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