Veradigm (MDRX) 10-K 22 Feb 19 2018 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2018	Feb. 20, 2019	Jun. 29, 2018
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	FY
Trading Symbol	MDRX
Entity Registrant Name	ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
Entity Central Index Key	1,124,804
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		171,331,796
Entity Public Float			$ 2,055,742,140

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 174,243	$ 119,470
Restricted cash	10,552	11,524
Accounts receivable, net of allowance of $50,406 and $31,386 as of December 31, 2018 and December 31, 2017, respectively	465,264	492,560
Contract assets	66,451	0
Prepaid expenses and other current assets	142,455	106,455
Current assets attributable to discontinued operations	0	127,101
Total current assets	858,965	857,110
Fixed assets, net	121,913	135,417
Software development costs, net	209,660	194,845
Intangible assets, net	431,081	435,573
Goodwill	1,373,744	1,292,747
Deferred taxes, net	5,036	4,574
Contract assets - long-term	71,879	0
Other assets	109,206	146,851
Long-term assets attributable to discontinued operations	0	1,163,033
Total assets	3,181,484	4,230,150
Current liabilities:
Accounts payable	73,166	85,749
Accrued expenses	106,072	77,800
Accrued compensation and benefits	100,076	83,072
Income tax payable	29,644	0
Deferred revenue	466,797	478,574
Current maturities of long-term debt	20,059	27,687
Current maturities of capital lease obligations	996	1,102
Current liabilities attributable to discontinued operations	920	135,641
Total current liabilities	797,730	889,625
Long-term debt	647,539	906,725
Long-term capital lease obligations	768	2,347
Deferred revenue	15,984	19,208
Deferred taxes, net	58,470	23,258
Other liabilities	80,566	89,864
Long-term liabilities attributable to discontinued operations	0	707,516
Total liabilities	1,601,057	2,638,543
Redeemable convertible non-controlling interest attributable to discontinued operations	0	431,535
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of December 31, 2018 and December 31, 2017	0	0
Common stock: $0.01 par value, 349,000 shares authorized as of December 31, 2018 and December 31, 2017; 270,955 and 171,224 shares issued and outstanding as of December 31, 2018, respectively; 269,335 and 180,832 shares issued and outstanding as of December 31, 2017, respectively	2,709	2,693
Treasury stock: at cost, 99,731 and 88,504 shares as of December 31, 2018 and December 31, 2017, respectively	(460,543)	(322,735)
Additional paid-in capital	1,881,494	1,781,059
Retained earnings (accumulated deficit)	132,842	(338,150)
Accumulated other comprehensive loss	(5,389)	(1,985)
Total Allscripts Healthcare Solutions, Inc.'s stockholders' equity	1,551,113	1,120,882
Non-controlling interest	29,314	39,190
Total stockholders’ equity	1,580,427	1,160,072
Total liabilities and stockholders’ equity	$ 3,181,484	$ 4,230,150

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Accounts receivable, allowance	$ 50,406	$ 31,386
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	349,000,000	349,000,000
Common stock, shares issued	270,955,000	269,335,000
Common stock, shares outstanding	171,224,000	180,832,000
Treasury stock at cost, shares	99,731,000	88,504,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Revenue from contract with customers			$ 442,346,000	$ 432,430,000	$ 441,464,000	$ 433,722,000	$ 436,411,000	$ 368,091,000	$ 350,150,000	$ 343,056,000	$ 1,749,962,000	$ 1,497,708,000	$ 1,386,069,000
Cost of revenue:
Amortization of software development and acquisition-related assets											102,876,000	84,725,000	71,215,000
Total cost of revenue			254,187,000	254,478,000	267,697,000	249,057,000	260,208,000	205,843,000	199,930,000	198,928,000	1,025,419,000	864,909,000	784,770,000
Gross profit			188,159,000	177,952,000	173,767,000	184,665,000	176,203,000	162,248,000	150,220,000	144,128,000	724,543,000	632,799,000	601,299,000
Selling, general and administrative expenses			99,992,000	108,125,000	122,913,000	119,937,000	123,113,000	93,790,000	91,033,000	92,752,000	450,967,000	400,688,000	334,521,000
Research and development			66,096,000	63,032,000	74,491,000	64,790,000	68,344,000	46,485,000	42,205,000	45,248,000	268,409,000	202,282,000	178,534,000
Asset impairment charges			28,091,000	0	30,075,000	0					58,166,000	0	4,650,000
Goodwill impairment charge	$ 0	$ 0	13,466,000	0	0	0					13,466,000	0	0
Amortization of intangible and acquisition-related assets			6,957,000	6,609,000	6,382,000	6,639,000	6,005,000	3,816,000	3,745,000	3,779,000	26,587,000	17,345,000	15,884,000
(Loss) income from operations			(26,443,000)	186,000	(60,094,000)	(6,701,000)	(21,259,000)	18,157,000	13,237,000	2,349,000	(93,052,000)	12,484,000	67,710,000
Interest expense			(13,989,000)	(13,251,000)	(11,979,000)	(11,695,000)	(11,594,000)	(9,251,000)	(8,279,000)	(8,416,000)	(50,914,000)	(37,540,000)	(29,478,000)
Other income (loss), net			658,000	(536,000)	(14,000)	(34,000)	160,000	(685,000)	(222,000)	235,000	74,000	(512,000)	829,000
Gain on sale of businesses, net			0	0	173,129,000	(871,000)					172,258,000	0	0
Impairment of long-term investments			0	0	(9,987,000)	(5,500,000)	0	(20,700,000)	(144,590,000)	0	(15,487,000)	(165,290,000)	0
Equity in net income (loss) of unconsolidated investments			(270,000)	(177,000)	767,000	(61,000)	115,000	449,000	(28,000)	285,000	259,000	821,000	(7,501,000)
Income (loss) from continuing operations before income taxes			(40,044,000)	(13,778,000)	91,822,000	(24,862,000)	(32,578,000)	(12,030,000)	(139,882,000)	(5,547,000)	13,138,000	(190,037,000)	31,560,000
Income tax (provision) benefit			5,449,000	1,637,000	(7,256,000)	(299,000)	9,973,000	(1,962,000)	(1,263,000)	(1,234,000)	(469,000)	5,514,000	(309,000)
Income (loss) from continuing operations, net of tax			(34,595,000)	(12,141,000)	84,566,000	(25,161,000)	(22,605,000)	(13,992,000)	(141,145,000)	(6,781,000)	12,669,000	(184,523,000)	31,251,000
Loss from discontinued operations			(39,854,000)	(13,857,000)	(14,109,000)	(5,016,000)					(72,836,000)	(11,915,000)	(46,344,000)
Gain on sale of Netsmart			500,471,000	0	0	0					500,471,000	0	0
Income tax effect on discontinued operations			(40,126,000)	2,152,000	3,815,000	1,662,000					(32,497,000)	42,263,000	18,123,000
Income (loss) from discontinued operations, net of tax			420,491,000	(11,705,000)	(10,294,000)	(3,354,000)	37,468,000	(3,470,000)	(1,866,000)	(1,784,000)	395,138,000	30,348,000	(28,221,000)
Net income (loss)			385,896,000	(23,846,000)	74,272,000	(28,515,000)	14,863,000	(17,462,000)	(143,011,000)	(8,565,000)	407,807,000	(154,175,000)	3,030,000
Less: Net loss (income) attributable to non-controlling interests			1,033,000	4,000	2,700,000	790,000	1,918,000	(163,000)	264,000	(453,000)	4,527,000	1,566,000	(146,000)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations			(12,148,000)	(12,149,000)	(12,148,000)	(12,149,000)	(10,963,000)	(10,962,000)	(10,963,000)	(10,962,000)	(48,594,000)	(43,850,000)	(28,536,000)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders			$ 374,781,000	$ (35,991,000)	$ 64,824,000	$ (39,874,000)	$ 5,818,000	$ (28,587,000)	$ (153,710,000)	$ (19,980,000)	$ 363,740,000	$ (196,459,000)	$ (25,652,000)
Basic
Continuing operations			$ (0.19)	$ (0.07)	$ 0.49	$ (0.14)	$ (0.12)	$ (0.08)	$ (0.78)	$ (0.04)	$ 0.10	$ (1.02)	$ 0.17
Discontinued operations			2.36	(0.13)	(0.13)	(0.08)	0.15	(0.08)	(0.07)	(0.07)	1.97	(0.07)	(0.31)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share			2.17	(0.20)	0.36	(0.22)	0.03	(0.16)	(0.85)	(0.11)	2.07	(1.09)	(0.14)
Diluted
Continuing operations			(0.19)	(0.07)	0.49	(0.14)	(0.12)	(0.08)	(0.78)	(0.04)	0.10	(1.02)	0.17
Discontinued operations			2.33	(0.13)	(0.13)	(0.08)	0.15	(0.08)	(0.07)	(0.07)	1.94	(0.07)	(0.31)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share			$ 2.14	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.04	$ (1.09)	$ (0.14)
Software delivery, Support and Maintenance [Member]
Revenue:
Revenue from contract with customers											$ 1,128,263,000	$ 958,187,000	$ 899,299,000
Cost of revenue:
Total cost of revenue											357,039,000	295,593,000	276,401,000
Client services [Member]
Revenue:
Revenue from contract with customers											621,699,000	539,521,000	486,770,000
Cost of revenue:
Total cost of revenue											$ 565,504,000	$ 484,591,000	$ 437,154,000

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement Of Income And Comprehensive Income [Abstract]
Net income (loss)	$ 407,807	$ (154,175)	$ 3,030
Other comprehensive (loss) income:
Foreign currency translation adjustments	(2,908)	3,352	(1,528)
Change in unrealized gain (loss) on available for sale securities	0	56,359	(56,359)
Change in fair value of derivatives qualifying as cash flow hedges	(873)	114	597
Other comprehensive (loss) income before income tax (provision) benefit	(3,781)	59,825	(57,290)
Income tax benefit (provision) related to items in other comprehensive income (loss)	377	19	(297)
Total other comprehensive (loss) income	(3,404)	59,844	(57,587)
Comprehensive income (loss)	404,403	(94,331)	(54,557)
Less: Comprehensive loss (income) attributable to non-controlling interests	4,527	1,566	(146)
Comprehensive income (loss), net	$ 408,930	$ (92,765)	$ (54,703)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock Issued [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive (Loss) Income [Member]	Non-controlling interest [Member]
Beginning Balance, Shares at Dec. 31, 2015		266,545	(77,237)
Beginning Balance at Dec. 31, 2015	$ 1,419,073	$ 2,665	$ (189,753)	$ 1,789,449	$ (190,235)	$ (4,242)	$ 11,189
Stock-based compensation				34,544
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,452
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 15		(8,133)
Issuance of treasury stock, Shares			0
Issuance of treasury stock	0		$ 0	0
Tax deficiency realized upon exercise of stock-based awards				(1,280)
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations				(28,536)
Purchase of treasury stock, Shares			(10,250)
Purchase of treasury stock			$ (121,240)
Warrants issued				3,915
Net (loss) income less net income attributable to non-controlling interests					2,884
Foreign currency translation adjustments, net	(1,528)					(1,528)
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						361
Unrecognized gain (loss) on available for sale securities, net of tax						(56,420)
Acquisition of non-controlling interest				0			29,400
ASC 606 implementation adjustments | ASC 606					0
Net (loss) income attributable to non-controlling interests	146						146
Recognition of previously unrecognized excess tax benefits					0
Ending Balance, Shares at Dec. 31, 2016		267,997	(87,487)
Ending Balance at Dec. 31, 2016	1,273,201	$ 2,680	$ (310,993)	1,789,959	(187,351)	(61,829)	40,735
Stock-based compensation				35,337
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,338
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 13		(5,767)
Issuance of treasury stock, Shares			22
Issuance of treasury stock	334		$ 335	(76)
Tax deficiency realized upon exercise of stock-based awards				0
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations				(43,850)
Subsidiary issuance of common stock				1,473
Purchase of treasury stock, Shares			(1,039)
Purchase of treasury stock			$ (12,077)
Warrants issued				3,983
Net (loss) income less net income attributable to non-controlling interests					(152,609)
Foreign currency translation adjustments, net	3,352					3,352
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						72
Unrecognized gain (loss) on available for sale securities, net of tax						56,420
Acquisition of non-controlling interest				0			21
ASC 606 implementation adjustments | ASC 606					0
Net (loss) income attributable to non-controlling interests	$ (1,566)						(1,566)
Recognition of previously unrecognized excess tax benefits					1,810
Ending Balance, Shares at Dec. 31, 2017	269,335	269,335	(88,504)
Ending Balance at Dec. 31, 2017	$ 1,160,072	$ 2,693	$ (322,735)	1,781,059	(338,150)	(1,985)	39,190
Stock-based compensation				34,638
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,620
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 16		(8,197)
Issuance of treasury stock, Shares			76
Issuance of treasury stock	1,121		$ 1,121	(61)
Tax deficiency realized upon exercise of stock-based awards				0
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations				72,386
Subsidiary issuance of common stock				0
Purchase of treasury stock, Shares			(11,303)
Purchase of treasury stock			$ (138,929)
Warrants issued				2,729
Net (loss) income less net income attributable to non-controlling interests					412,334
Foreign currency translation adjustments, net	(2,908)					(2,908)
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						(496)
Unrecognized gain (loss) on available for sale securities, net of tax						0
Acquisition of non-controlling interest				(1,060)			(5,349)
ASC 606 implementation adjustments | ASC 606					58,658
Net (loss) income attributable to non-controlling interests	$ (4,527)						(4,527)
Recognition of previously unrecognized excess tax benefits					0
Ending Balance, Shares at Dec. 31, 2018	270,955	270,955	(99,731)
Ending Balance at Dec. 31, 2018	$ 1,580,427	$ 2,709	$ (460,543)	$ 1,881,494	$ 132,842	$ (5,389)	$ 29,314

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net income (loss)	$ 407,807,000	$ (154,175,000)	$ 3,030,000
Less: Income (loss) from discontinued operations	395,138,000	30,348,000	(28,221,000)
Income (loss) from continuing operations	12,669,000	(184,523,000)	31,251,000
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	192,346,000	157,328,000	136,328,000
Stock-based compensation expense	34,638,000	36,540,000	37,093,000
Deferred taxes	4,144,000	(10,228,000)	(4,520,000)
Asset impairment charges	58,166,000	0	4,650,000
Goodwill impairment charge	13,466,000	0	0
Impairment of long-term investments	15,487,000	165,290,000	0
Equity in net income of unconsolidated investments	(259,000)	(821,000)	7,501,000
Gain on sale of businesses, net	(172,258,000)	0	0
Other (losses) income, net	(9,079,000)	3,726,000	3,526,000
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable and contract assets, net	(109,134,000)	(95,189,000)	(8,918,000)
Prepaid expenses and other assets	(55,818,000)	13,219,000	4,454,000
Accounts payable	(19,159,000)	(19,785,000)	45,524,000
Accrued expenses	40,484,000	10,131,000	(2,774,000)
Accrued compensation and benefits	13,440,000	18,717,000	(10,514,000)
Deferred revenue	58,010,000	112,684,000	(11,418,000)
Other liabilities	12,091,000	17,969,000	2,165,000
Net cash provided by operating activities - continuing operations	89,234,000	225,058,000	234,348,000
Net cash (used in) provided by operating activities - discontinued operations	(21,343,000)	54,357,000	34,656,000
Net cash provided by operating activities	67,891,000	279,415,000	269,004,000
Cash flows from investing activities:
Capital expenditures	(31,309,000)	(38,759,000)	(32,107,000)
Capitalized software	(113,308,000)	(118,241,000)	(92,179,000)
Cash paid for business acquisitions, net of cash acquired	(177,233,000)	(169,823,000)	(99,837,000)
Cash received from sale of businesses, net	807,764,000	0	0
Purchases of equity securities, other investments and related intangible assets	(16,934,000)	(5,606,000)	(21,185,000)
Other proceeds from investing activities	54,000	215,000	37,000
Net cash provided by (used in) investing activities - continuing operations	469,034,000	(332,214,000)	(245,271,000)
Net cash used in investing activities - discontinued operations	(221,021,000)	(80,758,000)	(908,735,000)
Net cash provided by (used in) investing activities	248,013,000	(412,972,000)	(1,154,006,000)
Cash flows from financing activities:
Proceeds from sale or issuance of common stock	1,283,000	1,568,000	84,000
Excess tax benefits from stock-based compensation	0	0	1,014,000
Taxes paid related to net share settlement of equity awards	(9,466,000)	(7,269,000)	(8,204,000)
Payments of capital lease obligations	(553,000)	(1,283,000)	(370,000)
Credit facility payments	(713,751,000)	(138,139,000)	(155,170,000)
Credit facility borrowings, net of issuance costs	430,843,000	325,001,000	250,000,000
Repurchase of common stock	(138,928,000)	(12,077,000)	(121,241,000)
Payment of acquisition financing obligations	(4,645,000)	0	0
Purchases of subsidiary shares owned by non-controlling interest	(7,198,000)	0	0
Net cash (used in) provided by financing activities - continuing operations	(442,415,000)	167,801,000	(33,887,000)
Net cash provided by financing activities - discontinued operations	149,432,000	30,784,000	899,158,000
Net cash (used in) provided by financing activities	(292,983,000)	198,585,000	865,271,000
Effect of exchange rate changes on cash and cash equivalents	(624,000)	860,000	(532,000)
Net increase (decrease) in cash and cash equivalents	22,297,000	65,888,000	(20,263,000)
Cash, cash equivalents and restricted cash, beginning of period	162,498,000	96,610,000	116,873,000
Cash, cash equivalents and restricted cash, end of period	184,795,000	162,498,000	96,610,000
Less: Cash and cash equivalents included in current assets attributable to discontinued operations	0	(31,504,000)	(25,064,000)
Cash, cash equivalents and restricted cash, end of period, excluding discontinued operations	$ 184,795,000	$ 130,994,000	$ 71,546,000

