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Acquisitions and divestitures (Tables)
 6 Months Ended
Jun. 30, 2019
Business Acquisition [Line Items]  
Schedule of Business Acquisitions by Acquisition, Contingent Consideration
The following is a reconciliation of changes in contingent earn-out obligations for the six months ended June 30, 2019:
Beginning balance December 31, 2018
$
2,608

Contingent earn-out obligations associated with acquisitions
12,440

Remeasurement of fair value for contingent earn-out obligations
(101
)
Payments on contingent earn-out obligations
(217
)
Ending balance June 30, 2019
$
14,730
Dialysis and other businesses  
Business Acquisition [Line Items]  
Assets Acquired and Liabilities Assumed in Business Acquisitions
The following table summarizes the assets acquired and liabilities assumed in these transactions at their estimated acquisition date fair values: 
Current assets
$
3,607

Property and equipment
2,135

Intangible and other long-term assets
8,443

Goodwill
66,614

Current liabilities
(2,067
)
Long-term liabilities
(88
)
Noncontrolling interests
(1,762
)

$
76,882