Held for Sale and Discontinued Operations Schedule of Financial Position of Discontinued Operations Related to DMG (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total current assets held for sale	$ 5,947,786	$ 5,761,642
Total current liabilities held for sale	1,419,621	1,185,070
DMG held for sale | Discontinued Operations, Held-for-sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash and cash equivalents	444,468	179,668
Other current assets	848,905	826,608
Property and equipment, net	438,332	379,945
Intangible assets, net	1,316,571	1,316,550
Other long-term assets	114,236	178,894
Goodwill	2,883,475	2,879,977
Valuation Allowance On Disposal Group	(98,201)	0
Other liabilities	652,502	505,734
Medical payables	457,748	457,040
Current portion of long-term debt	2,839	2,845
Long-term debt	33,595	35,003
Other long-term liabilities	$ 272,937	$ 184,448