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	1. Basis of Presentation and Significant Accounting Policies Principles of Consolidation The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated. Use of Estimates The preparation of consolidated financial statements in accordance with generally accepted accounting principles in the United States of America (“GAAP”) requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Actual results could differ materially from these estimates. Change in Presentation During 2018, we changed the presentation of certain bundled revenue streams and the associated cost of revenue which were previously included as part of software delivery, support and maintenance revenue. Under the new presentation, these amounts are included as part of client services revenue and cost of revenue, respectively. We have recast previously reported revenue and cost of revenue amounts to conform with the new presentation. This change in presentation had no impact on previously reported gross profit, net income (loss) or earnings (loss) per share. The following table illustrates the recast of cost of revenue and gross profit for the quarterly periods and the year ended December 31, 2018. Quarterly revenue previously reported during fiscal 2018 already reflected this change in presentation. Quarter ended Year ended (In thousands) March 31, 2018 June 30, 2018 September 30, 2018 December 31, 2018 December 31, 2018 Cost of revenue reclassification: Software delivery, support and maintenance $ (4,033 ) $ (7,202 ) $ (6,394 ) $ (6,400 ) $ (24,029 ) Client services 4,033 7,202 6,394 6,400 24,029 Amortization of software development and acquisition-related assets 0 0 0 0 0 Total cost of revenue: 0 0 0 0 0 Gross profit impact: Software delivery, support and maintenance (4,033 ) (7,202 ) (6,394 ) (6,400 ) (24,029 ) Client services 4,033 7,202 6,394 6,400 24,029 Total gross profit $ 0 $ 0 $ 0 $ 0 $ 0 The following table illustrates the recast for revenue and associated cost of revenue for the quarterly periods and the year ended December 31, 2017: Quarter ended Year ended (In thousands) March 31, 2017 June 30, 2017 September 30, 2017 December 31, 2017 December 31, 2017 Revenue reclassification: Software delivery, support and maintenance $ (4,270 ) $ (4,239 ) $ (5,119 ) $ (4,703 ) $ (18,331 ) Client services 4,270 4,239 5,119 4,703 18,331 Total revenue 0 0 0 0 0 Cost of revenue reclassification: Software delivery, support and maintenance (5,056 ) (5,556 ) (5,454 ) (5,454 ) (21,520 ) Client services 5,056 5,556 5,454 5,454 21,520 Amortization of software development and acquisition-related assets 0 0 0 0 0 Total cost of revenue: 0 0 0 0 0 Gross profit impact: Software delivery, support and maintenance 786 1,317 335 751 3,189 Client services (786 ) (1,317 ) (335 ) (751 ) (3,189 ) Total gross profit $ 0 $ 0 $ 0 $ 0 $ 0 The following table illustrates the recast of revenue and associated cost of revenue for the year ended December 31, 2016: Year ended (In thousands) December 31, 2016 Revenue reclassification: Software delivery, support and maintenance $ (8,734 ) Client services 8,734 Total revenue 0 Cost of revenue reclassification: Software delivery, support and maintenance (17,831 ) Client services 17,831 Amortization of software development and acquisition-related assets 0 Total cost of revenue: 0 Gross profit impact: Software delivery, support and maintenance 9,097 Client services (9,097 ) Total gross profit $ 0 Revenue Recognition We adopted Financial Accounting Standards Board (“FASB”) Accounting Standards Update 2014-09, Revenue from Contracts with Customers: Topic 606 Cash and Cash Equivalents We consider all highly liquid investments with an original maturity of three months or less, when purchased, to be cash equivalents. The fair values of these investments approximate their carrying values. Other Financial Assets and Liabilities Investments classified as available for sale securities included certain equity instruments which have a readily determinable market value. Changes in market value for these instruments, excluding other-than-temporary impairments, are reflected in other comprehensive income. Realized gains and losses are recorded using the specific identification method. We recognized other-than-temporary impairment charges of $142.2 million relating to these equity instrument during the second quarter of 2017. During the third quarter of 2017, we recognized an additional $20.7 million loss upon the final disposition of these instruments in connection with the NantHealth patient/provider engagement solutions business acquisition (refer to Note 3, “Business Combinations and Other Investments”). There were no other-than-temporary impairments related to our available for sale securities for the years ended December 31, 2018 and 2016. We also have investments in other equity investments for which it is not practicable to estimate fair value primarily because of their illiquidity and restricted marketability. Such investments are accounted under the cost and equity methods of accounting. Refer to Note 3, “Business Combinations and Other Investments” for additional information about these investments. Our long-term financial liabilities include borrowings outstanding under our Senior Secured Credit Facility (as defined in Note 8, “Debt”), with carrying values that approximate fair value since the variable interest rates approximate current market rates. In addition, as of December 31, 2018, the fair value of the 1.25% Notes (as defined in Note 8, “Debt”) was approximately equal to the 1.25% Notes’ principal balance (or par). We utilized the 1.25% Notes’ market trading prices near December 31, 2018 in making this fair value assessment. See Note 8, “Debt” for further information regarding our long-term financial liabilities. Derivative Financial Instruments Derivative instruments are recognized as either assets or liabilities and are measured at fair value. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the resulting designation. For derivative instruments designated as cash-flow hedges, the effective portion of the derivative’s gain (loss) is initially reported as a component of other comprehensive income and is subsequently recognized in earnings when the hedged exposure is recognized in earnings. Gains (losses) on derivatives representing either hedge components excluded from the assessment of effectiveness or hedge ineffectiveness are recognized in earnings. See Note 14, “Derivative Financial Instruments” for information regarding gains and losses from derivative instruments during the years ended December 31, 2018, 2017 and 2016. Allowance for Doubtful Accounts Receivable Accounts receivable are recorded at the invoiced amounts and do not bear interest. An allowance for doubtful accounts is recorded to provide for estimated losses resulting from uncollectible accounts and is based principally on specifically identified amounts where collection is deemed doubtful. Additional non-specific allowances are recorded based on historical experience and management’s assessment of a variety of factors related to the general financial condition of our clients, the industry in which we operate and general economic conditions. We regularly review the collectability of individual accounts and assess the adequacy of the allowance for doubtful accounts. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. If the financial condition of our clients were to deteriorate, resulting in an impairment of their ability to make payments, additional allowance and related bad debt expense may be required. Contingent Liabilities A liability is contingent if the amount is not presently known but may become known in the future as a result of the occurrence of some uncertain future event. We accrue a liability for an estimated loss if we determine that the potential loss is probable of occurring and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made. The assessment of contingent liabilities, including legal and income tax contingencies, involves the use of estimates, assumptions and judgments. Our estimates are based on our belief that future events will validate the current assumptions regarding the ultimate outcome of these exposures. However, there can be no assurance that future events, such as court decisions or Internal Revenue Service (“IRS”) positions, will not differ from our assessments. Fixed Assets Fixed assets are stated at cost. Depreciation and amortization are computed under the straight-line method over the estimated useful lives of the related assets. The depreciable life of leasehold improvements is the shorter of the lease term or the useful life. Upon asset retirement or other disposition, the fixed asset cost and the related accumulated depreciation or amortization are removed from the accounts, and any gain or loss is included in the consolidated statements of operations. Amounts incurred for repairs and maintenance are expensed as incurred. Business Combinations Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions as a part of the purchase price allocation process to accurately value the assets acquired, including intangible assets, and the liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we may record adjustments to the fair values of the assets acquired and the liabilities assumed, with a corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or the liabilities assumed, whichever comes first, any subsequent adjustments are reflected in our consolidated statements of operations. Goodwill and Intangible Assets Goodwill and intangible assets acquired in a business combination and determined to have an indefinite useful life are not amortized but are tested for impairment annually or between annual tests when an impairment indicator exists. If an optional qualitative goodwill impairment assessment is not performed, we are required to determine the fair value of each reporting unit. If a reporting unit’s fair value is lower than its carrying value, an impairment loss equal to the excess will be recorded not to exceed the carrying amount of goodwill assigned to the reporting unit. The recoverability of indefinite-lived intangible assets is assessed by comparison of the carrying value of an asset to its estimated fair value. If we determine that the carrying value of an asset exceeds its estimated fair value, an impairment loss equal to the excess will be recorded. The determination of the fair value of our reporting units is based on a combination of a market approach, that considers benchmark company market multiples, and an income approach, that utilizes discounted cash flows for each reporting unit and other Level 3 inputs. Under the income approach, we determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. Additionally, the discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. As part of the goodwill impairment testing, we also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units. In accordance with GAAP, definite-lived intangible assets are required to be amortized over their respective estimated useful lives and reviewed for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We estimate the useful lives of our intangible assets and ratably amortize their value over the estimated useful lives of those assets. If the estimates of the useful lives should change, we will amortize the remaining book value over the remaining useful lives or, if an asset is deemed to be impaired, a write-down of the value of the asset may be required at such time. Long-Lived Assets and Long-Lived Assets to Be Disposed Of We review our long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets. Software Development Costs We capitalize purchased software upon acquisition if it is accounted for as internal-use software or if it meets the future alternative use criteria. We capitalize incurred labor costs for software development from the time technological feasibility of the software is established, or when the preliminary project phase is completed in the case of internal-use software, until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We estimate the useful life of our capitalized software and amortize its value over that estimated life. If the actual useful life is shorter than our estimated useful life, we will amortize the remaining book value over the remaining useful life or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Upon the availability for general release, we commence amortization of the capitalized software costs on a product by product basis. Amortization of capitalized software is recorded using the greater of (i) the ratio of current revenues to total and anticipated future revenues for the applicable product or (ii) the straight-line method over the remaining estimated economic life, which is estimated to be three to five years. At each balance sheet date, the unamortized capitalized costs of a software product are compared with the net realizable value of that product. The net realizable value is the estimated future gross revenues from that product reduced by the estimated future costs of completing and disposing of that product, including the costs of performing maintenance and client support required to satisfy our responsibility set forth at the time of sale. The amount by which the unamortized capitalized costs of a software product exceed the net realizable value of that asset is written off. If we determine that the value of the capitalized software could not be recovered, a write-down of the value of the capitalized software to its recoverable value is recorded as a charge to earnings. The unamortized balances of capitalized software were as follows: December 31, (In thousands) 2018 2017 Software development costs $ 317,637 $ 280,146 Less: accumulated amortization (107,977 ) (85,301 ) Software development costs, net $ 209,660 $ 194,845 Capitalized software development costs, write-offs included in asset impairment changes and amortization of capitalized software development costs included in cost of revenue are shown in the table below. Capitalized software development costs for the year ended December 31, 2016 include $44 million of third-party software purchases to supplement our internal software development efforts, of which $24 million was accrued as of December 31, 2016 and paid during 2017. Year Ended December 31, (In thousands) 2018 2017 2016 Capitalized software development costs $ 113,308 $ 94,740 $ 115,710 Write-offs and divestitures of capitalized software development costs $ 34,083 $ 0 $ 4,625 Amortization of capitalized software development costs $ 64,409 $ 51,589 $ 40,764 Income Taxes We account for income taxes using the liability method, which requires the recognition of deferred tax assets or liabilities for the tax-effected temporary differences between the financial reporting and tax bases of our assets and liabilities and for net operating loss and tax credit carryforwards. The objectives of accounting for income taxes are to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in an entity’s financial statements or tax returns. Judgment is required in addressing the future tax consequences of events that have been recognized in our consolidated financial statements or tax returns. The deferred tax assets are recorded net of a valuation allowance when, based on the weight of available evidence, we believe it is more likely than not that some portion or all of the recorded deferred tax assets will not be realized in future periods. We consider many factors when assessing the likelihood of future realization of our deferred tax assets, including recent cumulative earnings experience, expectations of future taxable income, the ability to carryback losses and other relevant factors. In addition, we are subject to the continuous examination of our income tax returns by the IRS and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements. The calculation of tax liabilities involves dealing with uncertainties in the application of complex tax regulations. We recognize liabilities for anticipated tax audit issues based on our estimate of whether, and the extent to which, additional taxes may be required. If we ultimately determine that payment of these amounts is unnecessary, then we reverse the liability and recognize a tax benefit during the period in which we determine that the liability is no longer necessary. We also recognize tax benefits to the extent that it is more likely than not that our positions will be sustained if challenged by the taxing authorities. To the extent we prevail in matters for which liabilities have been established or are required to pay amounts in excess of our liabilities, our effective tax rate in a given period may be materially affected. An unfavorable tax settlement would require cash payments and may result in an increase in our effective tax rate in the year of resolution. A favorable tax settlement would be recognized as a reduction in our effective tax rate in the year of resolution. We report interest and penalties related to uncertain income tax positions in the income tax (provision) benefit line of our consolidated statements of operations. We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States. Stock-Based Compensation We account for stock-based compensation in accordance with GAAP, which requires the measurement and recognition of compensation expense for all share-based payment awards made to employees and non-employee directors based on their estimated fair value. We measure stock-based compensation cost at the grant date based on the fair value of the award and recognize the expense over the requisite service period typically on a straight-line basis, net of estimated forfeitures. We recognize stock-based compensation cost for awards with performance conditions if and when we conclude that it is probable that the performance conditions will be achieved. The fair value of service-based restricted stock units and restricted stock awards is measured at their underlying closing share price on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. The net proceeds from stock-based compensation activities are reflected as a financing activity within the accompanying consolidated statements of cash flows. We settle employee stock option exercises and stock awards with newly issued common shares. Refer to Note 10, “Stock Award Plans” for detailed discussion about our stock-based incentive plans. Employee Benefit Plans We provide employees with defined contribution savings plans. We recognize expense for our contributions to the savings plans at the time employees make contributions to the plans and we contributed the following amounts to these plans: Year Ended December 31, (In thousands) 2018 2017 2016 Company contributions to employee benefit plans $ 29,393 $ 18,861 $ 18,329 Foreign Currency The determination of the functional currency of our foreign subsidiaries is made based on the appropriate economic and management indicators. Our foreign subsidiaries use the local currency of their respective countries as the functional currency, with the exception of our operating subsidiaries in India and Israel which use the United States dollar as a functional currency. The assets and liabilities of foreign subsidiaries whose functional currency is the local currency are translated into United States dollars at the exchange rates in effect at the consolidated balance sheet date, while revenues and expenses are translated at the average rates of exchange during the year. Translation gains and losses are not included in determining net income or loss but are included as a separate component of accumulated other comprehensive loss. Gains and losses resulting from foreign currency transactions are included in determining net income or loss and have not been material in any years presented in the accompanying consolidated statements of operations. We periodically enter into non-deliverable forward foreign currency exchange contracts in order to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. See Note 14, “Derivative Financial Instruments,” for information regarding these foreign currency exchange contracts. Concentrations of Credit Risk Financial instruments that potentially subject us to a concentration of credit risk consist of cash, cash equivalents, marketable securities and trade receivables. We primarily maintain our cash balances with one major commercial bank domestically and several commercial banks internationally. We sell our products and services to healthcare providers. Credit risk with respect to trade receivables is generally diversified due to the large number of clients and their geographic dispersion. To reduce credit risk, we perform ongoing credit evaluations of significant clients and their payment histories. In general, we do not require collateral from our clients, but we do enter into advance deposit agreements, if appropriate. The majority of our revenue is derived from clients located in the United States. The majority of long-lived assets are also located in the United States. No single client accounted for more than 10% of our revenue in the years ended December 31, 2018, 2017 and 2016. No client represented more than 10% of accounts receivable as of December 31, 2018 or 2017. Recently Adopted Accounting Pronouncements In January 2016, the FASB issued Accounting Standards Update No. 2016-01, “Recognition and Measurement of Financial Assets and Financial Liabilities” In January 2017, the FASB issued Accounting Standards Update No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business In January 2017, the FASB issued Accounting Standards Update No. 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment In August 2018, the FASB issued Accounting Standards Update No. 2018-15, “ Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40)” Accounting Pronouncements Not Yet Adopted In February 2016, the FASB issued Accounting Standards Update No. 2016-02, “ Leases (Topic 842) In June 2016, the FASB issued Accounting Standards Update No. 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities In June 2018, the FASB issued Accounting Standards Update No. 2018-07, “ Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting In August 2018, the FASB issued Accounting Standards Update No. 2018-13, “Fair Value Measurement (Topic 820) – Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

Revenue from Contracts with Cus

Revenue from Contracts with Customers	12 Months Ended
	Dec. 31, 2018
Revenue From Contract With Customer [Abstract]
Revenue from Contracts with Customers	2. Revenue from Contracts with Customers Our two primary revenue streams are (i) software delivery, support and maintenance and (ii) client services. Software delivery, support and maintenance revenue consists of all of our proprietary software sales (either under a perpetual or term license delivery model), subscription-based software sales, transaction-related revenue, the resale of hardware and third-party software and revenue from post-contract client support and maintenance services, which include telephone support services, maintaining and upgrading software and ongoing enhanced maintenance. Client services revenue consists of revenue from managed services solutions, such as private cloud hosting, outsourcing and revenue cycle management, as well as other client services and project-based revenue from implementation, training and consulting services. For other clients, we offer an outsourced service in which we assume partial to total responsibility for a healthcare organization’s IT operations using our employees. Adoption of New Revenue Standard (“ASC 606”) In May 2014, the FASB issued ASC 606 to supersede nearly all existing revenue recognition guidance under GAAP. The core principle of ASC 606 is to recognize revenue when promised goods or services are transferred to customers in an amount that reflects the consideration that is expected to be received for those goods or services. ASC 606 defines a five-step process to achieve this principle and, in doing so, it is possible more judgment and estimates may be required within the revenue recognition process than required under the previous FASB Accounting Standards Codification 605, Revenue Recognition (“ASC 605”), including identifying performance obligations in the contract, estimating the amount of variable consideration to include in the transaction price and allocating the transaction price to each separate performance obligation and accounting for significant financing components. Additionally, ASC 606 provides guidance related to costs of obtaining a contract with a customer that an entity expects to recover. The new revenue recognition guidance permits two methods of adoption: retrospectively to each prior reporting period presented (full retrospective method), or retrospectively with the cumulative effect of initially applying the guidance recognized at the date of initial application (modified retrospective method). We adopted the standard effective on January 1, 2018 using the modified retrospective method. We also implemented internal controls, and continue to refine our updated processes and key systems to allow us to continue to comply with the new requirements. The reported results for the year ended December 31, 2018 reflect the adoption of ASC 606. The comparative information for the years ended December 31, 2017 and 2016 has not been restated and will continue to be reported under the previous guidance of ASC 605, which was in effect during those periods. The table below reflects the cumulative adjustments that were made to balances previously reported in the consolidated balance sheet as of December 31, 2017. As Reported Adjustments Adjusted (In thousands) December 31, 2017 due to ASC 606 January 1, 2018 Accounts receivable, net $ 492,560 $ (19,290 ) $ 473,270 Contract assets 0 77,791 77,791 Prepaid expenses and other current assets 106,455 7,381 113,836 Deferred revenue, current 478,574 (12,810 ) 465,764 Deferred revenue, long-term 19,208 0 19,208 Deferred taxes, net 23,258 20,034 43,292 Accumulated deficit (338,150 ) 58,658 (279,492 ) The following tables compare the reported consolidated balance sheet and statement of operations for the year ended December 31, 2018 to the pro-forma amounts assuming the previous guidance of ASC 605 had been in effect: December 31, 2018 (In thousands) As reported under ASC 606 Adjustments due to ASC 606 Pro forma under ASC 605 Accounts receivable, net $ 465,264 $ 54,489 $ 519,753 Contract assets 66,451 (66,451 ) 0 Prepaid expenses and other current assets 142,455 (7,719 ) 134,736 Contract assets - long-term 71,879 (71,879 ) 0 Deferred revenue, current 466,797 14,691 481,488 Deferred taxes, net 58,470 (27,195 ) 31,275 Retained earnings 132,842 (79,056 ) 53,786 Twelve Months Ended December, 31, 2018 (In thousands, except per share amounts) As reported under ASC 606 Adjustments due to ASC 606 Pro forma under ASC 605 Software delivery, support and maintenance $ 1,128,263 $ (21,780 ) $ 1,106,483 Client services 621,699 (6,185 ) 615,514 Gross profit 724,543 (26,906 ) 697,637 Selling, general and administrative expenses 450,967 (176 ) 450,791 Loss from operations (93,052 ) (26,730 ) (119,782 ) Income (loss) from continuing operations before income taxes 13,138 (27,559 ) (14,421 ) Income tax (provision) benefit (469 ) 7,160 6,691 Income (loss) from continuing operations, net of tax 12,669 (20,399 ) (7,730 ) Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 363,740 $ (20,399 ) $ 343,341 Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 2.07 $ (0.12 ) $ 1.95 Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 2.04 $ (0.11 ) $ 1.93 The recognition of revenue related to hardware sales, software-as-a-service-based offerings, client services, electronic data interchange services and managed services remained substantially unchanged under ASC 606. The adoption of ASC 606 resulted in an increase in contract assets driven by upfront recognition of revenue, rather than over the subscription period, from certain multi-year software subscription contracts that include both software licenses and software support and maintenance. Costs to Obtain or Fulfill a Contract Under ASC 605, we only capitalized direct sales commissions that were specifically associated with new or renewal contracts. The new revenue recognition guidance under ASC 606 requires the capitalization of all incremental costs of obtaining a contract with a customer that an entity expects to recover. As part of our implementation efforts, we identified certain indirect commissions and other payments that were eligible for capitalization under ASC 606 as they were incremental costs solely associated with new or renewal contracts that we expected to recover. Certain costs related to the fulfillment of contracts are also capitalized. As a result, we recorded a deferral for such costs of $5.5 million, net of tax, upon adoption of the new guidance on January 1, 2018, which was included in the cumulative effect of initially applying ASC 606. Capitalized costs to obtain or fulfill a contract are amortized over periods ranging from two to six years which represent the initial contract term or a longer period, if renewals are expected and the renewal commission, if any, is not commensurate with the initial commission. We classify such capitalized costs as current or non-current based on the expected timing of expense recognition. The current and non-current portions are included in Prepaid expenses and other current assets, and Other assets, respectively, in our consolidated balance sheets. At December 31, 2018, we had capitalized costs to obtain or fulfill a contract of $24.7 million in Prepaid and other current assets and $33.8 million in Other assets. During the year ended December 31, 2018, we recognized $29.7 million of amortization expense related to such capitalized costs, which is included in selling, general and administrative expenses. Contract Balances The timing of revenue recognition, billings and cash collections results in billed and unbilled accounts receivables, contract assets and customer advances and deposits. Accounts receivable, net includes both billed and unbilled amounts where the right to receive payment is unconditional and only subject to the passage of time. Contract assets include amounts where revenue recognized exceeds the amount billed to the customer and the right to payment is not solely subject to the passage of time. Deferred revenue includes advanced payments and billings in excess of revenue recognized. Our contract assets and deferred revenue are reported in a net position on an individual contract basis at the end of each reporting period. Contract assets are classified as current or long-term based on the timing of when we expect to complete the related performance obligations and bill the customer. Deferred revenue is classified as current or long-term based on the timing of when we expect to recognize revenue. In general, with the exception of fixed fee project-based client service offerings (such as implementation services), we sell our software solutions on date-based milestone events where control transfers and use of the software occurs on the delivery date but the associated payments for the software license occur on future milestone dates. In such instances, unbilled amounts are included in contract assets since our right to receive payment is conditional upon the continued functionality of the software and the provision of ongoing support and maintenance. Our fixed fee project-based client service offerings typically require us to provide the services with either a significant portion or all amounts due prior to service completion. Since our right to payment is not unconditional, amounts associated with work prior to the completion date are also deemed to be contract assets. Performance Obligations A performance obligation is a promise in a contract to transfer a distinct product or service to a customer and is the unit of account in ASC 606. A performance obligation is considered distinct when both (i) a customer can benefit from the product or service either on its own or together with other resources that are readily available to the customer and (ii) the promised product or service is separately identifiable from other promises in the contract. Activities related to the fulfillment of a contract that do not transfer products or services to a customer, such as contract preparation or legal review of contract terms, are not deemed to be performance obligations. Based on the similarities in the definitions of a “deliverable” under ASC 605 and “performance obligation” under ASC 606, our identification of performance obligations under ASC 606 did not result in a significant divergence from our existing identification approach. We generally sell our solutions through multi-element arrangements where we provide the customer with (1) software license, (2) support and maintenance, (3) embedded content such as third-party software and (4) client services. Incremental solutions, such as hardware and managed services are also provided based upon a customer’s preferences and requirements. We deem that a customer is typically able to benefit from a product or service on its own or together with readily available resources when we sell such product or service on a standalone basis. We have historically sold the majority of our performance obligations, with the exception of software licenses, on a standalone basis. Incremental solutions, such as hardware, client services and managed services, are often negotiated and fulfilled on an independent sales order basis as customer needs and requirements change over the course of a relationship period. In addition, support and maintenance and embedded content are provided on a stand-alone basis through the renewal process. One of the product offerings under our CareInMotion TM Additionally, our support and maintenance obligations include multiple discrete performance obligations, with the two largest being unspecified product upgrades or enhancements, and technical support, which can be offered at various points during a contract period. We believe that the multiple discrete performance obligations within our overall support and maintenance obligations can be viewed as a single performance obligation since both the unspecified product upgrades and technical support are activities to fulfill the maintenance performance obligation and are rendered concurrently. The breakdown of revenue recognized related based on the origination of performance obligations and elected accounting expedients is presented in the table below: (In thousands) Three Months Ended March 31, 2018 Three Months Ended June 30, 2018 Three Months Ended September 30, 2018 Three Months Ended December 31, 2018 Revenue related to deferred revenue balance at beginning of period $ 181,398 $ 196,163 $ 153,151 $ 141,127 Revenue related to new performance obligations satisfied during the period 200,232 180,001 225,641 237,963 Revenue recognized under "right-to-invoice" expedient 49,403 62,533 51,288 60,593 Reimbursed travel expenses, shipping and other revenue 2,689 2,767 2,350 2,663 Total revenue $ 433,722 $ 441,464 $ 432,430 $ 442,346 The aggregate amount of contract transaction price related to remaining unsatisfied performance obligations (commonly referred to as “backlog”) represents contracted revenue that has not yet been recognized and includes both deferred revenue and amounts that will be invoiced and recognized as revenue in future periods. Total backlog equaled $3.9 billion as of December 31, 2018, of which we expect to recognize approximately 39% over the next 12 months, and the remaining 61% thereafter. Transaction price and allocation Our contracts with customers often include multiple distinct performance obligations such as software licenses, software support and maintenance, hardware, client services, private cloud hosting and Software-as-a-Service. We adjust the transaction price on a contract-by-contract basis for (i) the effect of the time value of money when a contract has a significant financing component and/or (ii) customer discounts and incentives deemed to be variable consideration. We then allocate the contract transaction price to the distinct performance obligations in the contract. Such allocation is based on the stand-alone selling price (“SSP”) of each distinct performance obligation. The transaction price allocated to each distinct performance obligation is adjusted for discounts offered to customers that are outside of the Company’s established sufficiently narrow ranges for distinct performance obligations’ SSPs on a relative SSP basis. For each distinct performance obligation, we use observable stand-alone pricing to determine the SSP. Such observable SSPs are based upon our listed sales prices and consider discounts offered to customers. In instances where SSP is not directly observable because we do not sell the product or service separately, we determine the SSP through the residual approach or cost-plus margin models using information that includes market conditions and other observable inputs. Such instances primarily relate to sales of new products and service offerings and our acute suite of software licenses. Our acute suite of software licenses is sold to a diverse set of customers for a broad range of amounts and, therefore, SSP is not discernible from past transactions due to the high variability of selling prices. Our products and services are generally not sold with a right of return, except for certain hardware sales, which are not material to our consolidated revenue. We may provide credits or incentives on a contract-by-contract basis which are accounted for either as a material right or as variable consideration, respectively, when allocating the transaction price. Such credits and incentives have historically not been significant. We do not provide additional warranties to clients above and beyond warranties that the solutions purchased will perform in accordance with the agreed-upon specifications. On rare occasions, when additional warranties are granted, we evaluate on a case-by-case basis whether the additional warranty granted represents a separate performance obligation. Accounting Policy Elections and Practical Expedients We have elected to exclude from the measurement of the transaction price all taxes (e.g., sales, use, value-added) assessed by government authorities and collected from a customer. Therefore, revenue is recognized net of such taxes. Within the normal course of business, we contract with customers to deliver and ship tangible products, such as computer hardware. In these situations, the control of the products transfers to the customer when the product reaches the shipper based on free on board (FOB) shipping clauses. We have elected to use the practical expedient allowed under ASC 606 to account for shipping and handling activities that occur after the customer has obtained control of a promised good as fulfillment costs rather than as an additional promised service and, therefore, we do not allocate a portion of the transaction price to a shipping service obligation. Instead, we record as revenue any amounts billed to customers for shipping and handling costs and record as cost of revenue the actual shipping costs incurred. Additionally, our standard contract terms allow for the reimbursement by a customer for certain travel expenses necessary to provide on-site services to the customer, such as implementation and training. Such reimbursed travel expenses are reported on a gross basis. Since such reimbursed travel expenses do not represent a distinct good or service nor incremental value provided to a customer, a performance obligation is deemed not to exist. In certain situations, however, when the allowable reimbursable expenses amount is capped, we believe that such cap represents the most likely amount of variable consideration and the capped amount is included in the total contract transaction price. In accordance with ASC 606, if an entity has a right to consideration from a customer in an amount that corresponds directly with the value to the customer of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice (“right-to-invoice” practical expedient). We have elected to utilize this expedient as it relates to transaction-based services (such as revenue cycle management) and electronic data interchange transactions. Revenue Recognition We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer. The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment. The following table summarizes the pattern of revenue recognition for our most significant performance obligations: Performance Obligation Revenue Type Recurring or Non-recurring Nature Revenue Recognition Pattern Measure of progress Support and maintenance ("SMA") Software delivery, support and maintenance Recurring Over time Output method (time elapsed) – revenue is recognized ratably over the contract term Software as a service ("SaaS") Software delivery, support and maintenance Recurring Over time Output method (time elapsed) – revenue is recognized ratably over the contract term Private cloud hosting Client services Recurring Over time Output method (time elapsed) – revenue is recognized ratably over the contract term Client/Education services Client services Non-recurring Over time Input method (cost to cost) – revenue is recognized proportionally over the service implementation based on hours Outsourcing services Client services Recurring Over time Input method (cost to cost) – revenue is recognized proportionally over the outsourcing period Payerpath (transaction volume) Software delivery, support and maintenance Recurring Over time Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing. Software licenses Software delivery, support and maintenance Non-recurring Point in time Upon electronic delivery Hardware Software delivery, support and maintenance Non-recurring Point in time Upon shipment Recurring software delivery, support and maintenance revenue consists of recurring subscription-based software sales, support and maintenance revenue, and recurring transaction-related revenue. Non-recurring software delivery, support and maintenance revenue consists of perpetual software licenses sales, resale of hardware and non-recurring transaction-related revenue. Recurring client services revenue consists of revenue from managed services solutions, such as outsourcing, private cloud hosting and revenue cycle management. Non-recurring client services revenue consists of project-based client services revenue. When evaluating our SMA, SaaS and private cloud hosting performance obligations, we noted that these obligations are fulfilled as stand-ready obligations to perform and, therefore, we deem the obligations to be satisfied evenly over time. Client services, such as those relating to implementation, consulting, training or education, are generally not fulfilled evenly over the contract period but rather over a shorter timeline where work effort can rise or decline based upon stages of the project work effort. These client services are typically quoted to a customer as a fixed fee amount that covers the implementation effort. Delivery progress for these services is measured by establishing an approved cost budget with labor hour inputs utilized to gauge percentage of completion of the work effort. Therefore, revenue for our client, education and outsourcing services is recognized proportionally with the progress of the implementation work effort. Payerpath transaction volume and other transaction-based service obligations, such as revenue cycle management services, are fulfilled over time but are not provided evenly over the contract period and reliable inputs are not available to track progress of completion. We determined that value is provided to the customer throughout the contract period and the pricing charged to the customer varies on a monthly basis, based upon the volume of the customer’s transactions processed in that respective period. The invoiced amount to the customer represents this value and, accordingly, the practical expedient to recognize revenue based upon invoicing is most appropriate. We considered the specific implementation guidance for accounting for licenses of intellectual property (“IP”) to determine if point in time or over time recognition was more appropriate. The first step in the licensing framework is to determine whether the license is distinct or combined with other goods and services. For most of our software licensing products, the licenses are distinct, with the exception of one of our product offerings under our CareInMotion TM Disaggregation of Revenue We disaggregate our revenue from contracts with customers based on the type of revenue and nature of revenue stream, as we believe those categories best depict how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors. The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments: Year Ended December 31, (In thousands) 2018 2017 2016 Revenue: Software delivery, support and maintenance Recurring revenue $ 967,990 $ 802,080 $ 752,084 Non-recurring revenue 160,273 156,107 147,215 Total software delivery, support and maintenance 1,128,263 958,187 899,299 Client services Recurring revenue $ 443,752 $ 374,640 $ 324,635 Non-recurring revenue 177,947 164,881 162,135 Total client services 621,699 539,521 486,770 Total revenue $ 1,749,962 $ 1,497,708 $ 1,386,069 Twelve Months Ended December 31, 2018 (In thousands) Clinical and Financial Solutions Population Health Unallocated Total Software delivery, support and maintenance $ 958,144 $ 168,275 $ 1,844 $ 1,128,263 Client services 607,843 22,431 (8,575 ) 621,699 Total revenue $ 1,565,987 $ 190,706 $ (6,731 ) $ 1,749,962 Twelve Months Ended December 31, 2017 (In thousands) Clinical and Financial Solutions Population Health Unallocated Total Software delivery, support and maintenance $ 808,611 $ 160,015 $ (10,439 ) $ 958,187 Client services 528,419 13,794 (2,692 ) 539,521 Total revenue $ 1,337,030 $ 173,809 $ (13,131 ) $ 1,497,708 Twelve Months Ended December 31, 2016 (In thousands) Clinical and Financial Solutions Population Health Unallocated Total Software delivery, support and maintenance $ 710,679 $ 165,532 $ 23,088 $ 899,299 Client services 472,517 11,862 2,391 486,770 Total revenue $ 1,183,196 $ 177,394 $ 25,479 $ 1,386,069

