin tenant improvements on an additional 55,000 square feet of space during the third quarter of 2016, which we intend to occupy during the first quarter of 2017. Annual rent expense is expected to be approximately $2.9 million. The initial term of the lease agreement expires in February 2029. Our rent obligation does not require cash payments until September 2016.

On June 15, 2016, we signed a definitive merger agreement with Envision to combine the companies in an all-stock transaction. Also on June 15, 2016, we and Envision signed a commitment letter with JPMorgan Chase Bank, N.A. and Barclays Bank PLC (JPMorgan and Barclays) to allow both us and Envision to refinance certain debt instruments as necessary to effect the proposed merger. JPMorgan and Barclays have committed to (i) provide Envision and AmSurg with a term loan facility in an aggregate principal amount of up to $5.3 billion and (ii) a senior secured asset-based revolving credit facility in an aggregate principal amount of up to $1.0 billion in connection with the proposed Merger. If we were to terminate the Merger Agreement, under certain circumstances, we would be required to pay Envision a termination fee of $180.0 million and would be obligated to provide reimbursement for up to $15.0 million of expenses. In addition, we estimate that we will be obligated for approximately $20.0 million of transaction fees resulting from the Merger that will not be contingent upon a successful closing of the transaction.

Based upon our current operations and anticipated growth, we believe our operating cash flow and borrowing capacity will provide adequate resources to meet our working capital and capital expenditure requirements for the next 12 to 18 months for operations and acquisitions in the ordinary course of our business. In addition to acquiring and developing ASCs and physician practices, we may from time to time consider other acquisitions or strategic joint ventures, such as the proposed merger with Envision, involving other companies, multiple-center chains, networks of ASCs or physician practices. Such acquisitions, joint ventures or other opportunities may require an amendment to our current debt agreements or additional external financing, which may include sales of equity securities. We cannot assure you that any required financing will be available, or will be available on terms acceptable to us.

40

Item 3. Quantitative and Qualitative Disclosures About Market Risk

We are subject to market risk primarily from exposure to changes in interest rates based on our financing, investing and cash management activities. We utilize a balanced mix of maturities along with both fixed rate and variable rate debt to manage our exposures to changes in interest rates. Our variable debt instruments are primarily indexed to the prime rate or LIBOR. Interest rate changes would result in gains or losses in the market value of our fixed rate debt portfolio due to differences in market interest rates and the rates at the inception of the debt agreements. Based upon our indebtedness at June 30, 2016, a 100 basis point interest rate change would impact our net earnings and cash flow by approximately $7.5 million annually. Although there can be no assurances that interest rates will not change significantly, we do not expect changes in interest rates to have a material effect on our net earnings or cash flows in 2016 based on our indebtedness at June 30, 2016.

Item 4. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

Under the supervision and with the participation of our management team, including our chief executive officer and chief financial officer, we conducted an evaluation of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) of the Securities Exchange Act of 1934, as amended, or the Exchange Act) as of June 30, 2016. Based on that evaluation, our chief executive officer (principal executive officer) and chief financial officer (principal accounting officer) have concluded that our disclosure controls and procedures were effective.

Changes in Internal Control Over Financial Reporting

As a result of the completion of the acquisitions made in 2015, we have begun our analysis of the systems of disclosure controls and procedures and internal controls over financial reporting and we will continue to integrate them within our broader framework of controls and expect to be finalized as of December 31, 2016. The SEC’s rules require us to include acquired entities in our assessment of the effectiveness of internal control over financial reporting no later than the annual management report following the first anniversary of the acquisition. We plan to complete the evaluation and the integration of the 2015 acquisitions within the required time frames and report management’s assessment of our internal control over financial reporting in our first annual report in which such assessment is required for this acquisition. There has been no change in our internal control over financial reporting during the quarter ended June 30, 2016 that has materially affected or is reasonably likely to materially affect our internal control over financial reporting.

41

Part II

Item 1. Legal Proceedings

There have been no material changes during the six months ended June 30, 2016 to the legal proceedings we previously described in our Annual Report on Form 10-K for the fiscal year ended December 31, 2015.

Item 1A. Risk Factors

The risk factors set forth in the Company’s Current Report on Form 8-K filed with the SEC on August 4, 2016, are incorporated herein by reference.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

None.

Item 3. Defaults Upon Senior Securities

None.

Item 4. Mine Safety Disclosures

Not applicable.

Item 5. Other Information

None.

42

Item 6. Exhibits

Exhibit	Description
2.1	Agreement and Plan of Merger, dated as of June 15, 2016, by and among Envision Healthcare Holdings, Inc., AmSurg Corp. and New Amethyst Corp. (Incorporated by reference to the Current Report on Form 8-K filed by the Company with the Commission on June 16, 2016)
10.1	Commitment Letter, dated as of June 15, 2016, by and among Envision Healthcare Corporation, AmSurg Corp., JP Morgan Chase Bank, N.A. and Barclays Bank PLC. (Incorporated by reference to the Current Report on Form 8-K filed by the Company with the Commission on June 16, 2016)
10.2	Amended and Restated AmSurg Corp. 2014 Equity Incentive Plan (Incorporated by reference to the Current Report on Form 8-K filed by the Company with the Commission on May 27, 2016)
31.1	Certification of President and Chief Executive Officer pursuant to Rule 13a-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
31.2	Certification of Executive Vice President and Chief Financial Officer pursuant to Rule 13a-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
32.1	Certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101	Interactive data files pursuant to Rule 405 of Regulation S-T: (i) the Consolidated Balance Sheets at June 30, 2016 and December 31, 2015, (ii) the Consolidated Statements of Earnings for the three and six month periods ended June 30, 2016 and 2015, (iii) the Consolidated Statements of Changes in Equity for the six month periods ended June 30, 2016 and 2015, (iv) the Consolidated Statements of Cash Flows for the six month periods ended June 30, 2016 and 2015 and (v) the notes to the Unaudited Consolidated Financial Statements for the six month periods ended June 30, 2016 and 2015

43

Signature

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

		AMSURG CORP.
Date:	August 4, 2016
		By:	/s/ Claire M. Gulmi
			Claire M. Gulmi
			Executive Vice President and
			Chief Financial Officer
			(Principal Financial and Duly Authorized Officer)

44

EX-31.1

Exhibit 31.1

Certifications

I, Christopher A. Holden, certify that:

1. I have reviewed this quarterly report on Form 10-Q of AmSurg Corp.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of registrant's board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: August 4, 2016

By:	/s/ Christopher A. Holden
Name:	Christopher A. Holden
Title:	President and Chief Executive Officer

EX-31.2

Exhibit 31.2

Certifications

I, Claire M. Gulmi, certify that:

1. I have reviewed this quarterly report on Form 10-Q of AmSurg Corp.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of registrant's board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: August 4, 2016

By:	/s/ Claire M. Gulmi
Name:	Claire M. Gulmi
Title:	Executive Vice President and
	Chief Financial Officer

EX-32.1

Exhibit 32.1

AMSURG CORP.

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of AmSurg Corp. (the “Company”) on Form 10-Q for the period ending June 30, 2016, as filed with the Securities and Exchange Commission on the date hereof (the “Report”), each of the undersigned certifies, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1)	The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
(2)	The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

/s/ Christopher A. Holden

Christopher A. Holden

President and Chief Executive

Officer of the Company

August 4, 2016

/s/ Claire M. Gulmi

Claire M. Gulmi

Executive Vice President and

Chief Financial Officer of the Company

August 4, 2016

XML

Document And Entity Information - shares	6 Months Ended
	Jun. 30, 2016	Aug. 02, 2016
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2016
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	Q2
Entity Registrant Name	AMSURG CORP
Entity Central Index Key	0000895930
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		54,810,106

XML

Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Assets
Cash and cash equivalents	$ 74,105	$ 106,660
Restricted cash and marketable securities	12,794	13,506
Accounts receivable, net of allowance of $208,780 and $167,411, respectively	375,352	337,330
Supplies inventory	21,980	21,406
Prepaid and other current assets	74,565	75,771
Total current assets	558,796	554,673
Property and equipment, net	204,922	189,168
Investments in unconsolidated affiliates	179,056	169,170
Goodwill	4,175,008	3,970,210
Intangible assets, net	1,679,275	1,594,637
Other assets	46,263	21,450
Total assets	6,843,320	6,499,308
Liabilities and Equity
Current portion of long-term debt	20,772	20,377
Accounts payable	30,721	32,561
Accrued salaries and benefits	186,908	202,537
Accrued interest	30,400	30,480
Other accrued liabilities	92,571	119,237
Total current liabilities	361,372	405,192
Long-term debt	2,581,043	2,357,956
Deferred income taxes	743,447	699,498
Other long-term liabilities	119,478	96,183
Commitments and contingencies
Noncontrolling interests – redeemable	177,845	175,732
Equity:
Preferred stock, no par value, 5,000 shares authorized, 1,725 shares issued and outstanding	166,632	166,632
Common stock, no par value, 120,000 shares authorized, 54,816 and 54,294 shares issued and outstanding, respectively	1,356,829	1,345,418
Retained earnings	853,817	781,413
Total AmSurg Corp. equity	2,377,278	2,293,463
Noncontrolling interests – non-redeemable	482,857	471,284
Total equity	2,860,135	2,764,747
Total liabilities and equity	$ 6,843,320	$ 6,499,308

XML

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Allowances for accounts receivable	$ 208,780	$ 167,411
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	1,725,000	1,725,000
Preferred stock, shares outstanding	1,725,000	1,725,000
Common stock, shares authorized	120,000,000	120,000,000
Common stock, shares issued	54,816,000	54,294,000
Common stock, shares outstanding	54,816,000	54,294,000

XML

Consolidated Statements Of Earnings - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Revenues	$ 859,832	$ 707,733	$ 1,678,118	$ 1,345,930
Provision for uncollectibles			(207,046)	(144,514)
Net revenue	758,499	641,950	1,483,177	1,212,395
Operating expenses:
Salaries and benefits	404,011	320,396	813,850	622,575
Supply cost	49,703	45,790	96,666	88,374
Other operating expenses	111,145	105,002	218,827	195,572
Transaction costs	5,135	1,982	6,525	3,453
Depreciation and amortization	30,054	23,612	59,126	46,430
Total operating expenses	600,048	496,782	1,194,994	956,404
Net gain (loss) on disposals and deconsolidations	2,595	(3,035)	2,595	(3,258)
Equity in earnings of unconsolidated affiliates	7,351	3,989	13,930	6,640
Operating income	168,397	146,122	304,708	259,373
Interest expense, net	31,913	30,182	62,723	60,429
Earnings before income taxes	136,484	115,940	241,985	198,944
Income tax expense	33,365	25,193	54,162	39,442
Net earnings	103,119	90,747	187,823	159,502
Less net earnings attributable to noncontrolling interests	57,050	57,072	110,891	104,789
Net earnings attributable to AmSurg Corp. shareholders	46,069	33,675	76,932	54,713
Preferred stock dividends	(2,264)	(2,264)	(4,528)	(4,528)
Net earnings attributable to AmSurg Corp. common shareholders	$ 43,805	$ 31,411	$ 72,404	$ 50,185
Net earnings per share attributable to common shareholders:
Earnings Per Share, Basic	$ 0.82	$ 0.66	$ 1.35	$ 1.05
Earnings Per Share, Diluted	$ 0.80	$ 0.65	$ 1.34	$ 1.05
Weighted average number of shares and share equivalents outstanding:
Basic (in shares)	53,739	47,678	53,702	47,625
Diluted (in shares)	57,327	48,099	57,229	48,002
Physician Services [Member]
Provision for uncollectibles	$ (101,333)	$ (65,783)	$ (194,941)	$ (133,535)
Net revenue	$ 438,752	$ 330,959	$ 856,296	$ 617,494

XML

Consolidated Statements Of Changes In Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Mandatory Convertible Preferred Stock [Member]	Retained Earnings [Member]	Non-Controlling Interests - Non-Redeemable [Member]	Total Equity (Permanent) [Member]	Non-controlling Interests - Redeemable (Temporary Equity) [Member]
Balance at Dec. 31, 2014		$ 885,393	$ 166,632	$ 627,522	$ 418,684	$ 2,098,231	$ 184,099
Balance (in shares) at Dec. 31, 2014		48,113,000	1,725,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings	$ 159,502			54,713	33,117	87,830	71,672
Issuance of restricted common stock (in shares)		314,000
Cancellation of restricted common stock (in shares)		(7,000)
Stock options exercised		$ 2,080				2,080
Stock options exercised (in shares)		90,000
Stock repurchased	$ (3,700)	$ (3,684)				(3,684)
Stock repurchased (in shares)	(67,000)	(67,000)
Share-based compensation		$ 7,592				7,592
Tax benefit related to exercise of share-based awards		3,533				3,533
Dividends paid on preferred stock				(4,528)		(4,528)
Acquisitions and other transactions impacting noncontrolling interests		599			59,888	60,487	(408)
Distributions to noncontrolling interests, net of capital contributions					(30,989)	(30,989)	(69,819)
Disposals and other transactions impacting noncontrolling interests		(2,194)			2,229	35	(367)
Balance at Jun. 30, 2015		$ 893,319	$ 166,632	677,707	482,929	2,220,587	185,177
Balance (in shares) at Jun. 30, 2015		48,443,000	1,725,000
Balance at Dec. 31, 2015	$ 2,764,747	$ 1,345,418	$ 166,632	781,413	471,284	2,764,747	175,732
Balance (in shares) at Dec. 31, 2015		54,294,000	1,725,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings	$ 187,823			76,932	36,046	112,978	74,845
Issuance of restricted common stock (in shares)		587,000
Cancellation of restricted common stock (in shares)		(7,000)
Stock options exercised		$ 450				450
Stock options exercised (in shares)	19,718	20,000
Stock repurchased	$ (5,700)	$ (5,688)				(5,688)
Stock repurchased (in shares)	(77,780)	(78,000)
Share-based compensation		$ 15,068				15,068
Tax benefit related to exercise of share-based awards		3,734				3,734
Dividends paid on preferred stock				(4,528)		(4,528)
Acquisitions and other transactions impacting noncontrolling interests		780			13,584	14,364	4,013
Distributions to noncontrolling interests, net of capital contributions					(38,149)	(38,149)	(77,158)
Disposals and other transactions impacting noncontrolling interests		(2,933)			92	(2,841)	413
Balance at Jun. 30, 2016	$ 2,860,135	$ 1,356,829	$ 166,632	$ 853,817	$ 482,857	$ 2,860,135	$ 177,845
Balance (in shares) at Jun. 30, 2016		54,816,000	1,725,000

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Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Cash flows from operating activities:
Net earnings	$ 187,823	$ 159,502
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
Depreciation and amortization	59,126	46,430
Amortization of deferred loan costs	4,279	4,155
Provision for uncollectibles	207,046	144,514
Net (gain) loss on disposals and deconsolidations	(2,595)	3,258
Share-based compensation	15,068	7,592
Excess tax benefit from share-based compensation	(3,734)	(3,533)
Deferred income taxes	20,987	2,699
Equity in earnings of unconsolidated affiliates	(13,930)	(6,640)
Net change in fair value of contingent consideration	(2,598)	6,410
Increases (decreases) in cash and cash equivalents, net of acquisitions and dispositions:
Accounts receivable	(228,374)	(157,056)
Supplies inventory	(412)	(110)
Prepaid and other current assets	(23,744)	30,327
Accounts payable	(3,347)	(696)
Accrued expenses and other liabilities	(28,204)	12,648
Other, net	7,714	1,895
Net cash flows provided by operating activities	195,105	251,395
Cash flows from investing activities:
Acquisitions and related expenses	(281,113)	(196,032)
Acquisition of property and equipment	(37,618)	(32,665)
Proceeds from sale of interests in surgery centers	25	0
Purchases of marketable securities	(498)	(1,245)
Maturities of marketable securities	2,738	2,988
Other	(8,749)	(1,987)
Net cash flows used in investing activities	(325,215)	(228,941)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	317,151	7,795
Repayment on long-term borrowings and revolving credit facility	(98,763)	(10,288)
Distributions to noncontrolling interests	(115,589)	(101,033)
Proceeds from issuance of common stock upon exercise of stock options	450	2,080
Repurchase of common stock	(5,688)	(3,684)
Other	(6)	886
Net cash flows provided by (used in) financing activities	97,555	(104,244)
Net decrease in cash and cash equivalents	(32,555)	(81,790)
Cash and cash equivalents, beginning of period	106,660	208,079
Cash and cash equivalents, end of period	74,105	126,289
Supplemental cash flow information:
Interest payments	58,788	56,252
Income tax paid, net of refunds	$ 45,726	$ 7,772

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Basis of Presentation

6 Months Ended

Jun. 30, 2016

Accounting Policies [Abstract]

Basis of Presentation

Basis of Presentation    

These unaudited consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (GAAP) for interim financial reporting and in accordance with Rule 10-01 of Regulation S-X. In the opinion of management, the unaudited interim consolidated financial statements contained in this report reflect all normal recurring adjustments, which are necessary for a fair presentation of the financial position and the results of operations for the interim periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year. The accompanying unaudited consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in AmSurg Corp.'s (Company) Annual Report on Form 10-K for the fiscal year ended December 31, 2015.

Ambulatory Services

The Company, through its wholly-owned subsidiaries, owns interests, primarily 51%, in limited liability companies (LLCs) and limited partnerships (LPs) which own and operate ambulatory surgery centers (ASCs, surgery centers or centers). All LLCs and LPs are referred to herein as “partnerships” and “partners,” respectively. The Company has variable interests in the partnerships through its equity ownership interests. Each partnership is considered a variable interest entity (VIE) due to its structure as a limited partnership or functional equivalent under Financial Accounting Standards Board (FASB) Accounting Standard Update (ASU) No. 2015-02 “Consolidations (Topic 810) - Amendments to the Consolidation Analysis,” which was adopted effective January 1, 2016. For those partnerships in which the Company’s ownership interest is 51% or greater, the Company is considered the primary beneficiary. The Company is the primary beneficiary due to 1) ownership interest, operating agreements allowing the Company to govern the day-to-day activities, and the Company’s position as the managing member or general partner and 2) the Company's obligation to absorb losses or the right to receive returns proportionate to its equity interest in the partnerships. For the 24 partnerships in which the Company’s ownership interest is less than 51%, the Company is not deemed the primary beneficiary and therefore those partnerships are not consolidated with the exception of 2 partnerships which are consolidated because the Company holds substantive participation rights and has the obligation to absorb losses or right to receive returns proportionate to its equity interest in the partnerships. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries and the consolidated partnerships. The responsibilities of the Company’s noncontrolling partners (LPs and noncontrolling members) are to supervise the delivery of medical services, with their rights being restricted to those that protect their financial interests, such as approval of the acquisition of significant assets or the incurrence of debt which they are generally required to guarantee on a pro rata basis based upon their respective ownership interests. Intercompany profits, transactions and balances have been eliminated.

Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company’s equity. However, for instances in which certain redemption features that are not solely within the control of the Company are present, classification of noncontrolling interests outside of permanent equity is required. Consolidated net earnings attributable to the Company and to the noncontrolling interests are identified and presented on the consolidated statements of earnings; changes in ownership interests are accounted for as equity transactions when there is no change in control; and when a subsidiary is deconsolidated, any retained noncontrolling equity investment in the former subsidiary and the gain or loss on the deconsolidation of the subsidiary are measured at fair value. Certain transactions with noncontrolling interests are also classified within financing activities in the statements of cash flows. 

Center profits and losses of consolidated entities are allocated to the Company’s partners in proportion to their ownership percentages and reflected in the aggregate as net earnings attributable to noncontrolling interests. The partners of the Company’s center partnerships typically are organized as general partnerships, LPs or LLCs that are not subject to federal income tax. Each partner shares in the pre-tax earnings of the center in which it is a partner. Accordingly, the earnings attributable to noncontrolling interests in each of the Company’s consolidated partnerships are generally determined on a pre-tax basis, and total net earnings attributable to noncontrolling interests are presented after net earnings. However, the Company considers the impact of the net earnings attributable to noncontrolling interests on earnings before income taxes in order to determine the amount of pre-tax earnings on which the Company must determine its income tax expense. In addition, distributions from the partnerships are made to both the Company’s wholly-owned subsidiaries and the partners on a pre-tax basis.

Physician Services

The Company, through its wholly-owned subsidiary Sheridan Healthcare, is a national provider of multi-specialty physician and administrative services to hospitals, ambulatory surgery centers and other healthcare facilities. The Company focuses on delivering comprehensive physician services, primarily in the areas of anesthesiology, radiology, children's services and emergency medicine to healthcare facilities. Through its contracts with healthcare facilities, the Company is authorized to bill and collect charges for fee for service medical services rendered by its healthcare professionals and employees in exchange for the provision of services to the patients of these facilities. Contract revenue is earned directly from hospital customers through a variety of payment arrangements that are established to supplement payments from third-party payors. The Company also provides physician services and manages office-based practices in the areas of pain management, gynecology, obstetrics and perinatology. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries along with the accounts of affiliated professional corporations (PCs) with which the Company has management arrangements. The Company's agreements with these PCs provide that the term of the arrangements is permanent, subject only to termination by the Company, except in the case of gross negligence, fraud or bankruptcy of the Company. The PC structure is primarily used in states which prohibit the corporate practice of medicine. The arrangements are captive in nature as a majority of the outstanding voting equity instruments of the PCs are owned by nominee shareholders appointed at the sole discretion of the Company. The nominee shareholder is a medical doctor who is generally a senior corporate employee of the Company. The Company has a contractual right to transfer the ownership of the PCs at any time to any person it designates as the nominee shareholder. The Company has the right to all assets and to receive income, both as ongoing fees and as proceeds from the sale of any interest in the PCs, in an amount that fluctuates based on the performance of the PCs and the change in the fair value of the interest in the PCs. The Company has exclusive responsibility for the provision of all non-medical services required for the day-to-day operation and management of the PCs and establishes the guidelines for the employment and compensation of the physicians and other employees of the PCs which is consistent with the operation of the Company's wholly-owned subsidiaries. Based on the provisions of these agreements, the Company has determined that the PCs are variable interest entities and that the Company is the primary beneficiary as defined in ASC 810 “Consolidations.”

Variable Interest Entities

For its PCs and certain of its partnerships, the Company is considered the primary beneficiary of the variable interest entities and consolidates under the Variable Interest Model in ASC 810.The total assets of the VIEs, which are included in the accompanying consolidated balance sheets, as of June 30, 2016 and December 31, 2015, were $780.5 million and $740.1 million, respectively, and the total liabilities of the VIEs were $297.7 million and $299.0 million, respectively. Included in total assets as of June 30, 2016 and December 31, 2015, respectively, were $178.6 million and $176.8 million of assets which were restricted to use and could only be used to settle the obligations of the VIE. The creditors of the VIE have no recourse to the Company, with the exception of $18.2 million and $21.7 million of debt guaranteed by the Company at June 30, 2016 and December 31, 2015, respectively. The restricted assets and obligations, which are either restricted for use in the VIE or the creditor did not have recourse to the Company, generally consisted of the portion of assets and liabilities attributable to the Company's non-controlling partners.

The Company also has certain equity interests in unconsolidated affiliates which meet the definition of a variable interest entity. The Company has a variable interest in these investments through its equity interests; however, the Company is not the primary beneficiary of these entities as it holds 50% or less of the voting rights and does not have the power to direct the activities that most significantly impact the entities' economic performance as a result of the Company's shared or lack of control. As a result, the Company has accounted for these investments under the equity method of accounting. The Company's investment in these entities was $179.1 million and $169.2 million as of June 30, 2016 and December 31, 2015, respectively, and is reflected in the accompanying consolidated balance sheets as a component of investments in unconsolidated affiliates.

