Accounts Receivable (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense			$ 359,290	$ 212,546
Allowances for accounts receivable	$ 251,414		$ 251,414		$ 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			86.00%		80.00%
Ambulatory Services [Member] | Other Operating Expenses [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	5,600	$ 5,500	$ 17,700	16,500
Physician Services [Member]
Accounts, Notes, Loans and Financing Receivable [Line Items]
Bad debt expense	$ 146,606	$ 62,492	$ 341,547	$ 196,027