Business Combinations and Other

Business Combinations and Other Investments	12 Months Ended
	Dec. 31, 2018
Business Combinations [Abstract]
Business Combinations and Other Investments	3. Business Combinations and Other Investments 2018 Business Combinations and Divestitures Acquisition of Health Grid On May 18, 2018, we acquired all the capital stock of Health Grid Holding Company, a Delaware corporation (“Health Grid”), for a total price of $110.0 million, consisting of an initial payment of $60.0 million plus up to an aggregate of $50.0 million in future earnout payments based on Health Grid achieving certain revenue targets over the three years following the acquisition. At the time of closing, we pre-paid $10.0 million of the earnout payments and the remaining contingent consideration of up to $40.0 million was valued at $23.9 million. Health Grid is a patient engagement solutions provider that assists independent providers, hospitals and health systems to improve patient interactions and satisfaction. We have integrated the capabilities of Health Grid into our FollowMyHealth ® (In thousands) Aggregate purchase price $ 60,000 First earnout payment paid by Allscripts 10,000 Fair value of contingent consideration payment 23,915 Closing purchase price adjustments 2,009 Total consideration paid for Health Grid $ 95,924 The allocation of the fair value of the consideration transferred as of the acquisition date of May 18, 2018 is shown in the table below. The allocation of purchase price was finalized in the fourth quarter of 2018. The goodwill is not expected to be deductible for tax purposes. (In thousands) Cash and cash equivalents $ 1,783 Accounts receivable, net 3,968 Prepaid expenses and other assets 185 Fixed assets 200 Intangible assets 41,000 Goodwill 53,953 Accounts payable and accrued expenses (478 ) Deferred revenue (700 ) Long-term deferred tax liability (3,987 ) Net assets acquired $ 95,924 The following table summarizes the preliminary fair values of the identifiable intangible assets and their estimated useful lives: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships 15 $ 28,000 Technology 8 13,000 $ 41,000 We incurred $0.5 million of acquisition costs which are included in selling, general and administrative expenses in the accompanying consolidated statement of operations for the year ended December 31, 2018. The results of operations of Health Grid were not material to our consolidated results of operations for the year ended December 31, 2018. Acquisition of Practice Fusion, Inc. On February 13, 2018, we completed the acquisition of Practice Fusion, Inc., a Delaware corporation (“Practice Fusion”), for aggregate consideration of $113.6 million paid in cash. Practice Fusion offers an affordable certified cloud-based electronic health record (“EHR”) for traditionally hard-to-reach small, independent physician practices. The consideration paid for Practice Fusion is shown below: (In thousands) Aggregate purchase price $ 100,000 Add: Net working capital surplus 373 Add: Closing cash 14,951 Less: Adjustment to assumed indebtedness (1,684 ) Total consideration paid for Practice Fusion $ 113,640 The allocation of the fair value of the consideration transferred as of the acquisition date of February 13, 2018 is shown in the table below. (In thousands) Cash and cash equivalents $ 14,951 Accounts receivable, net 13,328 Prepaid expenses and other current assets 809 Fixed assets 1,764 Intangible assets 67,100 Goodwill 35,092 Other assets 42 Accounts payable and accrued expenses (7,378 ) Deferred revenue (2,400 ) Long-term deferred tax liability (8,853 ) Other liabilities (815 ) Net assets acquired $ 113,640 The following table summarizes the fair values of the identifiable intangible assets and their estimated useful lives: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships - Physician Practices 15 $ 29,000 Customer Relationships - Pharmaceutical Partners 20 19,400 Technology 8 14,800 Tradenames 10 3,900 $ 67,100 We incurred $1.2 million of acquisition costs which are included in selling, general and administrative expenses in the consolidated statement of operations for the year ended December 31, 2018. The results of operations of Practice Fusion were not material to our consolidated results of operations for the year ended December 31, 2018. Netsmart LLC Divestiture On December 31, 2018, we sold all of the Class A Common Units of Netsmart LLC, a Delaware limited liability company (“Netsmart”), owned by the Company in exchange for $566.6 million, plus a final settlement as determined following the closing pursuant to the terms of the sales agreement. Netsmart was originally acquired in April 2016 and we realized a pre-tax gain on sale of $500.5 million, which is included on the “Gain on sale of Netsmart” line in our consolidated statements of operations for the year ended December 31, 2018. The divestiture of Netsmart is being treated as a discontinued operation as of December 31, 2018. Refer to Note 16, “Discontinued operations” for further details regarding the historical assets, liabilities and results of operations of Netsmart. Other Acquisitions and Divestitures On June 15, 2018, we acquired all the outstanding minority interest in a third party for $6.9 million. We initially acquired a controlling interest in the third party in April 2015. Therefore, this transaction was treated as an equity transaction and the cash payment is reported as part of cash flow from financing activities in the consolidated statement of cash flows for the year ended December 31, 2018. On April 2, 2018, we sold substantially all of the assets of the Allscripts’ business providing hospitals and health systems document and other content management software and services generally known as “OneContent” to Hyland Software, Inc., an Ohio corporation (“Hyland”). Allscripts acquired the OneContent business during the fourth quarter of 2017 through the acquisition of the EIS Business (as defined below). Certain assets of Allscripts relating to the OneContent business were excluded from the transaction and retained by Allscripts. In addition, Hyland assumed certain liabilities related to the OneContent business. The total consideration for the OneContent business was $260 million, which was subject to certain adjustments for liabilities assumed by Hyland and net working capital. We realized a pre-tax gain upon sale of $177.9 million which is included in the “Gain on sales of businesses, net” line in our consolidated statements of operations for the year ended December 31, 2018. On March 15, 2018, we contributed certain assets and liabilities of our Strategic Sourcing business unit, acquired as part of the acquisition of the EIS Business in 2017, into a new entity together with $2.7 million of cash as additional consideration. In exchange for our contributions, we obtained a 35.7% interest in the new entity, which was valued at $4.0 million, and is included in Other assets in our consolidated balance sheet as of December 31, 2018. This investment is accounted for under the equity method of accounting. As a result of this transaction, we recognized an initial pre-tax loss of $0.9 million and $4.7 million in additional losses due to measurement period adjustments upon the finalization of carve-out balances, mainly related to accounts receivable. These losses are included on the “Gain on sale of businesses, net” line in our consolidated statements of operations for the year ended December 31, 2018. On February 6, 2018, we acquired all of the common stock of a cloud-based analytics software platform provider for a purchase price of $8.0 million in cash. The allocation of the consideration is as follows: $1.1 million of intangible assets related to technology; $0.6 million to customer relationships; $6.6 million of goodwill; $0.8 million to accounts receivable; deferred revenue of $0.6 million and $0.5 million of long-term deferred income tax liabilities. The allocation was finalized in the fourth quarter of 2018. The acquired intangible asset related to technology will be amortized over 8 years using a method that approximates the pattern of economic benefits to be gained from the intangible asset. The customer relationship will be amortized over one year. The goodwill is not expected to be deductible for tax purposes. The results of operations of this acquisition were not material to our consolidated results of operations for the year ended December 31, 2018. Pre-2018 Business Combination Updates Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc. On August 25, 2017, the Company completed the acquisition of substantially all of the assets relating to the provider/patient engagement solutions business of NantHealth, Inc. (“NantHealth”). The consideration for the transaction included the 15,000,000 shares of common stock of NantHealth that had been held by the Company as available for sale securities and which had a fair value of $42.8 million at the time of the transaction. The transaction also includes adjustments for working capital and deferred revenue obligations, as well as a modification of the commercial agreement between the parties. The allocation of the purchase price was finalized during the third quarter of 2018. Total consideration for the transaction was as follows: (In thousands) Cash $ 1,742 Add: Final net working capital surplus 1,022 Add: NantHealth common stock 42,750 Less: Value assigned to modification of existing commercial agreement with NantHealth (22,900 ) Total consideration for NantHealth provider/patient solutions business $ 22,614 The allocation of the fair value of the consideration transferred as of the acquisition date of August 25, 2017 is shown in the table below. The allocation has been finalized and the goodwill is expected to be deductible for tax purposes. (In thousands) Cash and cash equivalents $ 21 Accounts receivable, net 2,069 Prepaid expenses and other current assets 1,735 Fixed assets 3,401 Intangible assets 12,400 Goodwill 13,466 Other assets 204 Accounts payable and accrued expenses (1,477 ) Deferred revenue (9,205 ) Net assets acquired $ 22,614 The following table summarizes the estimated fair values of the most significant identifiable intangible assets and their estimated useful lives: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships 19 $ 9,200 Technology 5 3,000 Tradenames 5 200 $ 12,400 The NantHealth reporting unit incurred goodwill and intangible impairment losses and the existing commercial agreement was expensed during the fourth quarter of 2018. These losses were a result of an analysis of NantHealth’s fair market value conducted during our goodwill impairment review, which is annually performed during the fourth quarter. Refer to Note 6, “Goodwill and Intangible Assets” for further details. Acquisition of the Enterprise Information Solutions Business from McKesson Corporation On October 2, 2017, we purchased McKesson Corporation’s Enterprise Information Solutions Business division (the “EIS Business”), which provides certain software solutions and services to hospitals and health systems, by acquiring all of the outstanding equity interests of two indirect, wholly-owned subsidiaries of McKesson. The acquisition of the EIS Business was based on a total enterprise value of $185 million as shown in the table below. The net consideration paid was funded through incremental borrowings under our debt facilities. (In thousands) Aggregate purchase price $ 185,000 Add: Final net working capital surplus 1,331 Less: Assumption of restructuring indebtedness (16,834 ) Net consideration paid in cash for the EIS Business $ 169,497 The EIS Business acquisition is being accounted for under the acquisition method of accounting in accordance with Accounting Standards Codification Topic 805, Business Combinations The goodwill is expected to be deductible for tax purposes. Among the factors that contributed to a purchase price resulting in the recognition of goodwill were the expected growth and synergies that we believe will result from the integration of the EIS bBusiness with our software solutions and services to hospitals and health systems. The following table summarizes the allocation of the purchase price, which was finalized during the fourth quarter of 2018, as of the acquisition date: (In thousands) Cash and cash equivalents $ 1,068 Accounts receivable, net 72,996 Prepaid expenses and other current assets 19,358 Fixed assets 9,808 Intangible assets 143,000 Goodwill 61,337 Other assets 1,601 Accounts payable and accrued expenses (34,285 ) Deferred revenue (102,523 ) Other liabilities (2,863 ) Net assets acquired $ 169,497 The acquired intangible assets are being amortized over their useful lives, using a method that approximates the pattern of economic benefits to be gained by the intangible asset and consist of the following amounts for each class of acquired intangible asset: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships 10 $ 80,800 Technology 7 58,400 Tradenames 7 3,800 $ 143,000 Acquisition costs related to the EIS Business acquisition totaled $4.8 million for the year ended December 31, 2017. These acquisitions costs are included in selling, general and administrative expenses in the accompanying consolidated statement of operations for the year ended 2017. Supplemental Information The supplemental pro forma results below were calculated after applying our accounting policies and adjusting the results of the EIS Business to reflect (i) the additional amortization that would have been charged resulting from the fair value adjustments to intangible assets and (ii) the additional interest expense associated with Allscripts’ borrowings under its revolving facility, and (iii) the additional amortization of the estimated adjustment to decrease the assumed deferred revenue obligations to fair value that would have been charged assuming the acquisition occurred on January 1, 2017, together with the consequential tax effects. Supplemental pro forma results for the year ended December 31, 2017 were also adjusted to exclude acquisition-related and transaction costs incurred during this period. We also acquired the provider/patient engagement solutions business of NantHealth, Inc. (the “NantHealth business”) on August 25, 2017. The pro forma results below give effect to the NantHealth business acquisition and the EIS Business acquisition as if they had occurred on January 1, 2017 by applying pro forma adjustments attributable to these acquisitions to our historical financial results. (Unaudited) Year Ended December 31, (In thousands, except per share amounts) 2018 (2) 2017 Actual from NantHealth since acquisition date of August 25, 2017: Revenue n/a $ 6,268 Net loss n/a $ (4,393 ) Actual from EIS Business since acquisition date of October 2, 2017: (1) Revenue n/a $ 77,046 Net loss n/a $ (15,160 ) Supplemental pro forma data for combined entity: Revenue n/a $ 1,768,530 Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders n/a $ (192,653 ) Loss per share, basic and diluted n/a $ (1.07 ) ______________________ (1) Revenue and Net loss from the EIS Business excludes revenue and income from discontinued operations. Refer to Note 16, “Discontinued Operations”. (2) Pro forma information is not applicable as the results of NantHealth and the EIS Business were fully consolidated in consolidated statements of operations for the year ended December 31, 2018. The following table summarizes our other equity investments which are included in other assets in the accompanying consolidated balance sheets: Number of Investees Original Carrying Value at (In thousands, except for number of investees) at December 31, 2018 Cost December 31, 2018 December 31, 2017 Equity method investments (1) 8 $ 7,407 $ 10,667 $ 4,258 Cost method investments 5 37,874 25,923 22,020 Total long-term equity investments 13 $ 45,281 $ 36,590 $ 26,278 ( 1) . Other Acquisitions and Investments During 2018, w e acquired certain non-marketable equity securities of two third parties and entered into a commercial agreement with one of the third parties for total consideration of $11.7 million. During 2018, we also acquired a $1.8 million non-marketable convertible note of a third party. The carrying value of these investment is $13.5 million and is included in the “Other assets” line in the consolidated balance sheets as of December 31, 2018. These investments are primarily accounted for under the cost method . During 2017, we acquired a $2.6 million non-marketable convertible note of a third party with which we have an existing investment accounted for under the equity method. The carrying value of the convertible note was $2.6 million and was included in the “Other assets” line in the consolidated balance sheet as of December 31, 2017. During 2017, we acquired certain non-marketable equity securities of two third parties and entered into new commercial agreements with one of these third parties to license and distribute their products and services, for a total consideration of $2.8 million. Both of these investments are accounted for under the cost method. The carrying value of these investments was $3.5 and $2.8 million as of December 31, 2018 and 2017, respectively, and is included in the “Other assets” line in the accompanying consolidated balance sheets. As of December 31, 2018, it is not practicable to estimate the fair value of our equity investments primarily because of their illiquidity and restricted marketability. The factors we considered in trying to determine fair value include, but are not limited to, available financial information, the issuer’s ability to meet its current obligations and the issuer’s subsequent or planned raises of capital. Impairment of and Losses on Long-Term Investments We recognized non-cash impairment charges of $15.5 million during the year ended December 31, 2018 related to two of our cost-method equity investments and a related note receivable. These charges equaled the cost bases of the investments and the related note receivable prior to the impairment. The non-cash impairment charges are included on the Impairment of long-term investments line in our consolidated statements of operations for the year ended December 31, 2018. Each quarter, management performs an assessment of each of our investments on an individual basis to determine if any declines in fair value are other-than-temporary. Based on management's assessment , the Company determined that the decline in fair value of our available for sale marketable securities was other-than-temporary based on a number of factors, including, but not limited to, uncertainty regarding our intent to hold these investments for a period of time that would be sufficient to recover our cost basis in the event of a market recovery, the fact that the fair value of each investment had continued to decline below cost over the period held, and the Company's uncertainty around the near-term prospects for certain of the investments. The cost basis of these marketable securities prior to recognizing the impairment charges was approximately $205.6 million. The Company determined the fair value of these securities based on Level 1 inputs. The aggregate carrying value of this equity investment prior to recognizing the impairment charge was $2.1 million.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements Fair value measurements are based upon observable and unobservable inputs. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our view of market participant assumptions in the absence of observable market information. We utilize valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs. The fair values of assets and liabilities required to be measured at fair value are categorized based upon the level of judgment associated with the inputs used to measure their value in one of the following three categories: Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities. We held no Level 1 financial instruments at December 31, 2018 or 2017. Level 2: Quoted prices for similar instruments in active markets with inputs that are observable, either directly or indirectly. Our Level 2 derivative financial instruments include foreign currency forward contracts valued based upon observable values of spot and forward foreign currency exchange rates. Refer to Note 14, “Derivative Financial Instruments,” for further information regarding these derivative financial instruments. Level 3: Unobservable inputs or prices for which little or no market data exists. The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates: Balance Sheet December 31, 2018 December 31, 2017 (In thousands) Classifications Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Foreign exchange derivative assets Prepaid expenses and other current assets $ 0 $ 262 $ 0 $ 262 $ 0 $ 1,136 $ 0 $ 1,136 1.25% Call Option Other assets 0 0 9,104 9,104 0 0 46,578 46,578 Total assets $ 0 $ 262 $ 9,104 $ 9,366 $ 0 $ 1,136 $ 46,578 $ 47,714 Contingent consideration Accrued expenses $ 0 $ 0 $ 10,528 $ 10,528 $ 0 $ 0 $ 1,950 $ 1,950 Contingent consideration Other liabilities 0 0 15,317 15,317 0 0 5,086 5,086 1.25% Embedded cash conversion option Other liabilities 0 0 9,974 9,974 0 0 47,777 47,777 Total liabilities $ 0 $ 0 $ 35,819 $ 35,819 $ 0 $ 0 $ 54,813 $ 54,813 The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at December 31, 2018 are summarized as follows: (In thousands) Contingent Consideration 1.25% Notes Call Spread Overlay Balance at December 31, 2016 $ 5,285 $ (579 ) Additions 1,923 0 Payments (171 ) 0 Fair value adjustments (1 ) (620 ) Balance at December 31, 2017 7,036 (1,199 ) Additions 24,551 0 Payments (6,067 ) 0 Fair value adjustments 325 329 Balance at December 31, 2018 $ 25,845 $ (870 )

Fixed Assets

Fixed Assets	12 Months Ended
	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Fixed Assets	5. Fixed Assets Fixed assets consist of the following: Estimated December 31, December 31, (Dollar amounts in thousands) Useful Life 2018 2017 Computer equipment and software 3 to 10 years $ 332,826 $ 316,537 Facility furniture, fixtures and equipment 5 to 7 years 21,300 23,923 Leasehold improvements Shorter of 7 years or life of lease 37,555 33,031 Assets under capital leases 3 to 5 years 9,435 7,203 Fixed assets, gross 401,116 380,694 Less: Accumulated depreciation and amortization (279,203 ) (245,277 ) Fixed assets, net $ 121,913 $ 135,417 Accumulated amortization for assets under capital leases amounted to $7.3 million and $5.8 million as of December 31, 2018 and 2017, respectively. Fixed assets depreciation and amortization expense were as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Fixed assets depreciation and amortization expense, including capital leases $ 47,567 $ 40,717 $ 34,314

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets Goodwill and intangible assets consist of the following: December 31, 2018 December 31, 2017 Gross Gross Carrying Accumulated Intangible Carrying Accumulated Intangible (In thousands) Amount Amortization Assets, Net Amount Amortization Assets, Net Intangibles subject to amortization: Proprietary technology $ 537,834 $ (401,093 ) $ 136,741 $ 533,044 $ (365,828 ) $ 167,216 Customer contracts and relationships 704,808 (462,468 ) 242,340 654,849 (438,492 ) 216,357 Total $ 1,242,642 $ (863,561 ) $ 379,081 $ 1,187,893 $ (804,320 ) $ 383,573 Intangibles not subject to amortization: Registered trademarks $ 52,000 $ 52,000 Goodwill 1,373,744 1,292,747 Total $ 1,425,744 $ 1,344,747 During 2018, we made several organizational changes that affected our Clinical and Financial Solutions and Population Health reportable segments. Effective January 1, 2018, the dbMotion business unit, formerly included in the Population Health operating segment within the Population Health reportable segment, is now aligned with the Hospitals and Health Systems operating segment within the Clinical and Financial solutions reportable segment. Effective July 1, 2018, we transferred the Payerpath business, previously included in the Payer and Life Sciences operating segment, to the Ambulatory operating segment, both of which are included within our Clinical and Financial Solutions reportable segment. Effective October 1, 2018, we merged the remaining businesses of the EIS-EWS operating segment with the EIS-Classics operating segment and also merged the NantHealth operating segment with the Hospitals and Health Systems operating segment. The EIS-EWS and NantHealth operating segments were previously included in the Population Health reportable segment, while the EIS-Classics and Hospitals and Health Systems operating segments are included within the Clinical and Financial Solutions reportable segment. Refer to Note 17, “Business Segments,” for additional information about these organizational changes. During 2018, as a result of these organizational changes, we performed interim goodwill impairment tests as of January 1, 2018 and July 1, 2018. While there was no impairment indicated as a result of both these interim tests, the estimated fair value of our Hospitals and Health Systems reporting unit exceeded the unit’s carrying value by 10%. The fair values of all other reporting units substantially exceeded their carrying values. As of January 1, 2018, the goodwill allocated to the Hospitals and Health Systems reporting unit was $511.2 million. We performed our annual goodwill impairment test as of October 1, 2018. As a result of this test, we concluded that the carrying value of the NantHealth reporting unit exceeded its fair value. Our latest available financial forecasts at the time of the annual goodwill impairment test reflected that projected future operating costs exceeded projected revenues resulting in negative operating margins for the NantHealth reporting unit. As a result, we recognized a goodwill impairment charge of $13.5 million, representing the entire goodwill balance assigned to the NantHealth reporting unit. This goodwill impairment charge is reflected on the “Goodwill impairment charge” line in our consolidated statements of operations for the year ended December 31, 2018. In addition, the results of the annual goodwill impairment test indicated that the estimated fair value of our Hospitals and Health Systems reporting unit exceeded the unit’s carrying value by less than 10%. The fair values of all other reporting units substantially exceeded their carrying values. As of October 1, 2018, the goodwill allocated to the Hospitals and Health Systems reporting unit was $516.8 million. T he determination of the fair value of our reporting units is based on a combination of a market approach, that considers benchmark company market multiples, and an income approach, that utilizes discounted cash flows for each reporting unit and other Level 3 inputs. Under the income approach, we determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. Additionally, the discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. As part of the goodwill impairment testing, we also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units. During 2018, we also recognized an intangible asset impairment charge of $2.2 million relating to NantHealth’s acquired proprietary technology because the carrying value of this definite-lived intangible assets no longer appeared recoverable based on latest available financial forecasts at the time of the annual goodwill impairment test. This impairment charge is included in the “Asset impairment charges” line in our consolidated statements of operations for the year ended December 31, 2018. Accumulated impairment losses associated with goodwill totaled $13.5 million as of December 31, 2018. There were no accumulated impairment losses associated with our goodwill as of December 31, 2017, and no impairments were recorded during the years ended December 31, 2017 and 2016. Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2018 and 2017 were as follows: Clinical and Population (In thousands) Financial Solutions Health Total Balance as of December 31, 2016 $ 843,837 $ 404,875 $ 1,248,712 Additions arising from business acquisitions: NantHealth provider/patient solutions business 0 13,350 13,350 Enterprise Information Solutions business 16,367 12,860 29,227 Other additions 420 47 467 Total additions to goodwill 16,787 26,257 43,044 Foreign exchange translation 991 0 991 Balance as of December 31, 2017 $ 861,615 $ 431,132 $ 1,292,747 Additions arising from business acquisitions: Practice Fusion 35,092 0 35,092 Health Grid 0 53,953 53,953 Other additions 6,399 0 6,399 Total arising from business acquisitions 41,491 53,953 95,444 Increases due to measurement period adjustments related to prior year acquisitions: NantHealth provider/patient solutions business 0 116 116 Enterprise Information Solutions business 25,192 6,857 32,049 Total increases due to measurement period adjustments: 25,192 6,973 32,165 Total additions to goodwill 66,683 60,926 127,609 Divestitures 0 (32,306 ) (32,306 ) Goodwill impairment charge 0 (13,466 ) (13,466 ) Transfers 2,904 (2,904 ) 0 Foreign exchange translation (840 ) 0 (840 ) Balance as of December 31, 2018 $ 930,362 $ 443,382 $ 1,373,744 Other additions of $6.4 million during 2018 primarily resulted from the acquisition of a cloud-based analytics software platform provider. Goodwill was reduced by $2.2 million due to the divestiture of our Strategic Sourcing business unit and by $30.1 million related to the OneContent divestiture. Refer to Note 3, “Business Combinations and Other Investments” for additional information regarding these transactions. The $2.9 million transfer was the result of moving the EIS-EWS operating segment from the Population Health reportable segment to the Clinical and Financial Solutions reportable segment. Intangible assets are being amortized over their estimated useful lives and amortization expense related to intangible assets was as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Proprietary technology amortization included in cost of revenue $ 38,467 $ 33,137 $ 30,451 Intangible amortization included in operating expenses 26,587 17,345 15,884 Total intangible amortization expense $ 65,054 $ 50,482 $ 46,335 The increase in amortization expense since the year ended December 31, 2016 was due to acquisitions completed during the years ended December 31, 2018 and 2017. Estimated future amortization expense for the intangible assets that exist as of December 31, 2018, based on foreign currency exchange rates in effect as of such date, is as follows: Year Ended December 31, (In thousands) 2019 $ 63,010 2020 58,356 2021 52,928 2022 46,472 2023 30,272 Thereafter 128,043 Total $ 379,081