The Company has recorded its share of the earnings of these investments of $7.4 million and $4.0 million as a component of equity in earnings of the unconsolidated affiliates in the accompanying statements of earnings during the three months ended June 30, 2016 and 2015, respectively, and $13.9 million and $6.6 million during the six months ended June 30, 2016 and 2015, respectively. The Company recognized management and billing fees associated with these investments totaling $5.3 million and $3.8 million during the three months ended June 30, 2016 and 2015, respectively, and $11.6 million and $7.2 million during the six months ended June 30, 2016 and 2015, respectively, which are included in net revenue in the accompanying consolidated statements of earnings. The Company has also recorded receivables from these entities in the amount of $9.2 million and $6.0 million as of June 30, 2016 and December 31, 2015, respectively. These receivables are included in the other current assets in the accompanying consolidated balance sheets.

Restricted Cash and Marketable Securities

As of June 30, 2016 and December 31, 2015, the Company had $29.9 million and $27.4 million, respectively, of restricted cash and marketable securities in the accompanying consolidated balance sheets the majority of which is restricted for the purpose of satisfying the obligations of the Company's wholly-owned captive insurance company. The Company has reflected $17.1 million and $13.9 million as of June 30, 2016 and December 31, 2015, respectively, of its restricted cash and marketable securities as a component of other assets in the accompanying consolidated balance sheets. Restricted cash and marketable securities reflected as a component of total current assets in the accompanying consolidated balance sheets represent amounts available to satisfy the claims payments estimated to occur in the next 12 months. As of June 30, 2016 and December 31, 2015, the Company had $0.5 million and $2.7 million, respectively, included in restricted cash and marketable securities, consisting of certificates of deposit with maturities less than 180 days, which approximates fair value.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Reclassifications

Certain prior year amounts in the accompanying consolidated financial statements have been reclassified to reflect the adoption of ASU No. 2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs” as discussed further under “Recent Accounting Pronouncements.” The impact of the reclassification made to prior period balance sheet is presented below (in thousands).

	December 31, 2015
Consolidated Balance Sheet:	Previously reported		Reclassification			Revised
Intangible assets, net	$	1,641,811	$	(47,174	)	$	1,594,637
Long-term debt	$	2,405,130	$	(47,174	)	$	2,357,956

Recent Accounting Pronouncements

In May 2014, the FASB issued ASU 2014-09 “Revenue from Contracts with Customers,” which will eliminate the transaction and industry-specific revenue recognition guidance under current GAAP and replace it with a principle-based approach using the following steps: identify the contract(s) with a customer, identify the performance obligations in the contract, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when (or as) the entity satisfies a performance obligation. In August 2015, the FASB issued ASU 2015-14 “Revenue from Contracts with Customers (Topic 606), Deferral of the Effective Date” which granted a one-year deferral of this ASU. In 2016, the FASB issued the following ASUs to provide entities further clarity on the application of ASU 2014-09:

• ASU 2016-08 “Principal versus Agent Considerations (Reporting Revenue Gross versus Net)”

• ASU 2016-10 “Identifying Performance Obligations and Licensing”

• ASU 2016-12 “Narrow-Scope Improvements and Practical Expedients”

The guidance in ASU 2014-09 and the subsequently related ASUs will now be effective for public entities for annual reporting periods beginning after December 15, 2017, including interim periods therein. Early adoption will be permitted for annual reporting periods beginning after December 15, 2016, including interim periods therein. The Company has yet to assess the impact, if any, this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

In February 2015, the FASB issued ASU No. 2015-02, “Consolidations (Topic 810) - Amendments to the Consolidation Analysis”. The new guidance made amendments to the consolidation guidance, including introducing a separate consolidation analysis specific to limited partnerships and other similar entities. Under this analysis, limited partnerships and other similar entities are considered a variable-interest entity unless the limited partners hold substantive kick-out rights or participating rights. The standard is effective for annual periods beginning after December 15, 2015. The Company adopted this standard effective January 1, 2016 and applied the adoption retrospectively. The adoption of the standard did not result in a change of consolidated subsidiaries nor did it result in any impact to the Company's consolidated financial position, results of operations or cash flows as of and for the three months ended March 31, 2016 or for any previous period.

In April 2015, the FASB issued ASU No. 2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs.” ASU 2015-03 amended current presentation guidance by requiring that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. In August 2015, the FASB issued ASU 2015-15 “Interest - Imputation of Interest (Subtopic 835-50), Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements - Amendments to Securities and Exchange Commission (SEC) Paragraphs Pursuant to Staff Announcement at June 18, 2015 EITF Meeting (SEC Update)” which incorporated into the Accounting Standards Codification an SEC staff announcement that the SEC staff will not object to an entity presenting the cost of securing a revolving line of credit as an asset, regardless of whether a balance is outstanding. The standards were effective for annual periods beginning after December 15, 2015, and interim periods within those fiscal years. The Company adopted this ASU effective January 1, 2016 and accordingly, reclassified $47.2 million of deferred debt issuance costs from intangible assets, net to a reduction in long-term debt at December 31, 2015, in the accompanying balance sheets (see reclassification above).

In February 2016, the FASB issued ASU No. 2016-02, “Leases” which amends existing accounting standards for lease accounting, including requiring lessees to recognize most leases on the balance sheet and making changes to lessor accounting. The standard is effective for annual periods beginning after December 15, 2018 with early adoption permitted. The new standard requires a modified retrospective application for all leases existing at, or entered into, after the date of initial application, with an option to use certain transition relief. The Company has not yet determined the impact this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

In March 2016, the FASB issued ASU No. 2016-09, “Improvements to Employee Share-Based Payment Accounting” which will change how companies account for certain aspects of share-based payments to employees by requiring companies to recognize the income tax effects of awards in the income statement when the awards vest or are settled. The standard is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company has not yet determined the impact this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

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Business Combinations

6 Months Ended

Jun. 30, 2016

Business Combinations [Abstract]

Business Combinations

Business Combinations

On June 15, 2016, the Company entered into a definitive merger agreement with Envision Healthcare Holdings, Inc. (Envision). Pursuant to the merger agreement, AmSurg Corp. will change its state of incorporation from Tennessee to Delaware by merging AmSurg Corp. with and into New Amethyst Corp. (New Amethyst), a newly-formed Delaware corporation and a wholly-owned subsidiary of AmSurg Corp., with New Amethyst being the surviving corporation. AmSurg Corp. shareholders will receive one share of New Amethyst common stock for each share of AmSurg Corp. common stock owned and one share of New Amethyst mandatory convertible preferred stock for each share of AmSurg Corp. mandatory convertible preferred stock owned. Following the merger of AmSurg and New Amethyst, Envision will merge with and into New Amethyst, with New Amethyst being the surviving corporation.

If the merger is completed, Envision stockholders will receive 0.334 shares of New Amethyst common stock for each share of Envision common stock owned (the Exchange Ratio). The Exchange Ratio is fixed and will not be adjusted to reflect stock price changes prior to the closing. Upon completion of the merger, former Envision stockholders will own approximately 53% of the then outstanding New Amethyst common stock (on a fully diluted basis), including preferred shares. The value of the merger consideration to be received will fluctuate with the market value of AmSurg common stock and Envision common stock until the merger is completed. The merger is currently expected to be completed in the fourth quarter of 2016 and is subject to customary closing conditions, including obtaining regulatory approval and approval from the common shareholders of both AmSurg and Envision. Upon completion of the merger, New Amethyst will change its name to “Envision Healthcare Corporation.”

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Revenue Recognition

6 Months Ended

Jun. 30, 2016

Revenue Recognition [Abstract]

Revenue Recognition

Revenue Recognition

Ambulatory Services

Ambulatory services revenues consist of billing for the use of the centers’ facilities directly to the patient or third-party payor and, at certain of the Company’s centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by the Company’s centers. Such revenues are recognized when the related surgical procedures are performed. Revenues exclude any amounts billed for physicians’ surgical services, which are billed separately by the physicians to the patient or third-party payor.

Revenues from ambulatory services are recognized on the date of service, net of estimated contractual adjustments from third-party medical service payors including Medicare and Medicaid. During each of the six months ended June 30, 2016 and 2015, the Company derived approximately 26% of its ambulatory services net revenues from governmental healthcare programs, primarily Medicare and managed Medicare programs. 

Physician Services

Physician services revenues primarily consist of fee for service revenue and contract revenue and are derived principally from the provision of physician services to patients of the healthcare facilities the Company serves. Contract revenue represents income earned from the Company's hospital customers to supplement payments from third-party payors.

The Company records revenue at the time services are provided, net of a contractual allowance and a provision for uncollectibles. Revenue less the contractual allowance represents the net revenue expected to be collected from third-party payors (including managed care, commercial and governmental payors such as Medicare and Medicaid) and patients insured by these payors. The Company also recognizes revenue for services provided during the period that have not been billed. Expected collections are estimated based on fees and negotiated payment rates in the case of third-party payors, the specific benefits provided for under each patient’s healthcare plan, mandated payment rates under the Medicare and Medicaid programs, and historical cash collections.

The Company's provision for uncollectibles includes its estimate of uncollectible balances due from uninsured patients, uncollectible co-pay and deductible balances due from insured patients and special charges, if any, for uncollectible balances due from managed care, commercial and governmental payors. The Company records net revenue from uninsured patients at its estimated realizable value, which includes a provision for uncollectible balances, based on historical cash collections (net of recoveries).

Net revenue for the physician services segment consists of the following major payors (dollars in thousands):

	Three Months Ended June 30,										Six Months Ended June 30,
	2016					2015					2016					2015
Medicare	$	61,775		14	%	$	45,967		14	%	$	120,549		14	%	$	87,296		14	%
Medicaid	30,698			7		19,298			6		61,523			7		37,878			6
Commercial and managed care	337,553			77		254,481			77		661,724			77		474,599			77
Self-pay	71,648			16		45,298			14		133,365			16		88,569			14
Net fee for service revenue	501,674			114		365,044			110		977,161			114		688,342			111
Contract and other revenue	38,411			9		31,698			10		74,076			9		62,687			10
Provision for uncollectibles	(101,333		)	(23	)	(65,783		)	(20	)	(194,941		)	(23	)	(133,535		)	(22	)
Net revenue for physician services	$	438,752		100	%	$	330,959		100	%	$	856,296		100	%	$	617,494		100	%

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Accounts Receivable

6 Months Ended

Jun. 30, 2016

Receivables [Abstract]

Accounts Receivable

Accounts Receivable

The Company manages accounts receivable by regularly reviewing its accounts and contracts and by providing appropriate allowances for contractual adjustments and uncollectible amounts. Some of the factors considered by management in determining the amount of such allowances are the historical trends of cash collections, contractual and bad debt write-offs, accounts receivable agings, established fee schedules, contracts with payors, changes in payor mix and procedure statistics. Actual collections of accounts receivable in subsequent periods may require changes in the estimated contractual allowance and provision for uncollectibles. The Company tests its analysis by comparing cash collections to net patient revenues and monitoring self-pay utilization. In addition, when actual collection percentages differ from expected results, on a contract by contract basis, supplemental detailed reviews of the outstanding accounts receivable balances may be performed by the Company’s billing operations to determine whether there are facts and circumstances existing that may cause a different conclusion as to the estimate of the collectability of that contract’s accounts receivable from the estimate resulting from using the historical collection experience. The Company also supplements its allowance for doubtful accounts analysis for its physician services segment quarterly using a hindsight calculation that utilizes write-off data for all payor classes during the previous twelve month period to estimate the allowance for doubtful accounts at a point in time. Changes in these estimates, if any, are charged or credited to the consolidated statements of operations in the period of change. Material changes in estimates may result from unforeseen write-offs of patient or third-party accounts receivable, unsuccessful disputes with managed care payors, adverse macro-economic conditions which limit patients’ ability to meet their financial obligations for the care provided by physicians, or broad changes to government regulations that adversely impact reimbursement rates for services provided by the Company. Significant changes in payor mix, business office operations, general economic conditions and health care coverage provided by federal or state governments or private insurers may have a significant impact on the Company’s estimates and significantly affect its results of operations and cash flows.

Due to the nature of the Company's operations, it is required to separate the presentation of its bad debt expense on the consolidated statements of earnings. The Company records the portion of its bad debts associated with its physician services segment as a component of net revenue in the accompanying consolidated statements of earnings, and the remaining portion, which is associated with its ambulatory services segment, is recorded as a component of other operating expenses in the accompanying consolidated statements of earnings. The bifurcation is a result of the Company's ability to assess the ultimate collection of the patient service revenue associated with its ambulatory services segment before services are provided. The Company's ambulatory services segment is generally able to verify a patient's insurance coverage and ability to pay before services are provided as those services are pre-scheduled and non-emergent. Bad debt expense for ambulatory services is included in other operating expenses and was $6.3 million and $12.1 million for the three and six months ended June 30, 2016, respectively, and $4.7 million and $11.0 million for the three and six months ended June 30, 2015, respectively. Bad debt expense related to physician services was $101.3 million and $194.9 million for the three and six months ended June 30, 2016, respectively, and $65.8 million and $133.5 million for the three and six months ended June 30, 2015, respectively.

At June 30, 2016 and December 31, 2015, allowances for doubtful accounts were $208.8 million and $167.4 million, respectively. The increase in the allowance for doubtful accounts is primarily a result of having a full quarter of operations for acquisitions completed during the fourth quarter of 2015. At June 30, 2016 and December 31, 2015, approximately 82% and 80%, respectively, of the Company’s allowance for doubtful accounts was related to fee for service patient receivables associated with the physician services segment. The principal exposure for uncollectible fee for service visits is from self-pay patients and, to a lesser extent, for co-payments and deductibles from patients with insurance. Concentration of credit risk is limited by the diversity and number of facilities, patients, payors, and by the geographic dispersion of the Company's operations.

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Acquisitions and Disposals

6 Months Ended

Jun. 30, 2016

Business Combinations [Abstract]

Acquisitions and Disposals

Acquisitions and Disposals

The Company accounts for its business combinations under the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any noncontrolling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method.

Ambulatory Services Activity

During each of the six months ended June 30, 2016 and 2015, the Company, through a wholly-owned subsidiary, acquired a controlling interest in four surgery centers. The aggregate amount paid for the centers and for settlement of purchase price payable obligations during the six months ended June 30, 2016 and 2015 was approximately $25.7 million and $95.4 million, respectively, and was paid in cash and funded by a combination of operating cash flow and borrowings under the Company's revolving credit agreement.

The total fair value of an acquisition includes an amount allocated to goodwill, which results from the centers’ favorable reputations in their markets, their market positions and their ability to deliver quality care with high patient satisfaction consistent with the Company’s business model.

During the six months ended June 30, 2016, the Company disposed of two surgery centers and recognized a net gain from the disposals of $3.3 million in the six months ended June 30, 2016. The Company did not dispose of any surgery centers during the six months ended June 30, 2015.

Physician Services Activity

The Company completed the acquisition of six physician practices in the six months ended June 30, 2016 and four physician practices in the six months ended June 30, 2015. The aggregate amount paid for the physician practices and for settlement of purchase price payable obligations during the six months ended June 30, 2016 and 2015 was approximately $255.4 million and $100.7 million, respectively, and was paid in cash and funded by a combination of operating cash flow and borrowings under the Company's revolving credit agreement. In addition to the cash paid, approximately $15.4 million of consideration for one physician practice was deferred and will be paid in the next two years, $9.7 million of which is reflected in other accrued liabilities and $5.7 million is reflected in other long-term liabilities in the accompanying consolidated balance sheets.

As a result of certain acquisitions completed during prior periods, the Company has agreed to pay as additional consideration amounts which are contingent on the acquired entities achieving future performance metrics. As of June 30, 2016 and December 31, 2015, the Company had accrued $1.0 million and $5.5 million, respectively, as a component of other accrued liabilities in the accompanying consolidated balance sheets, which represents management's estimate of the fair values of the contingent consideration. During the six months ended June 30, 2016, the Company made a cash payment of $1.9 million for one acquisition and recognized a decrease of $2.6 million associated with the change in fair value of its remaining accrued contingent consideration. As of June 30, 2016, the Company estimates it may have to pay approximately $1.0 million in future contingent payments for one acquisition made prior to December 31, 2015 based upon the current projected financial performance or anticipated achievement of other targets of the acquired operations. The current estimate of future contingent payments could increase or decrease depending upon the actual performance of the acquisition over each respective measurement period. The acquisitions completed during the six months ended June 30, 2016 did not contain provisions for contingent consideration.

The Company utilizes Level 3 inputs, which include unobservable data, to measure the fair value of the contingent consideration. The fair value was determined utilizing future forecasts of both earnings and other performance metrics which are expected to be achieved during the performance period, in accordance with each respective purchase agreement. In estimating the fair value, management developed various scenarios and weighted the probable outcome of each scenario using a range of expected probability specific to each agreement. Management utilized a market rate to discount the results of such analysis in order to record the present value of the expected future payout. The timing of the potential remaining payments of contingent consideration is expected to occur within one year.

Purchase Price Allocations

The acquisition date fair value of the total consideration transferred and acquisition date fair value of each major financial class for both the ambulatory services and physician services acquisitions completed in the six months ended June 30, 2016, including post acquisition date adjustments recorded to purchase price allocations, are as follows (in thousands):

	Six Months Ended June 30, 2016 (1)
Accounts receivable	$	16,809
Other current assets	1,397
Property and equipment	4,258
Goodwill	209,194
Intangible assets	115,902
Other long-term assets	67
Accounts payable	(450		)
Other accrued liabilities	(20,331		)
Deferred income taxes	(20,706		)
Other long-term liabilities	(5,700		)
Long-term debt	(128		)
Total fair value	300,312
Less: Fair value attributable to noncontrolling interests	19,199
Acquisition date fair value of total consideration transferred	$	281,113

(1) Represents the preliminary allocation of fair value of acquired assets and liabilities associated with these acquisitions at June 30, 2016.

During 2016, no significant changes were made to the purchase price allocation of assets and liabilities, existing at the date of acquisition, related to individual acquisitions completed in 2015.

The total fair value of acquisitions completed by the Company include amounts allocated to goodwill, which result from the acquisitions' favorable reputations in their markets, their market positions and their ability to deliver quality care with high patient satisfaction consistent with the Company’s business model. Fair value attributable to noncontrolling interests is based on significant inputs that are not observable in the market. Key inputs used to determine the fair value include financial multiples used in the purchase of noncontrolling interests primarily from acquisitions of centers. Such multiples, based on earnings, are used as a benchmark for the discount to be applied for the lack of control or marketability. The fair value of noncontrolling interests for acquisitions where the purchase price allocation is not finalized may be subject to adjustment as the Company completes its initial accounting for acquired intangible assets. Additionally, the Company continues to obtain information relative to the fair values of assets acquired, liabilities assumed and any noncontrolling interests associated with acquisitions completed in the last 12 months. Acquired assets and assumed liabilities include, but are not limited to, fixed assets, licenses, intangible assets and professional liabilities. The valuations are based on appraisal reports, discounted cash flow analyses, actuarial analyses or other appropriate valuation techniques to determine the fair value of the assets acquired or liabilities assumed. A majority of the deferred income taxes recognized as a component of the Company's purchase price allocation is a result of the difference between the book and tax basis of the amortizable intangible assets recognized. The amount allocated to the deferred income tax liability is subject to change as a result of the final allocation of purchase price to amortizable intangibles. The Company expects to finalize the purchase price allocation for its most recent acquisitions as soon as practical.

During the three and six months ended June 30, 2016, the Company incurred approximately $5.1 million and $6.5 million of transaction costs, respectively, and during the three and six months ended June 30, 2015, the Company incurred approximately $2.0 million and $3.5 million, respectively. The costs incurred during the three months ended June 30, 2016 were primarily associated with the definitive merger agreement with Envision Healthcare Holdings, Inc. signed on June 15, 2016. See Note 2 for additional information.

Net revenue and net earnings included in the six months ended June 30, 2016 and 2015 associated with completed acquisitions are as follows (in thousands):

	Six Months Ended June 30,
	2016		2015
Net revenue	$	12,714	$	48,042
Net earnings	$	2,198	$	9,101
Less:  Net earnings attributable to noncontrolling interests	563		2,353
Net earnings attributable to AmSurg Corp. common shareholders	$	1,635	$	6,748

The unaudited consolidated pro forma results for the six months ended June 30, 2016 and 2015, assuming all 2016 acquisitions had been consummated on January 1, 2015, and all 2015 acquisitions had been consummated on January 1, 2014 are as follows (in thousands, except earnings per share):

	Six Months Ended June 30,
	2016		2015
Net revenue	$	1,558,347	$	1,488,632
Net earnings	198,383		221,765
Amounts attributable to AmSurg Corp. common shareholders:
Net earnings	82,806		68,374
Net earnings per common share:
Basic	$	1.53	$	1.44
Diluted	$	1.52	$	1.42

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Investments in Unconsolidated Affiliates

6 Months Ended

Jun. 30, 2016

Equity Method Investments and Joint Ventures [Abstract]

Investments in Unconsolidated Affiliates

Investments in Unconsolidated Affiliates

Investments in unconsolidated affiliates in which the Company exerts significant influence but does not control or otherwise consolidate are accounted for using the equity method. Equity method investments are initially recorded at cost, unless such investments are a result of the Company entering into a transaction whereby the Company loses control of a previously controlled entity but retains a noncontrolling interest. Such transactions, which result in the deconsolidation of a previously consolidated entity, are measured at fair value. The fair value measurement utilizes Level 3 inputs, which include unobservable data, to measure the fair value of the retained noncontrolling interest. The fair value determination is generally based on a combination of multiple valuation methods, which can include discounted cash flow, income approach, or market value approach which incorporates estimates of future earnings and market valuation multiples for certain guideline companies. These investments are included as investments in unconsolidated affiliates in the accompanying consolidated balance sheets. The Company’s share of the profits and losses from these investments is reported in equity in earnings of unconsolidated affiliates in the accompanying consolidated statements of earnings. The Company monitors its investments for other-than-temporary impairment by considering factors such as current economic and market conditions and the operating performance of the companies and records reductions in carrying values when necessary.

As of June 30, 2016 and December 31, 2015, the Company recorded in the accompanying consolidated balance sheets its investments in unconsolidated affiliates of $179.1 million and $169.2 million, respectively. The Company's net earnings from these investments during the three months ended June 30, 2016 and 2015 were approximately $7.4 million and $4.0 million, respectively, and during the six months ended June 30, 2016 and 2015 were approximately $13.9 million and $6.6 million, respectively.

During the six months ended June 30, 2016, the Company's ambulatory services segment sold a portion of its interest in one surgery center, which resulted in the surgery center being deconsolidated and subsequently accounted for as an equity method investment. During the six months ended June 30, 2015, the Company's ambulatory services segment entered into one equity method investment. As a result of this investment, the Company contributed its controlling interest in a center and a noncontrolling interest in an entity that owned one ASC prior to the transaction and, after the completion of the transaction, controls the contributed center and the center it previously owned.

During the six months ended June 30, 2015, the Company's physician services segment contributed one site of service into an entity jointly owned by the Company and a health system.Therewas no deconsolidation activity for the physician services segment during the six months ended June 30, 2016.

