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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