Asset Impairment Charges

Asset Impairment Charges	12 Months Ended
	Dec. 31, 2018
Asset Impairment Charges [Abstract]
Asset Impairment Charges	7. Asset Impairment Charges During the year ended December 31, 2018, we incurred several non-cash asset impairment charges as shown in the table below. We recorded non-cash asset impairment charges of $33.2 million related to the write-off of capitalized software as a result of our decision to discontinue several software development projects. We also recorded $22.9 million of non-cash asset impairment charges related to our acquisition of the patient/provider engagement solutions business from NantHealth in 2017, which included the write-downs of $2.2 million of acquired technology and $20.7 million, representing the unamortized value assigned to the modification of our existing commercial agreement with NantHealth, as we no longer expect to recover the value assigned to these assets. The remaining $2.1 million of non-cash asset impairment charges recorded during the year ended December 31, 2018 relate to the disposal of fixed assets as a result of relocating and consolidating business functions and locations from recent acquisitions. During the year ended December 31, 2018, we impaired all of the goodwill previously recognized as part of the acquisition of NantHealth’s provider/patient engagement solutions business following the completion of our annual goodwill impairment test. As a result, we recorded a goodwill impairment charge of $13.5 million. Refer to Note 6, “Goodwill and Intangible Assets” for further information regarding this impairment. Finally, w e recognized non-cash impairment charges of $15.5 million related to two of our cost-method equity investments and a related note receivable. These charges equaled the cost bases of the investments and the related note receivable prior to the impairment. During the year ended December 31, 2017, we recorded non-cash charges of $165.3 million, including other-than-temporary impairment charges of $144.6 million during the second quarter of 2017 associated with two of the Company’s long-term investments based on management’s assessment of the likelihood of near-term recovery of the investments’ value. The majority of the impairment charges relate to our investment in NantHealth common stock. During the three months ended September 30, 2017, we realized an additional $20.7 million loss upon the final disposition of the NantHealth common stock in connection with our acquisition of certain assets related to NantHealth’s provider/patient engagement solutions business. Refer to Note 3, “Business Combinations and Other Investments” and Note 13, “Accumulated Other Comprehensive Loss,” for further information regarding these impairments. During the year ended December 31, 2016, we incurred non-cash asset impairment charges totaling $4.7 million. These charges included $2.2 million for the impairment of capitalized software as a result of our decision to discontinue several software development projects, $2.1 million for the impairment of one of our cost method equity investments, and other charges of $0.4 million to write down a long-term asset to its estimated net realizable value. The following table summarizes the non-cash asset impairment charges recorded during the periods indicated and where they appear in the corresponding consolidated statements of operations: Year Ended December 31, (In thousands) 2018 2017 2016 Asset impairment charges $ 58,166 $ 0 $ 4,650 Goodwill impairment charge $ 13,466 $ 0 $ 0 Impairment of long-term investments $ 15,487 $ 165,290 $ 0

Debt

Debt	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
Debt	8. Debt Debt outstanding, excluding capital lease obligations, consisted of the following: December 31, 2018 December 31, 2017 (In thousands) Principal Balance Unamortized Discount and Debt Issuance Costs Net Carrying Amount Principal Balance Unamortized Discount and Debt Issuance Costs Net Carrying Amount 1.25% Cash Convertible Senior Notes $ 345,000 $ 22,112 $ 322,888 $ 345,000 $ 35,978 $ 309,022 Senior Secured Credit Facility 350,000 6,038 343,962 628,750 3,360 625,390 Other debt 748 0 748 0 0 0 Total debt $ 695,748 $ 28,150 $ 667,598 $ 973,750 $ 39,338 $ 934,412 Less: Debt payable within one year 20,538 479 20,059 28,125 438 27,687 Total long-term debt, less current maturities $ 675,210 $ 27,671 $ 647,539 $ 945,625 $ 38,900 $ 906,725 Interest expense consisted of the following: Year Ended December 31, (In thousands) 2018 2017 2016 Interest expense $ 35,366 $ 23,001 $ 15,556 Amortization of discounts and debt issuance costs 15,548 14,539 13,922 Total interest expense $ 50,914 $ 37,540 $ 29,478 Interest expense related to the 1.25% Cash Convertible Senior Notes, which is included in total interest expense above, was comprised of the following: Year Ended December 31, (In thousands) 2018 2017 2016 Coupon interest at 1.25% $ 4,312 $ 4,312 $ 4,312 Amortization of discounts and debt issuance costs 13,867 13,208 12,585 Total interest expense related to the 1.25% Notes $ 18,179 $ 17,520 $ 16,897 Allscripts Senior Secured Credit Facility On February 15, 2018, Allscripts and Healthcare LLC entered into a Second Amended and Restated Credit Agreement (the “Second Amended Credit Agreement”), with JPMorgan Chase Bank, N.A., as administrative agent (the “Administrative Agent”), the several banks and other financial institutions or entities from time to time party thereto, and Fifth Third Bank, KeyBank National Association, SunTrust Bank and Wells Fargo Bank, National Association, as syndication agents, amending and restating the Amended and Restated Credit Agreement, dated September 30, 2015, as amended on March 28, 2016 and December 22, 2016 (the “Prior Credit Agreement”). The Second Amended Credit Agreement provides for a $400 $250 $900 $550 a five-year The Term Loan is repayable in quarterly installments, which commenced on June 30, 2018. to $50 $10 $100 million The proceeds of the Revolving Facility can be used to finance Allscripts’ working capital needs and for general corporate purposes, including, without limitation, financing of permitted acquisitions, and for share repurchases. Allscripts is also permitted to add one or more incremental revolving and/or term loan facilities in an aggregate amount of up to $600 million, subject to certain conditions (an increase from the $300 million incremental facility permitted under the Prior Credit Agreement). The initial applicable interest rate margin for Base Rate borrowings is 1.00%, and for Eurocurrency Rate borrowings is 2.00%. On and after December 31, 2018, the interest rate margins will be determined from a pricing table and will depend upon Allscripts’ total leverage ratio. The applicable margins for Base Rate borrowings under the Second Amended Credit Agreement range from 0.50% to 1.25% depending on Allscripts’ total leverage ratio (as compared to the 0.00% to 1.25% range provided under the Prior Credit Agreement). The applicable margins for Eurocurrency Rate loans range from 1.50% to 2.25%, depending on Allscripts’ total leverage ratio (as compared to the 1.00% to 2.25% range provided under the Prior Credit Agreement). Subject to certain agreed upon exceptions, all obligations under the Senior Secured Credit Facility remain guaranteed by each of our existing and future direct and indirect material domestic subsidiaries other than Coniston Exchange LLC and certain domestic subsidiaries owned by our foreign subsidiaries (the “Guarantors”) pursuant to a related Guarantee and Collateral Agreement among Allscripts Healthcare Solutions, Inc., Allscripts Healthcare, LLC, certain of our other subsidiaries, and JPMorgan Chase Bank, N.A., as administrative agent. Our obligations under the Senior Secured Credit Facility, any swap agreements and any cash management arrangements provided by any lender, remain secured, subject to permitted liens and other agreed upon exceptions, by a perfected first priority security interest in all of the tangible and intangible assets (including, without limitation, intellectual property, material owned real property and all of the capital stock of each Guarantor and, in the case of foreign subsidiaries, up to 65% of the capital stock of first tier material foreign subsidiaries) of Allscripts Healthcare Solutions, Inc. and certain of our subsidiary guarantors. The Senior Secured Credit Facility requires us to maintain a minimum interest coverage ratio of 3.5 to 1.0 and a maximum total net leverage ratio of 4.25 to 1.0. The minimum interest coverage ratio is calculated by dividing earnings before interest expense, income tax expense, depreciation and amortization expense by cash interest expense, subject to various agreed upon adjustments. The total net leverage ratio is calculated by dividing total indebtedness reduced by a portion of domestic unrestricted cash, by earnings before interest expense, income tax expense, depreciation and amortization expense, subject to various agreed upon adjustments. The Second Amended Credit Agreement also provides that during the four-quarter period following permitted acquisitions that are financed in whole or in part with indebtedness and the consideration paid by us is $100 million or more, we are required to maintain a maximum total leverage ratio of 4.5 to 1.0. In addition, the Second Amended Credit Agreement requires mandatory prepayments of the debt outstanding under the Senior Secured Credit Facility in certain specific circumstances, and contains a number of covenants which, among other things, restrict our ability to incur additional indebtedness, engage in mergers, or declare dividends or other payments in respect of our capital stock. The Senior Secured Credit Facility also contains certain customary events of default, including relating to non-payment, breach of covenants, cross-default, bankruptcy and change of control. As of December 31, 2018, $350 million under the Term Loan, none under the Revolving Facility, and $0.8 million in letters of credit were outstanding under the Second Amended Credit Agreement. As of December 31, 2018, the interest rate on the Senior Secured Credit Facility was LIBOR plus 2.00%, which totaled 4.52%. We were in compliance with all financial covenants under the Second Amended Credit Agreement as of December 31, 2018. As of December 31, 2018, we had $899.2 million available borrowing capacity, net of outstanding letters of credit, under the Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of the Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings. Allscripts 1.25% Cash Convertible Senior Notes due 2020 On June 18, 2013, we issued $345.0 million aggregate principal amount of the 1.25% Cash Convertible Senior Notes due 2020 (the “1.25% Notes”). The aggregate net proceeds of the 1.25% Notes were $305.1 million, after payment of the net cost of the 1.25% Notes Call Spread Overlay (as described below) and transaction costs. Interest on the 1.25% Notes is payable semiannually in arrears on January 1 st st The 1.25% Notes are convertible only into cash, and not into shares of our common stock or any other securities. Holders may convert their 1.25% Notes solely into cash at their option at any time prior to the close of business on the business day immediately preceding January 1, 2020 only under the following circumstances: (1) during any calendar quarter (and only during such calendar quarter), if the last reported sale price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; (2) during the five business day period immediately after any five consecutive trading day period in which the trading price per $1,000 principal amount of the 1.25% Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day; or (3) upon the occurrence of specified corporate events. On or after January 1, 2020 until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their 1.25% Notes solely into cash at any time, regardless of the foregoing circumstances. Upon conversion, in lieu of receiving shares of our common stock, a holder will receive an amount in cash, per $1,000 principal amount of the 1.25% Notes, equal to the settlement amount, determined in the manner set forth in the Indenture. The initial conversion rate will be 58.1869 shares of our common stock per $1,000 principal amount of the 1.25% Notes (equivalent to an initial conversion price of approximately $17.19 per share of common stock). The conversion rate will be subject to adjustment in some events but will not be adjusted for any accrued and unpaid interest. In addition, following certain corporate events that occur prior to the maturity date, we will pay a cash make-whole premium by increasing the conversion rate for a holder who elects to convert such holder’s 1.25% Notes in connection with such a corporate event in certain circumstances. We may not redeem the 1.25% Notes prior to the maturity date, and no sinking fund is provided for the 1.25% Notes. If we undergo a fundamental change (as defined in the Indenture), holders may require us to repurchase for cash all or part of their 1.25% Notes at a repurchase price equal to 100% of the principal amount of the 1.25% Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date. The Indenture provides for customary events of default, including cross acceleration to certain other indebtedness of ours, and our subsidiaries. The 1.25% Notes are senior unsecured obligations, and rank senior in right of payment to any of our indebtedness that is expressly subordinated in right of payment to the 1.25% Notes; equal in right of payment to any of our unsecured indebtedness that is not so subordinated; effectively junior in right of payment to any of our secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities (including trade payables) of our subsidiaries. The 1.25% Notes contain an embedded cash conversion option. We have determined that the embedded cash conversion option is a derivative financial instrument, required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of operations until the cash conversion option transaction settles or expires. The initial fair value liability of the embedded cash conversion option was $82.8 million, which simultaneously reduced the carrying value of the 1.25% Notes (effectively an original issuance discount). For further discussion of the derivative financial instruments relating to the 1.25% Notes, refer to Note 14, “Derivative Financial Instruments.” The reduced carrying value of the 1.25% Notes resulted in a debt discount that is amortized to the 1.25% Notes’ principal amount through the recognition of non-cash interest expense over the expected term of the 1.25% Notes, which extends through their maturity date of July 1, 2020. This has resulted in our recognition of interest expense on the 1.25% Notes at an effective rate approximating what we would have incurred had nonconvertible debt with otherwise similar terms been issued. The effective interest rate of the 1.25% Notes at issuance was 5.4%, which was imputed based on the amortization of the fair value of the embedded cash conversion option over the remaining term of the 1.25% Notes. As of December 31, 2018, we expect the 1.25% Notes to be outstanding until their July 1, 2020 maturity date, for a remaining amortization period of approximately one and a half years. As of December 31, 2018, the if-converted value of the 1.25% Notes did not exceed the 1.25% Notes’ principal amount. In connection with the settlement of the 1.25% Notes, we paid $8.4 million in transaction costs. Such costs were allocated to the 1.25% Notes, the 1.25% Call Option (as defined below) and the 1.25% Warrants (as defined below). The amount allocated to the 1.25% Notes, or $8.3 million, was capitalized and is being amortized over the expected term of the 1.25% Notes. The outstanding capitalized amount of transaction costs related to the 1.25% Notes was $1.8 million and is reported as a reduction of long-term debt on our consolidated balance sheet as of December 31, 2018. Accrued and unpaid interest on the 1.25% Notes of $2.2 million is included in accrued expenses in the accompanying consolidated balance sheet as of December 31, 2018. 1.25% Notes Call Spread Overlay Also in June 2013, concurrent with the issuance of the 1.25% Notes, we entered into privately negotiated hedge transactions (collectively, the “1.25% Call Option”) and warrant transactions (collectively, the “1.25% Warrants”), with certain of the initial purchasers of the 1.25% Notes (collectively, the “Call Spread Overlay”). Assuming full performance by the counterparties, the 1.25% Call Option is intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes. We used $82.8 million from the initial proceeds of the 1.25% Notes to pay for the 1.25% Call Option, and simultaneously received $51.2 million from the sale of the 1.25% Warrants, for a net cash outlay of $31.6 million for the Call Spread Overlay. The 1.25% Call Option is a derivative financial instrument and is discussed further in Note 14, “Derivative Financial Instruments.” The 1.25% Warrants are equity instruments and are further discussed in Note 11, “Stockholders’ Equity.” The following table summarizes future debt payments as of December 31, 2018: (In thousands) Total 2019 2020 2021 2022 2023 Thereafter 1.25% Cash Convertible Senior Notes (1) $ 345,000 $ 0 $ 345,000 $ 0 $ 0 $ 0 $ 0 Term Loan 350,000 20,000 27,500 30,000 37,500 235,000 0 Other debt 748 538 210 0 0 0 0 Total debt $ 695,748 $ 20,538 $ 372,710 $ 30,000 $ 37,500 $ 235,000 $ 0 (1) Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	9. Income Taxes The following is a geographic breakdown of income (loss) before income tax benefits: Year Ended December 31, (In thousands) 2018 2017 2016 United States $ 14,045 $ (190,053 ) $ 33,027 Foreign (907 ) 16 (1,467 ) Income (loss) from continuing operations before income taxes $ 13,138 $ (190,037 ) $ 31,560 The following is a summary of the components of the provision (benefit) for income taxes: Year Ended December 31, (In thousands) 2018 2017 2016 Current tax provision Federal $ 838 $ 407 $ 372 State 737 1,796 625 Foreign 5,015 5,091 3,857 6,590 7,294 4,854 Deferred tax provision Federal (5,781 ) 2,800 (3,784 ) State 236 (12,695 ) 116 Foreign (576 ) (2,913 ) (877 ) (6,121 ) (12,808 ) (4,545 ) Income tax (benefit) provision $ 469 $ (5,514 ) $ 309 Taxes computed at the statutory federal income tax rate of 21% for the year ended December 31, 2018 and 35% for the years ended December 31, 2017 and 2016 are reconciled to the provision for income taxes as follows: Year Ended December 31, (In thousands) 2018 2017 2016 United States federal tax at statutory rate $ 2,759 $ (66,523 ) $ 10,869 Items affecting federal income tax rate Non-deductible acquisition and reorganization expenses 291 0 1,400 Research credits (6,185 ) (3,200 ) (2,700 ) Change in unrecognized tax benefits 3 395 (692 ) State income taxes, net of federal benefit 715 (7,121 ) 1,931 Compensation 3,213 2,950 651 Meals and entertainment 616 991 1,085 Impact of foreign operations 3,627 730 2,847 Provision-to-Return adjustments (2,140 ) (1,413 ) (1,116 ) Deemed Dividends 373 1,289 887 Dividends Accrued or Received 0 0 2,198 Federal, state and local rate changes 0 185 344 US Tax reform impact 0 10,189 0 One time Mandatory Repatriation Toll Charge 0 5,155 0 Non-deductible items 34 33 51 Noncontrolling interest 951 0 0 True-up of prior year income of Consolidated Investment 913 0 0 Valuation allowance (5,208 ) 47,959 (17,504 ) Other 507 2,867 58 Income tax provision (benefit) $ 469 $ (5,514 ) $ 309 Significant components of our deferred tax assets and liabilities consist of the following: December 31, (In thousands) 2018 2017 Deferred tax assets Accruals and reserves, net $ 31,565 $ 23,658 Allowance for doubtful accounts 11,378 6,014 Stock-based compensation, net 10,595 10,442 Deferred revenue 8,160 11,502 Net operating loss carryforwards 36,649 41,428 Capital loss carryforwards 0 42,702 Research and development tax credit 899 32,907 AMT credits 0 7,538 Other 10,784 11,108 Less: Valuation Allowance (18,734 ) (79,594 ) Total deferred tax assets 91,296 107,705 Deferred tax liabilities Prepaid expense (6,733 ) (6,166 ) Property and equipment, net (7,442 ) (8,464 ) Acquired intangibles, net (129,879 ) (111,112 ) Other (676 ) (647 ) Total deferred tax liabilities (144,730 ) (126,389 ) Net deferred tax liabilities $ (53,434 ) $ (18,684 ) The deferred tax assets (liabilities) are classified in the consolidated balance sheets as follows: December 31, (In thousands) 2018 2017 Non-current deferred tax assets, net $ 5,036 $ 4,574 Non-current deferred tax liabilities, net (58,470 ) (23,258 ) Non-current deferred tax liabilities, net $ (53,434 ) $ (18,684 ) The United States Tax Cuts and Jobs Act (the “Tax Act”) was enacted on December 22, 2017 and introduced significant changes to the income tax law in the United States. Effective in 2018, the Tax Act reduced the United States statutory tax rate from 35% to 21% and creates new taxes on certain foreign-sourced earnings and certain related-party payments, which are referred to as the global intangible low-taxed income tax and the base erosion tax, respectively. In addition, in 2017 we were subject to a one-time transition tax on accumulated foreign subsidiary earnings not previously subject to income tax in the United States. Due to the timing of the enactment and the complexity involved in applying the provisions of the Tax Act, we made reasonable estimates of the effects and recorded provisional expense of $15.3 million in our financial statements for the year ended December 31, 2017 in accordance with guidance in Staff Accounting Bulletin No. 118 (“SAB 118”), which allows a measurement period of up to one year after the enactment date to finalize the recording of the related tax impacts. This provisional expense included $10.1 million expense for the remeasurement of deferred tax balances to reflect the lower federal rate and expense of $5.2 million for the one-time transition tax on accumulated foreign subsidiary earnings not previously subject to income tax in the United States. Adjustments to these provisional amounts that we recorded in 2018 did not have a significant impact on our consolidated financial statements. Our accounting for the effects of the enactment of U.S. Tax Reform is now complete. Due to our divestiture of our investment in Netsmart, the amounts noted above do not include the provisional amounts recorded by Netsmart in 2017. As of December 31, 2018 and 2017, we had federal net operating loss (“NOL”) carryforwards of $164 million and $179 million, respectively. The federal NOL carryforward includes Israeli NOL carryovers of $49 million that do not expire. As of December 31, 2018 and 2017, we had state NOL carryforwards of $2 million and $4 million, respectively. The NOL carryforwards expire in various amounts starting in 2019 for both federal and state tax purposes. The utilization of the federal NOL carryforwards is subject to limitation under the rules regarding changes in stock ownership as determined by the Internal Revenue Code. For federal purposes, 2015 to 2018 tax years remain subject to income tax examination by federal authorities. For our state tax jurisdictions, 2007 to 2018 tax years remain open to income tax examination by state tax authorities. In Canada, the 2018 tax year remain open and in India the 2013 and 2018 tax years remain open. We have a subsidiary in India that is entitled to a tax holiday that allows for tax-free operations during such tax holiday. This tax holiday for the subsidiary began to partially expire in 2012 and fully expired in 2017. Tax savings realized from this holiday totaled $0.4 million and $0.7 million for the years ended December 31, 2017 and 2016, respectively, which reduced our loss per share by less than $0.01 in each of those years. There is a potential for a partial tax holiday for 5 years beginning on April 1, 2017, which is contingent upon a certain level of capital expenditure spending, among other conditions. Tax savings impact of $0.5 million has been recorded for this potential tax holiday for the year ended December 31, 2018, which impacted our diluted earnings per share by less than $0.01 in this year. U.S. GAAP principles prescribe a threshold of more-likely-than-not to be sustained upon examination for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. These principles also provide guidance on de-recognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. Changes in the amounts of unrecognized tax benefits were as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Beginning balance as of January 1 $ 10,939 $ 10,616 $ 11,777 Increases for tax positions related to the current year 8,977 640 570 Decreases for tax positions related to prior years 0 (146 ) 0 Increases for tax positions related to prior years 367 153 104 Increases acquired in business acquisitions 540 0 0 Foreign currency translation (5 ) 10 (1 ) Reductions due to lapsed statute of limitations (997 ) (334 ) (1,834 ) Ending balance as of December 31 $ 19,821 $ 10,939 $ 10,616 We had gross unrecognized tax benefits of $19.8 million and $10.9 million as of December 31, 2018 and 2017, respectively. The main driver of the increase in the unrecognized tax benefits as of December 31, 2018 is $7.7 million related to the uncertain positions taken on the state tax treatment of the Netsmart gain. If the current gross unrecognized tax benefits were recognized, the result would be an increase in our income tax benefit of $19.6 million and $0.1 million, respectively. These amounts are net of accrued interest and penalties relating to unrecognized tax benefits of $0.2 million and $0.7 million, respectively. We believe that it is reasonably possible that $1.8 million of our currently remaining unrecognized tax benefits may be recognized by the end of 2018, as a result of a lapse of the applicable statute of limitations. We recognized interest and penalties related to uncertain tax positions in our consolidated statements of operations as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Interest and penalties included in the provision for income taxes $ 543 $ 446 $ 6 The amount of interest and penalties included in our consolidated balance sheets is as follows: December 31, (In thousands) 2018 2017 Interest and penalties included in the liability for uncertain tax positions $ 198 $ 741 During the year ended December 31, 2018, we released valuation allowance of $42.7 million related to federal capital loss carryforwards utilized by capital gains incurred in 2018 and $22.1 million related to federal credit carryforwards. Of this total release of valuation allowance of $64.8 million, $55.3 million was allocated to the Netsmart gain recorded in discontinued operations. In addition, we recorded valuation allowance of $4.7 million related to the . In addition, we recorded valuation allowance of $5.3 million related to federal credit carryforwards, and foreign and state NOL carryforwards. Our effective rate was higher for the year ended December 31, 2018 as compared with the prior year, primarily due to stricter executive compensation rules offset by lower US federal rates. We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States. We are subject to the continuous examination of our income tax returns by the IRS and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements. We intend to indefinitely reinvest the undistributed earnings of our foreign subsidiaries as a general rule, as most of our foreign subsidiaries have third party customers, as well as formal sales proposals that could require significant resources. Specifically, our subsidiary in India may repatriate all current 2019 earnings at the discretion of management. As of December 31, 2018, we have no other plans to repatriate any other funds at this time. A Netherlands holding company currently holds all of our foreign subsidiaries. Our holding company makes it more efficient for us to share resources between the respective foreign subsidiaries. As we have determined that the earnings of these subsidiaries are not required as a source of funding for our United States operations, such earnings are not planned to be distributed to the United States in the foreseeable future.