As a result of these transactions, the Company recorded in the accompanying consolidated balance sheets, as a component of investments in unconsolidated affiliates, the fair value of the Company's investment in these entities of approximately $1.8 million and $2.3 million during the six months ended June 30, 2016 and 2015, respectively. In each of these transactions, the gain or loss on deconsolidation was determined based on the difference between the fair value of the Company’s interest, which was based on estimates of the expected future earnings, in the new entity and the carrying value of both the tangible and intangible assets of the contributed centers immediately prior to each transaction. During the three and six months ended June 30, 2016, the Company recognized a net loss on deconsolidation related to this center in the accompanying consolidated statements of earnings of approximately $0.7 million, respectively. During the three and six months ended June 30, 2015, the Company recognized a net loss on deconsolidation in the accompanying consolidated statements of earnings of approximately $3.0 million and $3.3 million, respectively.

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Prepaid and Other Current Assets

6 Months Ended

Jun. 30, 2016

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Prepaid and Other Current Assets

Prepaid and Other Current Assets

The following table presents a summary of items comprising prepaid and other current assets in the accompanying consolidated balance sheets as of June 30, 2016 and December 31, 2015 (in thousands):

	June 30,		December 31,
	2016		2015
Income taxes receivable	$	16,241	$	7,908
Prepaid expenses	22,104		18,900
Deferred compensation plan assets	23,530		16,623
Other	12,690		32,340
Total prepaid and other current assets	$	74,565	$	75,771

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Goodwill And Intangible Assets

6 Months Ended

Jun. 30, 2016

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill And Intangible Assets

Goodwill and Intangible Assets

The changes in the carrying amount of goodwill for the six months ended June 30, 2016 are as follows (in thousands):

Balance at December 31, 2015	$	3,970,210
Goodwill acquired, including post acquisition adjustments	207,333
Goodwill disposed, including impact of deconsolidation transactions	(2,535		)
Balance at June 30, 2016	$	4,175,008

As of June 30, 2016, the ambulatory services segment and the physician services segment each had approximately $2.1 billion of goodwill. During the six months ended June 30, 2016, goodwill increased $38.4 million for the ambulatory services segment primarily due to the acquisition of four centers, net of one deconsolidation. During the six months ended June 30, 2016, goodwill increased by $166.4 million for the physician services segment, primarily due to the acquisition of six physician practices and post-acquisition adjustments associated with acquisitions completed during 2015. For the six months ended June 30, 2016 and 2015, respectively, approximately $100.9 million and $107.6 million of goodwill recorded was deductible for tax purposes.

Intangible assets at June 30, 2016 and December 31, 2015 consisted of the following (in thousands):

	June 30, 2016							December 31, 2015
	Gross							Gross
	Carrying		Accumulated					Carrying		Accumulated
	Amount		Amortization			Net		Amount		Amortization			Net
Amortizable intangible assets:
Customer relationships with hospitals	$	1,494,790	$	(109,444	)	$	1,385,346	$	1,379,977	$	(74,490	)	$	1,305,487
Capitalized software	81,595		(33,500		)	48,095		71,462		(28,125		)	43,337
Agreements, contracts and other	12,358		(3,519		)	8,839		11,267		(2,449		)	8,818
Total amortizable intangible assets	1,588,743		(146,463		)	1,442,280		1,462,706		(105,064		)	1,357,642
Non-amortizable intangible assets:
Trade name	228,000		—			228,000		228,000		—			228,000
Restrictive covenant arrangements	8,995		—			8,995		8,995		—			8,995
Total non-amortizable intangible assets	236,995		—			236,995		236,995		—			236,995
Total intangible assets	$	1,825,738	$	(146,463	)	$	1,679,275	$	1,699,701	$	(105,064	)	$	1,594,637

Amortization of intangible assets for the three months ended June 30, 2016 and 2015 was $21.1 million and $14.7 million, respectively, and $41.5 million and $29.2 million for the six months ended June 30, 2016 and 2015, respectively. Estimated amortization of intangible assets for the remainder of 2016 and each of the following five years and thereafter is $44.9 million, $88.6 million, $87.4 million, $84.7 million, $82.4 million, $78.0 million and $976.3 million, respectively. The Company expects to recognize amortization of all intangible assets over a weighted average period of 17.9 years with no expected residual values.

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Other Accrued Liabilities

6 Months Ended

Jun. 30, 2016

Accrued Liabilities, Current [Abstract]

Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Current [Text Block]

Other Accrued Liabilities

The following table presents a summary of items comprising other accrued liabilities in the accompanying consolidated balance sheets as of June 30, 2016 and December 31, 2015 (in thousands):

	June 30,		December 31,
	2016		2015
Accrued professional liabilities	$	14,541	$	14,362
Contingent purchase price payable	1,000		5,509
Current income taxes payable	—		7,892
Refunds payable	29,626		48,415
Other	47,404		43,059
Total other accrued liabilities	$	92,571	$	119,237

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Accrued Professional Liabilities

6 Months Ended

Jun. 30, 2016

Payables and Accruals [Abstract]

Accounts Professional Liabilities

Accrued Professional Liabilities

The Company maintains professional liability insurance policies with third-party insurers generally on a claims-made basis, subject to self-insured retention, exclusions and other restrictions. A substantial portion of the professional liability loss risks are being provided by a third-party insurer, which is fully reinsured by the Company's wholly-owned captive insurance subsidiary. The Company records an estimate of liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss patterns, which are not discounted.

At June 30, 2016 and December 31, 2015, the Company's accrued professional liabilities are presented in the accompanying consolidated balance sheets as a component of other accrued liabilities and other long-term liabilities as follows (in thousands):

	June 30, 2016		December 31, 2015
Estimated losses under self-insured programs	$	32,652	$	30,748
Incurred but not reported losses	35,955		36,166
Total accrued professional liabilities	68,607		66,914
Less estimated losses payable within one year	14,541		14,362
Total	$	54,066	$	52,552

The changes to the Company's estimated losses under self-insured programs as of June 30, 2016 were as follows (in thousands):

Balance at December 31, 2015	$	66,914
Assumed liabilities through acquisitions	1,862
Provision related to current period reserves	10,037
Payments for current period reserves	(39		)
Benefit related to changes in prior period reserves	(249		)
Payments for prior period reserves	(6,307		)
Other, net including post-acquisition adjustments	(3,611		)
Balance at June 30, 2016	$	68,607

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Long-Term Debt

6 Months Ended

Jun. 30, 2016

Debt Disclosure [Abstract]

Long-Term Debt

Long-term Debt

Long-term debt at June 30, 2016 and December 31, 2015 consisted of the following (in thousands):

	June 30,		December 31,
	2016		2015
Revolving credit agreement	$	400,000	$	175,000
Term loan	852,600		856,950
5.625% Senior Unsecured Notes due 2020	250,000		250,000
5.625% Senior Unsecured Notes due 2022	1,100,000		1,100,000
Other debt due through 2025	23,920		24,944
Capitalized lease arrangements due through 2026	18,202		18,613
	2,644,722		2,425,507
Less current portion	20,772		20,377
Less net deferred financing costs	42,907		47,174
Long-term debt	$	2,581,043	$	2,357,956

The fair value of fixed rate long-term debt, with a carrying value of $1,391.1 million, was $1,438.2 million at June 30, 2016. The fair value of variable rate long-term debt approximates its carrying value of $1,253.6 million at June 30, 2016. With the exception of the Company’s 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes (each defined below), the fair value of fixed rate debt (Level 2) is determined based on an estimation of discounted future cash flows of the debt at rates currently quoted or offered to the Company for similar debt instruments of comparable maturities by its lenders. The fair value of the Company’s 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes (Level 1) is determined based on quoted prices in an active market.

a. Term Loan and Credit Facility

The Company has a credit facility that is comprised of an $870.0 million term loan and a $500.0 million revolving credit facility. On October 21, 2015, the Company exercised the accordion feature of its revolving credit facility and increased the Company's borrowing capacity by $200.0 million to $500.0 million. As of June 30, 2016, the Company had available $100.0 million under the revolving credit facility.

The term loan matures on July 16, 2021 and bears interest at a rate equal to, at the Company’s option, the alternative base rate as defined in the agreement (ABR) plus 1.75% to 2.00% or LIBOR plus 2.75% to 3.00%, with a LIBOR floor of 0.75%, or a combination thereof (3.50% on June 30, 2016). The term loan requires quarterly principal payments of 0.25% of the face amount totaling $8.7 million annually.

The revolving credit facility matures on July 16, 2019 and permits the Company to borrow up to $500.0 million at an interest rate equal to, at the Company’s option, the ABR plus 1.75% to 2.00% or LIBOR plus 2.75% to 3.00%, or a combination thereof, and provides for a fee of 0.375% of unused commitments. The Company has the option to increase borrowings under the senior secured credit facility by an unlimited amount as long as certain financial covenants are met and lender approval is obtained. The senior credit facility contains certain covenants relating to the ratio of debt to operating performance measurements and interest coverage ratios and is secured by a pledge of the stock of the Company’s wholly-owned subsidiaries and certain of the Company’s less than wholly-owned subsidiaries. As of June 30, 2016, the Company was in compliance with the covenants contained in the term loan and credit facility.

b. Senior Unsecured Notes

2020 Senior Unsecured Notes

The Company has $250.0 million aggregate principal amount of 5.625% senior unsecured notes due 2020 (the 2020 Senior Unsecured Notes). The 2020 Senior Unsecured Notes are unsecured obligations of the Company and are guaranteed by its existing and subsequently acquired or organized wholly-owned domestic subsidiaries. The 2020 Senior Unsecured Notes are pari passu in right of payment with all the existing and future senior debt of the Company and senior to all existing and future subordinated debt of the Company. Interest on the 2020 Senior Unsecured Notes accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on May 30 and November 30, through the maturity date of November 30, 2020.

The Company may redeem the 2020 Senior Unsecured Notes in whole or in part. The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve month period beginning on November 30 of the years indicated below:  

Period	Redemption Price
2015	104.219	%
2016	102.813	%
2017	101.406	%
2018 and thereafter	100.000	%

The 2020 Senior Unsecured Notes contain certain covenants which, among other things, limit, but may not restrict the Company’s ability to enter into or guarantee additional borrowings, sell preferred stock, pay dividends and repurchase stock. Based on the terms of the 2020 Senior Unsecured Notes, the Company has adequate ability to meet its obligations to pay dividends as required under the terms of its mandatory convertible preferred stock. The Company was in compliance with the covenants contained in the indenture relating to the 2020 Senior Unsecured Notes at June 30, 2016.

2022 Senior Unsecured Notes

The Company has $1.1 billion aggregate principal amount of 5.625% senior unsecured notes due 2022 (the 2022 Senior Unsecured Notes). The 2022 Senior Unsecured Notes are unsecured obligations of the Company and are guaranteed by the Company and existing and subsequently acquired or organized wholly-owned domestic subsidiaries. The 2022 Senior Unsecured Notes are pari passu in right of payment with all the existing and future senior debt of the Company and senior to all existing and future subordinated debt of the Company. Interest on the 2022 Senior Unsecured Notes accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on January 15 and July 15, through the maturity date of July 15, 2022.

Prior to July 15, 2017, the Company may redeem up to 35% of the aggregate principal amount of the 2022 Senior Unsecured Notes at a redemption price of 105.625% of the principal amount thereof, plus accrued and unpaid interest and liquidated damages, if any, using proceeds of one or more equity offerings. On or after July 15, 2017, the Company may redeem the 2022 Senior Unsecured Notes in whole or in part. The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve month period beginning on July 15 of the years indicated below:

Period	Redemption Price
2017	104.219	%
2018	102.813	%
2019	101.406	%
2020 and thereafter	100.000	%

The 2022 Senior Unsecured Notes contain certain covenants which, among other things, limit, but may not restrict the Company’s ability to enter into or guarantee additional borrowings, sell preferred stock, pay dividends and repurchase stock. Based on the terms of the 2022 Senior Unsecured Notes, the Company has adequate ability to meet its obligations to pay dividends as required under the terms of its mandatory preferred stock. The Company was in compliance with the covenants contained in the indenture relating to the 2022 Senior Unsecured Notes at June 30, 2016.

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Other Long-Term Liabilities

6 Months Ended

Jun. 30, 2016

Other Long-Term Liabilities [Abstract]

Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Noncurrent [Text Block]

Other Long-Term Liabilities

Other long-term liabilities consist of the following (in thousands):

	June 30,		December 31,
	2016		2015
Accrued professional liabilities	$	54,066	$	52,552
Deferred rent	27,330		18,958
Tax-effected unrecognized benefits	3,426		3,426
Other	34,656		21,247
Other long-term liabilities	$	119,478	$	96,183

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Shareholders' Equity

6 Months Ended

Jun. 30, 2016

Equity [Abstract]

Shareholders' Equity

Shareholders’ Equity

a. Common Stock

During December 2015, the Company issued 5,835,000 shares of its common stock in a public offering, at $80.00 per share, prior to underwriting discounts, commissions, and other related offering expenses of approximately $19.1 million. Proceeds were used to repay a portion of the Company's revolving credit facility, to fund a portion of the acquisitions completed during the three months ended December 31, 2015 and for general corporate purposes.

In addition, the Company repurchases shares by withholding a portion of employee restricted stock that vests to cover payroll withholding taxes in accordance with the restricted stock agreements. During the six months ended June 30, 2016 and 2015, the Company repurchased 77,780 shares and 67,000 shares, respectively, of common stock for approximately $5.7 million and $3.7 million, respectively.

b. Preferred Stock

The Company has 1,725,000 shares outstanding of its mandatory convertible preferred stock. The mandatory convertible preferred stock pays dividends at an annual rate of 5.25% of the initial liquidation preference of $100 per share. Dividends accrue and cumulate and, to the extent lawful and declared by the Company's Board of Directors, will be paid on each January 1, April 1, July 1 and October 1 in cash or, at the Company's election (subject to certain limitations), by delivery of any combination of cash and shares of common stock. Each share of the mandatory convertible preferred stock has a liquidation preference of $100, plus an amount equal to accrued and unpaid dividends. Each share of the mandatory convertible preferred stock will automatically convert on July 1, 2017 (subject to postponement in certain cases), into between 1.8141 and 2.2222 shares of common stock (the “minimum conversion rate” and “maximum conversion rate,” respectively), each subject to adjustment. The number of shares of common stock issuable on conversion will be determined based on the average volume weighted average price per share of the Company's common stock over the 20 consecutive trading day period commencing on and including the 22nd scheduled trading day prior to July 1, 2017. At any time prior to July 1, 2017, holders may elect to convert all or a portion of their shares of mandatory convertible preferred stock into shares of common stock at the minimum conversion rate. If any holder elects to convert shares of mandatory convertible preferred stock during a specified period beginning on the effective date of a fundamental change the conversion rate will be adjusted under certain circumstances and such holder will also be entitled to a fundamental change dividend make-whole amount.

During each of the six months ended June 30, 2016 and 2015, the Company's Board of Directors declared two dividends each of $1.3125 per share in cash, or $2.3 million, for the Company’s mandatory convertible preferred stock. As ofJune 30, 2016, the dividend declared in May 2016 was funded to the paying agent to be paid to shareholders of record as of June 15, 2016.

c. Stock Incentive Plans

In May 2014, the Company adopted the AmSurg Corp. 2014 Equity and Incentive Plan (the “2014 Plan”), which was amended in May 2016. The amendment increased the number of shares that may be awarded under the 2014 Plan from 1,200,000 to 3,200,000. The Company also has unvested restricted stock and fully vested options outstanding under the AmSurg Corp. 2006 Stock Incentive Plan, as amended, under which no additional awards may be granted. Under these plans, the Company has granted restricted stock and non-qualified options to purchase shares of common stock to employees and outside directors from its authorized but unissued common stock. At June 30, 2016, 3,200,000 shares were authorized for grant under the 2014 Plan and 2,396,435 shares were available for future equity grants. Restricted stock granted to outside directors vests on the first anniversary of the date of grant. Restricted stock granted to employees generally vests over four years in three equal installments beginning on the second anniversary of the date of grant. The fair value of restricted stock is determined based on the closing bid price of the Company’s common stock on the grant date. Under Company policy, shares held by outside directors and senior management are subject to certain holding requirements and restrictions.

The Company has not issued options subsequent to 2008, and all outstanding options are fully vested. Options were granted at market value on the date of the grant and vested over four years. Outstanding options have a term of ten years from the date of grant.

Other information pertaining to share-based activity during the three and six months ended June 30, 2016 and 2015 was as follows (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2016		2015		2016		2015
Share-based compensation expense	$	7,900	$	3,883	$	15,068	$	7,592
Fair value of shares vested	1,282		1,746		18,243		13,220
Cash received from option exercises	174		334		450		2,080
Tax benefit from exercises of share based awards	129		216		3,734		3,533

As of June 30, 2016, the Company had total unrecognized compensation cost of approximately $45.6 million related to non-vested awards, which the Company expects to recognize through 2020 and over a weighted average period of 1.2 years. For the three and six months ended June 30, 2016 and 2015, there were no options that were anti-dilutive.

A summary of the status of non-vested restricted shares at June 30, 2016 and changes during the six months ended June 30, 2016 is as follows:

			Weighted
	Number		Average
	of Shares		Grant Price
Non-vested shares at December 31, 2015	734,101		$	44.73
Shares granted	586,791		74.00
Shares vested	(249,421	)	38.61
Shares forfeited	(5,407	)	55.40
Non-vested shares at June 30, 2016	1,066,064		$	62.22

In addition to the non-vested restricted shares, during the six months ended June 30, 2016, the Company granted 74,752 performance-based restricted stock units (RSUs) to certain of its officers and physician employees. The weighted average fair value of the Company's common stock on the grant date of these RSUs was $74.09. Subject to achieving applicable performance thresholds, the RSUs will vest ratably over a three year period from the grant date. The conversion of the RSUs to restricted stock is contingent on the Company’s achievement of a specified one-year financial performance goal for the year ended December 31, 2016 and, if achieved, would occur during the first quarter of 2017. If the financial performance goal is not achieved, the RSUs will be forfeited. The number of RSUs that will ultimately be received by the holders range from 0% to 150% of the units granted, depending on the Company’s level of achievement with respect to the financial performance goal. At June 30, 2016, the Company believes the RSUs will vest at approximately 150%.

A summary of stock option activity for the six months ended June 30, 2016 is summarized as follows:

					Weighted
			Weighted		Average
			Average		Remaining
	Number		Exercise		Contractual
	of Shares		Price		Term (in years)
Outstanding at December 31, 2015	33,751		$	22.98	1.1
Options exercised with total intrinsic value of $1.0 million	(19,718	)	22.84
Options terminated	(4,200	)	21.07
Outstanding, Vested and Exercisable at June 30, 2016 with an aggregate intrinsic value of $0.5 million	9,833		$	24.09	0.5

The aggregate intrinsic value represents the total pre-tax intrinsic value received by the option holders on the exercise date or that would have been received by the option holders had all holders of in-the-money outstanding options at June 30, 2016 exercised their options at the Company’s closing stock price on June 30, 2016.

d. Earnings per Share

Basic net earnings attributable to AmSurg Corp. common stockholders, per common share, excludes dilution and is computed by dividing net earnings attributable to AmSurg Corp. common stockholders by the weighted-average number of common shares outstanding during the period. Diluted net earnings attributable to AmSurg common stockholders, per common share is computed by dividing net earnings attributable to AmSurg Corp. common stockholders by the weighted-average number of common shares outstanding during the period plus any potential dilutive common share equivalents, including shares issuable (1) upon the vesting of restricted stock awards as determined under the treasury stock method and (2) upon conversion of the Company's mandatory convertible preferred stock as determined under the if-converted method. For purposes of calculating diluted earnings per share, preferred stock dividends have been subtracted from both net earnings from continuing operations attributable to AmSurg Corp. and net earnings attributable to AmSurg Corp. common shareholders in periods in which utilizing the if-converted method would be anti-dilutive. For the three and six months ended June 30, 2015, approximately 3.1 million common share equivalents related to the mandatory convertible preferred stock were anti-dilutive and therefore are excluded from the dilutive weighted average number of shares outstanding.

The following is a reconciliation of the numerator and denominators of basic and diluted earnings per share (in thousands, except per share amounts):

	Three Months Ended June 30,					Six Months Ended June 30,
	Earnings		Shares	Per Share		Earnings		Shares	Per Share
	(Numerator)		(Denominator)	Amount		(Numerator)		(Denominator)	Amount
2016:
Net earnings attributable to AmSurg Corp. common shareholders (basic)	$	43,805	53,739	$	0.82	$	72,404	53,702	$	1.35
Preferred stock dividends	2,264		—			4,528		—
Effect of dilutive securities, options and non-vested shares	—		3,588			—		3,527
Net earnings attributable to AmSurg Corp. common shareholders (diluted)	$	46,069	57,327	$	0.80	$	76,932	57,229	$	1.34
2015:
Net earnings attributable to AmSurg Corp. common shareholders (basic)	$	31,411	47,678	$	0.66	$	50,185	47,625	$	1.05
Effect of dilutive securities, options and non-vested shares	—		421			—		377
Net earnings attributable to AmSurg Corp. common shareholders (diluted)	$	31,411	48,099	$	0.65	$	50,185	48,002	$	1.05

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Income Taxes

6 Months Ended

Jun. 30, 2016

Income Tax Disclosure [Abstract]

Income Taxes

Income Taxes

The Company files a consolidated federal income tax return. Income taxes are accounted for under the asset and liability method.  Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date.

The Company applies recognition thresholds and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return as it relates to accounting for uncertainty in income taxes. In addition, it is the Company’s policy to recognize interest accrued and penalties, if any, related to unrecognized benefits as income tax expense in its consolidated statements of earnings. The Company does not expect significant changes to its tax positions or liability for tax uncertainties during the next 12 months.

The Company and its subsidiaries file U.S. federal and various state tax returns. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2012.

During the six months ended June 30, 2016 and 2015 the Company had net income tax payments of $45.7 million and $7.8 million, respectively. The increase in net payments made is primarily due to lower taxes paid in the six months ended June 30, 2015 due to the tax benefit resulting from significant transaction costs incurred in association with the Sheridan acquisition completed during 2014.

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Commitments And Contingencies

6 Months Ended

Jun. 30, 2016

Commitments and Contingencies Disclosure [Abstract]

Commitments And Contingencies

Commitments and Contingencies

Litigation

From time to time the Company is named as a party to legal claims and proceedings in the ordinary course of business. The Company's management is not aware of any claims or proceedings that are expected to have a material adverse impact on the Company's consolidated financial condition, results of operations or cash flows.

Insurance Programs

Given the nature of the services provided, the Company and its subsidiaries are subject to professional and general liability claims and related lawsuits in the ordinary course of business. The Company maintains professional insurance with third-party insurers generally on a claims-made basis, subject to self-insured retentions, exclusions and other restrictions. A substantial portion of the professional liability loss risks are being provided by a third-party insurer, which is fully reinsured by the Company's wholly-owned captive insurance subsidiary. In addition, the captive provides stop loss coverage for the Company’s self-insured employee health program. The assets, liabilities and results of operations of the wholly-owned captive are consolidated in the accompanying consolidated financial statements. The liabilities for self-insurance in the accompanying consolidated balance sheets include estimates of the ultimate costs related to both reported claims on an individual and aggregate basis and unreported claims. The Company also obtains professional liability insurance on a claims-made basis from third-party insurers for its surgery centers and certain of its owned practices and employed physicians.

