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