Stock Award Plan

Stock Award Plan	12 Months Ended
	Dec. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Award Plan	10. Stock Award Plan Total recognized stock-based compensation expense is included in our consolidated statements of operations as shown in the table below. Stock-based compensation expense includes both non-cash expense related to grants of stock-based awards as well as cash expense related to the employee discount applied to purchases of our common stock under our employee stock purchase plan. Year Ended December 31, (In thousands) 2018 2017 2016 Cost of revenue: Software delivery, support and maintenance $ 2,184 $ 2,879 $ 4,125 Client services 3,997 4,484 4,363 Total cost of revenue 6,181 7,363 8,488 Selling, general and administrative expenses 24,213 23,497 21,829 Research and development 8,937 8,605 8,029 Total stock-based compensation expense $ 39,331 $ 39,465 $ 38,346 The estimated income tax benefit of stock-based compensation expense included in the provision for income taxes for the year ended December 31, 2018 is approximately $4.9 million. No stock-based compensation costs were capitalized during the years ended December 31, 2018, 2017 and 2016. The calculation of stock-based compensation expenses includes an estimate for forfeitures at the time of grant. This estimate can be revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. As of December 31, 2018, total unrecognized stock-based compensation expense related to non-vested awards and options was $61.3 million and this expense is expected to be recognized over a weighted-average period of 2.4 years. Allscripts Long-Term Incentive Plan Allscripts Amended and Restated 2011 Stock Incentive Plan (the “Plan”) provides for the granting of stock options, service-based share awards, performance-based share awards and market-based share awards, among other awards. As of December 31, 2018, there were 4.9 million shares of common stock reserved for issuance under future share-based awards to be granted to any of Allscripts employees, officers, directors or independent consultants at terms and prices to be determined by our Board, and subject to the terms of the Plan. We issue service-based, performance-based and market-based awards in the form of restricted stock units, stock options or shares. A description of each category of awards is presented below. Service-based Share Awards Service-based share awards include stock options, restricted stock units and restricted shares, and typically vest over a four-year period commencing on the date of grant subject to continued service with the Company. Upon termination of an employee’s employment, any unvested service-based share awards are forfeited unless otherwise provided in an employee’s employment agreement. Deferred share units are awarded to directors and vest within one year, when issued in lieu of annual share awards, or immediately, when issued in lieu of cash compensation. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures. As of December 31, 2018, there was $50.9 million of total estimated unrecognized stock-based compensation expense related to the service-based share awards, which is expected to be recognized over a weighted-average period of 2.6 years. Performance-based Share Awards Performance-based share awards include restricted stock units and restricted shares. The purpose of such awards is to align management’s compensation with our financial performance and other operational objectives and, in certain cases, to retain key employees over a specified performance period. Awards granted under this category are based on the achievement of various targeted financial measures, including, but not limited to, non-GAAP EBITDA and revenue growth, as defined in the grant agreements. The awards are earned based on actual results achieved compared to targeted amounts. Stock-based compensation expense related to these awards is recognized over three-year and four-year vesting periods under the accelerated attribution method if and when we conclude that it is probable that the performance conditions will be achieved. As of December 31, 2018, there was $1.2 million of total estimated unrecognized stock-based compensation expense, assuming various target attainments related to the performance-based share awards, which is expected to be recognized over a weighted-average period of 1.0 years. Market-based Share Awards Market-based share awards include restricted stock units. The purpose of such awards is to align management’s compensation with the performance of our common stock relative to the market. Awards granted under this category are dependent on our total shareholder returns relative to a specified peer group of companies over three-year performance periods with vesting based on three annual performance segments from the grant dates. Fair values of the awards were estimated at the date of the grants using the Monte Carlo pricing model. Following completion of each of the three-year performance periods, the Compensation Committee of our Board determines the number of awards that will vest considering overall performance over the three-year performance periods. If the number of shares that would vest under this scenario is greater than the amount vesting under the three annual performance segments, then such greater number of awards will vest, reduced by the number of awards previously vested. Stock-based compensation expense related to these awards is recognized over the three-year vesting periods under the accelerated attribution method. As of December 31, 2018, there was $9.2 million of total estimated unrecognized stock-based compensation expense, which is expected to be recognized over a weighted-average period of 1.8 years. Restricted Stock Units The following table summarizes the activity for restricted stock units during the periods presented: Weighted-Average (In thousands, except per share amounts) Shares Grant Date Fair Value Unvested restricted stock units as of December 31, 2015 5,379 $ 14.15 Awarded 3,480 12.88 Vested (2,095 ) 13.84 Forfeited (517 ) 14.30 Unvested restricted stock units as of December 31, 2016 6,247 13.54 Awarded 3,690 12.52 Vested (1,835 ) 13.74 Forfeited (843 ) 16.97 Unvested restricted stock units as of December 31, 2017 7,259 12.57 Awarded 4,024 13.25 Vested (2,222 ) 13.03 Forfeited (1,111 ) 12.43 Unvested restricted stock units as of December 31, 2018 7,950 $ 12.81 Net Share-settlements Upon vesting, restricted stock units are generally net share-settled upon vesting to cover the required withholding tax and the remaining amount is converted into an equivalent number of shares of common stock. The majority of restricted stock units that vested during the years ended December 31, 2018, 2017 and 2016 were net-share settled such that we withheld shares with value equivalent to the employees’ minimum statutory tax obligations for the applicable income and other employment taxes and remitted the equivalent amount of cash to the appropriate taxing authorities. Total payments for the employees’ minimum statutory tax obligations are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld during the years ended December 31, 2018, 2017 and 2016 were 695 thousand, 606 thousand and 648 thousand, respectively, and were based on the value of the restricted stock units on their vesting date as determined by our closing stock price. These net-share settlements had the effect of share repurchases by us as they reduced the number of shares that would have otherwise been issued at the vesting date. Stock Options The following table summarizes the status of stock options outstanding and the changes during the periods presented: Options Weighted-Average Options Weighted-Average (In thousands, except per share amounts) Outstanding Exercise Price Exercisable Exercise Price Balance as of December 31, 2015 2,343 $ 14.24 1,282 $ 14.52 Options granted 0 0.00 Options exercised (6 ) 14.01 Options forfeited (434 ) 15.51 Balance as of December 31, 2016 1,903 13.95 1,431 13.98 Options granted 0 0.00 Options exercised (108 ) 14.01 Options forfeited (160 ) 15.00 Balance as of December 31, 2017 1,635 13.85 1,635 13.85 Options granted 0 0.00 Options exercised (92 ) 14.01 Options forfeited (211 ) 14.74 Balance as of December 31, 2018 1,332 $ 13.69 1,332 $ 13.69 We estimate the fair value of our service-based stock option awards on the date of grant using the Black-Scholes-Merton option-pricing model. Option valuation models, including the Black-Scholes-Merton option-pricing model, require the input of certain assumptions that involve judgment. Changes in the input assumptions can materially affect the fair value estimates and, ultimately, how much we recognize as stock-based compensation expense. Our stock options have a contractual term of 7 years. The aggregate intrinsic value of stock options outstanding or exercisable as of December 31, 2018 was zero, based on our closing stock price of $9.64 as of December 31, 2018. The intrinsic value of stock options outstanding represents the amount that would have been received by the option holders had all option holders exercised their stock options as of that date. The following activity occurred under the Plan: Year Ended December 31, (In thousands) 2018 2017 2016 Total intrinsic value of stock options exercised $ 69 $ 45 $ 1 Total fair value of share awards vested $ 28,954 $ 25,220 $ 26,892 The following table summarizes information about stock options outstanding under the Plan as of December 31, 2018: Number of Number of Options Weighted-Average Options Weighted-Average Range of Exercise Prices Outstanding Exercise Price Exercisable Exercise Price $12.72 to $14.01 1,323,447 $ 13.69 1,323,447 $ 13.69 $14.78 to $15.22 8,239 $ 14.81 8,239 $ 14.81 1,331,686 1,331,686 Allscripts Employee Stock Purchase Plan Our Employee Stock Purchase Plan (the “ESPP”) allows eligible employees to authorize payroll deductions of up to 20% of their base salary to be applied toward the purchase of full shares of common stock on the last business day of each offering period. Offering periods under the ESPP are three months in duration and begin on each March 1 st st st st We treat the ESPP as a compensatory plan in accordance with GAAP. There were 1.6 million and 1.0 million shares purchased under the ESPP during the years ended December 31, 2018 and 2017, respectively.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Stockholders' Equity	11. Stockholders’ Equity Stock Repurchases On November 17, 2016, we announced that our Board approved a stock purchase program (the “2016 Program”) under which we may repurchase up to $200 million of our common stock through December 31, 2019. On August 2, 2018, we announced that our Board approved a new stock purchase program (the “2018 Program”) under which we may repurchase up to $250 million of our common stock through December 31, 2020, replacing the 2016 Program. We repurchased 3.6 million shares of our common stock under the 2018 Program for a total $37.0 million during the fourth quarter of 2018. We repurchased 7.7 million shares of our common stock under the 2016 Program for a total of $101.9 million during the nine months ended September 30, 2018. During the year ended December 31, 2017, we repurchased 1.0 $12.1 million Issuance of Common Stock and Warrants On June 30, 2016, we issued to a commercial partner, as part of an overall commercial relationship, unregistered warrants to purchase (i) 900,000 shares of our common stock, par value $0.01 per share, at a price per share of $12.47, (ii) 1,000,000 shares of our common stock at a price per share of $14.34 and (iii) 1,100,000 shares of our common stock at a price per share of $15.59, in each case subject to customary anti-dilution adjustments. The warrants vest in four equal annual installments of 750 thousand shares beginning in June 2017 and expire in June 2026. Our issuance of the warrants was a private placement exempt from registration pursuant to Section 4(a)(2) under the Securities Act of 1933, as amended. These warrants are not actively traded and were valued based on an option pricing model that uses observable and unobservable market data for inputs. The warrants were valued at $11 million and are being amortized into earnings over the four-year vesting period. The amortization expense is included as a reduction to revenue in the accompanying consolidated statements of operations. In June 2013, in connection with the issuance of the 1.25% Notes, we issued the 1.25% Warrants exercisable for 20.1 million shares of our common stock (subject to anti-dilution adjustments under certain circumstances) with an initial exercise price of $23.135 per share, subject to customary adjustments. The net proceeds from the sale of the 1.25% Warrants of $51.2 million are included as additional paid in capital in the accompanying consolidated balance sheets as of December 31, 2018 and 2017. The 1.25% Warrants expire over a period of 70 trading days beginning on October 1, 2020 and are exercisable only upon expiration. Additionally, if the market value per share of our common stock exceeds the strike price of the 1.25% Warrants on any trading day during the 70 trading day measurement period, we will, for each such trading day, be obligated to issue to the counterparties a number of shares equal in value to the product of the amount by which such market value exceeds such strike price and 1/70th of the aggregate number of shares of our common stock underlying the 1.25% Warrants transactions, subject to a share delivery cap. For each 1.25% Warrant that is exercised, we will deliver to the option counterparties a number of shares of our common stock equal to the amount by which the settlement price exceeds the exercise price, divided by the settlement price, plus cash in lieu of fractional shares. We will not receive any additional proceeds if the 1.25% Warrants are exercised. The number of warrants and the strike price are subject to adjustment under certain circumstances. The 1.25% Warrants could separately have a dilutive effect to the extent that the market value per share of our common stock (as measured under the terms of the warrant transactions) exceeds the applicable strike price of the 1.25% Warrants. In June 2013, we agreed to issue a warrant to a commercial partner as part of an overall commercial relationship pursuant to which the warrant holder has the right to purchase 1.5 million shares of our common stock at a strike price of $12.94 per share. The warrant vests in four equal annual installments of 375 thousand shares (beginning in June 2014) and expires in June 2020. Our issuance of the warrant was a private placement exempt from registration pursuant to Section 4(a)(2) under the Securities Act of 1933, as amended. This warrant is not actively traded and was valued based on an option pricing model that uses observable and unobservable market data for inputs. The warrant was valued at $10.2 million and was amortized into earnings over the four-year vesting period. The amortization of the warrant value is included in stock-based compensation expense in the accompanying consolidated statements of cash flows.

Earnings (Loss) Per Share

Earnings (Loss) Per Share	12 Months Ended
	Dec. 31, 2018
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	12. Earnings (Loss) Per Share Basic earnings (loss) per share is computed by dividing net income (loss) by the weighted-average shares of common stock outstanding. For purposes of calculating diluted earnings per share, the denominator includes both the weighted average shares of common stock outstanding and dilutive common stock equivalents. Dilutive common stock equivalents consist of stock options, restricted stock unit awards and warrants calculated under the treasury stock method. The calculations of earnings (loss) per share are as follows: Year Ended December 31, (In thousands, except per share amounts) 2018 2017 2016 Basic Income (Loss) per Common Share: Income (loss) from continuing operations, net of tax $ 12,669 $ (184,523 ) $ 31,251 Less: Net loss (income) attributable to non-controlling interests 4,527 1,566 (146 ) Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 17,196 $ (182,957 ) $ 31,105 Income (loss) from discontinued operations, net of tax 395,138 30,348 (28,221 ) Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations (48,594 ) (43,850 ) (28,536 ) Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 346,544 (13,502 ) (56,757 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 363,740 $ (196,459 ) $ (25,652 ) Weighted-average common shares outstanding 176,038 180,830 186,188 Basic Income (Loss) from continuing operations per Common Share $ 0.10 $ (1.02 ) $ 0.17 Basic Income (Loss) from discontinued operations per Common Share $ 1.97 $ (0.07 ) $ (0.31 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ 2.07 $ (1.09 ) $ (0.14 ) Diluted Income (Loss) per Common Share: Income (loss) from continuing operations, net of tax $ 12,669 $ (184,523 ) $ 31,251 Less: Net loss (income) attributable to non-controlling interests 4,527 1,566 (146 ) Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 17,196 $ (182,957 ) $ 31,105 Income (loss) from discontinued operations, net of tax $ 395,138 $ 30,348 $ (28,221 ) Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations (48,594 ) (43,850 ) (28,536 ) Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 346,544 (13,502 ) (56,757 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 363,740 $ (196,459 ) $ (25,652 ) Weighted-average common shares outstanding 176,038 180,830 186,188 Dilutive effect of stock options, restricted stock unit awards and warrants 2,491 0 0 Weighted-average common shares outstanding assuming dilution 178,529 180,830 186,188 Diluted Income (Loss) from continuing operations per Common Share $ 0.10 $ (1.02 ) $ 0.17 Diluted Income (Loss) from discontinued operations per Common Share $ 1.94 $ (0.07 ) $ (0.31 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ 2.04 $ (1.09 ) $ (0.14 ) As a result of the net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders for the years ended December 31, 2017 and 2016, we used basic weighted-average common shares outstanding in the calculation of diluted loss per share for each of these years, since the inclusion of any stock equivalents would be anti-dilutive. The following stock options, restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such stock options, restricted stock unit awards and warrants in the computation would be anti-dilutive: Year Ended December 31, (In thousands) 2018 2017 2016 Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation 26,175 26,515 25,277

Accumulated Other Comprehensive

Accumulated Other Comprehensive Loss	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Accumulated Other Comprehensive Loss	13. Accumulated Other Comprehensive Loss Accumulated Other Comprehensive Loss Changes in the balances of each component included in accumulated other comprehensive loss (“AOCI”) are presented in the tables below. All amounts are net of tax and exclude non-controlling interest. (In thousands) Foreign Currency Translation Adjustments Unrealized Net Gains (Losses) on Available for Sale Securities Unrealized Net Gains (Losses) on Foreign Exchange Contracts Total Balance as of December 31, 2015 (1) $ (4,500 ) $ 0 $ 258 $ (4,242 ) Other comprehensive (loss) income before reclassifications (1,528 ) (56,420 ) 683 (57,265 ) Net losses (gains) reclassified from accumulated other comprehensive loss 0 0 (322 ) (322 ) Net other comprehensive (loss) income (1,528 ) (56,420 ) 361 (57,587 ) Balance as of December 31, 2016 (2) (6,028 ) (56,420 ) 619 (61,829 ) Other comprehensive (loss) income before reclassifications 3,352 (106,445 ) 1,697 (101,396 ) Net losses (gains) reclassified from accumulated other comprehensive loss 0 162,865 (1,625 ) 161,240 Net other comprehensive (loss) income 3,352 56,420 72 59,844 Balance as of December 31, 2017 (3) (2,676 ) 0 691 (1,985 ) Other comprehensive (loss) income before reclassifications (2,908 ) 0 (264 ) (3,172 ) Net losses (gains) reclassified from accumulated other comprehensive loss 0 0 (232 ) (232 ) Net other comprehensive (loss) income (2,908 ) 0 (496 ) (3,404 ) Balance as of December 31, 2018 (4) $ (5,584 ) $ 0 $ 195 $ (5,389 ) (1) (2) (3) (4) Income Tax Effects Related to Components of Other Comprehensive Loss The following tables reflect the tax effects allocated to each component of other comprehensive loss (“OCI”) Year Ended December 31, 2018 (In thousands) Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ (2,908 ) $ 0 $ (2,908 ) Derivatives qualifying as cash flow hedges: Foreign exchange contracts: Net (losses) gains arising during the period (357 ) 93 (264 ) Net (gains) losses reclassified into income (1) (516 ) 284 (232 ) Net change in unrealized (losses) gains on foreign exchange contracts (873 ) 377 (496 ) Net gain (loss) on cash flow hedges (873 ) 377 (496 ) Other comprehensive loss $ (3,781 ) $ 377 $ (3,404 ) (1) Year Ended December 31, 2017 (In thousands) Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ 3,352 $ 0 $ 3,352 Available for sale securities: Net gain arising during the period (106,506 ) 61 (106,445 ) Net gain reclassified into income 162,865 0 162,865 Net change in unrealized gains on available for sale securities 56,359 61 56,420 Derivatives qualifying as cash flow hedges: Foreign exchange contracts: Net gains (losses) arising during the period 2,776 (1,079 ) 1,697 Net (gains) losses reclassified into income (2,662 ) 1,037 (1,625 ) Net change in unrealized gains (losses) on foreign exchange contracts 114 (42 ) 72 Net gain (loss) on cash flow hedges 114 (42 ) 72 Other comprehensive loss $ 59,825 $ 19 $ 59,844 Year Ended December 31, 2016 (In thousands) Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ (1,528 ) $ 0 $ (1,528 ) Available for sale securities: Net gain arising during the period (56,359 ) (61 ) (56,420 ) Net gain reclassified into income 0 0 0 Net change in unrealized gains on available for sale securities (56,359 ) (61 ) (56,420 ) Derivatives qualifying as cash flow hedges: Foreign exchange contracts: Net gains (losses) arising during the period 1,128 (445 ) 683 Net (gains) losses reclassified into income (531 ) 209 (322 ) Net change in unrealized gains (losses) on foreign exchange contracts 597 (236 ) 361 Net gain (loss) on cash flow hedges 597 (236 ) 361 Other comprehensive loss $ (57,290 ) $ (297 ) $ (57,587 )

Derivative Financial Instrument

Derivative Financial Instruments	12 Months Ended
	Dec. 31, 2018
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments	14. Derivative Financial Instruments The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates: December 31, 2018 Asset Derivatives Liability Derivatives (In thousands) Balance Sheet Location Fair Value Balance Sheet Location Fair Value Derivatives qualifying as cash flow hedges: Foreign exchange contracts Prepaid expenses and other current assets $ 262 Accrued expenses $ 0 Derivatives not subject to hedge accounting: 1.25% Call Option Other assets 9,104 N/A 1.25% Embedded cash conversion option N/A Other liabilities 9,974 Total derivatives $ 9,366 $ 9,974 December 31, 2017 Asset Derivatives Liability Derivatives (In thousands) Balance Sheet Location Fair Value Balance Sheet Location Fair Value Derivatives qualifying as cash flow hedges: Foreign exchange contracts Prepaid expenses and other current assets $ 1,136 Accrued expenses $ 0 Derivatives not subject to hedge accounting: 1.25% Call Option Other assets 46,578 N/A 1.25% Embedded cash conversion option N/A Other liabilities 47,777 Total derivatives $ 47,714 $ 47,777 N/A – Foreign Exchange Contracts We have entered into non-deliverable forward foreign currency exchange contracts with reputable banking counterparties in order to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. These forward contracts cover a decreasing percentage of forecasted monthly INR expenses over time. As of December 31, 2018, there were 12 forward contracts outstanding that were staggered to mature monthly starting in January 2019 and ending in December 2019. The critical terms of the forward contracts and the related hedged forecasted future expenses matched and allowed us to designate the forward contracts as highly effective cash flow hedges. The effective portion of the change in fair value is initially recorded in accumulated other comprehensive loss (“AOCI”) and subsequently reclassified to income in the period in which the cash flows from the associated hedged transactions affect income. Any ineffective portion of the change in fair value of the cash flow hedges is recognized in current period income. During the year ended December 31, 2018, no no $0.3 twelve months The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive income (loss): Amount of Gain (Loss) Recognized in OCI (Effective Portion) Location of Gain (Loss) Reclassified from AOCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion) Year Ended December 31, Year Ended December 31, (In thousands) 2018 2017 2016 2018 2017 2016 Foreign exchange contracts $ (357 ) $ 2,776 $ 1,128 Cost of Revenue $ 165 $ 905 $ 165 Selling, general and administrative expenses 138 692 133 Research and development 214 1,065 233 1.25% Call Option In June 2013, concurrent with the issuance of the 1.25% Notes, we entered into the 1.25% Call Option with certain of the initial purchasers of the 1.25% Notes (the “Option Counterparties”). Assuming full performance by the option counterparties, the 1.25% Call Option is intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes. Aside from the initial payment of a premium to the Option Counterparties of $82.8 million for the 1.25% Call Option, we will not be required to make any cash payments to the Option Counterparties under the 1.25% Call Option, and, subject to the terms and conditions thereof, will be entitled to receive from the Option Counterparties an amount of cash, generally equal to the amount by which the market price per share of our common stock exceeds the strike price of the 1.25% Call Option during the relevant valuation period. The strike price under the 1.25% Call Option is initially equal to the conversion price of the 1.25% Notes of $17.19 per share of our common stock. The 1.25% Call Option, which is indexed to our common stock, is a derivative asset that requires mark-to-market accounting treatment due to the cash settlement features until the 1.25% Call Option settles or expires. The 1.25% Call Option is measured and reported at fair value on a recurring basis within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the 1.25% Call Option, refer to Note 1, “Basis of Presentation and Significant Accounting Policies.” The 1.25% Call Option does not qualify for hedge accounting treatment. Therefore, the change in fair value of this instrument is recognized immediately in our consolidated statements of operations in Other income (loss), net. Because the terms of the 1.25% Call Option are substantially similar to those of the 1.25% Notes embedded cash conversion option, discussed next, we expect the net effect of those two derivative instruments on our results of operations to continue to be minimal. 1.25% Notes Embedded Cash Conversion Option The embedded cash conversion option within the 1.25% Notes is required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value recognized immediately in our consolidated statements of operations in Other income (loss), net until the cash conversion option settles or expires. The initial fair value liability of the embedded cash conversion option was $82.8 million, which simultaneously reduced the carrying value of the 1.25% Notes (effectively an original issuance discount). The embedded cash conversion option is measured and reported at fair value on a recurring basis within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the embedded cash conversion option, refer to Note 1, “Basis of Presentation and Significant Accounting Policies.” The following table shows the net impact of the changes in fair values of the 1.25% Call Option and 1.25% Notes embedded cash conversion option in the consolidated statements of operations: Year Ended December 31, (In thousands) 2018 2017 2016 1.25% Call Option $ (37,474 ) $ 29,498 $ (63,128 ) 1.25% Embedded cash conversion option 37,803 (30,118 ) 63,551 Net loss included in other income, net $ 329 $ (620 ) $ 423

Commitments

Commitments	12 Months Ended
	Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Commitments	15. Commitments Operating and Capital Leases We conduct our operations from leased premises under a number of operating leases. We also lease office and IT equipment under capital leases. Certain office leases contain renewal options and rent escalation clauses calling for rent increases over the term of the leases. All leases which contain a rent escalation clause are accounted for on a straight-line basis. Total rent expense recognized, which consists of the base rental amount and other lessor charges when mandated in a lease agreement, was as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Rent expense $ 28,677 $ 22,499 $ 18,113 Our future commitments under capital and operating leases are shown below. Future operating lease commitments are calculated using the base rental amount and foreign currency exchange rates in effect as of December 31, 2018. Capital Operating (In thousands) Leases Leases 2019 $ 1,351 $ 26,330 2020 422 22,394 2021 46 18,824 2022 14 17,493 2023 0 15,582 Thereafter 0 31,658 1,833 $ 132,281 Less amount representing interest (69 ) 1,764 Current maturities of capital lease obligations 996 Capital lease obligations, net of current maturities $ 768 Commitment with Strategic Partner During 2017, we completed renegotiations with Atos and our other largest hosting partners to improve the operating cost structure of our private cloud hosting operations. As a result of these renegotiations, we signed a new amended and restated agreement with Atos and, therefore, starting in 2018, we began to transition substantially all of our hosting services to Atos. The increased scale of the relationship is expected to result in future reductions in the base fees and volume fee rates. The new amended and restated agreement extends the term to 2023 with annual auto-renewal periods for an additional two years thereafter. The new agreement also provides for the payment of initial annual base fees of $30 million per year (decreasing to $25 million by the end of the agreement) plus charges for volume-based services currently projected using volumes estimated based on historical actuals and forecasted projections. Expenses under our agreement with Atos, which are included in cost of revenue in our consolidated statements of operations, are as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Expenses incurred under Atos agreement $ 55,903 $ 58,787 $ 62,266