The Company’s reserves for professional liability claims within the self-insured retention are based upon periodic actuarial calculations. These actuarial estimates consider historical claims frequency and severity, loss development patterns and other actuarial assumptions and are not discounted to present value.

The Company also maintains insurance for director and officer liability, workers’ compensation liability and property damage. Certain policies are subject to deductibles. In addition to the insurance coverage provided, the Company indemnifies its officers and directors for actions taken on behalf of the Company and its subsidiaries. 

Redeemable Noncontrolling Interests

Certain of the Company’s wholly-owned subsidiaries are responsible for all debts incurred but unpaid by the Company's less than wholly-owned partnerships as these subsidiaries are the general partner. As manager of the operations of these partnerships, the Company has the ability to limit potential liabilities by curtailing operations or taking other operating actions. In the event of a change in current law that would prohibit the physicians’ current form of ownership in the partnerships, the Company would be obligated to purchase the physicians’ interests in a substantial majority of the Company’s partnerships. The purchase price to be paid in such event would be determined by a predefined formula, as specified in the partnership agreements. The Company believes the likelihood of a change in current law that would trigger such purchases was remote as of June 30, 2016. As a result, the noncontrolling interests that are subject to this redemption feature are not included as part of the Company’s equity and are classified as noncontrolling interests – redeemable on the Company’s consolidated balance sheets.

Physician Services Operating Lease

On January 16, 2015, the Company entered into an agreement to lease approximately 222,000 square feet of office space in Plantation, Florida, which will be utilized by its physician services segment. The Company took possession of the space in the fourth quarter of 2015 and began tenant improvements on approximately 167,000 square feet of space, which it intends to begin to occupy during the third quarter of 2016. In addition, the Company plans to begin tenant improvements on an additional 55,000 square feet of space during the third quarter of 2016, which it intends to occupy during the first quarter of 2017. Annual rent expense is expected to be approximately $2.9 million. The initial term of this lease agreement expires in February 2029.

Merger with Envision Healthcare Holdings, Inc.

On June 15, 2016, the Company signed a definitive merger agreement with Envision as previously mentioned in Note 2. If the Company were to terminate the merger agreement, under certain circumstances, it would be required to pay Envision a termination fee of $180.0 million and would be obligated to provide reimbursement for up to $15.0 million of expenses.

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Segment Reporting

6 Months Ended

Jun. 30, 2016

Segment Reporting [Abstract]

Segment Reporting

Segment Reporting

The Company operates in two major lines of business - ambulatory surgery centers and outsourced physician services, which have been identified as its operating and reportable segments. Through the ambulatory services segment, the Company acquires, develops and operates ambulatory surgery centers in partnership with physicians. Through the physician services segment, the Company provides outsourced physician services in multiple specialties to hospitals, ambulatory surgery centers and other healthcare facilities, primarily in the areas of anesthesiology, radiology, children’s services, and emergency medicine.

The Company’s financial information by operating segment is prepared on an internal management reporting basis and includes allocations of corporate overhead to each segment. This financial information is used by the chief operating decision maker to allocate resources and assess the performance of the operating segments. The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker which is its Chief Executive Officer.

The following table presents financial information for each reportable segment (in thousands):

	Three Months Ended June 30,						Six Months Ended June 30,
	2016			2015			2016			2015
Net Revenue:
Ambulatory Services	$	319,747		$	310,991		$	626,881		$	594,901
Physician Services	438,752			330,959			856,296			617,494
Total	$	758,499		$	641,950		$	1,483,177		$	1,212,395
Adjusted EBITDA:
Ambulatory Services	$	61,746		$	60,304		$	115,372		$	107,612
Physician Services	87,497			67,668			153,971			114,115
Total	$	149,243		$	127,972		$	269,343		$	221,727
Adjusted EBITDA:	$	149,243		$	127,972		$	269,343		$	221,727
Net earnings attributable to noncontrolling interests	57,050			57,072			110,891			104,789
Interest expense, net	(31,913		)	(30,182		)	(62,723		)	(60,429		)
Depreciation and amortization	(30,054		)	(23,612		)	(59,126		)	(46,430		)
Share-based compensation	(7,900		)	(3,883		)	(15,068		)	(7,592		)
Net change in fair value of contingent consideration	2,598			(6,410		)	2,598			(6,410		)
Transaction costs	(5,135		)	(1,982		)	(6,525		)	(3,453		)
Net gain (loss) on disposals and deconsolidations	2,595			(3,035		)	2,595			(3,258		)
Earnings before income taxes	$	136,484		$	115,940		$	241,985		$	198,944
Acquisition and Capital Expenditures:
Ambulatory Services	$	35,031		$	64,514		$	43,401		$	118,610
Physician Services	265,019			22,822			275,330			110,087
Total	$	300,050		$	87,336		$	318,731		$	228,697

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Financial Information for the Company and Its Subsidiaries

6 Months Ended

Jun. 30, 2016

Condensed Financial Information of Parent Company Only Disclosure [Abstract]

Financial Information for the Company and Its Subsidiaries

Financial Information for the Company and Its Subsidiaries

The 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes are senior unsecured obligations of the Company and are guaranteed by its existing and subsequently acquired or organized 100% owned domestic subsidiaries. The 2020 Senior Unsecured Notes and 2022 Senior Unsecured Notes are guaranteed on a full and unconditional and joint and several basis, with limited exceptions considered customary for such guarantees, including the release of the guarantee when a subsidiary's assets are sold. The following condensed consolidating financial statements present the Company (as parent issuer), the subsidiary guarantors, the subsidiary non-guarantors and consolidating adjustments. These condensed consolidating financial statements have been prepared and presented in accordance with Rule 3-10 of Regulation S-X “Financial Statements of Guarantors and Issuers of Guaranteed Securities Registered or Being Registered.” The operating and investing activities of the separate legal entities are fully interdependent and integrated. Accordingly, the results of the separate legal entities are not representative of what the operating results would be on a stand-alone basis.

Condensed Consolidating Balance Sheet - June 30, 2016 (In thousands)
	Parent Issuer		Guarantor Subsidiaries		Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Assets
Current assets:
Cash and cash equivalents	$	4,591	$	16,215	$	53,299	$	—		$	74,105
Restricted cash and marketable securities	—		—		12,794		—			12,794
Accounts receivable, net	—		258,863		116,489		—			375,352
Supplies inventory	—		—		21,980		—			21,980
Prepaid and other current assets	45,542		24,074		26,261		(21,312		)	74,565
Total current assets	50,133		299,152		230,823		(21,312		)	558,796
Property and equipment, net	11,877		27,822		165,223		—			204,922
Investments in and receivables from unconsolidated affiliates	5,219,975		1,807,424		—		(6,848,343		)	179,056
Goodwill	—		2,123,067		—		2,051,941			4,175,008
Intangible assets, net	13,037		1,664,313		1,925		—			1,679,275
Other assets	7,186		20,825		20,251		(1,999		)	46,263
Total assets	$	5,302,208	$	5,942,603	$	418,222	$	(4,819,713	)	$	6,843,320
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	8,700	$	20	$	12,052	$	—		$	20,772
Accounts payable	3,073		1,640		29,569		(3,561		)	30,721
Accrued salaries and benefits	29,533		140,149		17,226		—			186,908
Accrued interest	30,386		—		14		—			30,400
Other accrued liabilities	5,171		69,166		35,985		(17,751		)	92,571
Total current liabilities	76,863		210,975		94,846		(21,312		)	361,372
Long-term debt	2,550,996		36		56,065		(26,054		)	2,581,043
Deferred income taxes	288,503		456,942		—		(1,998		)	743,447
Other long-term liabilities	8,568		76,144		34,766		—			119,478
Intercompany payable	—		1,228,157		—		(1,228,157		)	—
Noncontrolling interests – redeemable	—		—		60,886		116,959			177,845
Equity:
Total AmSurg Corp. equity	2,377,278		3,967,431		125,450		(4,092,881		)	2,377,278
Noncontrolling interests – non-redeemable	—		2,918		46,209		433,730			482,857
Total equity	2,377,278		3,970,349		171,659		(3,659,151		)	2,860,135
Total liabilities and equity	$	5,302,208	$	5,942,603	$	418,222	$	(4,819,713	)	$	6,843,320

Condensed Consolidating Balance Sheet - December 31, 2015 (In thousands)
	Parent Issuer		Guarantor Subsidiaries		Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Assets
Current assets:
Cash and cash equivalents	$	20,437	$	27,507	$	58,716	$	—		$	106,660
Restricted cash and marketable securities	—		—		13,506		—			13,506
Accounts receivable, net	—		223,434		113,896		—			337,330
Supplies inventory	—		—		21,406		—			21,406
Prepaid and other current assets	28,739		39,046		16,062		(8,076		)	75,771
Total current assets	49,176		289,987		223,586		(8,076		)	554,673
Property and equipment, net	12,515		14,601		162,052		—			189,168
Investments in and receivables from unconsolidated affiliates	4,901,026		1,775,272		—		(6,507,128		)	169,170
Goodwill	—		1,956,741		—		2,013,469			3,970,210
Intangible assets, net	12,780		1,579,537		2,320		—			1,594,637
Other assets	4,653		1,717		17,078		(1,998		)	21,450
Total assets	$	4,980,150	$	5,617,855	$	405,036	$	(4,503,733	)	$	6,499,308
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	8,700	$	—	$	11,677	$	—		$	20,377
Accounts payable	2,816		3,760		29,837		(3,852		)	32,561
Accrued salaries and benefits	31,510		158,705		12,322		—			202,537
Accrued interest	30,463		—		17		—			30,480
Other accrued liabilities	13,962		76,590		32,909		(4,224		)	119,237
Total current liabilities	87,451		239,055		86,762		(8,076		)	405,192
Long-term debt	2,326,103		—		55,249		(23,396		)	2,357,956
Deferred income taxes	268,573		432,923		—		(1,998		)	699,498
Other long-term liabilities	4,560		71,509		20,114		—			96,183
Intercompany payable	—		1,228,157		—		(1,228,157		)	—
Noncontrolling interests – redeemable	—		—		63,060		112,672			175,732
Equity:
Total AmSurg Corp. equity	2,293,463		3,646,211		132,267		(3,778,478		)	2,293,463
Noncontrolling interests – non-redeemable	—		—		47,584		423,700			471,284
Total equity	2,293,463		3,646,211		179,851		(3,354,778		)	2,764,747
Total liabilities and equity	$	4,980,150	$	5,617,855	$	405,036	$	(4,503,733	)	$	6,499,308

Condensed Consolidating Statement of Operations - For the Three Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	7,700		$	437,042		$	324,047		$	(10,290	)	$	758,499
Operating expenses:
Salaries and benefits	22,246			305,173			76,727			(135		)	404,011
Supply cost	—			1,145			48,578			(20		)	49,703
Other operating expenses	6,034			44,213			71,033			(10,135		)	111,145
Transaction costs	2,099			3,036			—			—			5,135
Depreciation and amortization	1,103			21,192			7,759			—			30,054
Total operating expenses	31,482			374,759			204,097			(10,290		)	600,048
Net gain (loss) on disposals and deconsolidations	—			2,857			(262		)	—			2,595
Equity in earnings of unconsolidated affiliates	87,700			68,939			—			(149,288		)	7,351
Operating income	63,918			134,079			119,688			(149,288		)	168,397
Interest expense (income), net	(4,215		)	35,528			600			—			31,913
Earnings before income taxes	68,133			98,551			119,088			(149,288		)	136,484
Income tax expense	22,064			10,858			443			—			33,365
Net earnings	46,069			87,693			118,645			(149,288		)	103,119
Less net earnings (loss) attributable to noncontrolling interests	—			(7		)	57,057			—			57,050
Net earnings attributable to AmSurg Corp. shareholders	46,069			87,700			61,588			(149,288		)	46,069
Preferred stock dividends	(2,264		)	—			—			—			(2,264		)
Net earnings attributable to AmSurg Corp. common shareholders	$	43,805		$	87,700		$	61,588		$	(149,288	)	$	43,805

Condensed Consolidating Statement of Operations - For the Six Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	16,244		$	852,872		$	634,659		$	(20,598	)	$	1,483,177
Operating expenses:
Salaries and benefits	46,341			614,753			153,024			(268		)	813,850
Supply cost	—			2,152			94,547			(33		)	96,666
Other operating expenses	13,652			87,552			137,920			(20,297		)	218,827
Transaction costs	2,276			4,249			—			—			6,525
Depreciation and amortization	2,175			41,528			15,423			—			59,126
Total operating expenses	64,444			750,234			400,914			(20,598		)	1,194,994
Net gain (loss) on disposals and deconsolidations	—			2,857			(262		)	—			2,595
Equity in earnings of unconsolidated affiliates	156,742			134,375			—			(277,187		)	13,930
Operating income	108,542			239,870			233,483			(277,187		)	304,708
Interest expense (income), net	(7,034		)	68,504			1,253			—			62,723
Earnings before income taxes	115,576			171,366			232,230			(277,187		)	241,985
Income tax expense	38,644			14,632			886			—			54,162
Net earnings	76,932			156,734			231,344			(277,187		)	187,823
Less net earnings (loss) attributable to noncontrolling interests	—			(7		)	110,898			—			110,891
Net earnings attributable to AmSurg Corp. shareholders	76,932			156,741			120,446			(277,187		)	76,932
Preferred stock dividends	(4,528		)	—			—			—			(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	72,404		$	156,741		$	120,446		$	(277,187	)	$	72,404

Condensed Consolidating Statement of Operations - For the Three Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Net revenue	$	7,079		$	329,579		$	314,780	$	(9,488	)	$	641,950
Operating expenses:
Salaries and benefits	15,511			228,618			76,391		(124		)	320,396
Supply cost	—			489			45,335		(34		)	45,790
Other operating expenses	5,783			42,099			66,450		(9,330		)	105,002
Transaction costs	324			1,658			—		—			1,982
Depreciation and amortization	1,056			14,617			7,939		—			23,612
Total operating expenses	22,674			287,481			196,115		(9,488		)	496,782
Net gain (loss) on disposals and deconsolidations	—			(3,035		)	—		—			(3,035		)
Equity in earnings of unconsolidated affiliates	76,931			64,513			—		(137,455		)	3,989
Operating income	61,336			103,576			118,665		(137,455		)	146,122
Interest expense, net	11,978			17,624			580		—			30,182
Earnings before income taxes	49,358			85,952			118,085		(137,455		)	115,940
Income tax expense	15,683			9,021			489		—			25,193
Net earnings	33,675			76,931			117,596		(137,455		)	90,747
Less net earnings attributable to noncontrolling interests	—			—			57,072		—			57,072
Net earnings attributable to AmSurg Corp. shareholders	33,675			76,931			60,524		(137,455		)	33,675
Preferred stock dividends	(2,264		)	—			—		—			(2,264		)
Net earnings attributable to AmSurg Corp. common shareholders	$	31,411		$	76,931		$	60,524	$	(137,455	)	$	31,411

Condensed Consolidating Statement of Operations - For the Six Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	14,170		$	615,158		$	601,409		$	(18,342	)	$	1,212,395
Operating expenses:
Salaries and benefits	33,154			440,219			149,454			(252		)	622,575
Supply cost	—			885			87,523			(34		)	88,374
Other operating expenses	12,417			71,710			129,501			(18,056		)	195,572
Transaction costs	592			2,861			—			—			3,453
Depreciation and amortization	1,890			28,924			15,616			—			46,430
Total operating expenses	48,053			544,599			382,094			(18,342		)	956,404
Net gain (loss) on disposals and deconsolidations	(188		)	(3,223		)	(35		)	188			(3,258		)
Equity in earnings of unconsolidated affiliates	137,318			119,096			—			(249,774		)	6,640
Operating income	103,247			186,432			219,280			(249,586		)	259,373
Interest expense, net	23,864			35,378			1,187			—			60,429
Earnings before income taxes	79,383			151,054			218,093			(249,586		)	198,944
Income tax expense	24,670			13,924			848			—			39,442
Net earnings	54,713			137,130			217,245			(249,586		)	159,502
Less net earnings attributable to noncontrolling interests	—			—			104,789			—			104,789
Net earnings attributable to AmSurg Corp. shareholders	54,713			137,130			112,456			(249,586		)	54,713
Preferred stock dividends	(4,528		)	—			—			—			(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	50,185		$	137,130		$	112,456		$	(249,586	)	$	50,185

Condensed Consolidating Statement of Cash Flows - For the Six Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Cash flows from operating activities:
Net cash flows provided by operating activities	$	39,294		$	131,227		$	255,297		$	(230,713	)	$	195,105
Cash flows from investing activities:
Acquisitions and related expenses	(265,258		)	(284,010		)	—			268,155			(281,113		)
Acquisition of property and equipment	(1,676		)	(19,916		)	(16,026		)	—			(37,618		)
Proceeds from sale of interests in surgery centers	—			25			—			—			25
Purchases of marketable securities	—			—			(498		)	—			(498		)
Maturities of marketable securities	—			—			2,738			—			2,738
Other	—			(4,057		)	(4,692		)	—			(8,749		)
Net cash flows used in investing activities	(266,934		)	(307,958		)	(18,478		)	268,155			(325,215		)
Cash flows from financing activities:
Proceeds from long-term borrowings	313,000			—			4,151			—			317,151
Repayment on long-term borrowings	(92,350		)	(9		)	(6,404		)	—			(98,763		)
Distributions to owners, including noncontrolling interests	—			(102,330		)	(243,972		)	230,713			(115,589		)
Capital contributions	—			265,258			—			(265,258		)	—
Changes in intercompany balances with affiliates, net	(2,657		)	—			2,657			—			—
Other, net	(6,199		)	2,520			1,332			(2,897		)	(5,244		)
Net cash flows provided by (used in) financing activities	211,794			165,439			(242,236		)	(37,442		)	97,555
Net decrease in cash and cash equivalents	(15,846		)	(11,292		)	(5,417		)	—			(32,555		)
Cash and cash equivalents, beginning of period	20,437			27,507			58,716			—			106,660
Cash and cash equivalents, end of period	$	4,591		$	16,215		$	53,299		$	—		$	74,105

Condensed Consolidating Statement of Cash Flows - For the Six Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Cash flows from operating activities:
Net cash flows provided by (used in) operating activities	$	(27,553	)	$	172,907		$	232,423		$	(126,382	)	$	251,395
Cash flows from investing activities:
Acquisitions and related expenses	(51,852		)	(197,718		)	—			53,538			(196,032		)
Acquisition of property and equipment	(4,490		)	(9,424		)	(18,751		)	—			(32,665		)
Purchases of marketable securities	—			—			(1,245		)	—			(1,245		)
Maturities of marketable securities	—			—			2,988			—			2,988
Other	—			(1,441		)	(546		)	—			(1,987		)
Net cash flows used in investing activities	(56,342		)	(208,583		)	(17,554		)	53,538			(228,941		)
Cash flows from financing activities:
Proceeds from long-term borrowings	—			—			7,795			—			7,795
Repayment on long-term borrowings	(4,350		)	—			(5,938		)	—			(10,288		)
Distributions to owners, including noncontrolling interests	—			(15,108		)	(212,307		)	126,382			(101,033		)
Capital contributions	—			51,852			—			(51,852		)	—
Changes in intercompany balances with affiliates, net	444			—			(444		)	—			—
Other financing activities, net	(2,892		)	2,573			1,287			(1,686		)	(718		)
Net cash flows provided by (used in) financing activities	(6,798		)	39,317			(209,607		)	72,844			(104,244		)
Net increase (decrease) in cash and cash equivalents	(90,693		)	3,641			5,262			—			(81,790		)
Cash and cash equivalents, beginning of period	134,351			23,471			50,257			—			208,079
Cash and cash equivalents, end of period	$	43,658		$	27,112		$	55,519		$	—		$	126,289

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Basis of Presentation (Policies)

6 Months Ended

Jun. 30, 2016

Accounting Policies [Abstract]

Principles of Consolidation

These unaudited consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (GAAP) for interim financial reporting and in accordance with Rule 10-01 of Regulation S-X. In the opinion of management, the unaudited interim consolidated financial statements contained in this report reflect all normal recurring adjustments, which are necessary for a fair presentation of the financial position and the results of operations for the interim periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year. The accompanying unaudited consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in AmSurg Corp.'s (Company) Annual Report on Form 10-K for the fiscal year ended December 31, 2015.

Ambulatory Services

The Company, through its wholly-owned subsidiaries, owns interests, primarily 51%, in limited liability companies (LLCs) and limited partnerships (LPs) which own and operate ambulatory surgery centers (ASCs, surgery centers or centers). All LLCs and LPs are referred to herein as “partnerships” and “partners,” respectively. The Company has variable interests in the partnerships through its equity ownership interests. Each partnership is considered a variable interest entity (VIE) due to its structure as a limited partnership or functional equivalent under Financial Accounting Standards Board (FASB) Accounting Standard Update (ASU) No. 2015-02 “Consolidations (Topic 810) - Amendments to the Consolidation Analysis,” which was adopted effective January 1, 2016. For those partnerships in which the Company’s ownership interest is 51% or greater, the Company is considered the primary beneficiary. The Company is the primary beneficiary due to 1) ownership interest, operating agreements allowing the Company to govern the day-to-day activities, and the Company’s position as the managing member or general partner and 2) the Company's obligation to absorb losses or the right to receive returns proportionate to its equity interest in the partnerships. For the 24 partnerships in which the Company’s ownership interest is less than 51%, the Company is not deemed the primary beneficiary and therefore those partnerships are not consolidated with the exception of 2 partnerships which are consolidated because the Company holds substantive participation rights and has the obligation to absorb losses or right to receive returns proportionate to its equity interest in the partnerships. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries and the consolidated partnerships. The responsibilities of the Company’s noncontrolling partners (LPs and noncontrolling members) are to supervise the delivery of medical services, with their rights being restricted to those that protect their financial interests, such as approval of the acquisition of significant assets or the incurrence of debt which they are generally required to guarantee on a pro rata basis based upon their respective ownership interests. Intercompany profits, transactions and balances have been eliminated.

Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company’s equity. However, for instances in which certain redemption features that are not solely within the control of the Company are present, classification of noncontrolling interests outside of permanent equity is required. Consolidated net earnings attributable to the Company and to the noncontrolling interests are identified and presented on the consolidated statements of earnings; changes in ownership interests are accounted for as equity transactions when there is no change in control; and when a subsidiary is deconsolidated, any retained noncontrolling equity investment in the former subsidiary and the gain or loss on the deconsolidation of the subsidiary are measured at fair value. Certain transactions with noncontrolling interests are also classified within financing activities in the statements of cash flows. 

Center profits and losses of consolidated entities are allocated to the Company’s partners in proportion to their ownership percentages and reflected in the aggregate as net earnings attributable to noncontrolling interests. The partners of the Company’s center partnerships typically are organized as general partnerships, LPs or LLCs that are not subject to federal income tax. Each partner shares in the pre-tax earnings of the center in which it is a partner. Accordingly, the earnings attributable to noncontrolling interests in each of the Company’s consolidated partnerships are generally determined on a pre-tax basis, and total net earnings attributable to noncontrolling interests are presented after net earnings. However, the Company considers the impact of the net earnings attributable to noncontrolling interests on earnings before income taxes in order to determine the amount of pre-tax earnings on which the Company must determine its income tax expense. In addition, distributions from the partnerships are made to both the Company’s wholly-owned subsidiaries and the partners on a pre-tax basis.

