Segment Reporting (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016 USD ($)	Sep. 30, 2015 USD ($)	Sep. 30, 2016 USD ($) segment	Sep. 30, 2015 USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment			2
Segment Reporting Information [Line Items]
Net revenue	$ 822,216	$ 650,227	$ 2,305,393	$ 1,862,622
Adjusted EBITDA	153,049	133,177	422,392	354,904
Net earnings attributable to noncontrolling interests	55,626	55,618	166,517	160,407
Interest expense, net	(32,915)	(30,242)	(95,638)	(90,671)
Depreciation and amortization	(31,585)	(24,106)	(90,711)	(70,536)
Share-based compensation	(6,175)	(3,727)	(21,243)	(11,319)
Net change in fair value of contingent consideration	0	(1,928)	2,598	(8,338)
Transaction costs	(16,906)	(2,107)	(23,431)	(5,560)
Net gain on disposals and deconsolidations	4,144	9,112	6,739	5,854
Earnings before income taxes	125,238	135,797	367,223	334,741
Acquisition and Capital Expenditures	97,012	51,799	415,743	280,496
Ambulatory Services [Member]
Segment Reporting Information [Line Items]
Net revenue	314,609	308,983	941,490	903,884
Adjusted EBITDA	61,111	55,353	176,483	162,965
Acquisition and Capital Expenditures	24,521	25,872	67,923	144,482
Physician Services [Member]
Segment Reporting Information [Line Items]
Net revenue	507,607	341,244	1,363,903	958,738
Adjusted EBITDA	91,938	77,824	245,909	191,939
Net change in fair value of contingent consideration			2,600
Acquisition and Capital Expenditures	$ 72,491	$ 25,927	$ 347,820	$ 136,014