Discontinued Operations

Discontinued Operations	12 Months Ended
	Dec. 31, 2018
Discontinued Operations And Disposal Groups [Abstract]
Discontinued Operations	16. Discontinued Operations Netsmart Discontinued Operation On December 31, 2018, we sold all of the Class A Common Units of Netsmart held by the Company in exchange for $566.6 million in cash plus a final settlement as determined following the closing. Prior to the sale, Netsmart comprised a separate reportable segment, which due to its significance to our historical consolidated financial statements and results of operations, is reported as a discontinued operation as a result of the sale. Refer to Note 3, “Business Combinations and Other Investments” for additional information about this transaction. The following table summarizes Netsmart’s major classes of assets and liabilities as reported on the consolidated balance sheets as of December 31, 2017 as the balances were fully deconsolidated as of December 31, 2018: (In thousands) December 31, 2017 Carrying amounts of major classes of assets associated with Netsmart included as part of assets attributable to discontinued operations: Cash and cash equivalents $ 31,504 Accounts receivable, net 75,313 Prepaid expenses and other current assets 9,008 Total current assets attributable to Netsmart discontinued operations 115,825 Fixed assets, net 30,186 Software development costs, net 27,344 Intangible assets, net 391,299 Goodwill 712,206 Other assets 1,998 Total noncurrent assets attributable to Netsmart discontinued operations $ 1,163,033 Carrying amounts of major classes of liabilities associated with Netsmart included as part of liabilities attributable to discontinued operations: Accounts payable $ 11,834 Accrued expenses 8,115 Accrued compensation and benefits 16,560 Deferred revenue 68,256 Current maturities of non-recourse long-term debt - Netsmart 2,755 Current maturities of capital lease obligations 6,763 Total current liabilities attributable to Netsmart 114,283 Non-recourse long-term debt - Netsmart 625,193 Long-term capital lease obligations 4,758 Deferred revenue long-term 4,838 Deferred taxes, net 70,385 Other liabilities 2,342 Total noncurrent liabilities attributable to Netsmart $ 707,516 Redeemable convertible non-controlling interest attributable to discontinued operations $ 431,535 Non-controlling interest attributable to discontinued operations $ 48 The following table summarizes Netsmart’s major income and expense line items as reported in the consolidated statements of operations for the years ended December 31, 2018, 2017 and 2016: Year ended December 31, (In thousands) 2018 2017 2016 Major income and expense line items related to Netsmart: (1) Revenue: Software delivery, support and maintenance $ 214,065 $ 198,204 $ 104,319 Client services 131,166 110,430 59,511 Total revenue 345,231 308,634 163,830 Cost of revenue: Software delivery, support and maintenance 60,100 51,079 36,823 Client services 94,061 78,317 39,851 Amortization of software development and acquisition related assets 34,357 29,876 17,416 Total cost of revenue 188,518 159,272 94,090 Gross profit 156,713 149,362 69,740 Selling, general and administrative expenses 125,807 85,583 58,344 Research and development 25,315 17,937 9,372 Amortization of intangible and acquisition-related assets 24,029 16,409 9,963 (Loss) income from discontinued operations for the Netsmart sale before income taxes (18,438 ) 29,433 (7,939 ) Interest expense (59,541 ) (49,939 ) (38,663 ) Other income 101 925 258 Income tax benefit 22,933 45,253 18,123 (Loss) income from discontinued operations, net of tax for Netsmart $ (54,945 ) $ 25,672 $ (28,221 ) (1) Activity includes both Netsmart and intercompany transactions that would not have been eliminated if Netsmart’s results were not consolidated. Horizon Clinicals and Series2000 Revenue Cycle Discontinued Operation Two of the product offerings acquired with the EIS Business in 2017, Horizon Clinicals and Series2000 Revenue Cycle, were sunset after March 31, 2018. The decision to discontinue maintaining and supporting these solutions was made prior to our acquisition of the EIS Business and, therefore, they are presented below as discontinued operations. Until the end of the first quarter of 2018, we were involved in ongoing maintenance and support for these solutions until customers transitioned to other platforms. No disposal gains or losses were recognized during the year ended December 31, 2018 related to these discontinued solutions. The following table summarizes the major classes of assets and liabilities of these discontinued solutions, as reported on the consolidated balance sheets as of December 31, 2018 and 2017: (In thousands) December 31, 2018 December 31, 2017 Carrying amounts of major classes of assets associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of assets attributable to discontinued operations: Accounts receivable, net $ 0 $ 8,196 Prepaid expenses and other current assets 0 3,080 Total current assets attributable to discontinued operations $ 0 $ 11,276 Carrying amounts of major classes of liabilities associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of liabilities attributable to discontinued operations: Accounts payable $ 0 $ 114 Accrued expenses 920 5,599 Accrued compensation and benefits 0 7,728 Deferred revenue 0 7,241 Other classes of liabilities that are not major 0 676 Total current liabilities attributable to discontinued operations $ 920 $ 21,358 The following table summarizes the major income and expense line items of these discontinued solutions, as reported in the consolidated statements of operations for the years ended December 31, 2018 and 2017: Year ended December 31, 2018 (In thousands) 2018 2017 Major income and expense line items relating to the Horizon Clinicals and Series2000 Revenue Cycle discontinued solutions: Revenue: Software delivery, support and maintenance $ 9,441 $ 10,949 Client services 404 1,044 Total revenue 9,845 11,993 Cost of revenue: Software delivery, support and maintenance 2,322 2,918 Client services 830 261 Total cost of revenue 3,152 3,179 Gross profit 6,693 8,814 Research and development 1,651 1,148 Income from discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle before income taxes 5,042 7,666 Income tax provision (1,311 ) (2,990 ) Income from discontinued operations, net of tax for Horizon Clinicals and Series2000 Revenue Cycle $ 3,731 $ 4,676

Business Segments

Business Segments	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Business Segments	17. Business Segments We primarily derive our revenues from sales of our proprietary software (either as a direct license sale or under a subscription delivery model), which also serves as the basis for our recurring service contracts for software support and maintenance and certain transaction-related services. In addition, we provide various other client services, including installation, and managed services such as outsourcing, private cloud hosting and revenue cycle management. During the first quarter of 2018, in an effort to further streamline and align our operating structure around our key acute and population health management solutions, we made several changes to our organizational and reporting structure. These changes included the split of our former Population Health operating segment, which was part of our Population Health reportable segment, into several components. The dbMotion business unit, previously included in the Population Health operating segment, was aligned with the Hospitals and Health Systems operating segment within the Clinical and Financial solutions reportable segment. The Care Management, Referral Management and Careport business units, previously included in the Population Health operating segment, were combined into a new Careport operating segment within the Population Health reportable segment. In addition, the 2bPrecise business became a separate operating segment. The segment disclosures below for the years ended December 31, 2017 and 2016, were have been revised to conform to the current year presentation. During the second quarter of 2018, we changed the presentation of certain research and development expenses related to common solutions and resources that benefit all of our business units. Such expenses were previously internally allocated to our business units. Under the new presentation, such expenses are no longer internally allocated and are included as part of “Unallocated Amounts.” The gross profit and income from operations previously reported for our reportable segments for the years ended December 31, 2017 and 2016 have been recast to match the new presentation. As a result, the gross profit and income from operations of the Clinical and Financial Solutions reportable segment increased by $3 million and $38 million, respectively, for the year ended December 31, 2017 and by $2 million and $44 million, respectively, for the year ended December 31, 2016. In addition, the gross profit and income from operations of the Population Health reportable segment increased by nil and $1 million, respectively, for the year ended December 31, 2017 and increased by nil and $2 million, respectively, for the year ended December 31, 2016. During the third quarter of 2018, as part of our continued efforts to improve operating efficiency and offer innovative products and services, we transferred the Payerpath business, previously part of the Veradigm operating segment (f/k/a Payor and Life Sciences operating segment), to the Ambulatory operating segment. This transfer had no impact on our reportable segments since both the Ambulatory and Veradigm operating segments are included within the Clinical and Financial Solutions reportable segment. During the fourth quarter of 2018, we further streamlined the Company’s operating segments. We merged the leadership and remaining businesses of the EIS-EWS operating segment with the EIS-Classics operating segment. This change was primarily driven by the sale of the Strategic Sourcing and OneContent business units earlier in 2018, which together comprised a substantial majority of the EIS-EWS operating segment. Refer to Note 3, “Business Combinations and Other Investments” for additional information regarding the sale of the Strategic Sourcing and OneContent business units. We also merged the leadership and assets of the NantHealth operating segment with the Hospitals and Health Systems operating segment. The EIS-EWS and NantHealth operating segments were previously included in the Population Health reportable segment, while the EIS-Classics and Hospitals and Health Systems operating segments are included within the Clinical and Financial Solutions reportable segment. The segment disclosures below for the years ended December 31, 2017 and 2016, have been revised to conform to the current year presentation. Finally, on December 31, 2018, we sold all of our investment in Netsmart. Prior to the sale, Netsmart comprised a separate reportable segment, which due to its significance to our historical consolidated financial statements and results of operations, is reported as a discontinued operation as a result of the sale. In addition, the results of operations related to two of the product offerings acquired with the EIS Business (Horizon Clinicals and Series2000) are also presented throughout these financial statements as discontinued operations and are included within the Clinical and Financial Solutions reportable segment, except for acquisition-related deferred revenue adjustments, which are included in “Unallocated Amounts”. Refer to Note 16, “Discontinued Operations.” As a result of the above changes, a s of December 31, 2018, we had operating segments, which are aggregated into reportable segments. The Clinical and Financial Solutions reportable segment includes the Hospitals and Health Systems, Ambulatory, Veradigm, and EIS-Classics strategic business units, each of which represents a separate operating segment. This reportable segment derives its revenue from the sale of integrated clinical software applications and financial and information solutions, which primarily include EHR-related software, connectivity and coordinated care solutions, financial and practice management software, related installation, support and maintenance, outsourcing, private cloud hosting, revenue cycle management, training and electronic claims administration services. The Population Health reportable segment is comprised of separate operating segments: Careport, FollowMyHealth ® , and EPSi TM . This reportable segment derives its revenue from the sale of health management, financial management and patient engagement solutions, which are mainly targeted at hospitals, health systems, other care facilities and Accountable Care Organizations (“ACOs”). The 2bPrecise operating segment is included in “Unallocated Amounts” based on materiality. Our Chief Operating Decision Maker (“CODM”) uses segment revenues, gross profit and income from operations as measures of performance and to make decisions about the allocation of resources. In determining these performance measures, we do not include in revenue the amortization of acquisition-related deferred revenue adjustments, which reflect the fair value adjustments to deferred revenue acquired in a business combination. We also exclude the amortization of intangible assets, stock-based compensation expense, non-recurring expenses and transaction-related costs, and non-cash asset impairment charges from the operating segment data provided to our CODM. Non-recurring expenses relate to certain severance, product consolidation, legal, consulting and other charges incurred in connection with activities that are considered one-time. Accordingly, these amounts are not included in our reportable segment results and are included in an “Unallocated Amounts” category within our segment disclosure. The “Unallocated Amounts” category also includes (i) corporate general and administrative expenses (including marketing expenses) and certain research and development expenses related to common solutions and resources that benefit all of our business units (refer to discussion above), all of which are centrally managed, (ii) revenue and the associated cost from the resale of certain ancillary products, primarily hardware and (iii) the results of the 2bPrecise operating segment. We do not track our assets by segment. Year Ended December 31, (In thousands) 2018 2017 2016 Revenue: Clinical and Financial Solutions $ 1,565,987 $ 1,337,030 $ 1,183,196 Population Health 190,706 173,809 177,394 Unallocated Amounts (6,731 ) (13,131 ) 25,479 Total revenue $ 1,749,962 $ 1,497,708 $ 1,386,069 Gross Profit: Clinical and Financial Solutions $ 663,005 $ 574,386 $ 496,595 Population Health 146,614 142,514 149,338 Unallocated Amounts (85,076 ) (84,101 ) (44,634 ) Total gross profit $ 724,543 $ 632,799 $ 601,299 Income (loss) from operations: Clinical and Financial Solutions $ 344,568 $ 335,005 $ 287,077 Population Health 100,118 112,577 123,685 Unallocated Amounts (537,738 ) (435,098 ) (343,052 ) Total income (loss) from operations $ (93,052 ) $ 12,484 $ 67,710

Supplemental Disclosures

Supplemental Disclosures	12 Months Ended
	Dec. 31, 2018
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Supplemental Disclosures	18. Supplemental Disclosures The majority of the restricted cash balance as of December 31, 2018 represents the remaining balance of the escrow account established as part of the acquisition of Netsmart in 2016 to be used by Netsmart to facilitate the integration of our Homecare TM December 31, (In thousands) 2018 2017 Reconciliation of cash, cash equivalents and restricted cash: Cash and cash equivalents $ 174,243 $ 119,470 Restricted cash 10,552 11,524 Total cash, cash equivalents and restricted cash $ 184,795 $ 130,994 Year Ended December 31, (In thousands) 2018 2017 2016 Cash paid during the period for: Interest $ 28,888 $ 21,183 $ 14,989 Income taxes paid, net of tax refunds $ 10,108 $ 6,675 $ 5,466 Non-cash transactions: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations $ 48,594 $ 43,850 $ 28,536 Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement $ 0 $ 42,750 $ 0 Obligations incurred to purchase capitalized software or enter into capital leases $ 1,501 $ 1,897 $ 27,127 Contribution of assets in exchange for equity interest $ 4,000 $ 0 $ 0 Issuance of treasury stock to commercial partner $ 1,121 $ 334 $ 0 Accrued expenses consist of the following: December 31, December 31, (In thousands) 2018 2017 Royalties, certain third-party product costs and licenses $ 26,371 $ 14,195 Other 79,701 63,605 Total accrued expenses $ 106,072 $ 77,800 Other consists of various accrued expenses and no individual item accounted for more than 5% of the current liabilities balance at the respective balance sheet dates. Other assets consist of the following: December 31, December 31, (In thousands) 2018 2017 Reseller agreement with Nant Health, LLC $ 0 $ 22,252 Fair value of 1.25% Call Option 9,104 46,578 Long-term deferred hosting fees 20,805 0 Long-term prepaid commissions 32,660 32,938 Investments in non-marketable securities 37,040 30,013 Long-term deposits and other assets 9,597 15,070 Total other assets $ 109,206 $ 146,851

Geographic Information

Geographic Information	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Geographic Information	19. Geographic Information Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below: Year Ended December 31, (In thousands) 2018 2017 2016 United States $ 1,697,178 $ 1,440,842 $ 1,336,799 Canada 15,377 15,818 18,694 Other international 37,407 41,048 30,576 Total $ 1,749,962 $ 1,497,708 $ 1,386,069 A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below: December 31, December 31, (In thousands) 2018 2017 United States $ 111,836 $ 129,021 India 4,231 4,154 Israel 3,830 1,322 Canada 60 146 Other international 1,956 774 Total $ 121,913 $ 135,417

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Contingencies	20. Contingencies In addition to commitments and obligations in the ordinary course of business, we are currently subject to various legal proceedings and claims that have not been fully adjudicated. We intend to vigorously defend ourselves in these matters. No less than quarterly, we review the status of each significant matter and assess our potential financial exposure. We accrue a liability for an estimated loss if the potential loss from any legal proceeding or claim is considered probable and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made. The outcome of legal proceedings is inherently uncertain, and we may incur substantial defense costs and expenses defending any of these matters. In the opinion of our management, the ultimate disposition of pending legal proceedings or claims will not have a material adverse effect on our consolidated financial position, liquidity or results of operations. However, if one or more of these legal proceedings were resolved against us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that reporting period could be materially adversely affected. Additionally, the resolution of a legal proceeding against us could prevent us from offering our products and services to current or prospective clients or cause us to incur increased compliance costs, either of which could further adversely affect our operating results. On May 1, 2012, Physicians Healthsource, Inc. filed a class action complaint in the U.S. District Court for the Northern District of Illinois against us. The complaint alleges that, on multiple occasions between July 2008 and December 2011, we or our agent sent advertisements by fax to the plaintiff and a class of similarly situated persons, without first receiving the recipients’ express permission or invitation in violation of the Telephone Consumer Protection Act, 47 U.S.C. § 227 (the “TCPA”). The plaintiff sought $500 The EIS Business acquired from McKesson on October 2, 2017 is subject to a May 2017 civil investigative demand (“CID”) from the U.S. Attorney’s Office for the Eastern District of New York. The CID requests documents and information related to the certification McKesson obtained for Horizon Clinicals in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program. In August 2018, McKesson received an additional CID seeking similar information for Paragon. McKesson has agreed, with respect to the CIDs, to indemnify Allscripts for amounts paid or payable to the government (or any private relator) involving any products or services marketed, sold or licensed by the EIS Business as of or prior to the closing of the acquisition. To date, there has been no claim or legal proceeding against Allscripts related to this investigation. Practice Fusion, acquired by Allscripts on February 13, 2018, received in March 2017 a request for documents and information from the U.S. Attorney’s Office for the District of Vermont pursuant to a CID. Between April 2018 and January 2019, Practice Fusion received five additional requests for documents and information through additional CIDs and Health Insurance Portability and Accountability Act subpoenas. These requests relate to the certification Practice Fusion obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program, compliance with the Anti-Kickback Statute and related business practices. Practice Fusion has produced documents in response to these requests. To date, there has been no claim or legal proceeding against Practice Fusion related to this investigation. On January 25, 2018, a complaint was filed in Surfside Non-Surgical Orthopedics, P.A. v. Allscripts Healthcare Solutions, Inc.

Quarterly Financial Information

Quarterly Financial Information (Unaudited)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Information (Unaudited)	21. Quarterly Financial Information (Unaudited) The following tables contain a summary of our unaudited quarterly consolidated results of operations for our last eight fiscal quarters, which have been restated to illustrate Netsmart as a discontinued operation. Quarter Ended December 31, September 30, June 30, March 31, (In thousands, except per share amounts) 2018 2018 2018 (1) 2018 (1) Revenue $ 442,346 $ 432,430 $ 441,464 $ 433,722 Cost of revenue 254,187 254,478 267,697 249,057 Gross profit 188,159 177,952 173,767 184,665 Selling, general and administrative expenses 99,992 108,125 122,913 119,937 Research and development 66,096 63,032 74,491 64,790 Asset impairment charges 28,091 0 30,075 0 Goodwill impairment charge 13,466 0 0 0 Amortization of intangible and acquisition-related assets 6,957 6,609 6,382 6,639 (Loss) income from operations (26,443 ) 186 (60,094 ) (6,701 ) Interest expense (13,989 ) (13,251 ) (11,979 ) (11,695 ) Other income (loss), net 658 (536 ) (14 ) (34 ) Gain on sale of businesses, net 0 0 173,129 (871 ) Impairment of and losses on long-term investments 0 0 (9,987 ) (5,500 ) Equity in net (loss) income of unconsolidated investments (270 ) (177 ) 767 (61 ) (Loss) income from continuing operations before income taxes (40,044 ) (13,778 ) 91,822 (24,862 ) Income tax benefit (provision) 5,449 1,637 (7,256 ) (299 ) (Loss) income from continuing operations, net of tax (34,595 ) (12,141 ) 84,566 (25,161 ) Loss from discontinued operations (39,854 ) (13,857 ) (14,109 ) (5,016 ) Gain on sale of Netsmart 500,471 0 0 0 Income tax effect on discontinued operations (40,126 ) 2,152 3,815 1,662 Income (loss) from discontinued operations, net of tax 420,491 (11,705 ) (10,294 ) (3,354 ) Net income (loss) 385,896 (23,846 ) 74,272 (28,515 ) Less: Net loss attributable to non-controlling interest 1,033 4 2,700 790 Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations (12,148 ) (12,149 ) (12,148 ) (12,149 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 374,781 $ (35,991 ) $ 64,824 $ (39,874 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share: Basic Continuing operations $ (0.19 ) $ (0.07 ) $ 0.49 $ (0.14 ) Discontinued operations $ 2.36 $ (0.13 ) $ (0.13 ) $ (0.08 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 2.17 $ (0.20 ) $ 0.36 $ (0.22 ) Diluted Continuing operations $ (0.19 ) $ (0.07 ) $ 0.49 $ (0.14 ) Discontinued operations $ 2.33 $ (0.13 ) $ (0.13 ) $ (0.08 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 2.14 $ (0.20 ) $ 0.36 $ (0.22 ) Quarter Ended December 31, September 30, June 30, March 31, (In thousands, except per share amounts) 2017 (2) 2017 (2) 2017 2017 Revenue $ 436,411 $ 368,091 $ 350,150 $ 343,056 Cost of revenue 260,208 205,843 199,930 198,928 Gross profit 176,203 162,248 150,220 144,128 Selling, general and administrative expenses 123,113 93,790 91,033 92,752 Research and development 68,344 46,485 42,205 45,248 Amortization of intangible and acquisition-related assets 6,005 3,816 3,745 3,779 Income from operations (21,259 ) 18,157 13,237 2,349 Interest expense (11,594 ) (9,251 ) (8,279 ) (8,416 ) Other income (loss), net 160 (685 ) (222 ) 235 Impairment of and losses on long-term investments 0 (20,700 ) (144,590 ) 0 Equity in net loss of unconsolidated investments 115 449 (28 ) 285 Loss from continuing operations before income taxes (32,578 ) (12,030 ) (139,882 ) (5,547 ) Income tax benefit (provision) 9,973 (3) (1,962 ) (1,263 ) (1,234 ) Loss from continuing operations, net of tax (22,605 ) (13,992 ) (141,145 ) (6,781 ) Income from discontinued operations, net of tax 37,468 (3,470 ) (1,866 ) (1,784 ) Net income (loss) 14,863 (17,462 ) (143,011 ) (8,565 ) Less: Net loss (income) attributable to non-controlling interest 1,918 (163 ) 264 (453 ) Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations (10,963 ) (10,962 ) (10,963 ) (10,962 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 5,818 $ (28,587 ) $ (153,710 ) $ (19,980 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share: Basic Continuing operations $ (0.12 ) $ (0.08 ) $ (0.78 ) $ (0.04 ) Discontinued operations $ 0.15 $ (0.08 ) $ (0.07 ) $ (0.07 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 0.03 $ (0.16 ) $ (0.85 ) $ (0.11 ) Diluted Continuing operations $ (0.12 ) $ (0.08 ) $ (0.78 ) $ (0.04 ) Discontinued operations $ 0.15 $ (0.08 ) $ (0.07 ) $ (0.07 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 0.03 $ (0.16 ) $ (0.85 ) $ (0.11 ) (1) Results of operations for the quarter include the results of operations of (i) Practice Fusion since February 13, 2018 and (ii) Health Grid since May 18, 2018. (2) Results of operations for the quarter include the results of operations of (i) the provider/ patient engagement solutions business of NantHealth, Inc. since August 25, 2017 and (ii) the EIS Business since October 2, 2017. (3)

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2018
Subsequent Events [Abstract]
Subsequent Events	Error extracting Word content

Schedule II-Valuation and Quali

Schedule II-Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2018
Valuation And Qualifying Accounts [Abstract]
Schedule II-Valuation and Qualifying Accounts	Schedule II—Valuation and Qualifying Accounts Charged to Balance at Expenses/ Deferred Write-Offs, Balance at Beginning of Against Revenue Net of End of (In thousands) Year Revenue Reclassification Recoveries Year Allowance for doubtful accounts and sales credits Year ended December 31, 2018 $ 31,386 $ 21,156 $ 5,512 $ (7,648 ) $ 50,406 Year ended December 31, 2017 28,655 7,384 1,482 (6,135 ) 31,386 Year ended December 31, 2016 31,266 6,979 661 (10,251 ) 28,655 All other schedules are omitted, since the required information is not applicable or is not present in amounts sufficient to require submission of the schedule, or because the information required is included in the consolidated financial statements and notes thereto.