Physician Services

The Company, through its wholly-owned subsidiary Sheridan Healthcare, is a national provider of multi-specialty physician and administrative services to hospitals, ambulatory surgery centers and other healthcare facilities. The Company focuses on delivering comprehensive physician services, primarily in the areas of anesthesiology, radiology, children's services and emergency medicine to healthcare facilities. Through its contracts with healthcare facilities, the Company is authorized to bill and collect charges for fee for service medical services rendered by its healthcare professionals and employees in exchange for the provision of services to the patients of these facilities. Contract revenue is earned directly from hospital customers through a variety of payment arrangements that are established to supplement payments from third-party payors. The Company also provides physician services and manages office-based practices in the areas of pain management, gynecology, obstetrics and perinatology. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries along with the accounts of affiliated professional corporations (PCs) with which the Company has management arrangements. The Company's agreements with these PCs provide that the term of the arrangements is permanent, subject only to termination by the Company, except in the case of gross negligence, fraud or bankruptcy of the Company. The PC structure is primarily used in states which prohibit the corporate practice of medicine. The arrangements are captive in nature as a majority of the outstanding voting equity instruments of the PCs are owned by nominee shareholders appointed at the sole discretion of the Company. The nominee shareholder is a medical doctor who is generally a senior corporate employee of the Company. The Company has a contractual right to transfer the ownership of the PCs at any time to any person it designates as the nominee shareholder. The Company has the right to all assets and to receive income, both as ongoing fees and as proceeds from the sale of any interest in the PCs, in an amount that fluctuates based on the performance of the PCs and the change in the fair value of the interest in the PCs. The Company has exclusive responsibility for the provision of all non-medical services required for the day-to-day operation and management of the PCs and establishes the guidelines for the employment and compensation of the physicians and other employees of the PCs which is consistent with the operation of the Company's wholly-owned subsidiaries. Based on the provisions of these agreements, the Company has determined that the PCs are variable interest entities and that the Company is the primary beneficiary as defined in ASC 810 “Consolidations.”

Restricted Cash

Restricted Cash and Marketable Securities

As of June 30, 2016 and December 31, 2015, the Company had $29.9 million and $27.4 million, respectively, of restricted cash and marketable securities in the accompanying consolidated balance sheets the majority of which is restricted for the purpose of satisfying the obligations of the Company's wholly-owned captive insurance company. The Company has reflected $17.1 million and $13.9 million as of June 30, 2016 and December 31, 2015, respectively, of its restricted cash and marketable securities as a component of other assets in the accompanying consolidated balance sheets. Restricted cash and marketable securities reflected as a component of total current assets in the accompanying consolidated balance sheets represent amounts available to satisfy the claims payments estimated to occur in the next 12 months. As of June 30, 2016 and December 31, 2015, the Company had $0.5 million and $2.7 million, respectively, included in restricted cash and marketable securities, consisting of certificates of deposit with maturities less than 180 days, which approximates fair value.

Reclassifications

Reclassifications

Certain prior year amounts in the accompanying consolidated financial statements have been reclassified to reflect the adoption of ASU No. 2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs” as discussed further under “Recent Accounting Pronouncements.

Use of Estimates

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Recent Accounting Pronouncements

Recent Accounting Pronouncements

In May 2014, the FASB issued ASU 2014-09 “Revenue from Contracts with Customers,” which will eliminate the transaction and industry-specific revenue recognition guidance under current GAAP and replace it with a principle-based approach using the following steps: identify the contract(s) with a customer, identify the performance obligations in the contract, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when (or as) the entity satisfies a performance obligation. In August 2015, the FASB issued ASU 2015-14 “Revenue from Contracts with Customers (Topic 606), Deferral of the Effective Date” which granted a one-year deferral of this ASU. In 2016, the FASB issued the following ASUs to provide entities further clarity on the application of ASU 2014-09:

• ASU 2016-08 “Principal versus Agent Considerations (Reporting Revenue Gross versus Net)”

• ASU 2016-10 “Identifying Performance Obligations and Licensing”

• ASU 2016-12 “Narrow-Scope Improvements and Practical Expedients”

The guidance in ASU 2014-09 and the subsequently related ASUs will now be effective for public entities for annual reporting periods beginning after December 15, 2017, including interim periods therein. Early adoption will be permitted for annual reporting periods beginning after December 15, 2016, including interim periods therein. The Company has yet to assess the impact, if any, this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

In February 2015, the FASB issued ASU No. 2015-02, “Consolidations (Topic 810) - Amendments to the Consolidation Analysis”. The new guidance made amendments to the consolidation guidance, including introducing a separate consolidation analysis specific to limited partnerships and other similar entities. Under this analysis, limited partnerships and other similar entities are considered a variable-interest entity unless the limited partners hold substantive kick-out rights or participating rights. The standard is effective for annual periods beginning after December 15, 2015. The Company adopted this standard effective January 1, 2016 and applied the adoption retrospectively. The adoption of the standard did not result in a change of consolidated subsidiaries nor did it result in any impact to the Company's consolidated financial position, results of operations or cash flows as of and for the three months ended March 31, 2016 or for any previous period.

In April 2015, the FASB issued ASU No. 2015-03, “Interest - Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs.” ASU 2015-03 amended current presentation guidance by requiring that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. In August 2015, the FASB issued ASU 2015-15 “Interest - Imputation of Interest (Subtopic 835-50), Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements - Amendments to Securities and Exchange Commission (SEC) Paragraphs Pursuant to Staff Announcement at June 18, 2015 EITF Meeting (SEC Update)” which incorporated into the Accounting Standards Codification an SEC staff announcement that the SEC staff will not object to an entity presenting the cost of securing a revolving line of credit as an asset, regardless of whether a balance is outstanding. The standards were effective for annual periods beginning after December 15, 2015, and interim periods within those fiscal years. The Company adopted this ASU effective January 1, 2016 and accordingly, reclassified $47.2 million of deferred debt issuance costs from intangible assets, net to a reduction in long-term debt at December 31, 2015, in the accompanying balance sheets (see reclassification above).

In February 2016, the FASB issued ASU No. 2016-02, “Leases” which amends existing accounting standards for lease accounting, including requiring lessees to recognize most leases on the balance sheet and making changes to lessor accounting. The standard is effective for annual periods beginning after December 15, 2018 with early adoption permitted. The new standard requires a modified retrospective application for all leases existing at, or entered into, after the date of initial application, with an option to use certain transition relief. The Company has not yet determined the impact this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

In March 2016, the FASB issued ASU No. 2016-09, “Improvements to Employee Share-Based Payment Accounting” which will change how companies account for certain aspects of share-based payments to employees by requiring companies to recognize the income tax effects of awards in the income statement when the awards vest or are settled. The standard is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company has not yet determined the impact this ASU will have on the Company's consolidated financial position, results of operations or cash flows.

Revenue Recognition

Ambulatory Services

Ambulatory services revenues consist of billing for the use of the centers’ facilities directly to the patient or third-party payor and, at certain of the Company’s centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by the Company’s centers. Such revenues are recognized when the related surgical procedures are performed. Revenues exclude any amounts billed for physicians’ surgical services, which are billed separately by the physicians to the patient or third-party payor.

Revenues from ambulatory services are recognized on the date of service, net of estimated contractual adjustments from third-party medical service payors including Medicare and Medicaid. During each of the six months ended June 30, 2016 and 2015, the Company derived approximately 26% of its ambulatory services net revenues from governmental healthcare programs, primarily Medicare and managed Medicare programs. 

Physician Services

Physician services revenues primarily consist of fee for service revenue and contract revenue and are derived principally from the provision of physician services to patients of the healthcare facilities the Company serves. Contract revenue represents income earned from the Company's hospital customers to supplement payments from third-party payors.

The Company records revenue at the time services are provided, net of a contractual allowance and a provision for uncollectibles. Revenue less the contractual allowance represents the net revenue expected to be collected from third-party payors (including managed care, commercial and governmental payors such as Medicare and Medicaid) and patients insured by these payors. The Company also recognizes revenue for services provided during the period that have not been billed. Expected collections are estimated based on fees and negotiated payment rates in the case of third-party payors, the specific benefits provided for under each patient’s healthcare plan, mandated payment rates under the Medicare and Medicaid programs, and historical cash collections.

The Company's provision for uncollectibles includes its estimate of uncollectible balances due from uninsured patients, uncollectible co-pay and deductible balances due from insured patients and special charges, if any, for uncollectible balances due from managed care, commercial and governmental payors. The Company records net revenue from uninsured patients at its estimated realizable value, which includes a provision for uncollectible balances, based on historical cash collections (net of recoveries).

Accounts Receivable

The Company manages accounts receivable by regularly reviewing its accounts and contracts and by providing appropriate allowances for contractual adjustments and uncollectible amounts. Some of the factors considered by management in determining the amount of such allowances are the historical trends of cash collections, contractual and bad debt write-offs, accounts receivable agings, established fee schedules, contracts with payors, changes in payor mix and procedure statistics. Actual collections of accounts receivable in subsequent periods may require changes in the estimated contractual allowance and provision for uncollectibles. The Company tests its analysis by comparing cash collections to net patient revenues and monitoring self-pay utilization. In addition, when actual collection percentages differ from expected results, on a contract by contract basis, supplemental detailed reviews of the outstanding accounts receivable balances may be performed by the Company’s billing operations to determine whether there are facts and circumstances existing that may cause a different conclusion as to the estimate of the collectability of that contract’s accounts receivable from the estimate resulting from using the historical collection experience. The Company also supplements its allowance for doubtful accounts analysis for its physician services segment quarterly using a hindsight calculation that utilizes write-off data for all payor classes during the previous twelve month period to estimate the allowance for doubtful accounts at a point in time. Changes in these estimates, if any, are charged or credited to the consolidated statements of operations in the period of change. Material changes in estimates may result from unforeseen write-offs of patient or third-party accounts receivable, unsuccessful disputes with managed care payors, adverse macro-economic conditions which limit patients’ ability to meet their financial obligations for the care provided by physicians, or broad changes to government regulations that adversely impact reimbursement rates for services provided by the Company. Significant changes in payor mix, business office operations, general economic conditions and health care coverage provided by federal or state governments or private insurers may have a significant impact on the Company’s estimates and significantly affect its results of operations and cash flows.

Due to the nature of the Company's operations, it is required to separate the presentation of its bad debt expense on the consolidated statements of earnings. The Company records the portion of its bad debts associated with its physician services segment as a component of net revenue in the accompanying consolidated statements of earnings, and the remaining portion, which is associated with its ambulatory services segment, is recorded as a component of other operating expenses in the accompanying consolidated statements of earnings. The bifurcation is a result of the Company's ability to assess the ultimate collection of the patient service revenue associated with its ambulatory services segment before services are provided. The Company's ambulatory services segment is generally able to verify a patient's insurance coverage and ability to pay before services are provided as those services are pre-scheduled and non-emergent.

Acquisitions

The Company accounts for its business combinations under the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any noncontrolling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method.

Investments in Unconsolidated Affiliates

Investments in unconsolidated affiliates in which the Company exerts significant influence but does not control or otherwise consolidate are accounted for using the equity method. Equity method investments are initially recorded at cost, unless such investments are a result of the Company entering into a transaction whereby the Company loses control of a previously controlled entity but retains a noncontrolling interest. Such transactions, which result in the deconsolidation of a previously consolidated entity, are measured at fair value. The fair value measurement utilizes Level 3 inputs, which include unobservable data, to measure the fair value of the retained noncontrolling interest. The fair value determination is generally based on a combination of multiple valuation methods, which can include discounted cash flow, income approach, or market value approach which incorporates estimates of future earnings and market valuation multiples for certain guideline companies. These investments are included as investments in unconsolidated affiliates in the accompanying consolidated balance sheets. The Company’s share of the profits and losses from these investments is reported in equity in earnings of unconsolidated affiliates in the accompanying consolidated statements of earnings. The Company monitors its investments for other-than-temporary impairment by considering factors such as current economic and market conditions and the operating performance of the companies and records reductions in carrying values when necessary.

Earnings per Share

Basic net earnings attributable to AmSurg Corp. common stockholders, per common share, excludes dilution and is computed by dividing net earnings attributable to AmSurg Corp. common stockholders by the weighted-average number of common shares outstanding during the period. Diluted net earnings attributable to AmSurg common stockholders, per common share is computed by dividing net earnings attributable to AmSurg Corp. common stockholders by the weighted-average number of common shares outstanding during the period plus any potential dilutive common share equivalents, including shares issuable (1) upon the vesting of restricted stock awards as determined under the treasury stock method and (2) upon conversion of the Company's mandatory convertible preferred stock as determined under the if-converted method. For purposes of calculating diluted earnings per share, preferred stock dividends have been subtracted from both net earnings from continuing operations attributable to AmSurg Corp. and net earnings attributable to AmSurg Corp. common shareholders in periods in which utilizing the if-converted method would be anti-dilutive.

Income Taxes

The Company files a consolidated federal income tax return. Income taxes are accounted for under the asset and liability method.  Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date.

The Company applies recognition thresholds and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return as it relates to accounting for uncertainty in income taxes. In addition, it is the Company’s policy to recognize interest accrued and penalties, if any, related to unrecognized benefits as income tax expense in its consolidated statements of earnings. The Company does not expect significant changes to its tax positions or liability for tax uncertainties during the next 12 months.

Insurance Programs

Insurance Programs

Given the nature of the services provided, the Company and its subsidiaries are subject to professional and general liability claims and related lawsuits in the ordinary course of business. The Company maintains professional insurance with third-party insurers generally on a claims-made basis, subject to self-insured retentions, exclusions and other restrictions. A substantial portion of the professional liability loss risks are being provided by a third-party insurer, which is fully reinsured by the Company's wholly-owned captive insurance subsidiary. In addition, the captive provides stop loss coverage for the Company’s self-insured employee health program. The assets, liabilities and results of operations of the wholly-owned captive are consolidated in the accompanying consolidated financial statements. The liabilities for self-insurance in the accompanying consolidated balance sheets include estimates of the ultimate costs related to both reported claims on an individual and aggregate basis and unreported claims. The Company also obtains professional liability insurance on a claims-made basis from third-party insurers for its surgery centers and certain of its owned practices and employed physicians.

The Company’s reserves for professional liability claims within the self-insured retention are based upon periodic actuarial calculations. These actuarial estimates consider historical claims frequency and severity, loss development patterns and other actuarial assumptions and are not discounted to present value.

Segments

The Company operates in two major lines of business - ambulatory surgery centers and outsourced physician services, which have been identified as its operating and reportable segments. Through the ambulatory services segment, the Company acquires, develops and operates ambulatory surgery centers in partnership with physicians. Through the physician services segment, the Company provides outsourced physician services in multiple specialties to hospitals, ambulatory surgery centers and other healthcare facilities, primarily in the areas of anesthesiology, radiology, children’s services, and emergency medicine.

The Company’s financial information by operating segment is prepared on an internal management reporting basis and includes allocations of corporate overhead to each segment. This financial information is used by the chief operating decision maker to allocate resources and assess the performance of the operating segments. The Company’s operating segments have been defined based on the separate financial information that is regularly produced and reviewed by the Company’s chief operating decision maker which is its Chief Executive Officer.

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Basis of Presentation (Tables)

6 Months Ended

Jun. 30, 2016

Accounting Policies [Abstract]

Schedule of New Accounting Pronouncement Impact

The impact of the reclassification made to prior period balance sheet is presented below (in thousands).

	December 31, 2015
Consolidated Balance Sheet:	Previously reported		Reclassification			Revised
Intangible assets, net	$	1,641,811	$	(47,174	)	$	1,594,637
Long-term debt	$	2,405,130	$	(47,174	)	$	2,357,956

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Revenue Recognition (Tables)

6 Months Ended

Jun. 30, 2016

Revenue Recognition [Abstract]

Schedule of Revenue and Fees by Segment and Major Payors

Net revenue for the physician services segment consists of the following major payors (dollars in thousands):

	Three Months Ended June 30,										Six Months Ended June 30,
	2016					2015					2016					2015
Medicare	$	61,775		14	%	$	45,967		14	%	$	120,549		14	%	$	87,296		14	%
Medicaid	30,698			7		19,298			6		61,523			7		37,878			6
Commercial and managed care	337,553			77		254,481			77		661,724			77		474,599			77
Self-pay	71,648			16		45,298			14		133,365			16		88,569			14
Net fee for service revenue	501,674			114		365,044			110		977,161			114		688,342			111
Contract and other revenue	38,411			9		31,698			10		74,076			9		62,687			10
Provision for uncollectibles	(101,333		)	(23	)	(65,783		)	(20	)	(194,941		)	(23	)	(133,535		)	(22	)
Net revenue for physician services	$	438,752		100	%	$	330,959		100	%	$	856,296		100	%	$	617,494		100	%

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Acquisitions and Disposals (Tables)

6 Months Ended

Jun. 30, 2016

Business Combinations [Abstract]

Schedule of Business Acquisitions, by Acquisition [Table Text Block]

The acquisition date fair value of the total consideration transferred and acquisition date fair value of each major financial class for both the ambulatory services and physician services acquisitions completed in the six months ended June 30, 2016, including post acquisition date adjustments recorded to purchase price allocations, are as follows (in thousands):

	Six Months Ended June 30, 2016 (1)
Accounts receivable	$	16,809
Other current assets	1,397
Property and equipment	4,258
Goodwill	209,194
Intangible assets	115,902
Other long-term assets	67
Accounts payable	(450		)
Other accrued liabilities	(20,331		)
Deferred income taxes	(20,706		)
Other long-term liabilities	(5,700		)
Long-term debt	(128		)
Total fair value	300,312
Less: Fair value attributable to noncontrolling interests	19,199
Acquisition date fair value of total consideration transferred	$	281,113

(1) Represents the preliminary allocation of fair value of acquired assets and liabilities associated with these acquisitions at June 30, 2016

Revenues And Net Earnings Associated With Acquisitions

Net revenue and net earnings included in the six months ended June 30, 2016 and 2015 associated with completed acquisitions are as follows (in thousands):

	Six Months Ended June 30,
	2016		2015
Net revenue	$	12,714	$	48,042
Net earnings	$	2,198	$	9,101
Less:  Net earnings attributable to noncontrolling interests	563		2,353
Net earnings attributable to AmSurg Corp. common shareholders	$	1,635	$	6,748

Consolidated Pro Forma Results Of Acquisition

The unaudited consolidated pro forma results for the six months ended June 30, 2016 and 2015, assuming all 2016 acquisitions had been consummated on January 1, 2015, and all 2015 acquisitions had been consummated on January 1, 2014 are as follows (in thousands, except earnings per share):

	Six Months Ended June 30,
	2016		2015
Net revenue	$	1,558,347	$	1,488,632
Net earnings	198,383		221,765
Amounts attributable to AmSurg Corp. common shareholders:
Net earnings	82,806		68,374
Net earnings per common share:
Basic	$	1.53	$	1.44
Diluted	$	1.52	$	1.42

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Prepaid and Other Current Assets (Tables)

6 Months Ended

Jun. 30, 2016

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Schedule of Prepaid and Other Current Assets

The following table presents a summary of items comprising prepaid and other current assets in the accompanying consolidated balance sheets as of June 30, 2016 and December 31, 2015 (in thousands):

	June 30,		December 31,
	2016		2015
Income taxes receivable	$	16,241	$	7,908
Prepaid expenses	22,104		18,900
Deferred compensation plan assets	23,530		16,623
Other	12,690		32,340
Total prepaid and other current assets	$	74,565	$	75,771

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Goodwill And Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2016

Goodwill and Intangible Assets Disclosure [Abstract]

Changes In Carrying Amount Of Goodwill

The changes in the carrying amount of goodwill for the six months ended June 30, 2016 are as follows (in thousands):

Balance at December 31, 2015	$	3,970,210
Goodwill acquired, including post acquisition adjustments	207,333
Goodwill disposed, including impact of deconsolidation transactions	(2,535		)
Balance at June 30, 2016	$	4,175,008

Schedule of Finite-Lived Intangible Assets

Intangible assets at June 30, 2016 and December 31, 2015 consisted of the following (in thousands):

	June 30, 2016							December 31, 2015
	Gross							Gross
	Carrying		Accumulated					Carrying		Accumulated
	Amount		Amortization			Net		Amount		Amortization			Net
Amortizable intangible assets:
Customer relationships with hospitals	$	1,494,790	$	(109,444	)	$	1,385,346	$	1,379,977	$	(74,490	)	$	1,305,487
Capitalized software	81,595		(33,500		)	48,095		71,462		(28,125		)	43,337
Agreements, contracts and other	12,358		(3,519		)	8,839		11,267		(2,449		)	8,818
Total amortizable intangible assets	1,588,743		(146,463		)	1,442,280		1,462,706		(105,064		)	1,357,642
Non-amortizable intangible assets:
Trade name	228,000		—			228,000		228,000		—			228,000
Restrictive covenant arrangements	8,995		—			8,995		8,995		—			8,995
Total non-amortizable intangible assets	236,995		—			236,995		236,995		—			236,995
Total intangible assets	$	1,825,738	$	(146,463	)	$	1,679,275	$	1,699,701	$	(105,064	)	$	1,594,637

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Other Accrued Liabilities (Tables)

6 Months Ended

Jun. 30, 2016

Accrued Liabilities, Current [Abstract]

Schedule of Accounts Payable and Accrued Liabilities [Table Text Block]

The following table presents a summary of items comprising other accrued liabilities in the accompanying consolidated balance sheets as of June 30, 2016 and December 31, 2015 (in thousands):

	June 30,		December 31,
	2016		2015
Accrued professional liabilities	$	14,541	$	14,362
Contingent purchase price payable	1,000		5,509
Current income taxes payable	—		7,892
Refunds payable	29,626		48,415
Other	47,404		43,059
Total other accrued liabilities	$	92,571	$	119,237

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Accrued Professional Liabilities (Tables)

6 Months Ended

Jun. 30, 2016

Payables and Accruals [Abstract]

Schedule of Accrued Professional Liabilities

At June 30, 2016 and December 31, 2015, the Company's accrued professional liabilities are presented in the accompanying consolidated balance sheets as a component of other accrued liabilities and other long-term liabilities as follows (in thousands):

	June 30, 2016		December 31, 2015
Estimated losses under self-insured programs	$	32,652	$	30,748
Incurred but not reported losses	35,955		36,166
Total accrued professional liabilities	68,607		66,914
Less estimated losses payable within one year	14,541		14,362
Total	$	54,066	$	52,552

Schedule of Self Insurance Reserve Roll Forward

The changes to the Company's estimated losses under self-insured programs as of June 30, 2016 were as follows (in thousands):

Balance at December 31, 2015	$	66,914
Assumed liabilities through acquisitions	1,862
Provision related to current period reserves	10,037
Payments for current period reserves	(39		)
Benefit related to changes in prior period reserves	(249		)
Payments for prior period reserves	(6,307		)
Other, net including post-acquisition adjustments	(3,611		)
Balance at June 30, 2016	$	68,607

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Long-Term Debt (Tables)

6 Months Ended

Jun. 30, 2016

Debt Disclosure [Abstract]

Components Of Long-Term Debt

Long-term debt at June 30, 2016 and December 31, 2015 consisted of the following (in thousands):

	June 30,		December 31,
	2016		2015
Revolving credit agreement	$	400,000	$	175,000
Term loan	852,600		856,950
5.625% Senior Unsecured Notes due 2020	250,000		250,000
5.625% Senior Unsecured Notes due 2022	1,100,000		1,100,000
Other debt due through 2025	23,920		24,944
Capitalized lease arrangements due through 2026	18,202		18,613
	2,644,722		2,425,507
Less current portion	20,772		20,377
Less net deferred financing costs	42,907		47,174
Long-term debt	$	2,581,043	$	2,357,956