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in accordance with generally accepted accounting principles in the United States of America (“GAAP”) requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Actual results could differ materially from these estimates.
Change in Presentation	Change in Presentation During 2018, we changed the presentation of certain bundled revenue streams and the associated cost of revenue which were previously included as part of software delivery, support and maintenance revenue. Under the new presentation, these amounts are included as part of client services revenue and cost of revenue, respectively. We have recast previously reported revenue and cost of revenue amounts to conform with the new presentation. This change in presentation had no impact on previously reported gross profit, net income (loss) or earnings (loss) per share. The following table illustrates the recast of cost of revenue and gross profit for the quarterly periods and the year ended December 31, 2018. Quarterly revenue previously reported during fiscal 2018 already reflected this change in presentation. Quarter ended Year ended (In thousands) March 31, 2018 June 30, 2018 September 30, 2018 December 31, 2018 December 31, 2018 Cost of revenue reclassification: Software delivery, support and maintenance $ (4,033 ) $ (7,202 ) $ (6,394 ) $ (6,400 ) $ (24,029 ) Client services 4,033 7,202 6,394 6,400 24,029 Amortization of software development and acquisition-related assets 0 0 0 0 0 Total cost of revenue: 0 0 0 0 0 Gross profit impact: Software delivery, support and maintenance (4,033 ) (7,202 ) (6,394 ) (6,400 ) (24,029 ) Client services 4,033 7,202 6,394 6,400 24,029 Total gross profit $ 0 $ 0 $ 0 $ 0 $ 0 The following table illustrates the recast for revenue and associated cost of revenue for the quarterly periods and the year ended December 31, 2017: Quarter ended Year ended (In thousands) March 31, 2017 June 30, 2017 September 30, 2017 December 31, 2017 December 31, 2017 Revenue reclassification: Software delivery, support and maintenance $ (4,270 ) $ (4,239 ) $ (5,119 ) $ (4,703 ) $ (18,331 ) Client services 4,270 4,239 5,119 4,703 18,331 Total revenue 0 0 0 0 0 Cost of revenue reclassification: Software delivery, support and maintenance (5,056 ) (5,556 ) (5,454 ) (5,454 ) (21,520 ) Client services 5,056 5,556 5,454 5,454 21,520 Amortization of software development and acquisition-related assets 0 0 0 0 0 Total cost of revenue: 0 0 0 0 0 Gross profit impact: Software delivery, support and maintenance 786 1,317 335 751 3,189 Client services (786 ) (1,317 ) (335 ) (751 ) (3,189 ) Total gross profit $ 0 $ 0 $ 0 $ 0 $ 0 The following table illustrates the recast of revenue and associated cost of revenue for the year ended December 31, 2016: Year ended (In thousands) December 31, 2016 Revenue reclassification: Software delivery, support and maintenance $ (8,734 ) Client services 8,734 Total revenue 0 Cost of revenue reclassification: Software delivery, support and maintenance (17,831 ) Client services 17,831 Amortization of software development and acquisition-related assets 0 Total cost of revenue: 0 Gross profit impact: Software delivery, support and maintenance 9,097 Client services (9,097 ) Total gross profit $ 0
Revenue Recognition	Revenue Recognition We adopted Financial Accounting Standards Board (“FASB”) Accounting Standards Update 2014-09, Revenue from Contracts with Customers: Topic 606 Revenue Recognition We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer. The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment. The following table summarizes the pattern of revenue recognition for our most significant performance obligations: Performance Obligation Revenue Type Recurring or Non-recurring Nature Revenue Recognition Pattern Measure of progress Support and maintenance ("SMA") Software delivery, support and maintenance Recurring Over time Output method (time elapsed) – revenue is recognized ratably over the contract term Software as a service ("SaaS") Software delivery, support and maintenance Recurring Over time Output method (time elapsed) – revenue is recognized ratably over the contract term Private cloud hosting Client services Recurring Over time Output method (time elapsed) – revenue is recognized ratably over the contract term Client/Education services Client services Non-recurring Over time Input method (cost to cost) – revenue is recognized proportionally over the service implementation based on hours Outsourcing services Client services Recurring Over time Input method (cost to cost) – revenue is recognized proportionally over the outsourcing period Payerpath (transaction volume) Software delivery, support and maintenance Recurring Over time Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing. Software licenses Software delivery, support and maintenance Non-recurring Point in time Upon electronic delivery Hardware Software delivery, support and maintenance Non-recurring Point in time Upon shipment Recurring software delivery, support and maintenance revenue consists of recurring subscription-based software sales, support and maintenance revenue, and recurring transaction-related revenue. Non-recurring software delivery, support and maintenance revenue consists of perpetual software licenses sales, resale of hardware and non-recurring transaction-related revenue. Recurring client services revenue consists of revenue from managed services solutions, such as outsourcing, private cloud hosting and revenue cycle management. Non-recurring client services revenue consists of project-based client services revenue. When evaluating our SMA, SaaS and private cloud hosting performance obligations, we noted that these obligations are fulfilled as stand-ready obligations to perform and, therefore, we deem the obligations to be satisfied evenly over time. Client services, such as those relating to implementation, consulting, training or education, are generally not fulfilled evenly over the contract period but rather over a shorter timeline where work effort can rise or decline based upon stages of the project work effort. These client services are typically quoted to a customer as a fixed fee amount that covers the implementation effort. Delivery progress for these services is measured by establishing an approved cost budget with labor hour inputs utilized to gauge percentage of completion of the work effort. Therefore, revenue for our client, education and outsourcing services is recognized proportionally with the progress of the implementation work effort. Payerpath transaction volume and other transaction-based service obligations, such as revenue cycle management services, are fulfilled over time but are not provided evenly over the contract period and reliable inputs are not available to track progress of completion. We determined that value is provided to the customer throughout the contract period and the pricing charged to the customer varies on a monthly basis, based upon the volume of the customer’s transactions processed in that respective period. The invoiced amount to the customer represents this value and, accordingly, the practical expedient to recognize revenue based upon invoicing is most appropriate. We considered the specific implementation guidance for accounting for licenses of intellectual property (“IP”) to determine if point in time or over time recognition was more appropriate. The first step in the licensing framework is to determine whether the license is distinct or combined with other goods and services. For most of our software licensing products, the licenses are distinct, with the exception of one of our product offerings under our CareInMotion TM
Cash and Cash Equivalents	Cash and Cash Equivalents We consider all highly liquid investments with an original maturity of three months or less, when purchased, to be cash equivalents. The fair values of these investments approximate their carrying values.
Other Financial Assets and Liabilities	Other Financial Assets and Liabilities Investments classified as available for sale securities included certain equity instruments which have a readily determinable market value. Changes in market value for these instruments, excluding other-than-temporary impairments, are reflected in other comprehensive income. Realized gains and losses are recorded using the specific identification method. We recognized other-than-temporary impairment charges of $142.2 million relating to these equity instrument during the second quarter of 2017. During the third quarter of 2017, we recognized an additional $20.7 million loss upon the final disposition of these instruments in connection with the NantHealth patient/provider engagement solutions business acquisition (refer to Note 3, “Business Combinations and Other Investments”). There were no other-than-temporary impairments related to our available for sale securities for the years ended December 31, 2018 and 2016. We also have investments in other equity investments for which it is not practicable to estimate fair value primarily because of their illiquidity and restricted marketability. Such investments are accounted under the cost and equity methods of accounting. Refer to Note 3, “Business Combinations and Other Investments” for additional information about these investments. Our long-term financial liabilities include borrowings outstanding under our Senior Secured Credit Facility (as defined in Note 8, “Debt”), with carrying values that approximate fair value since the variable interest rates approximate current market rates. In addition, as of December 31, 2018, the fair value of the 1.25% Notes (as defined in Note 8, “Debt”) was approximately equal to the 1.25% Notes’ principal balance (or par). We utilized the 1.25% Notes’ market trading prices near December 31, 2018 in making this fair value assessment. See Note 8, “Debt” for further information regarding our long-term financial liabilities.
Derivative Financial Instruments	Derivative Financial Instruments Derivative instruments are recognized as either assets or liabilities and are measured at fair value. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the resulting designation. For derivative instruments designated as cash-flow hedges, the effective portion of the derivative’s gain (loss) is initially reported as a component of other comprehensive income and is subsequently recognized in earnings when the hedged exposure is recognized in earnings. Gains (losses) on derivatives representing either hedge components excluded from the assessment of effectiveness or hedge ineffectiveness are recognized in earnings. See Note 14, “Derivative Financial Instruments” for information regarding gains and losses from derivative instruments during the years ended December 31, 2018, 2017 and 2016.
Allowance for Doubtful Accounts Receivable	Allowance for Doubtful Accounts Receivable Accounts receivable are recorded at the invoiced amounts and do not bear interest. An allowance for doubtful accounts is recorded to provide for estimated losses resulting from uncollectible accounts and is based principally on specifically identified amounts where collection is deemed doubtful. Additional non-specific allowances are recorded based on historical experience and management’s assessment of a variety of factors related to the general financial condition of our clients, the industry in which we operate and general economic conditions. We regularly review the collectability of individual accounts and assess the adequacy of the allowance for doubtful accounts. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. If the financial condition of our clients were to deteriorate, resulting in an impairment of their ability to make payments, additional allowance and related bad debt expense may be required.
Contingent Liabilities	Contingent Liabilities A liability is contingent if the amount is not presently known but may become known in the future as a result of the occurrence of some uncertain future event. We accrue a liability for an estimated loss if we determine that the potential loss is probable of occurring and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made. The assessment of contingent liabilities, including legal and income tax contingencies, involves the use of estimates, assumptions and judgments. Our estimates are based on our belief that future events will validate the current assumptions regarding the ultimate outcome of these exposures. However, there can be no assurance that future events, such as court decisions or Internal Revenue Service (“IRS”) positions, will not differ from our assessments.
Fixed Assets	Fixed Assets Fixed assets are stated at cost. Depreciation and amortization are computed under the straight-line method over the estimated useful lives of the related assets. The depreciable life of leasehold improvements is the shorter of the lease term or the useful life. Upon asset retirement or other disposition, the fixed asset cost and the related accumulated depreciation or amortization are removed from the accounts, and any gain or loss is included in the consolidated statements of operations. Amounts incurred for repairs and maintenance are expensed as incurred.
Business Combinations	Business Combinations Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions as a part of the purchase price allocation process to accurately value the assets acquired, including intangible assets, and the liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we may record adjustments to the fair values of the assets acquired and the liabilities assumed, with a corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or the liabilities assumed, whichever comes first, any subsequent adjustments are reflected in our consolidated statements of operations.
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill and intangible assets acquired in a business combination and determined to have an indefinite useful life are not amortized but are tested for impairment annually or between annual tests when an impairment indicator exists. If an optional qualitative goodwill impairment assessment is not performed, we are required to determine the fair value of each reporting unit. If a reporting unit’s fair value is lower than its carrying value, an impairment loss equal to the excess will be recorded not to exceed the carrying amount of goodwill assigned to the reporting unit. The recoverability of indefinite-lived intangible assets is assessed by comparison of the carrying value of an asset to its estimated fair value. If we determine that the carrying value of an asset exceeds its estimated fair value, an impairment loss equal to the excess will be recorded. The determination of the fair value of our reporting units is based on a combination of a market approach, that considers benchmark company market multiples, and an income approach, that utilizes discounted cash flows for each reporting unit and other Level 3 inputs. Under the income approach, we determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. Additionally, the discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. As part of the goodwill impairment testing, we also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units. In accordance with GAAP, definite-lived intangible assets are required to be amortized over their respective estimated useful lives and reviewed for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We estimate the useful lives of our intangible assets and ratably amortize their value over the estimated useful lives of those assets. If the estimates of the useful lives should change, we will amortize the remaining book value over the remaining useful lives or, if an asset is deemed to be impaired, a write-down of the value of the asset may be required at such time.
Long-Lived Assets and Long-Lived Assets to Be Disposed Of	Long-Lived Assets and Long-Lived Assets to Be Disposed Of We review our long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets.
Software Development Costs	Software Development Costs We capitalize purchased software upon acquisition if it is accounted for as internal-use software or if it meets the future alternative use criteria. We capitalize incurred labor costs for software development from the time technological feasibility of the software is established, or when the preliminary project phase is completed in the case of internal-use software, until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We estimate the useful life of our capitalized software and amortize its value over that estimated life. If the actual useful life is shorter than our estimated useful life, we will amortize the remaining book value over the remaining useful life or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Upon the availability for general release, we commence amortization of the capitalized software costs on a product by product basis. Amortization of capitalized software is recorded using the greater of (i) the ratio of current revenues to total and anticipated future revenues for the applicable product or (ii) the straight-line method over the remaining estimated economic life, which is estimated to be three to five years. At each balance sheet date, the unamortized capitalized costs of a software product are compared with the net realizable value of that product. The net realizable value is the estimated future gross revenues from that product reduced by the estimated future costs of completing and disposing of that product, including the costs of performing maintenance and client support required to satisfy our responsibility set forth at the time of sale. The amount by which the unamortized capitalized costs of a software product exceed the net realizable value of that asset is written off. If we determine that the value of the capitalized software could not be recovered, a write-down of the value of the capitalized software to its recoverable value is recorded as a charge to earnings. The unamortized balances of capitalized software were as follows: December 31, (In thousands) 2018 2017 Software development costs $ 317,637 $ 280,146 Less: accumulated amortization (107,977 ) (85,301 ) Software development costs, net $ 209,660 $ 194,845 Capitalized software development costs, write-offs included in asset impairment changes and amortization of capitalized software development costs included in cost of revenue are shown in the table below. Capitalized software development costs for the year ended December 31, 2016 include $44 million of third-party software purchases to supplement our internal software development efforts, of which $24 million was accrued as of December 31, 2016 and paid during 2017. Year Ended December 31, (In thousands) 2018 2017 2016 Capitalized software development costs $ 113,308 $ 94,740 $ 115,710 Write-offs and divestitures of capitalized software development costs $ 34,083 $ 0 $ 4,625 Amortization of capitalized software development costs $ 64,409 $ 51,589 $ 40,764
Income Taxes	Income Taxes We account for income taxes using the liability method, which requires the recognition of deferred tax assets or liabilities for the tax-effected temporary differences between the financial reporting and tax bases of our assets and liabilities and for net operating loss and tax credit carryforwards. The objectives of accounting for income taxes are to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in an entity’s financial statements or tax returns. Judgment is required in addressing the future tax consequences of events that have been recognized in our consolidated financial statements or tax returns. The deferred tax assets are recorded net of a valuation allowance when, based on the weight of available evidence, we believe it is more likely than not that some portion or all of the recorded deferred tax assets will not be realized in future periods. We consider many factors when assessing the likelihood of future realization of our deferred tax assets, including recent cumulative earnings experience, expectations of future taxable income, the ability to carryback losses and other relevant factors. In addition, we are subject to the continuous examination of our income tax returns by the IRS and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements. The calculation of tax liabilities involves dealing with uncertainties in the application of complex tax regulations. We recognize liabilities for anticipated tax audit issues based on our estimate of whether, and the extent to which, additional taxes may be required. If we ultimately determine that payment of these amounts is unnecessary, then we reverse the liability and recognize a tax benefit during the period in which we determine that the liability is no longer necessary. We also recognize tax benefits to the extent that it is more likely than not that our positions will be sustained if challenged by the taxing authorities. To the extent we prevail in matters for which liabilities have been established or are required to pay amounts in excess of our liabilities, our effective tax rate in a given period may be materially affected. An unfavorable tax settlement would require cash payments and may result in an increase in our effective tax rate in the year of resolution. A favorable tax settlement would be recognized as a reduction in our effective tax rate in the year of resolution. We report interest and penalties related to uncertain income tax positions in the income tax (provision) benefit line of our consolidated statements of operations. We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States.
Stock-Based Compensation	Stock-Based Compensation We account for stock-based compensation in accordance with GAAP, which requires the measurement and recognition of compensation expense for all share-based payment awards made to employees and non-employee directors based on their estimated fair value. We measure stock-based compensation cost at the grant date based on the fair value of the award and recognize the expense over the requisite service period typically on a straight-line basis, net of estimated forfeitures. We recognize stock-based compensation cost for awards with performance conditions if and when we conclude that it is probable that the performance conditions will be achieved. The fair value of service-based restricted stock units and restricted stock awards is measured at their underlying closing share price on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. The net proceeds from stock-based compensation activities are reflected as a financing activity within the accompanying consolidated statements of cash flows. We settle employee stock option exercises and stock awards with newly issued common shares. Refer to Note 10, “Stock Award Plans” for detailed discussion about our stock-based incentive plans.
Employee Benefit Plans	Employee Benefit Plans We provide employees with defined contribution savings plans. We recognize expense for our contributions to the savings plans at the time employees make contributions to the plans and we contributed the following amounts to these plans: Year Ended December 31, (In thousands) 2018 2017 2016 Company contributions to employee benefit plans $ 29,393 $ 18,861 $ 18,329
Foreign Currency	Foreign Currency The determination of the functional currency of our foreign subsidiaries is made based on the appropriate economic and management indicators. Our foreign subsidiaries use the local currency of their respective countries as the functional currency, with the exception of our operating subsidiaries in India and Israel which use the United States dollar as a functional currency. The assets and liabilities of foreign subsidiaries whose functional currency is the local currency are translated into United States dollars at the exchange rates in effect at the consolidated balance sheet date, while revenues and expenses are translated at the average rates of exchange during the year. Translation gains and losses are not included in determining net income or loss but are included as a separate component of accumulated other comprehensive loss. Gains and losses resulting from foreign currency transactions are included in determining net income or loss and have not been material in any years presented in the accompanying consolidated statements of operations. We periodically enter into non-deliverable forward foreign currency exchange contracts in order to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. See Note 14, “Derivative Financial Instruments,” for information regarding these foreign currency exchange contracts.
Concentrations of Credit Risk	Concentrations of Credit Risk Financial instruments that potentially subject us to a concentration of credit risk consist of cash, cash equivalents, marketable securities and trade receivables. We primarily maintain our cash balances with one major commercial bank domestically and several commercial banks internationally. We sell our products and services to healthcare providers. Credit risk with respect to trade receivables is generally diversified due to the large number of clients and their geographic dispersion. To reduce credit risk, we perform ongoing credit evaluations of significant clients and their payment histories. In general, we do not require collateral from our clients, but we do enter into advance deposit agreements, if appropriate. The majority of our revenue is derived from clients located in the United States. The majority of long-lived assets are also located in the United States. No single client accounted for more than 10% of our revenue in the years ended December 31, 2018, 2017 and 2016. No client represented more than 10% of accounts receivable as of December 31, 2018 or 2017.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In January 2016, the FASB issued Accounting Standards Update No. 2016-01, “Recognition and Measurement of Financial Assets and Financial Liabilities” In January 2017, the FASB issued Accounting Standards Update No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business In January 2017, the FASB issued Accounting Standards Update No. 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment In August 2018, the FASB issued Accounting Standards Update No. 2018-15, “ Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40)”
Accounting Pronouncements Not Yet Adopted	Accounting Pronouncements Not Yet Adopted In February 2016, the FASB issued Accounting Standards Update No. 2016-02, “ Leases (Topic 842) In June 2016, the FASB issued Accounting Standards Update No. 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities In June 2018, the FASB issued Accounting Standards Update No. 2018-07, “ Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting In August 2018, the FASB issued Accounting Standards Update No. 2018-13, “Fair Value Measurement (Topic 820) – Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Schedule of Revenue and Associated Cost of Revenue Recast Totals and Gross Profit Impact	The following table illustrates the recast of cost of revenue and gross profit for the quarterly periods and the year ended December 31, 2018. Quarterly revenue previously reported during fiscal 2018 already reflected this change in presentation. Quarter ended Year ended (In thousands) March 31, 2018 June 30, 2018 September 30, 2018 December 31, 2018 December 31, 2018 Cost of revenue reclassification: Software delivery, support and maintenance $ (4,033 ) $ (7,202 ) $ (6,394 ) $ (6,400 ) $ (24,029 ) Client services 4,033 7,202 6,394 6,400 24,029 Amortization of software development and acquisition-related assets 0 0 0 0 0 Total cost of revenue: 0 0 0 0 0 Gross profit impact: Software delivery, support and maintenance (4,033 ) (7,202 ) (6,394 ) (6,400 ) (24,029 ) Client services 4,033 7,202 6,394 6,400 24,029 Total gross profit $ 0 $ 0 $ 0 $ 0 $ 0 The following table illustrates the recast for revenue and associated cost of revenue for the quarterly periods and the year ended December 31, 2017: Quarter ended Year ended (In thousands) March 31, 2017 June 30, 2017 September 30, 2017 December 31, 2017 December 31, 2017 Revenue reclassification: Software delivery, support and maintenance $ (4,270 ) $ (4,239 ) $ (5,119 ) $ (4,703 ) $ (18,331 ) Client services 4,270 4,239 5,119 4,703 18,331 Total revenue 0 0 0 0 0 Cost of revenue reclassification: Software delivery, support and maintenance (5,056 ) (5,556 ) (5,454 ) (5,454 ) (21,520 ) Client services 5,056 5,556 5,454 5,454 21,520 Amortization of software development and acquisition-related assets 0 0 0 0 0 Total cost of revenue: 0 0 0 0 0 Gross profit impact: Software delivery, support and maintenance 786 1,317 335 751 3,189 Client services (786 ) (1,317 ) (335 ) (751 ) (3,189 ) Total gross profit $ 0 $ 0 $ 0 $ 0 $ 0 The following table illustrates the recast of revenue and associated cost of revenue for the year ended December 31, 2016: Year ended (In thousands) December 31, 2016 Revenue reclassification: Software delivery, support and maintenance $ (8,734 ) Client services 8,734 Total revenue 0 Cost of revenue reclassification: Software delivery, support and maintenance (17,831 ) Client services 17,831 Amortization of software development and acquisition-related assets 0 Total cost of revenue: 0 Gross profit impact: Software delivery, support and maintenance 9,097 Client services (9,097 ) Total gross profit $ 0
Unamortized Balances of Capitalized Software	The unamortized balances of capitalized software were as follows: December 31, (In thousands) 2018 2017 Software development costs $ 317,637 $ 280,146 Less: accumulated amortization (107,977 ) (85,301 ) Software development costs, net $ 209,660 $ 194,845
Capitalized Software Development Costs, Write Offs Included in Asset Impairment Changes and Amortization of Capitalized Software Development Costs Included in Cost of Revenue	Capitalized software development costs, write-offs included in asset impairment changes and amortization of capitalized software development costs included in cost of revenue are shown in the table below. Capitalized software development costs for the year ended December 31, 2016 include $44 million of third-party software purchases to supplement our internal software development efforts, of which $24 million was accrued as of December 31, 2016 and paid during 2017. Year Ended December 31, (In thousands) 2018 2017 2016 Capitalized software development costs $ 113,308 $ 94,740 $ 115,710 Write-offs and divestitures of capitalized software development costs $ 34,083 $ 0 $ 4,625 Amortization of capitalized software development costs $ 64,409 $ 51,589 $ 40,764
Company Contributions to Employee Benefit Plan	We provide employees with defined contribution savings plans. We recognize expense for our contributions to the savings plans at the time employees make contributions to the plans and we contributed the following amounts to these plans: Year Ended December 31, (In thousands) 2018 2017 2016 Company contributions to employee benefit plans $ 29,393 $ 18,861 $ 18,329

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	12 Months Ended
	Dec. 31, 2018
Revenue Recognized Related To Various Performance Obligations And Elected Accounting Expedients	The breakdown of revenue recognized related based on the origination of performance obligations and elected accounting expedients is presented in the table below: (In thousands) Three Months Ended March 31, 2018 Three Months Ended June 30, 2018 Three Months Ended September 30, 2018 Three Months Ended December 31, 2018 Revenue related to deferred revenue balance at beginning of period $ 181,398 $ 196,163 $ 153,151 $ 141,127 Revenue related to new performance obligations satisfied during the period 200,232 180,001 225,641 237,963 Revenue recognized under "right-to-invoice" expedient 49,403 62,533 51,288 60,593 Reimbursed travel expenses, shipping and other revenue 2,689 2,767 2,350 2,663 Total revenue $ 433,722 $ 441,464 $ 432,430 $ 442,346
Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments	The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments: Year Ended December 31, (In thousands) 2018 2017 2016 Revenue: Software delivery, support and maintenance Recurring revenue $ 967,990 $ 802,080 $ 752,084 Non-recurring revenue 160,273 156,107 147,215 Total software delivery, support and maintenance 1,128,263 958,187 899,299 Client services Recurring revenue $ 443,752 $ 374,640 $ 324,635 Non-recurring revenue 177,947 164,881 162,135 Total client services 621,699 539,521 486,770 Total revenue $ 1,749,962 $ 1,497,708 $ 1,386,069
Disaggregation of Revenue by Product Line and Segment	Twelve Months Ended December 31, 2018 (In thousands) Clinical and Financial Solutions Population Health Unallocated Total Software delivery, support and maintenance $ 958,144 $ 168,275 $ 1,844 $ 1,128,263 Client services 607,843 22,431 (8,575 ) 621,699 Total revenue $ 1,565,987 $ 190,706 $ (6,731 ) $ 1,749,962 Twelve Months Ended December 31, 2017 (In thousands) Clinical and Financial Solutions Population Health Unallocated Total Software delivery, support and maintenance $ 808,611 $ 160,015 $ (10,439 ) $ 958,187 Client services 528,419 13,794 (2,692 ) 539,521 Total revenue $ 1,337,030 $ 173,809 $ (13,131 ) $ 1,497,708 Twelve Months Ended December 31, 2016 (In thousands) Clinical and Financial Solutions Population Health Unallocated Total Software delivery, support and maintenance $ 710,679 $ 165,532 $ 23,088 $ 899,299 Client services 472,517 11,862 2,391 486,770 Total revenue $ 1,183,196 $ 177,394 $ 25,479 $ 1,386,069
ASC 606
Impact of Adoption of ASC 606 on Financial Statements	The table below reflects the cumulative adjustments that were made to balances previously reported in the consolidated balance sheet as of December 31, 2017. As Reported Adjustments Adjusted (In thousands) December 31, 2017 due to ASC 606 January 1, 2018 Accounts receivable, net $ 492,560 $ (19,290 ) $ 473,270 Contract assets 0 77,791 77,791 Prepaid expenses and other current assets 106,455 7,381 113,836 Deferred revenue, current 478,574 (12,810 ) 465,764 Deferred revenue, long-term 19,208 0 19,208 Deferred taxes, net 23,258 20,034 43,292 Accumulated deficit (338,150 ) 58,658 (279,492 ) December 31, 2018 (In thousands) As reported under ASC 606 Adjustments due to ASC 606 Pro forma under ASC 605 Accounts receivable, net $ 465,264 $ 54,489 $ 519,753 Contract assets 66,451 (66,451 ) 0 Prepaid expenses and other current assets 142,455 (7,719 ) 134,736 Contract assets - long-term 71,879 (71,879 ) 0 Deferred revenue, current 466,797 14,691 481,488 Deferred taxes, net 58,470 (27,195 ) 31,275 Retained earnings 132,842 (79,056 ) 53,786 Twelve Months Ended December, 31, 2018 (In thousands, except per share amounts) As reported under ASC 606 Adjustments due to ASC 606 Pro forma under ASC 605 Software delivery, support and maintenance $ 1,128,263 $ (21,780 ) $ 1,106,483 Client services 621,699 (6,185 ) 615,514 Gross profit 724,543 (26,906 ) 697,637 Selling, general and administrative expenses 450,967 (176 ) 450,791 Loss from operations (93,052 ) (26,730 ) (119,782 ) Income (loss) from continuing operations before income taxes 13,138 (27,559 ) (14,421 ) Income tax (provision) benefit (469 ) 7,160 6,691 Income (loss) from continuing operations, net of tax 12,669 (20,399 ) (7,730 ) Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 363,740 $ (20,399 ) $ 343,341 Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 2.07 $ (0.12 ) $ 1.95 Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 2.04 $ (0.11 ) $ 1.93