Redemption Price Percentage

The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve month period beginning on November 30 of the years indicated below:  

Period	Redemption Price
2015	104.219	%
2016	102.813	%
2017	101.406	%
2018 and thereafter	100.000	%

The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve month period beginning on July 15 of the years indicated below:

Period	Redemption Price
2017	104.219	%
2018	102.813	%
2019	101.406	%
2020 and thereafter	100.000	%

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Other Long-Term Liabilities (Tables)

6 Months Ended

Jun. 30, 2016

Other Long-Term Liabilities [Abstract]

Other Noncurrent Liabilities

Other long-term liabilities consist of the following (in thousands):

	June 30,		December 31,
	2016		2015
Accrued professional liabilities	$	54,066	$	52,552
Deferred rent	27,330		18,958
Tax-effected unrecognized benefits	3,426		3,426
Other	34,656		21,247
Other long-term liabilities	$	119,478	$	96,183

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Shareholders' Equity (Tables)

6 Months Ended

Jun. 30, 2016

Equity [Abstract]

Share-Based Activity

Other information pertaining to share-based activity during the three and six months ended June 30, 2016 and 2015 was as follows (in thousands):

	Three Months Ended June 30,				Six Months Ended June 30,
	2016		2015		2016		2015
Share-based compensation expense	$	7,900	$	3,883	$	15,068	$	7,592
Fair value of shares vested	1,282		1,746		18,243		13,220
Cash received from option exercises	174		334		450		2,080
Tax benefit from exercises of share based awards	129		216		3,734		3,533

Schedule Of Changes In Non-Vested Restricted Shares

A summary of the status of non-vested restricted shares at June 30, 2016 and changes during the six months ended June 30, 2016 is as follows:

			Weighted
	Number		Average
	of Shares		Grant Price
Non-vested shares at December 31, 2015	734,101		$	44.73
Shares granted	586,791		74.00
Shares vested	(249,421	)	38.61
Shares forfeited	(5,407	)	55.40
Non-vested shares at June 30, 2016	1,066,064		$	62.22

Schedule Of Stock Option Activity

A summary of stock option activity for the six months ended June 30, 2016 is summarized as follows:

					Weighted
			Weighted		Average
			Average		Remaining
	Number		Exercise		Contractual
	of Shares		Price		Term (in years)
Outstanding at December 31, 2015	33,751		$	22.98	1.1
Options exercised with total intrinsic value of $1.0 million	(19,718	)	22.84
Options terminated	(4,200	)	21.07
Outstanding, Vested and Exercisable at June 30, 2016 with an aggregate intrinsic value of $0.5 million	9,833		$	24.09	0.5

Schedule Of Reconciliation Of Numerator And Denominators Of Basic And Diluted Earnings Per Share

The following is a reconciliation of the numerator and denominators of basic and diluted earnings per share (in thousands, except per share amounts):

	Three Months Ended June 30,					Six Months Ended June 30,
	Earnings		Shares	Per Share		Earnings		Shares	Per Share
	(Numerator)		(Denominator)	Amount		(Numerator)		(Denominator)	Amount
2016:
Net earnings attributable to AmSurg Corp. common shareholders (basic)	$	43,805	53,739	$	0.82	$	72,404	53,702	$	1.35
Preferred stock dividends	2,264		—			4,528		—
Effect of dilutive securities, options and non-vested shares	—		3,588			—		3,527
Net earnings attributable to AmSurg Corp. common shareholders (diluted)	$	46,069	57,327	$	0.80	$	76,932	57,229	$	1.34
2015:
Net earnings attributable to AmSurg Corp. common shareholders (basic)	$	31,411	47,678	$	0.66	$	50,185	47,625	$	1.05
Effect of dilutive securities, options and non-vested shares	—		421			—		377
Net earnings attributable to AmSurg Corp. common shareholders (diluted)	$	31,411	48,099	$	0.65	$	50,185	48,002	$	1.05

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Segment Reporting (Tables)

6 Months Ended

Jun. 30, 2016

Segment Reporting [Abstract]

Schedule of Segment Reporting Information, by Segment

The following table presents financial information for each reportable segment (in thousands):

	Three Months Ended June 30,						Six Months Ended June 30,
	2016			2015			2016			2015
Net Revenue:
Ambulatory Services	$	319,747		$	310,991		$	626,881		$	594,901
Physician Services	438,752			330,959			856,296			617,494
Total	$	758,499		$	641,950		$	1,483,177		$	1,212,395
Adjusted EBITDA:
Ambulatory Services	$	61,746		$	60,304		$	115,372		$	107,612
Physician Services	87,497			67,668			153,971			114,115
Total	$	149,243		$	127,972		$	269,343		$	221,727
Adjusted EBITDA:	$	149,243		$	127,972		$	269,343		$	221,727
Net earnings attributable to noncontrolling interests	57,050			57,072			110,891			104,789
Interest expense, net	(31,913		)	(30,182		)	(62,723		)	(60,429		)
Depreciation and amortization	(30,054		)	(23,612		)	(59,126		)	(46,430		)
Share-based compensation	(7,900		)	(3,883		)	(15,068		)	(7,592		)
Net change in fair value of contingent consideration	2,598			(6,410		)	2,598			(6,410		)
Transaction costs	(5,135		)	(1,982		)	(6,525		)	(3,453		)
Net gain (loss) on disposals and deconsolidations	2,595			(3,035		)	2,595			(3,258		)
Earnings before income taxes	$	136,484		$	115,940		$	241,985		$	198,944
Acquisition and Capital Expenditures:
Ambulatory Services	$	35,031		$	64,514		$	43,401		$	118,610
Physician Services	265,019			22,822			275,330			110,087
Total	$	300,050		$	87,336		$	318,731		$	228,697

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Financial Information for the Company and Its Subsidiaries (Tables)

6 Months Ended

Jun. 30, 2016

Condensed Financial Information of Parent Company Only Disclosure [Abstract]

Condensed Consolidating Balance Sheet

Condensed Consolidating Balance Sheet - June 30, 2016 (In thousands)
	Parent Issuer		Guarantor Subsidiaries		Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Assets
Current assets:
Cash and cash equivalents	$	4,591	$	16,215	$	53,299	$	—		$	74,105
Restricted cash and marketable securities	—		—		12,794		—			12,794
Accounts receivable, net	—		258,863		116,489		—			375,352
Supplies inventory	—		—		21,980		—			21,980
Prepaid and other current assets	45,542		24,074		26,261		(21,312		)	74,565
Total current assets	50,133		299,152		230,823		(21,312		)	558,796
Property and equipment, net	11,877		27,822		165,223		—			204,922
Investments in and receivables from unconsolidated affiliates	5,219,975		1,807,424		—		(6,848,343		)	179,056
Goodwill	—		2,123,067		—		2,051,941			4,175,008
Intangible assets, net	13,037		1,664,313		1,925		—			1,679,275
Other assets	7,186		20,825		20,251		(1,999		)	46,263
Total assets	$	5,302,208	$	5,942,603	$	418,222	$	(4,819,713	)	$	6,843,320
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	8,700	$	20	$	12,052	$	—		$	20,772
Accounts payable	3,073		1,640		29,569		(3,561		)	30,721
Accrued salaries and benefits	29,533		140,149		17,226		—			186,908
Accrued interest	30,386		—		14		—			30,400
Other accrued liabilities	5,171		69,166		35,985		(17,751		)	92,571
Total current liabilities	76,863		210,975		94,846		(21,312		)	361,372
Long-term debt	2,550,996		36		56,065		(26,054		)	2,581,043
Deferred income taxes	288,503		456,942		—		(1,998		)	743,447
Other long-term liabilities	8,568		76,144		34,766		—			119,478
Intercompany payable	—		1,228,157		—		(1,228,157		)	—
Noncontrolling interests – redeemable	—		—		60,886		116,959			177,845
Equity:
Total AmSurg Corp. equity	2,377,278		3,967,431		125,450		(4,092,881		)	2,377,278
Noncontrolling interests – non-redeemable	—		2,918		46,209		433,730			482,857
Total equity	2,377,278		3,970,349		171,659		(3,659,151		)	2,860,135
Total liabilities and equity	$	5,302,208	$	5,942,603	$	418,222	$	(4,819,713	)	$	6,843,320

Condensed Consolidating Balance Sheet - December 31, 2015 (In thousands)
	Parent Issuer		Guarantor Subsidiaries		Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Assets
Current assets:
Cash and cash equivalents	$	20,437	$	27,507	$	58,716	$	—		$	106,660
Restricted cash and marketable securities	—		—		13,506		—			13,506
Accounts receivable, net	—		223,434		113,896		—			337,330
Supplies inventory	—		—		21,406		—			21,406
Prepaid and other current assets	28,739		39,046		16,062		(8,076		)	75,771
Total current assets	49,176		289,987		223,586		(8,076		)	554,673
Property and equipment, net	12,515		14,601		162,052		—			189,168
Investments in and receivables from unconsolidated affiliates	4,901,026		1,775,272		—		(6,507,128		)	169,170
Goodwill	—		1,956,741		—		2,013,469			3,970,210
Intangible assets, net	12,780		1,579,537		2,320		—			1,594,637
Other assets	4,653		1,717		17,078		(1,998		)	21,450
Total assets	$	4,980,150	$	5,617,855	$	405,036	$	(4,503,733	)	$	6,499,308
Liabilities and Equity
Current liabilities:
Current portion of long-term debt	$	8,700	$	—	$	11,677	$	—		$	20,377
Accounts payable	2,816		3,760		29,837		(3,852		)	32,561
Accrued salaries and benefits	31,510		158,705		12,322		—			202,537
Accrued interest	30,463		—		17		—			30,480
Other accrued liabilities	13,962		76,590		32,909		(4,224		)	119,237
Total current liabilities	87,451		239,055		86,762		(8,076		)	405,192
Long-term debt	2,326,103		—		55,249		(23,396		)	2,357,956
Deferred income taxes	268,573		432,923		—		(1,998		)	699,498
Other long-term liabilities	4,560		71,509		20,114		—			96,183
Intercompany payable	—		1,228,157		—		(1,228,157		)	—
Noncontrolling interests – redeemable	—		—		63,060		112,672			175,732
Equity:
Total AmSurg Corp. equity	2,293,463		3,646,211		132,267		(3,778,478		)	2,293,463
Noncontrolling interests – non-redeemable	—		—		47,584		423,700			471,284
Total equity	2,293,463		3,646,211		179,851		(3,354,778		)	2,764,747
Total liabilities and equity	$	4,980,150	$	5,617,855	$	405,036	$	(4,503,733	)	$	6,499,308

Condensed Consolidating Statement of Operations

Condensed Consolidating Statement of Operations - For the Three Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	7,700		$	437,042		$	324,047		$	(10,290	)	$	758,499
Operating expenses:
Salaries and benefits	22,246			305,173			76,727			(135		)	404,011
Supply cost	—			1,145			48,578			(20		)	49,703
Other operating expenses	6,034			44,213			71,033			(10,135		)	111,145
Transaction costs	2,099			3,036			—			—			5,135
Depreciation and amortization	1,103			21,192			7,759			—			30,054
Total operating expenses	31,482			374,759			204,097			(10,290		)	600,048
Net gain (loss) on disposals and deconsolidations	—			2,857			(262		)	—			2,595
Equity in earnings of unconsolidated affiliates	87,700			68,939			—			(149,288		)	7,351
Operating income	63,918			134,079			119,688			(149,288		)	168,397
Interest expense (income), net	(4,215		)	35,528			600			—			31,913
Earnings before income taxes	68,133			98,551			119,088			(149,288		)	136,484
Income tax expense	22,064			10,858			443			—			33,365
Net earnings	46,069			87,693			118,645			(149,288		)	103,119
Less net earnings (loss) attributable to noncontrolling interests	—			(7		)	57,057			—			57,050
Net earnings attributable to AmSurg Corp. shareholders	46,069			87,700			61,588			(149,288		)	46,069
Preferred stock dividends	(2,264		)	—			—			—			(2,264		)
Net earnings attributable to AmSurg Corp. common shareholders	$	43,805		$	87,700		$	61,588		$	(149,288	)	$	43,805

Condensed Consolidating Statement of Operations - For the Six Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	16,244		$	852,872		$	634,659		$	(20,598	)	$	1,483,177
Operating expenses:
Salaries and benefits	46,341			614,753			153,024			(268		)	813,850
Supply cost	—			2,152			94,547			(33		)	96,666
Other operating expenses	13,652			87,552			137,920			(20,297		)	218,827
Transaction costs	2,276			4,249			—			—			6,525
Depreciation and amortization	2,175			41,528			15,423			—			59,126
Total operating expenses	64,444			750,234			400,914			(20,598		)	1,194,994
Net gain (loss) on disposals and deconsolidations	—			2,857			(262		)	—			2,595
Equity in earnings of unconsolidated affiliates	156,742			134,375			—			(277,187		)	13,930
Operating income	108,542			239,870			233,483			(277,187		)	304,708
Interest expense (income), net	(7,034		)	68,504			1,253			—			62,723
Earnings before income taxes	115,576			171,366			232,230			(277,187		)	241,985
Income tax expense	38,644			14,632			886			—			54,162
Net earnings	76,932			156,734			231,344			(277,187		)	187,823
Less net earnings (loss) attributable to noncontrolling interests	—			(7		)	110,898			—			110,891
Net earnings attributable to AmSurg Corp. shareholders	76,932			156,741			120,446			(277,187		)	76,932
Preferred stock dividends	(4,528		)	—			—			—			(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	72,404		$	156,741		$	120,446		$	(277,187	)	$	72,404

Condensed Consolidating Statement of Operations - For the Three Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries		Consolidating Adjustments			Total Consolidated
Net revenue	$	7,079		$	329,579		$	314,780	$	(9,488	)	$	641,950
Operating expenses:
Salaries and benefits	15,511			228,618			76,391		(124		)	320,396
Supply cost	—			489			45,335		(34		)	45,790
Other operating expenses	5,783			42,099			66,450		(9,330		)	105,002
Transaction costs	324			1,658			—		—			1,982
Depreciation and amortization	1,056			14,617			7,939		—			23,612
Total operating expenses	22,674			287,481			196,115		(9,488		)	496,782
Net gain (loss) on disposals and deconsolidations	—			(3,035		)	—		—			(3,035		)
Equity in earnings of unconsolidated affiliates	76,931			64,513			—		(137,455		)	3,989
Operating income	61,336			103,576			118,665		(137,455		)	146,122
Interest expense, net	11,978			17,624			580		—			30,182
Earnings before income taxes	49,358			85,952			118,085		(137,455		)	115,940
Income tax expense	15,683			9,021			489		—			25,193
Net earnings	33,675			76,931			117,596		(137,455		)	90,747
Less net earnings attributable to noncontrolling interests	—			—			57,072		—			57,072
Net earnings attributable to AmSurg Corp. shareholders	33,675			76,931			60,524		(137,455		)	33,675
Preferred stock dividends	(2,264		)	—			—		—			(2,264		)
Net earnings attributable to AmSurg Corp. common shareholders	$	31,411		$	76,931		$	60,524	$	(137,455	)	$	31,411

Condensed Consolidating Statement of Operations - For the Six Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Net revenue	$	14,170		$	615,158		$	601,409		$	(18,342	)	$	1,212,395
Operating expenses:
Salaries and benefits	33,154			440,219			149,454			(252		)	622,575
Supply cost	—			885			87,523			(34		)	88,374
Other operating expenses	12,417			71,710			129,501			(18,056		)	195,572
Transaction costs	592			2,861			—			—			3,453
Depreciation and amortization	1,890			28,924			15,616			—			46,430
Total operating expenses	48,053			544,599			382,094			(18,342		)	956,404
Net gain (loss) on disposals and deconsolidations	(188		)	(3,223		)	(35		)	188			(3,258		)
Equity in earnings of unconsolidated affiliates	137,318			119,096			—			(249,774		)	6,640
Operating income	103,247			186,432			219,280			(249,586		)	259,373
Interest expense, net	23,864			35,378			1,187			—			60,429
Earnings before income taxes	79,383			151,054			218,093			(249,586		)	198,944
Income tax expense	24,670			13,924			848			—			39,442
Net earnings	54,713			137,130			217,245			(249,586		)	159,502
Less net earnings attributable to noncontrolling interests	—			—			104,789			—			104,789
Net earnings attributable to AmSurg Corp. shareholders	54,713			137,130			112,456			(249,586		)	54,713
Preferred stock dividends	(4,528		)	—			—			—			(4,528		)
Net earnings attributable to AmSurg Corp. common shareholders	$	50,185		$	137,130		$	112,456		$	(249,586	)	$	50,185

Condensed Consolidating Statement of Cash Flows

Condensed Consolidating Statement of Cash Flows - For the Six Months Ended June 30, 2016 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Cash flows from operating activities:
Net cash flows provided by operating activities	$	39,294		$	131,227		$	255,297		$	(230,713	)	$	195,105
Cash flows from investing activities:
Acquisitions and related expenses	(265,258		)	(284,010		)	—			268,155			(281,113		)
Acquisition of property and equipment	(1,676		)	(19,916		)	(16,026		)	—			(37,618		)
Proceeds from sale of interests in surgery centers	—			25			—			—			25
Purchases of marketable securities	—			—			(498		)	—			(498		)
Maturities of marketable securities	—			—			2,738			—			2,738
Other	—			(4,057		)	(4,692		)	—			(8,749		)
Net cash flows used in investing activities	(266,934		)	(307,958		)	(18,478		)	268,155			(325,215		)
Cash flows from financing activities:
Proceeds from long-term borrowings	313,000			—			4,151			—			317,151
Repayment on long-term borrowings	(92,350		)	(9		)	(6,404		)	—			(98,763		)
Distributions to owners, including noncontrolling interests	—			(102,330		)	(243,972		)	230,713			(115,589		)
Capital contributions	—			265,258			—			(265,258		)	—
Changes in intercompany balances with affiliates, net	(2,657		)	—			2,657			—			—
Other, net	(6,199		)	2,520			1,332			(2,897		)	(5,244		)
Net cash flows provided by (used in) financing activities	211,794			165,439			(242,236		)	(37,442		)	97,555
Net decrease in cash and cash equivalents	(15,846		)	(11,292		)	(5,417		)	—			(32,555		)
Cash and cash equivalents, beginning of period	20,437			27,507			58,716			—			106,660
Cash and cash equivalents, end of period	$	4,591		$	16,215		$	53,299		$	—		$	74,105

Condensed Consolidating Statement of Cash Flows - For the Six Months Ended June 30, 2015 (In thousands)
	Parent Issuer			Guarantor Subsidiaries			Non-Guarantor Subsidiaries			Consolidating Adjustments			Total Consolidated
Cash flows from operating activities:
Net cash flows provided by (used in) operating activities	$	(27,553	)	$	172,907		$	232,423		$	(126,382	)	$	251,395
Cash flows from investing activities:
Acquisitions and related expenses	(51,852		)	(197,718		)	—			53,538			(196,032		)
Acquisition of property and equipment	(4,490		)	(9,424		)	(18,751		)	—			(32,665		)
Purchases of marketable securities	—			—			(1,245		)	—			(1,245		)
Maturities of marketable securities	—			—			2,988			—			2,988
Other	—			(1,441		)	(546		)	—			(1,987		)
Net cash flows used in investing activities	(56,342		)	(208,583		)	(17,554		)	53,538			(228,941		)
Cash flows from financing activities:
Proceeds from long-term borrowings	—			—			7,795			—			7,795
Repayment on long-term borrowings	(4,350		)	—			(5,938		)	—			(10,288		)
Distributions to owners, including noncontrolling interests	—			(15,108		)	(212,307		)	126,382			(101,033		)
Capital contributions	—			51,852			—			(51,852		)	—
Changes in intercompany balances with affiliates, net	444			—			(444		)	—			—
Other financing activities, net	(2,892		)	2,573			1,287			(1,686		)	(718		)
Net cash flows provided by (used in) financing activities	(6,798		)	39,317			(209,607		)	72,844			(104,244		)
Net increase (decrease) in cash and cash equivalents	(90,693		)	3,641			5,262			—			(81,790		)
Cash and cash equivalents, beginning of period	134,351			23,471			50,257			—			208,079
Cash and cash equivalents, end of period	$	43,658		$	27,112		$	55,519		$	—		$	126,289

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Basis of Presentation (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016 USD ($) center	Jun. 30, 2015 USD ($)	Jun. 30, 2016 USD ($) center	Jun. 30, 2015 USD ($)	Dec. 31, 2015 USD ($)
Variable Interest Entity [Line Items]
Number of ownership interests of less than 51% | center	24		24
Investments in unconsolidated affiliates	$ 179,056		$ 179,056		$ 169,170
Income (Loss) from Equity Method Investments	7,351	$ 3,989	13,930	$ 6,640
Net revenue	758,499	641,950	1,483,177	1,212,395
Prepaid and other current assets	74,565		74,565		75,771
Restricted Cash and Marketable Securities
Restricted cash and marketable securities, total	29,900		29,900		27,400
Restricted cash and investments, noncurrent	17,100		17,100		13,900
Restricted marketable securities	500		500		2,700
Variable Interest Entity, Primary Beneficiary, Aggregated Disclosure [Member]
Variable Interest Entity [Line Items]
Assets of VIEs	780,500		780,500		740,100
Liabilities of VIEs	297,700		297,700		299,000
Restricted use assets of VIEs	178,600		178,600		176,800
Debt of VIEs guaranteed by AmSurg	18,200		18,200		21,700
Variable Interest Entity, Not Primary Beneficiary, Aggregated Disclosure [Member]
Variable Interest Entity [Line Items]
Net revenue	5,300	3,800	11,600	7,200
Prepaid and other current assets	$ 9,200		$ 9,200		$ 6,000
Consolidated [Member]
Variable Interest Entity [Line Items]
Number of ownership interests of less than 51% | center	2		2
Ambulatory Services [Member]
Variable Interest Entity [Line Items]
Net revenue	$ 319,747	$ 310,991	$ 626,881	$ 594,901
Maximum [Member] | Variable Interest Entity, Not Primary Beneficiary, Aggregated Disclosure [Member]
Variable Interest Entity [Line Items]
Percent of voting rights in unconsolidated affiliates			50.00%

XML

Basis of Presentation - Reclassifications (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Intangible assets, net	$ 1,679,275	$ 1,594,637
Long-term debt	2,581,043	2,357,956
Deferred debt issuance costs	$ (42,907)	(47,174)
Accounting Standards Update 2015-03 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Intangible assets, net		(47,174)
Long-term debt		(47,174)
Accounting Standards Update 2015-03 [Member] | Intangible Assets, Net [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Deferred debt issuance costs		(47,200)
Accounting Standards Update 2015-03 [Member] | Long-term Debt [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Deferred debt issuance costs		47,200
Previously Reported [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Intangible assets, net		1,641,811
Long-term debt		$ 2,405,130

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Business Combinations (Details) - Scenario, Forecast [Member] - Merger of AmSurg and Envision into New Amethyst [Member]	Dec. 31, 2016
AmSurg [Member] | Common Stock [Member]
Business Acquisition [Line Items]
Number of shares to be issued for one share of acquiree's stock	1
AmSurg [Member] | Mandatory Convertible Preferred Stock [Member]
Business Acquisition [Line Items]
Number of shares to be issued for one share of acquiree's stock	1
Envision [Member]
Business Acquisition [Line Items]
Envision stockholders' percent of ownership in New Amethyst on date of merger	53.00%
Envision [Member] | Common Stock [Member]
Business Acquisition [Line Items]
Number of shares to be issued for one share of acquiree's stock	0.334

XML

Revenue Recognition (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Revenue, Major Customer [Line Items]
Provision for uncollectibles			$ (207,046)	$ (144,514)
Net revenue	$ 758,499	$ 641,950	$ 1,483,177	$ 1,212,395
Ambulatory Services [Member]
Revenue, Major Customer [Line Items]
Percentage of revenues from governmental healthcare programs			26.00%	26.00%
Net revenue	319,747	310,991	$ 626,881	$ 594,901
Physician Services [Member]
Revenue, Major Customer [Line Items]
Net fee for service revenue	501,674	365,044	977,161	688,342
Contract and other revenue	38,411	31,698	74,076	62,687
Provision for uncollectibles	(101,333)	(65,783)	(194,941)	(133,535)
Net revenue	438,752	330,959	856,296	617,494
Medicare [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Net fee for service revenue	61,775	45,967	120,549	87,296
Medicaid [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Net fee for service revenue	30,698	19,298	61,523	37,878
Commercial and Managed Care [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Net fee for service revenue	337,553	254,481	661,724	474,599
Self-Pay [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Net fee for service revenue	$ 71,648	$ 45,298	$ 133,365	$ 88,569
Sales Revenue, Net [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	100.00%	100.00%	100.00%	100.00%
Health Care Organization, Patient Service Revenue [Member] | Sales Revenue, Net [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	114.00%	110.00%	114.00%	111.00%
Health Care Organization, Patient Service Revenue [Member] | Sales Revenue, Net [Member] | Medicare [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	14.00%	14.00%	14.00%	14.00%
Health Care Organization, Patient Service Revenue [Member] | Sales Revenue, Net [Member] | Medicaid [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	7.00%	6.00%	7.00%	6.00%
Health Care Organization, Patient Service Revenue [Member] | Sales Revenue, Net [Member] | Commercial and Managed Care [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	77.00%	77.00%	77.00%	77.00%
Health Care Organization, Patient Service Revenue [Member] | Sales Revenue, Net [Member] | Self-Pay [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	16.00%	14.00%	16.00%	14.00%
Contract and Other Revenue [Member] | Sales Revenue, Net [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	9.00%	10.00%	9.00%	10.00%
Provision for Uncollectibles [Member] | Sales Revenue, Net [Member] | Physician Services [Member]
Revenue, Major Customer [Line Items]
Percent of net revenue, over	23.00%	20.00%	23.00%	22.00%

XML

Accounts Receivable (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense			$ 207,046	$ 144,514
Allowances for accounts receivable	$ 208,780		$ 208,780		$ 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			82.00%		80.00%
Ambulatory Services [Member] | Other Operating Expenses [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	6,300	$ 4,700	$ 12,100	11,000
Physician Services [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	$ 101,333	$ 65,783	$ 194,941	$ 133,535

XML

Acquisitions and Disposals (Narrative) (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016 USD ($)	Jun. 30, 2015 USD ($)	Jun. 30, 2016 USD ($) physician_practice center	Jun. 30, 2015 USD ($) physician_practice center	Dec. 31, 2015 USD ($)
Business Acquisition [Line Items]
Acquisitions and related expenses, net			$ 281,113	$ 196,032
Net change in fair value of contingent consideration	$ (2,598)	$ 6,410	(2,598)	6,410
Transaction costs	5,135	$ 1,982	$ 6,525	$ 3,453
Ambulatory Services [Member]
Business Acquisition [Line Items]
Number of business acquisitions | center			4	4
Acquisitions and related expenses, net			$ 25,700	$ 95,400
Ambulatory Services [Member] | Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Number of center disposals | center			2	0
Net gain from disposals			$ 3,300
Physician Services [Member]
Business Acquisition [Line Items]
Net change in fair value of contingent consideration			$ (2,600)
Physician Services [Member] | Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Number of business acquisitions | physician_practice			6	4
Cash paid to acquire business			$ 255,400	$ 100,700
Deferred Consideration			$ 15,400
Deferred consideration period			2 years
Accrued liability, contingent consideration	1,000		$ 1,000		$ 5,500
Cash payment for previous acquisition			1,900
Contingent consideration arrangements, high	$ 1,000		1,000
Other Accrued Liabilities [Member] | Physician Services [Member] | Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Deferred Consideration			9,700
Other Long-term Liabilities [Member] | Physician Services [Member] | Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Deferred Consideration			$ 5,700

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Acquisitions and Disposals (Revs and Earnings) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Business Acquisition [Line Items]
Net revenue	$ 758,499	$ 641,950	$ 1,483,177	$ 1,212,395
Net earnings	103,119	90,747	187,823	159,502
Less: Net earnings attributable to noncontrolling interests	57,050	57,072	110,891	104,789
Net earnings attributable to AmSurg Corp. shareholders	$ 46,069	$ 33,675	76,932	54,713
Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Net revenue			12,714	48,042
Net earnings			2,198	9,101
Less: Net earnings attributable to noncontrolling interests			563	2,353
Net earnings attributable to AmSurg Corp. shareholders			$ 1,635	$ 6,748

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Acquisitions and Disposals (Consolidated Pro Forma Results Of Acquisition) (Details) - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Business Combinations [Abstract]
Net revenue	$ 1,558,347	$ 1,488,632
Net earnings	198,383	221,765
Net earnings attributable to AmSurg Corp. common shareholders	$ 82,806	$ 68,374
Net earnings per common share, Basic (usd per share)	$ 1.53	$ 1.44
Net earnings per common share, Diluted (usd per share)	$ 1.52	$ 1.42

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Acquisitions and Disposals (Fair Value Of Total Consideration Transferred And Major Class Of Consideration) (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 4,175,008	$ 3,970,210
Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Accounts receivable	16,809
Other current assets	1,397
Property and equipment	4,258
Goodwill	209,194
Intangible assets	115,902
Other long-term assets	67
Accounts payable	(450)
Other accrued liabilities	(20,331)
Deferred income taxes	(20,706)
Other long-term liabilities	(5,700)
Long-term debt	(128)
Total fair value	300,312
Less: Fair value attributable to noncontrolling interests	19,199
Acquisition date fair value of total consideration transferred	$ 281,113

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Investments in Unconsolidated Affiliates (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016 USD ($)	Jun. 30, 2015 USD ($)	Jun. 30, 2016 USD ($) equity_method_investment center	Jun. 30, 2015 USD ($) equity_method_investment center	Dec. 31, 2015 USD ($)
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated affiliates	$ 179,056		$ 179,056		$ 169,170
Equity in earnings of unconsolidated affiliates	7,351	$ 3,989	13,930	$ 6,640
Net loss on deconsolidation	(700)	(3,000)	$ (700)	$ (3,300)
Joint Venture [Member] | Ambulatory Services [Member]
Schedule of Equity Method Investments [Line Items]
Number Of Consolidated Entities Contributed To Joint Venture | center			1
Joint Venture [Member] | Ambulatory Services [Member] | Noncontrolling Interest In Centers [Member]
Schedule of Equity Method Investments [Line Items]
Number of separate equity method investments | equity_method_investment			1	1
Variable Interest Entity, Not Primary Beneficiary, Aggregated Disclosure [Member] | Joint Venture [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated affiliates	$ 1,800	$ 2,300	$ 1,800	$ 2,300
Controlling Interest [Member] | Joint Venture [Member] | Physician Services [Member]
Schedule of Equity Method Investments [Line Items]
Number Of Consolidated Entities Contributed To Joint Venture | center			0	1

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Prepaid and Other Current Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Income Taxes Receivable	$ 16,241	$ 7,908
Prepaid expenses	22,104	18,900
Deferred compensation plan assets	23,530	16,623
Other	12,690	32,340
Total prepaid and other current assets	$ 74,565	$ 75,771

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Goodwill And Intangible Assets (Narrative) (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016 USD ($)	Jun. 30, 2015 USD ($)	Jun. 30, 2016 USD ($) physician_practice center	Jun. 30, 2015 USD ($) physician_practice center	Dec. 31, 2015 USD ($)
Segment Reporting Information [Line Items]
Goodwill	$ 4,175,008		$ 4,175,008		$ 3,970,210
Increase in goodwill			207,333
Goodwill deductible for tax purposes	100,900	$ 107,600	100,900	$ 107,600
Amortization of Intangible Assets	21,100	$ 14,700	41,500	$ 29,200
Estimated amortization of intangible assets, remainder of 2016	44,900		44,900
Estimated amortization of intangible assets, 2017	88,600		88,600
Estimated amortization of intangible assets, 2018	87,400		87,400
Estimated amortization of intangible assets, 2019	84,700		84,700
Estimated amortization of intangible assets, 2020	82,400		82,400
Estimated amortization of intangible assets, 2021	78,000		78,000
Estimated amortization of intangible assets, 2022 and thereafter	976,300		$ 976,300
Weighted average amortization period			17 years 328 days
Series of Individually Immaterial Business Acquisitions [Member]
Segment Reporting Information [Line Items]
Goodwill	209,194		$ 209,194
Ambulatory Services [Member]
Segment Reporting Information [Line Items]
Goodwill	2,100,000		2,100,000
Increase in goodwill			$ 38,400
Number of business acquisitions | center			4	4
Physician Services [Member]
Segment Reporting Information [Line Items]
Goodwill	$ 2,100,000		$ 2,100,000
Increase in goodwill			$ 166,400
Physician Services [Member] | Series of Individually Immaterial Business Acquisitions [Member]
Segment Reporting Information [Line Items]
Number of business acquisitions | physician_practice			6	4
Joint Venture [Member] | Ambulatory Services [Member]
Segment Reporting Information [Line Items]
Number Of Consolidated Entities Contributed To Joint Venture | center			1

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Goodwill And Intangible Assets (Changes In Carrying Amount Of Goodwill) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2016 USD ($)
Goodwill [Roll Forward]
Balance, beginning of period	$ 3,970,210
Goodwill acquired, including post acquisition adjustments	207,333
Goodwill disposed, including impact of deconsolidation transactions	(2,535)
Balance, end of period	$ 4,175,008

XML

Goodwill And Intangible Assets (Summary Of Intangible Assets) (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Indefinite-lived Intangible Assets [Line Items]
Non-amortizable intangible assets	$ 236,995	$ 236,995
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,588,743	1,462,706
Accumulated Amortization	(146,463)	(105,064)
Net	1,442,280	1,357,642
Total intangible assets, gross carrying amount	1,825,738	1,699,701
Accumulated Amortization	(146,463)	(105,064)
Total intangible assets, net	1,679,275	1,594,637
Trade name [Member]
Indefinite-lived Intangible Assets [Line Items]
Non-amortizable intangible assets	228,000	228,000
Restrictive covenant arrangements [Member]
Indefinite-lived Intangible Assets [Line Items]
Non-amortizable intangible assets	8,995	8,995
Customer relationships with hospitals [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,494,790	1,379,977
Accumulated Amortization	(109,444)	(74,490)
Net	1,385,346	1,305,487
Accumulated Amortization	(109,444)	(74,490)
Capitalized software [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	81,595	71,462
Accumulated Amortization	(33,500)	(28,125)
Net	48,095	43,337
Accumulated Amortization	(33,500)	(28,125)
Agreements, contracts, and other intangible assets
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	12,358	11,267
Accumulated Amortization	(3,519)	(2,449)
Net	8,839	8,818
Accumulated Amortization	$ (3,519)	$ (2,449)

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Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Accrued Liabilities, Current [Abstract]
Accrued professional liabilities	$ 14,541	$ 14,362
Contingent purchase price payable	1,000	5,509
Current income taxes payable	0	7,892
Refunds payable	29,626	48,415
Other	47,404	43,059
Total other accrued liabilities	$ 92,571	$ 119,237

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Accrued Professional Liabilities - Components of Reserves (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Payables and Accruals [Abstract]
Estimated losses under self-insured programs	$ 32,652	$ 30,748
Incurred but not reported losses	35,955	36,166
Total accrued professional liabilities	68,607	66,914
Less estimated losses payable within one year	14,541	14,362
Total	$ 54,066	$ 52,552

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Accrued Professional Liabilities - Rollforward of Reserves (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2016 USD ($)
Self Insurance Reserve [Roll Forward]
Balance at December 31, 2015	$ 66,914
Assumed liabilities through acquisitions	1,862
Provision related to current period reserves	10,037
Payments for current period reserves	(39)
Benefit related to changes in prior period reserves	(249)
Payments for prior period reserves	(6,307)
Other, net including post-acquisition adjustments	(3,611)
Balance at June 30, 2016	$ 68,607

XML

Long-Term Debt (Narrative) (Details) - USD ($) $ in Thousands		6 Months Ended
	Jul. 16, 2014	Jun. 30, 2016	Dec. 31, 2015	Oct. 21, 2015	Nov. 20, 2012
Revolving Credit Facility [Member]
Schedule of Capitalization, Long-term Debt [Line Items]
Long-term Debt		$ 400,000	$ 175,000
Term Loan and Credit Facility
Line of Credit Facility, Remaining Borrowing Capacity		$ 100,000
Senior Secured Credit Facility - Term Loan [Member]
Term Loan and Credit Facility
Borrowing capacity of new revolving credit agreement	$ 870,000
Quarterly principal payment as a percent of face amount	0.25%
Annual principal payment	$ 8,700
Senior Secured Credit Facility - Term Loan [Member] | Base Rate [Member] | Maximum [Member]
Term Loan and Credit Facility
Basis spread	2.00%
Senior Secured Credit Facility - Term Loan [Member] | Base Rate [Member] | Minimum [Member]
Term Loan and Credit Facility
Basis spread	1.75%
Senior Secured Credit Facility - Term Loan [Member] | LIBOR [Member]
Term Loan and Credit Facility
Floor rate	0.75%
Current variable rate		3.50%
Senior Secured Credit Facility - Term Loan [Member] | LIBOR [Member] | Maximum [Member]
Term Loan and Credit Facility
Basis spread	3.00%
Senior Secured Credit Facility - Term Loan [Member] | LIBOR [Member] | Minimum [Member]
Term Loan and Credit Facility
Basis spread	2.75%
Revolving Credit Facility [Member]
Term Loan and Credit Facility
Borrowing capacity of new revolving credit agreement	$ 500,000			$ 500,000
Increase to borrowing capacity from exercise of accordion feature				$ 200,000
Unused capacity commitment fee, percentage	0.375%
Revolving Credit Facility [Member] | Base Rate [Member] | Maximum [Member]
Term Loan and Credit Facility
Basis spread	2.00%
Revolving Credit Facility [Member] | Base Rate [Member] | Minimum [Member]
Term Loan and Credit Facility
Basis spread	1.75%
Revolving Credit Facility [Member] | LIBOR [Member] | Maximum [Member]
Term Loan and Credit Facility
Basis spread	3.00%
Revolving Credit Facility [Member] | LIBOR [Member] | Minimum [Member]
Term Loan and Credit Facility
Basis spread	2.75%
Fixed Interest Rate [Member]
Schedule of Capitalization, Long-term Debt [Line Items]
Long-term Debt		$ 1,391,100
Long-term Debt, Fair Value		1,438,200
Variable Interest Rate [Member]
Schedule of Capitalization, Long-term Debt [Line Items]
Long-term Debt, Fair Value		1,253,600
5.625% Senior Unsecured Notes due 2020 [Member] | Senior Notes [Member]
Schedule of Capitalization, Long-term Debt [Line Items]
Long-term Debt		250,000	250,000
Senior Unsecured Debt
Face amount					$ 250,000
Interest rate					5.625%
Senior Secured Debt
Face amount					$ 250,000
Interest rate					5.625%
5.625% Senior Unsecured Notes due 2022 [Member] | Senior Notes [Member]
Schedule of Capitalization, Long-term Debt [Line Items]
Long-term Debt		$ 1,100,000	$ 1,100,000
Senior Unsecured Debt
Face amount	$ 1,100,000
Interest rate	5.625%
Redeemable principal percentage		35.00%
Senior Secured Debt
Face amount	$ 1,100,000
Interest rate	5.625%
5.625% Senior Unsecured Notes due 2022 [Member] | Period Prior to July 15, 2017 [Member] | Senior Notes [Member]
Senior Unsecured Debt
Redemption price as percent of the principal amount		105.625%

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Long-Term Debt (Components Of Long-Term Debt) (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Other debt due through 2025	$ 23,920	$ 24,944
Capitalized lease arrangements due through 2026	18,202	18,613
Long-term debt and capitalized lease arrangements	2,644,722	2,425,507
Less current portion	20,772	20,377
Deferred Finance Costs, Noncurrent, Net	42,907	47,174
Long-term debt	2,581,043	2,357,956
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Long-term Debt	400,000	175,000
Term Loan [Member]
Debt Instrument [Line Items]
Long-term Debt	852,600	856,950
5.625% Senior Unsecured Notes due 2020 [Member] | Senior Notes [Member]
Debt Instrument [Line Items]
Long-term Debt	250,000	250,000
5.625% Senior Unsecured Notes due 2022 [Member] | Senior Notes [Member]
Debt Instrument [Line Items]
Long-term Debt	$ 1,100,000	$ 1,100,000

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Long-Term Debt (Redemption Price) (Details) - Senior Notes [Member]	6 Months Ended
	Jun. 30, 2016
2015 [Member] | 5.625% Senior Unsecured Notes due 2020 [Member]
Redemption price as percent of the principal amount	104.219%
2016 [Member] | 5.625% Senior Unsecured Notes due 2020 [Member]
Redemption price as percent of the principal amount	102.813%
2017 [Member] | 5.625% Senior Unsecured Notes due 2020 [Member]
Redemption price as percent of the principal amount	101.406%
2017 [Member] | 5.625% Senior Unsecured Notes due 2022 [Member]
Redemption price as percent of the principal amount	104.219%
2018 and thereafter [Member] | 5.625% Senior Unsecured Notes due 2020 [Member]
Redemption price as percent of the principal amount	100.00%
2018 [Member] | 5.625% Senior Unsecured Notes due 2022 [Member]
Redemption price as percent of the principal amount	102.813%
2019 [Member] | 5.625% Senior Unsecured Notes due 2022 [Member]
Redemption price as percent of the principal amount	101.406%
2020 and thereafter [Member] | 5.625% Senior Unsecured Notes due 2022 [Member]
Redemption price as percent of the principal amount	100.00%

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Other Long-Term Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Other Long-Term Liabilities [Abstract]
Accrued professional liabilities	$ 54,066	$ 52,552
Deferred Rent	27,330	18,958
Tax-effected unrecognized benefits	3,426	3,426
Other	34,656	21,247
Other long-term liabilities	$ 119,478	$ 96,183

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Shareholder's Equity (Narrative) (Details) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended				6 Months Ended
	Dec. 31, 2015 USD ($) $ / shares shares	Jun. 30, 2016 USD ($) $ / shares shares	Mar. 31, 2016 USD ($) $ / shares	Jun. 30, 2015 USD ($) $ / shares shares	Mar. 31, 2015 USD ($) $ / shares	Jun. 30, 2016 USD ($) installment $ / shares shares	Jun. 30, 2015 USD ($) shares	Jun. 30, 2014 shares
Common Stock:
Repurchase of common stock, shares						77,780	67,000
Repurchase of common stock | $						$ 5,700	$ 3,700
Mandatory Convertible Preferred Stock
Preferred stock dividends | $		$ (2,264)	$ (2,300)	$ (2,264)	$ (2,300)	$ (4,528)	$ (4,528)
Preferred Stock, Shares Outstanding	1,725,000	1,725,000				1,725,000
Stock Incentive Plans:
Number of shares authorized for grant under share incentive plan		3,200,000				3,200,000		1,200,000
Shares available for future grants/issuance under stock incentive plan		2,396,435				2,396,435
Unrecognized compensation cost on non vested awards | $		$ 45,600				$ 45,600
Weighted average period						1 year 2 months
Number of units granted						586,791
Grant date value of common stock | $ / shares						$ 74.00
Stock Options [Member]
Stock Incentive Plans:
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period						4 years
Options term						10 years
Employees [Member] | Restricted Stock [Member]
Stock Incentive Plans:
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period						4 years
Number of installments in restricted stock granted. | installment						3
Mandatory Convertible Preferred Stock [Member]
Stock Incentive Plans:
Number of anti-dilutive options				3,100,000			3,100,000
Stock Options [Member]
Stock Incentive Plans:
Number of anti-dilutive options		0		0		0	0
Common Stock [Member]
Issuance of stock (in shares)	5,835,000
Issuance of stock, price per share | $ / shares	$ 80.00
Stock offering expenses | $	$ 19,100
Mandatory Convertible Preferred Stock [Member]
Mandatory Convertible Preferred Stock
Dividend rate						5.25%
Initial liquidation preference (usd per share) | $ / shares		$ 100				$ 100
Consecutive trading day						20 days
Dividends declared (usd per share) | $ / shares		$ 1.3125	$ 1.3125	$ 1.3125	$ 1.3125
Minimum [Member] | Mandatory Convertible Preferred Stock [Member]
Mandatory Convertible Preferred Stock
Conversion rate		1.8141				1.8141
Maximum [Member] | Mandatory Convertible Preferred Stock [Member]
Mandatory Convertible Preferred Stock
Conversion rate		2.2222				2.2222
Performance-based Restricted Stock Units [Member]
Stock Incentive Plans:
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period						3 years
Number of units granted						74,752
Grant date value of common stock | $ / shares						$ 74.09
Performance goal period for vesting						1 year
Projected vesting percentage						150.00%
Performance-based Restricted Stock Units [Member] | Minimum [Member]
Stock Incentive Plans:
Projected vesting percentage						0.00%
Performance-based Restricted Stock Units [Member] | Maximum [Member]
Stock Incentive Plans:
Projected vesting percentage						150.00%

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Shareholders' Equity (Share-Based Activity) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Equity [Abstract]
Share-based compensation expense	$ 7,900	$ 3,883	$ 15,068	$ 7,592
Fair value of shares vested	1,282	1,746	18,243	13,220
Cash received from option exercises	174	334	450	2,080
Tax benefit from exercises of share-based awards	$ 129	$ 216	$ 3,734	$ 3,533

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Shareholders Equity (Schedule Of Changes In Non-Vested Restricted Shares) (Details)	6 Months Ended
	Jun. 30, 2016 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Non-vested shares at beginning of period, Number of Shares | shares	734,101
Shares granted, Number of Shares | shares	586,791
Shares vested, Number of Shares | shares	(249,421)
Shares forfeited, Number of Shares | shares	(5,407)
Non-vested shares at end of period, Number of Shares | shares	1,066,064
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Non-vested shares at beginning of period, Weighted Average Grant Price | $ / shares	$ 44.73
Shares granted, Weighted Average Grant Price | $ / shares	74.00
Shares vested, Weighted Average Grant Price | $ / shares	38.61
Shares forfeited, Weighted Average Grant Price | $ / shares	55.40
Non-vested shares at end of period, Weighted Average Grant Price | $ / shares	$ 62.22

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Shareholder's Equity (Schedule of Stock Option Activity (Details) - $ / shares	6 Months Ended	12 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Outstanding at beginning of period, Number of Shares	33,751
Options exercised, Number of Shares	(19,718)
Options terminated, Number of Shares	(4,200)
Outstanding at end of period, Number of Shares	9,833	33,751
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Outstanding at beginning of period, Weighted Average Exercise Price	$ 22.98
Options exercised, Weighted Average Exercise Price	22.84
Options terminated, Weighted Average Exercise Price	21.07
Outstanding at end of period, Weighted Average Exercise Price	$ 24.09	$ 22.98
Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]
Outstanding at beginning of period, Weighted Average Remaining Contractual Life (in years)	180 days	1 year 36 days
Outstanding at end of period, Weighted Average Remaining Contractual Life (in years)	180 days	1 year 36 days

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Shareholder's Equity (Schedule of Stock Option Activity-Additional) (Details) $ / shares in Units, $ in Millions	6 Months Ended
	Jun. 30, 2016 USD ($) $ / shares shares
Equity [Abstract]
Total intrinsic value with options exercised	$ 1.0
Aggregate intrinsic value of options outstanding	0.5
Total intrinsic value of options vested or expected to vest	$ 0.5
Vested or expected to vest at end of period, Number of Shares | shares	9,833
Vested or expected to vest at end of period, weighted average exercise price | $ / shares	$ 24.09
Vested or expected to vest at end of period, Weighted Average Remaining Contractual Life (in years)	180 days
Total Intrinsic value of options exercisable	$ 0.5
Exercisable at end of period, Number of Shares | shares	9,833
Exercisable at end of period, Weighted Average Exercise Price | $ / shares	$ 24.09
Exercisable at end of period, Weighted Average Remaining Contractual Life (in years)	180 days

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Shareholder's Equity (Schedule Of Reconciliation Of Numerator And Denominators Of Basic And Diluted Earnings Per Share) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Convertible Preferred Dividends, Net of Tax	$ 2,264		$ 4,528
Net earnings (loss) from continuing operations attributable to AmSurg Corp. common shareholders (Numerator)	$ 43,805	$ 31,411	$ 72,404	$ 50,185
Net earnings (loss) from continuing operations attributable to AmSurg Corp. common shareholders (basic), shares (Denominator)	53,739	47,678	53,702	47,625
Earnings Per Share, Basic	$ 0.82	$ 0.66	$ 1.35	$ 1.05
Effect of dilutive securities, options and non-vested shares	3,588	421	3,527	377
Net Income (Loss) Attributable to Parent, Diluted	$ 46,069	$ 31,411	$ 76,932	$ 50,185
Net earnings (loss) from continuing operations attributable to AmSurg Corp. (diluted), shares (Denominator)	57,327	48,099	57,229	48,002
Earnings Per Share, Diluted	$ 0.80	$ 0.65	$ 1.34	$ 1.05
Mandatory Convertible Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Number of anti-dilutive shares		3,100		3,100

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Income Taxes (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Income Tax Disclosure [Abstract]
Income tax paid, net of refunds	$ 45,726	$ 7,772

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Commitments and Contingencies (Details) ft² in Thousands, $ in Millions		3 Months Ended
	Jan. 16, 2015 USD ($) ft²	Mar. 31, 2017 ft²	Sep. 30, 2016 ft²	Jun. 15, 2016 USD ($)
Schedule Of Operating Leases Square Footage [Line Items]
Lease square footage | ft²	222
Annual rent expense	$ 2.9
Scenario, Forecast [Member]
Schedule Of Operating Leases Square Footage [Line Items]
Lease square footage | ft²		55	167
Merger of AmSurg and Envision into New Amethyst [Member]
Schedule Of Operating Leases Square Footage [Line Items]
Potential merger termination fee				$ 180.0
Potential merger termination reimbursement of expenses				$ 15.0

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Segment Reporting (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016 USD ($)	Jun. 30, 2015 USD ($)	Jun. 30, 2016 USD ($) segment	Jun. 30, 2015 USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment			2
Segment Reporting Information [Line Items]
Net revenue	$ 758,499	$ 641,950	$ 1,483,177	$ 1,212,395
Adjusted EBITDA	149,243	127,972	269,343	221,727
Earnings from continuing operations attributable to noncontrolling interests	57,050	57,072	110,891	104,789
Interest expense, net	(31,913)	(30,182)	(62,723)	(60,429)
Depreciation and amortization	(30,054)	(23,612)	(59,126)	(46,430)
Share-based compensation	(7,900)	(3,883)	(15,068)	(7,592)
Net change in fair value of contingent consideration	2,598	(6,410)	2,598	(6,410)
Transaction costs	(5,135)	(1,982)	(6,525)	(3,453)
Deconsolidation And Disposals, Gain (Loss), Amount	2,595	(3,035)	2,595	(3,258)
Earnings before income taxes	136,484	115,940	241,985	198,944
Acquisition and Capital Expenditures	300,050	87,336	318,731	228,697
Ambulatory Services [Member]
Segment Reporting Information [Line Items]
Net revenue	319,747	310,991	626,881	594,901
Adjusted EBITDA	61,746	60,304	115,372	107,612
Acquisition and Capital Expenditures	35,031	64,514	43,401	118,610
Physician Services [Member]
Segment Reporting Information [Line Items]
Net revenue	438,752	330,959	856,296	617,494
Adjusted EBITDA	87,497	67,668	153,971	114,115
Net change in fair value of contingent consideration			2,600
Acquisition and Capital Expenditures	$ 265,019	$ 22,822	$ 275,330	$ 110,087

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Financial Information for the Company and Its Subsidiaries (Balance Sheets) (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015	Jun. 30, 2015	Dec. 31, 2014
Assets
Cash and cash equivalents	$ 74,105	$ 106,660	$ 126,289	$ 208,079
Restricted cash and marketable securities	12,794	13,506
Accounts receivable, net	375,352	337,330
Supplies inventory	21,980	21,406
Prepaid and other current assets	74,565	75,771
Total current assets	558,796	554,673
Property and equipment, net	204,922	189,168
Investments in and receivables from unconsolidated affiliates	179,056	169,170
Goodwill	4,175,008	3,970,210
Intangible assets, net	1,679,275	1,594,637
Other assets	46,263	21,450
Total assets	6,843,320	6,499,308
Liabilities and Equity
Current portion of long-term debt	20,772	20,377
Accounts payable	30,721	32,561
Accrued salaries and benefits	186,908	202,537
Accrued interest	30,400	30,480
Other accrued liabilities	92,571	119,237
Total current liabilities	361,372	405,192
Long-term debt	2,581,043	2,357,956
Deferred income taxes	743,447	699,498
Other long-term liabilities	119,478	96,183
Intercompany payable	0	0
Noncontrolling interests – redeemable	177,845	175,732
Equity:
Total AmSurg Corp. equity	2,377,278	2,293,463
Noncontrolling interests – non-redeemable	482,857	471,284
Total equity	2,860,135	2,764,747
Total liabilities and equity	6,843,320	6,499,308
Consolidation, Eliminations [Member]
Assets
Cash and cash equivalents	0	0	0	0
Restricted cash and marketable securities	0	0
Accounts receivable, net	0	0
Supplies inventory	0	0
Prepaid and other current assets	(21,312)	(8,076)
Total current assets	(21,312)	(8,076)
Property and equipment, net	0	0
Investments in and receivables from unconsolidated affiliates	(6,848,343)	(6,507,128)
Goodwill	2,051,941	2,013,469
Intangible assets, net	0	0
Other assets	(1,999)	(1,998)
Total assets	(4,819,713)	(4,503,733)
Liabilities and Equity
Current portion of long-term debt	0	0
Accounts payable	(3,561)	(3,852)
Accrued salaries and benefits	0	0
Accrued interest	0	0
Other accrued liabilities	(17,751)	(4,224)
Total current liabilities	(21,312)	(8,076)
Long-term debt	(26,054)	(23,396)
Deferred income taxes	(1,998)	(1,998)
Other long-term liabilities	0	0
Intercompany payable	(1,228,157)	(1,228,157)
Noncontrolling interests – redeemable	116,959	112,672
Equity:
Total AmSurg Corp. equity	(4,092,881)	(3,778,478)
Noncontrolling interests – non-redeemable	433,730	423,700
Total equity	(3,659,151)	(3,354,778)
Total liabilities and equity	(4,819,713)	(4,503,733)
Parent Company [Member]
Assets
Cash and cash equivalents	4,591	20,437	43,658	134,351
Restricted cash and marketable securities	0	0
Accounts receivable, net	0	0
Supplies inventory	0	0
Prepaid and other current assets	45,542	28,739
Total current assets	50,133	49,176
Property and equipment, net	11,877	12,515
Investments in and receivables from unconsolidated affiliates	5,219,975	4,901,026
Goodwill	0	0
Intangible assets, net	13,037	12,780
Other assets	7,186	4,653
Total assets	5,302,208	4,980,150
Liabilities and Equity
Current portion of long-term debt	8,700	8,700
Accounts payable	3,073	2,816
Accrued salaries and benefits	29,533	31,510
Accrued interest	30,386	30,463
Other accrued liabilities	5,171	13,962
Total current liabilities	76,863	87,451
Long-term debt	2,550,996	2,326,103
Deferred income taxes	288,503	268,573
Other long-term liabilities	8,568	4,560
Intercompany payable	0	0
Noncontrolling interests – redeemable	0	0
Equity:
Total AmSurg Corp. equity	2,377,278	2,293,463
Noncontrolling interests – non-redeemable	0	0
Total equity	2,377,278	2,293,463
Total liabilities and equity	5,302,208	4,980,150
Guarantor Subsidiaries [Member]
Assets
Cash and cash equivalents	16,215	27,507	27,112	23,471
Restricted cash and marketable securities	0	0
Accounts receivable, net	258,863	223,434
Supplies inventory	0	0
Prepaid and other current assets	24,074	39,046
Total current assets	299,152	289,987
Property and equipment, net	27,822	14,601
Investments in and receivables from unconsolidated affiliates	1,807,424	1,775,272
Goodwill	2,123,067	1,956,741
Intangible assets, net	1,664,313	1,579,537
Other assets	20,825	1,717
Total assets	5,942,603	5,617,855
Liabilities and Equity
Current portion of long-term debt	20	0
Accounts payable	1,640	3,760
Accrued salaries and benefits	140,149	158,705
Accrued interest	0	0
Other accrued liabilities	69,166	76,590
Total current liabilities	210,975	239,055
Long-term debt	36	0
Deferred income taxes	456,942	432,923
Other long-term liabilities	76,144	71,509
Intercompany payable	1,228,157	1,228,157
Noncontrolling interests – redeemable	0	0
Equity:
Total AmSurg Corp. equity	3,967,431	3,646,211
Noncontrolling interests – non-redeemable	2,918	0
Total equity	3,970,349	3,646,211
Total liabilities and equity	5,942,603	5,617,855
Non-Guarantor Subsidiaries [Member]
Assets
Cash and cash equivalents	53,299	58,716	$ 55,519	$ 50,257
Restricted cash and marketable securities	12,794	13,506
Accounts receivable, net	116,489	113,896
Supplies inventory	21,980	21,406
Prepaid and other current assets	26,261	16,062
Total current assets	230,823	223,586
Property and equipment, net	165,223	162,052
Investments in and receivables from unconsolidated affiliates	0	0
Goodwill	0	0
Intangible assets, net	1,925	2,320
Other assets	20,251	17,078
Total assets	418,222	405,036
Liabilities and Equity
Current portion of long-term debt	12,052	11,677
Accounts payable	29,569	29,837
Accrued salaries and benefits	17,226	12,322
Accrued interest	14	17
Other accrued liabilities	35,985	32,909
Total current liabilities	94,846	86,762
Long-term debt	56,065	55,249
Deferred income taxes	0	0
Other long-term liabilities	34,766	20,114
Intercompany payable	0	0
Noncontrolling interests – redeemable	60,886	63,060
Equity:
Total AmSurg Corp. equity	125,450	132,267
Noncontrolling interests – non-redeemable	46,209	47,584
Total equity	171,659	179,851
Total liabilities and equity	$ 418,222	$ 405,036

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Financial Information for the Company and Its Subsidiaries (Income Statements) (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2015	Mar. 31, 2015	Jun. 30, 2016	Jun. 30, 2015
Condensed Financial Statements, Captions [Line Items]
Net revenue	$ 758,499		$ 641,950		$ 1,483,177	$ 1,212,395
Operating expenses:
Salaries and benefits	404,011		320,396		813,850	622,575
Supply cost	49,703		45,790		96,666	88,374
Other operating expenses	111,145		105,002		218,827	195,572
Transaction costs	5,135		1,982		6,525	3,453
Depreciation and amortization	30,054		23,612		59,126	46,430
Total operating expenses	600,048		496,782		1,194,994	956,404
Net gain (loss) on disposals and deconsolidations	2,595		(3,035)		2,595	(3,258)
Equity in earnings of unconsolidated affiliates	7,351		3,989		13,930	6,640
Operating income	168,397		146,122		304,708	259,373
Interest expense (income), net	31,913		30,182		62,723	60,429
Earnings before income taxes	136,484		115,940		241,985	198,944
Income tax expense	33,365		25,193		54,162	39,442
Net earnings	103,119		90,747		187,823	159,502
Less net earnings attributable to noncontrolling interests	57,050		57,072		110,891	104,789
Net earnings attributable to AmSurg Corp. shareholders	46,069		33,675		76,932	54,713
Preferred stock dividends	(2,264)	$ (2,300)	(2,264)	$ (2,300)	(4,528)	(4,528)
Net earnings attributable to AmSurg Corp. common shareholders	43,805		31,411		72,404	50,185
Consolidation, Eliminations [Member]
Condensed Financial Statements, Captions [Line Items]
Net revenue	(10,290)		(9,488)		(20,598)	(18,342)
Operating expenses:
Salaries and benefits	(135)		(124)		(268)	(252)
Supply cost	(20)		(34)		(33)	(34)
Other operating expenses	(10,135)		(9,330)		(20,297)	(18,056)
Transaction costs	0		0		0	0
Depreciation and amortization	0		0		0	0
Total operating expenses	(10,290)		(9,488)		(20,598)	(18,342)
Net gain (loss) on disposals and deconsolidations	0		0		0	188
Equity in earnings of unconsolidated affiliates	(149,288)		(137,455)		(277,187)	(249,774)
Operating income	(149,288)		(137,455)		(277,187)	(249,586)
Interest expense (income), net	0		0		0	0
Earnings before income taxes	(149,288)		(137,455)		(277,187)	(249,586)
Income tax expense	0		0		0	0
Net earnings	(149,288)		(137,455)		(277,187)	(249,586)
Less net earnings attributable to noncontrolling interests	0		0		0	0
Net earnings attributable to AmSurg Corp. shareholders	(149,288)		(137,455)		(277,187)	(249,586)
Preferred stock dividends	0		0		0	0
Net earnings attributable to AmSurg Corp. common shareholders	(149,288)		(137,455)		(277,187)	(249,586)
Parent Company [Member]
Condensed Financial Statements, Captions [Line Items]
Net revenue	7,700		7,079		16,244	14,170
Operating expenses:
Salaries and benefits	22,246		15,511		46,341	33,154
Supply cost	0		0		0	0
Other operating expenses	6,034		5,783		13,652	12,417
Transaction costs	2,099		324		2,276	592
Depreciation and amortization	1,103		1,056		2,175	1,890
Total operating expenses	31,482		22,674		64,444	48,053
Net gain (loss) on disposals and deconsolidations	0		0		0	(188)
Equity in earnings of unconsolidated affiliates	87,700		76,931		156,742	137,318
Operating income	63,918		61,336		108,542	103,247
Interest expense (income), net	(4,215)		11,978		(7,034)	23,864
Earnings before income taxes	68,133		49,358		115,576	79,383
Income tax expense	22,064		15,683		38,644	24,670
Net earnings	46,069		33,675		76,932	54,713
Less net earnings attributable to noncontrolling interests	0		0		0	0
Net earnings attributable to AmSurg Corp. shareholders	46,069		33,675		76,932	54,713
Preferred stock dividends	(2,264)		(2,264)		(4,528)	(4,528)
Net earnings attributable to AmSurg Corp. common shareholders	43,805		31,411		72,404	50,185
Guarantor Subsidiaries [Member]
Condensed Financial Statements, Captions [Line Items]
Net revenue	437,042		329,579		852,872	615,158
Operating expenses:
Salaries and benefits	305,173		228,618		614,753	440,219
Supply cost	1,145		489		2,152	885
Other operating expenses	44,213		42,099		87,552	71,710
Transaction costs	3,036		1,658		4,249	2,861
Depreciation and amortization	21,192		14,617		41,528	28,924
Total operating expenses	374,759		287,481		750,234	544,599
Net gain (loss) on disposals and deconsolidations	2,857		(3,035)		2,857	(3,223)
Equity in earnings of unconsolidated affiliates	68,939		64,513		134,375	119,096
Operating income	134,079		103,576		239,870	186,432
Interest expense (income), net	35,528		17,624		68,504	35,378
Earnings before income taxes	98,551		85,952		171,366	151,054
Income tax expense	10,858		9,021		14,632	13,924
Net earnings	87,693		76,931		156,734	137,130
Less net earnings attributable to noncontrolling interests	(7)		0		(7)	0
Net earnings attributable to AmSurg Corp. shareholders	87,700		76,931		156,741	137,130
Preferred stock dividends	0		0		0	0
Net earnings attributable to AmSurg Corp. common shareholders	87,700		76,931		156,741	137,130
Non-Guarantor Subsidiaries [Member]
Condensed Financial Statements, Captions [Line Items]
Net revenue	324,047		314,780		634,659	601,409
Operating expenses:
Salaries and benefits	76,727		76,391		153,024	149,454
Supply cost	48,578		45,335		94,547	87,523
Other operating expenses	71,033		66,450		137,920	129,501
Transaction costs	0		0		0	0
Depreciation and amortization	7,759		7,939		15,423	15,616
Total operating expenses	204,097		196,115		400,914	382,094
Net gain (loss) on disposals and deconsolidations	(262)		0		(262)	(35)
Equity in earnings of unconsolidated affiliates	0		0		0	0
Operating income	119,688		118,665		233,483	219,280
Interest expense (income), net	600		580		1,253	1,187
Earnings before income taxes	119,088		118,085		232,230	218,093
Income tax expense	443		489		886	848
Net earnings	118,645		117,596		231,344	217,245
Less net earnings attributable to noncontrolling interests	57,057		57,072		110,898	104,789
Net earnings attributable to AmSurg Corp. shareholders	61,588		60,524		120,446	112,456
Preferred stock dividends	0		0		0	0
Net earnings attributable to AmSurg Corp. common shareholders	$ 61,588		$ 60,524		$ 120,446	$ 112,456

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Financial Information for the Company and Its Subsidiaries (Cash Flow Statements) (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Cash flows from operating activities:
Net cash flows provided by operating activities	$ 195,105	$ 251,395
Cash flows from investing activities:
Acquisitions and related expenses	(281,113)	(196,032)
Acquisition of property and equipment	(37,618)	(32,665)
Proceeds from sale of interests in surgery centers	25	0
Purchases of marketable securities	(498)	(1,245)
Maturities of marketable securities	2,738	2,988
Other	(8,749)	(1,987)
Net cash flows used in investing activities	(325,215)	(228,941)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	317,151	7,795
Repayment on long-term borrowings and revolving credit facility	(98,763)	(10,288)
Distributions to owners, including noncontrolling interests	(115,589)	(101,033)
Capital contributions	0	0
Changes in intercompany balances with affiliates, net	0	0
Other, net	(5,244)	(718)
Net cash flows provided by (used in) financing activities	97,555	(104,244)
Net decrease in cash and cash equivalents	(32,555)	(81,790)
Cash and cash equivalents, beginning of period	106,660	208,079
Cash and cash equivalents, end of period	74,105	126,289
Consolidation, Eliminations [Member]
Cash flows from operating activities:
Net cash flows provided by operating activities	(230,713)	(126,382)
Cash flows from investing activities:
Acquisitions and related expenses	268,155	53,538
Acquisition of property and equipment	0	0
Proceeds from sale of interests in surgery centers	0
Purchases of marketable securities	0	0
Maturities of marketable securities	0	0
Other	0	0
Net cash flows used in investing activities	268,155	53,538
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	0	0
Repayment on long-term borrowings and revolving credit facility	0	0
Distributions to owners, including noncontrolling interests	230,713	126,382
Capital contributions	(265,258)	(51,852)
Changes in intercompany balances with affiliates, net	0	0
Other, net	(2,897)	(1,686)
Net cash flows provided by (used in) financing activities	(37,442)	72,844
Net decrease in cash and cash equivalents	0	0
Cash and cash equivalents, beginning of period	0	0
Cash and cash equivalents, end of period	0	0
Parent Company [Member]
Cash flows from operating activities:
Net cash flows provided by operating activities	39,294	(27,553)
Cash flows from investing activities:
Acquisitions and related expenses	(265,258)	(51,852)
Acquisition of property and equipment	(1,676)	(4,490)
Proceeds from sale of interests in surgery centers	0
Purchases of marketable securities	0	0
Maturities of marketable securities	0	0
Other	0	0
Net cash flows used in investing activities	(266,934)	(56,342)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	313,000	0
Repayment on long-term borrowings and revolving credit facility	(92,350)	(4,350)
Distributions to owners, including noncontrolling interests	0	0
Capital contributions	0	0
Changes in intercompany balances with affiliates, net	(2,657)	444
Other, net	(6,199)	(2,892)
Net cash flows provided by (used in) financing activities	211,794	(6,798)
Net decrease in cash and cash equivalents	(15,846)	(90,693)
Cash and cash equivalents, beginning of period	20,437	134,351
Cash and cash equivalents, end of period	4,591	43,658
Guarantor Subsidiaries [Member]
Cash flows from operating activities:
Net cash flows provided by operating activities	131,227	172,907
Cash flows from investing activities:
Acquisitions and related expenses	(284,010)	(197,718)
Acquisition of property and equipment	(19,916)	(9,424)
Proceeds from sale of interests in surgery centers	25
Purchases of marketable securities	0	0
Maturities of marketable securities	0	0
Other	(4,057)	(1,441)
Net cash flows used in investing activities	(307,958)	(208,583)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	0	0
Repayment on long-term borrowings and revolving credit facility	(9)	0
Distributions to owners, including noncontrolling interests	(102,330)	(15,108)
Capital contributions	265,258	51,852
Changes in intercompany balances with affiliates, net	0	0
Other, net	2,520	2,573
Net cash flows provided by (used in) financing activities	165,439	39,317
Net decrease in cash and cash equivalents	(11,292)	3,641
Cash and cash equivalents, beginning of period	27,507	23,471
Cash and cash equivalents, end of period	16,215	27,112
Non-Guarantor Subsidiaries [Member]
Cash flows from operating activities:
Net cash flows provided by operating activities	255,297	232,423
Cash flows from investing activities:
Acquisitions and related expenses	0	0
Acquisition of property and equipment	(16,026)	(18,751)
Proceeds from sale of interests in surgery centers	0
Purchases of marketable securities	(498)	(1,245)
Maturities of marketable securities	2,738	2,988
Other	(4,692)	(546)
Net cash flows used in investing activities	(18,478)	(17,554)
Cash flows from financing activities:
Proceeds from long-term borrowings and revolving credit facility	4,151	7,795
Repayment on long-term borrowings and revolving credit facility	(6,404)	(5,938)
Distributions to owners, including noncontrolling interests	(243,972)	(212,307)
Capital contributions	0	0
Changes in intercompany balances with affiliates, net	2,657	(444)
Other, net	1,332	1,287
Net cash flows provided by (used in) financing activities	(242,236)	(209,607)
Net decrease in cash and cash equivalents	(5,417)	5,262
Cash and cash equivalents, beginning of period	58,716	50,257
Cash and cash equivalents, end of period	$ 53,299	$ 55,519