Business Combinations and Oth_2

Business Combinations and Other Investments (Tables)	12 Months Ended
	Dec. 31, 2018
Proforma Results	(Unaudited) Year Ended December 31, (In thousands, except per share amounts) 2018 (2) 2017 Actual from NantHealth since acquisition date of August 25, 2017: Revenue n/a $ 6,268 Net loss n/a $ (4,393 ) Actual from EIS Business since acquisition date of October 2, 2017: (1) Revenue n/a $ 77,046 Net loss n/a $ (15,160 ) Supplemental pro forma data for combined entity: Revenue n/a $ 1,768,530 Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders n/a $ (192,653 ) Loss per share, basic and diluted n/a $ (1.07 ) ______________________ (1) Revenue and Net loss from the EIS Business excludes revenue and income from discontinued operations. Refer to Note 16, “Discontinued Operations”. (2) Pro forma information is not applicable as the results of NantHealth and the EIS Business were fully consolidated in consolidated statements of operations for the year ended December 31, 2018.
Summary of Other Equity Investments Included in Other Assets	The following table summarizes our other equity investments which are included in other assets in the accompanying consolidated balance sheets: Number of Investees Original Carrying Value at (In thousands, except for number of investees) at December 31, 2018 Cost December 31, 2018 December 31, 2017 Equity method investments (1) 8 $ 7,407 $ 10,667 $ 4,258 Cost method investments 5 37,874 25,923 22,020 Total long-term equity investments 13 $ 45,281 $ 36,590 $ 26,278
Health Grid [Member]
Schedule of Consideration Funded by Sources of Funds	The consideration paid for Health Grid is shown below: (In thousands) Aggregate purchase price $ 60,000 First earnout payment paid by Allscripts 10,000 Fair value of contingent consideration payment 23,915 Closing purchase price adjustments 2,009 Total consideration paid for Health Grid $ 95,924
Assets Acquired and Liabilities Assumed	The allocation of the fair value of the consideration transferred as of the acquisition date of May 18, 2018 is shown in the table below. The allocation of purchase price was finalized in the fourth quarter of 2018. The goodwill is not expected to be deductible for tax purposes. (In thousands) Cash and cash equivalents $ 1,783 Accounts receivable, net 3,968 Prepaid expenses and other assets 185 Fixed assets 200 Intangible assets 41,000 Goodwill 53,953 Accounts payable and accrued expenses (478 ) Deferred revenue (700 ) Long-term deferred tax liability (3,987 ) Net assets acquired $ 95,924
Acquired Intangible Assets Amortization	The following table summarizes the preliminary fair values of the identifiable intangible assets and their estimated useful lives: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships 15 $ 28,000 Technology 8 13,000 $ 41,000
Practice Fusion, Inc. [Member]
Schedule of Consideration Funded by Sources of Funds	The consideration paid for Practice Fusion is shown below: (In thousands) Aggregate purchase price $ 100,000 Add: Net working capital surplus 373 Add: Closing cash 14,951 Less: Adjustment to assumed indebtedness (1,684 ) Total consideration paid for Practice Fusion $ 113,640
Assets Acquired and Liabilities Assumed	The allocation of the fair value of the consideration transferred as of the acquisition date of February 13, 2018 is shown in the table below. (In thousands) Cash and cash equivalents $ 14,951 Accounts receivable, net 13,328 Prepaid expenses and other current assets 809 Fixed assets 1,764 Intangible assets 67,100 Goodwill 35,092 Other assets 42 Accounts payable and accrued expenses (7,378 ) Deferred revenue (2,400 ) Long-term deferred tax liability (8,853 ) Other liabilities (815 ) Net assets acquired $ 113,640
Acquired Intangible Assets Amortization	The following table summarizes the fair values of the identifiable intangible assets and their estimated useful lives: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships - Physician Practices 15 $ 29,000 Customer Relationships - Pharmaceutical Partners 20 19,400 Technology 8 14,800 Tradenames 10 3,900 $ 67,100
NantHealth, Inc. [Member]
Schedule of Consideration Funded by Sources of Funds	Total consideration for the transaction was as follows: (In thousands) Cash $ 1,742 Add: Final net working capital surplus 1,022 Add: NantHealth common stock 42,750 Less: Value assigned to modification of existing commercial agreement with NantHealth (22,900 ) Total consideration for NantHealth provider/patient solutions business $ 22,614
Assets Acquired and Liabilities Assumed	The allocation of the fair value of the consideration transferred as of the acquisition date of August 25, 2017 is shown in the table below. The allocation has been finalized and the goodwill is expected to be deductible for tax purposes. (In thousands) Cash and cash equivalents $ 21 Accounts receivable, net 2,069 Prepaid expenses and other current assets 1,735 Fixed assets 3,401 Intangible assets 12,400 Goodwill 13,466 Other assets 204 Accounts payable and accrued expenses (1,477 ) Deferred revenue (9,205 ) Net assets acquired $ 22,614
Acquired Intangible Assets Amortization	The following table summarizes the estimated fair values of the most significant identifiable intangible assets and their estimated useful lives: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships 19 $ 9,200 Technology 5 3,000 Tradenames 5 200 $ 12,400
EIS Business [Member]
Schedule of Consideration Funded by Sources of Funds	The net consideration paid was funded through incremental borrowings under our debt facilities. (In thousands) Aggregate purchase price $ 185,000 Add: Final net working capital surplus 1,331 Less: Assumption of restructuring indebtedness (16,834 ) Net consideration paid in cash for the EIS Business $ 169,497
Assets Acquired and Liabilities Assumed	(In thousands) Cash and cash equivalents $ 1,068 Accounts receivable, net 72,996 Prepaid expenses and other current assets 19,358 Fixed assets 9,808 Intangible assets 143,000 Goodwill 61,337 Other assets 1,601 Accounts payable and accrued expenses (34,285 ) Deferred revenue (102,523 ) Other liabilities (2,863 ) Net assets acquired $ 169,497
Acquired Intangible Assets Amortization	The acquired intangible assets are being amortized over their useful lives, using a method that approximates the pattern of economic benefits to be gained by the intangible asset and consist of the following amounts for each class of acquired intangible asset: Useful Life Fair Value Description (In years) (In thousands) Customer Relationships 10 $ 80,800 Technology 7 58,400 Tradenames 7 3,800 $ 143,000

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis	The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates: Balance Sheet December 31, 2018 December 31, 2017 (In thousands) Classifications Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total Foreign exchange derivative assets Prepaid expenses and other current assets $ 0 $ 262 $ 0 $ 262 $ 0 $ 1,136 $ 0 $ 1,136 1.25% Call Option Other assets 0 0 9,104 9,104 0 0 46,578 46,578 Total assets $ 0 $ 262 $ 9,104 $ 9,366 $ 0 $ 1,136 $ 46,578 $ 47,714 Contingent consideration Accrued expenses $ 0 $ 0 $ 10,528 $ 10,528 $ 0 $ 0 $ 1,950 $ 1,950 Contingent consideration Other liabilities 0 0 15,317 15,317 0 0 5,086 5,086 1.25% Embedded cash conversion option Other liabilities 0 0 9,974 9,974 0 0 47,777 47,777 Total liabilities $ 0 $ 0 $ 35,819 $ 35,819 $ 0 $ 0 $ 54,813 $ 54,813
Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis	The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at December 31, 2018 are summarized as follows: (In thousands) Contingent Consideration 1.25% Notes Call Spread Overlay Balance at December 31, 2016 $ 5,285 $ (579 ) Additions 1,923 0 Payments (171 ) 0 Fair value adjustments (1 ) (620 ) Balance at December 31, 2017 7,036 (1,199 ) Additions 24,551 0 Payments (6,067 ) 0 Fair value adjustments 325 329 Balance at December 31, 2018 $ 25,845 $ (870 )

Fixed Assets (Tables)

Fixed Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Property Plant And Equipment [Abstract]
Fixed Assets	Fixed assets consist of the following: Estimated December 31, December 31, (Dollar amounts in thousands) Useful Life 2018 2017 Computer equipment and software 3 to 10 years $ 332,826 $ 316,537 Facility furniture, fixtures and equipment 5 to 7 years 21,300 23,923 Leasehold improvements Shorter of 7 years or life of lease 37,555 33,031 Assets under capital leases 3 to 5 years 9,435 7,203 Fixed assets, gross 401,116 380,694 Less: Accumulated depreciation and amortization (279,203 ) (245,277 ) Fixed assets, net $ 121,913 $ 135,417
Depreciation and Amortization Expense	Fixed assets depreciation and amortization expense were as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Fixed assets depreciation and amortization expense, including capital leases $ 47,567 $ 40,717 $ 34,314

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and intangible assets consist of the following: December 31, 2018 December 31, 2017 Gross Gross Carrying Accumulated Intangible Carrying Accumulated Intangible (In thousands) Amount Amortization Assets, Net Amount Amortization Assets, Net Intangibles subject to amortization: Proprietary technology $ 537,834 $ (401,093 ) $ 136,741 $ 533,044 $ (365,828 ) $ 167,216 Customer contracts and relationships 704,808 (462,468 ) 242,340 654,849 (438,492 ) 216,357 Total $ 1,242,642 $ (863,561 ) $ 379,081 $ 1,187,893 $ (804,320 ) $ 383,573 Intangibles not subject to amortization: Registered trademarks $ 52,000 $ 52,000 Goodwill 1,373,744 1,292,747 Total $ 1,425,744 $ 1,344,747
Changes in Carrying Amount of Goodwill	Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2018 and 2017 were as follows: Clinical and Population (In thousands) Financial Solutions Health Total Balance as of December 31, 2016 $ 843,837 $ 404,875 $ 1,248,712 Additions arising from business acquisitions: NantHealth provider/patient solutions business 0 13,350 13,350 Enterprise Information Solutions business 16,367 12,860 29,227 Other additions 420 47 467 Total additions to goodwill 16,787 26,257 43,044 Foreign exchange translation 991 0 991 Balance as of December 31, 2017 $ 861,615 $ 431,132 $ 1,292,747 Additions arising from business acquisitions: Practice Fusion 35,092 0 35,092 Health Grid 0 53,953 53,953 Other additions 6,399 0 6,399 Total arising from business acquisitions 41,491 53,953 95,444 Increases due to measurement period adjustments related to prior year acquisitions: NantHealth provider/patient solutions business 0 116 116 Enterprise Information Solutions business 25,192 6,857 32,049 Total increases due to measurement period adjustments: 25,192 6,973 32,165 Total additions to goodwill 66,683 60,926 127,609 Divestitures 0 (32,306 ) (32,306 ) Goodwill impairment charge 0 (13,466 ) (13,466 ) Transfers 2,904 (2,904 ) 0 Foreign exchange translation (840 ) 0 (840 ) Balance as of December 31, 2018 $ 930,362 $ 443,382 $ 1,373,744
Amortization Expense Related to Intangible Assets	Intangible assets are being amortized over their estimated useful lives and amortization expense related to intangible assets was as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Proprietary technology amortization included in cost of revenue $ 38,467 $ 33,137 $ 30,451 Intangible amortization included in operating expenses 26,587 17,345 15,884 Total intangible amortization expense $ 65,054 $ 50,482 $ 46,335
Estimated Future Amortization Expense for Intangible Assets	The increase in amortization expense since the year ended December 31, 2016 was due to acquisitions completed during the years ended December 31, 2018 and 2017. Estimated future amortization expense for the intangible assets that exist as of December 31, 2018, based on foreign currency exchange rates in effect as of such date, is as follows: Year Ended December 31, (In thousands) 2019 $ 63,010 2020 58,356 2021 52,928 2022 46,472 2023 30,272 Thereafter 128,043 Total $ 379,081

Asset Impairment Charges (Table

Asset Impairment Charges (Tables)	12 Months Ended
	Dec. 31, 2018
Asset Impairment Charges [Abstract]
Summary of Non-Cash Asset Impairment Charges	The following table summarizes the non-cash asset impairment charges recorded during the periods indicated and where they appear in the corresponding consolidated statements of operations: Year Ended December 31, (In thousands) 2018 2017 2016 Asset impairment charges $ 58,166 $ 0 $ 4,650 Goodwill impairment charge $ 13,466 $ 0 $ 0 Impairment of long-term investments $ 15,487 $ 165,290 $ 0

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2018
Debt Instrument [Line Items]
Debt Outstanding Excluding Capital Lease Obligations	Debt outstanding, excluding capital lease obligations, consisted of the following: December 31, 2018 December 31, 2017 (In thousands) Principal Balance Unamortized Discount and Debt Issuance Costs Net Carrying Amount Principal Balance Unamortized Discount and Debt Issuance Costs Net Carrying Amount 1.25% Cash Convertible Senior Notes $ 345,000 $ 22,112 $ 322,888 $ 345,000 $ 35,978 $ 309,022 Senior Secured Credit Facility 350,000 6,038 343,962 628,750 3,360 625,390 Other debt 748 0 748 0 0 0 Total debt $ 695,748 $ 28,150 $ 667,598 $ 973,750 $ 39,338 $ 934,412 Less: Debt payable within one year 20,538 479 20,059 28,125 438 27,687 Total long-term debt, less current maturities $ 675,210 $ 27,671 $ 647,539 $ 945,625 $ 38,900 $ 906,725
Interest Expense	Interest expense consisted of the following: Year Ended December 31, (In thousands) 2018 2017 2016 Interest expense $ 35,366 $ 23,001 $ 15,556 Amortization of discounts and debt issuance costs 15,548 14,539 13,922 Total interest expense $ 50,914 $ 37,540 $ 29,478
Summary of Future Debt Payments	The following table summarizes future debt payments as of December 31, 2018: (In thousands) Total 2019 2020 2021 2022 2023 Thereafter 1.25% Cash Convertible Senior Notes (1) $ 345,000 $ 0 $ 345,000 $ 0 $ 0 $ 0 $ 0 Term Loan 350,000 20,000 27,500 30,000 37,500 235,000 0 Other debt 748 538 210 0 0 0 0 Total debt $ 695,748 $ 20,538 $ 372,710 $ 30,000 $ 37,500 $ 235,000 $ 0 (1) Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Interest Expense Related to 1.25% Cash Convertible Senior Notes	Interest expense related to the 1.25% Cash Convertible Senior Notes, which is included in total interest expense above, was comprised of the following: Year Ended December 31, (In thousands) 2018 2017 2016 Coupon interest at 1.25% $ 4,312 $ 4,312 $ 4,312 Amortization of discounts and debt issuance costs 13,867 13,208 12,585 Total interest expense related to the 1.25% Notes $ 18,179 $ 17,520 $ 16,897

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Geographic Breakdown of Income (Loss) Before Income Tax Benefits	The following is a geographic breakdown of income (loss) before income tax benefits: Year Ended December 31, (In thousands) 2018 2017 2016 United States $ 14,045 $ (190,053 ) $ 33,027 Foreign (907 ) 16 (1,467 ) Income (loss) from continuing operations before income taxes $ 13,138 $ (190,037 ) $ 31,560
Components of Provision (Benefit) for Income Taxes	The following is a summary of the components of the provision (benefit) for income taxes: Year Ended December 31, (In thousands) 2018 2017 2016 Current tax provision Federal $ 838 $ 407 $ 372 State 737 1,796 625 Foreign 5,015 5,091 3,857 6,590 7,294 4,854 Deferred tax provision Federal (5,781 ) 2,800 (3,784 ) State 236 (12,695 ) 116 Foreign (576 ) (2,913 ) (877 ) (6,121 ) (12,808 ) (4,545 ) Income tax (benefit) provision $ 469 $ (5,514 ) $ 309
Taxes Computed at Statutory Federal Income Tax Rate Reconciled to Provision for Income Taxes	Taxes computed at the statutory federal income tax rate of 21% for the year ended December 31, 2018 and 35% for the years ended December 31, 2017 and 2016 are reconciled to the provision for income taxes as follows: Year Ended December 31, (In thousands) 2018 2017 2016 United States federal tax at statutory rate $ 2,759 $ (66,523 ) $ 10,869 Items affecting federal income tax rate Non-deductible acquisition and reorganization expenses 291 0 1,400 Research credits (6,185 ) (3,200 ) (2,700 ) Change in unrecognized tax benefits 3 395 (692 ) State income taxes, net of federal benefit 715 (7,121 ) 1,931 Compensation 3,213 2,950 651 Meals and entertainment 616 991 1,085 Impact of foreign operations 3,627 730 2,847 Provision-to-Return adjustments (2,140 ) (1,413 ) (1,116 ) Deemed Dividends 373 1,289 887 Dividends Accrued or Received 0 0 2,198 Federal, state and local rate changes 0 185 344 US Tax reform impact 0 10,189 0 One time Mandatory Repatriation Toll Charge 0 5,155 0 Non-deductible items 34 33 51 Noncontrolling interest 951 0 0 True-up of prior year income of Consolidated Investment 913 0 0 Valuation allowance (5,208 ) 47,959 (17,504 ) Other 507 2,867 58 Income tax provision (benefit) $ 469 $ (5,514 ) $ 309
Components of Deferred Tax Assets and Liabilities	Significant components of our deferred tax assets and liabilities consist of the following: December 31, (In thousands) 2018 2017 Deferred tax assets Accruals and reserves, net $ 31,565 $ 23,658 Allowance for doubtful accounts 11,378 6,014 Stock-based compensation, net 10,595 10,442 Deferred revenue 8,160 11,502 Net operating loss carryforwards 36,649 41,428 Capital loss carryforwards 0 42,702 Research and development tax credit 899 32,907 AMT credits 0 7,538 Other 10,784 11,108 Less: Valuation Allowance (18,734 ) (79,594 ) Total deferred tax assets 91,296 107,705 Deferred tax liabilities Prepaid expense (6,733 ) (6,166 ) Property and equipment, net (7,442 ) (8,464 ) Acquired intangibles, net (129,879 ) (111,112 ) Other (676 ) (647 ) Total deferred tax liabilities (144,730 ) (126,389 ) Net deferred tax liabilities $ (53,434 ) $ (18,684 )
Schedule Of Deferred Tax Assets And Liabilities Classified In Consolidated Balance Sheets	The deferred tax assets (liabilities) are classified in the consolidated balance sheets as follows: December 31, (In thousands) 2018 2017 Non-current deferred tax assets, net $ 5,036 $ 4,574 Non-current deferred tax liabilities, net (58,470 ) (23,258 ) Non-current deferred tax liabilities, net $ (53,434 ) $ (18,684 )
Change in the Amount of Unrecognized Tax Benefits	Changes in the amounts of unrecognized tax benefits were as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Beginning balance as of January 1 $ 10,939 $ 10,616 $ 11,777 Increases for tax positions related to the current year 8,977 640 570 Decreases for tax positions related to prior years 0 (146 ) 0 Increases for tax positions related to prior years 367 153 104 Increases acquired in business acquisitions 540 0 0 Foreign currency translation (5 ) 10 (1 ) Reductions due to lapsed statute of limitations (997 ) (334 ) (1,834 ) Ending balance as of December 31 $ 19,821 $ 10,939 $ 10,616
Recognized Interest and Penalties Related to Uncertain Tax Positions	We recognized interest and penalties related to uncertain tax positions in our consolidated statements of operations as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Interest and penalties included in the provision for income taxes $ 543 $ 446 $ 6
Amount of Interest and Penalties Included in Consolidated Balance Sheets	The amount of interest and penalties included in our consolidated balance sheets is as follows: December 31, (In thousands) 2018 2017 Interest and penalties included in the liability for uncertain tax positions $ 198 $ 741

Stock Award Plan (Tables)

Stock Award Plan (Tables)	12 Months Ended
	Dec. 31, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation Expense	Total recognized stock-based compensation expense is included in our consolidated statements of operations as shown in the table below. Stock-based compensation expense includes both non-cash expense related to grants of stock-based awards as well as cash expense related to the employee discount applied to purchases of our common stock under our employee stock purchase plan. Year Ended December 31, (In thousands) 2018 2017 2016 Cost of revenue: Software delivery, support and maintenance $ 2,184 $ 2,879 $ 4,125 Client services 3,997 4,484 4,363 Total cost of revenue 6,181 7,363 8,488 Selling, general and administrative expenses 24,213 23,497 21,829 Research and development 8,937 8,605 8,029 Total stock-based compensation expense $ 39,331 $ 39,465 $ 38,346
Activity for Restricted Stock Awards	The following table summarizes the activity for restricted stock units during the periods presented: Weighted-Average (In thousands, except per share amounts) Shares Grant Date Fair Value Unvested restricted stock units as of December 31, 2015 5,379 $ 14.15 Awarded 3,480 12.88 Vested (2,095 ) 13.84 Forfeited (517 ) 14.30 Unvested restricted stock units as of December 31, 2016 6,247 13.54 Awarded 3,690 12.52 Vested (1,835 ) 13.74 Forfeited (843 ) 16.97 Unvested restricted stock units as of December 31, 2017 7,259 12.57 Awarded 4,024 13.25 Vested (2,222 ) 13.03 Forfeited (1,111 ) 12.43 Unvested restricted stock units as of December 31, 2018 7,950 $ 12.81
Stock Options Outstanding	The following table summarizes the status of stock options outstanding and the changes during the periods presented: Options Weighted-Average Options Weighted-Average (In thousands, except per share amounts) Outstanding Exercise Price Exercisable Exercise Price Balance as of December 31, 2015 2,343 $ 14.24 1,282 $ 14.52 Options granted 0 0.00 Options exercised (6 ) 14.01 Options forfeited (434 ) 15.51 Balance as of December 31, 2016 1,903 13.95 1,431 13.98 Options granted 0 0.00 Options exercised (108 ) 14.01 Options forfeited (160 ) 15.00 Balance as of December 31, 2017 1,635 13.85 1,635 13.85 Options granted 0 0.00 Options exercised (92 ) 14.01 Options forfeited (211 ) 14.74 Balance as of December 31, 2018 1,332 $ 13.69 1,332 $ 13.69
Stock Option Activity	The following activity occurred under the Plan: Year Ended December 31, (In thousands) 2018 2017 2016 Total intrinsic value of stock options exercised $ 69 $ 45 $ 1 Total fair value of share awards vested $ 28,954 $ 25,220 $ 26,892
Stock Option Awards	The following table summarizes information about stock options outstanding under the Plan as of December 31, 2018: Number of Number of Options Weighted-Average Options Weighted-Average Range of Exercise Prices Outstanding Exercise Price Exercisable Exercise Price $12.72 to $14.01 1,323,447 $ 13.69 1,323,447 $ 13.69 $14.78 to $15.22 8,239 $ 14.81 8,239 $ 14.81 1,331,686 1,331,686

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	12 Months Ended
	Dec. 31, 2018
Earnings Per Share [Abstract]
Calculations of Earnings (Loss) Per Share	The calculations of earnings (loss) per share are as follows: Year Ended December 31, (In thousands, except per share amounts) 2018 2017 2016 Basic Income (Loss) per Common Share: Income (loss) from continuing operations, net of tax $ 12,669 $ (184,523 ) $ 31,251 Less: Net loss (income) attributable to non-controlling interests 4,527 1,566 (146 ) Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 17,196 $ (182,957 ) $ 31,105 Income (loss) from discontinued operations, net of tax 395,138 30,348 (28,221 ) Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations (48,594 ) (43,850 ) (28,536 ) Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 346,544 (13,502 ) (56,757 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 363,740 $ (196,459 ) $ (25,652 ) Weighted-average common shares outstanding 176,038 180,830 186,188 Basic Income (Loss) from continuing operations per Common Share $ 0.10 $ (1.02 ) $ 0.17 Basic Income (Loss) from discontinued operations per Common Share $ 1.97 $ (0.07 ) $ (0.31 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ 2.07 $ (1.09 ) $ (0.14 ) Diluted Income (Loss) per Common Share: Income (loss) from continuing operations, net of tax $ 12,669 $ (184,523 ) $ 31,251 Less: Net loss (income) attributable to non-controlling interests 4,527 1,566 (146 ) Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 17,196 $ (182,957 ) $ 31,105 Income (loss) from discontinued operations, net of tax $ 395,138 $ 30,348 $ (28,221 ) Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations (48,594 ) (43,850 ) (28,536 ) Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 346,544 (13,502 ) (56,757 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 363,740 $ (196,459 ) $ (25,652 ) Weighted-average common shares outstanding 176,038 180,830 186,188 Dilutive effect of stock options, restricted stock unit awards and warrants 2,491 0 0 Weighted-average common shares outstanding assuming dilution 178,529 180,830 186,188 Diluted Income (Loss) from continuing operations per Common Share $ 0.10 $ (1.02 ) $ 0.17 Diluted Income (Loss) from discontinued operations per Common Share $ 1.94 $ (0.07 ) $ (0.31 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ 2.04 $ (1.09 ) $ (0.14 )
Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share	The following stock options, restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such stock options, restricted stock unit awards and warrants in the computation would be anti-dilutive: Year Ended December 31, (In thousands) 2018 2017 2016 Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation 26,175 26,515 25,277

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Loss (Tables)	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Components of Accumulated Other Comprehensive Loss	Changes in the balances of each component included in accumulated other comprehensive loss (“AOCI”) are presented in the tables below. All amounts are net of tax and exclude non-controlling interest. (In thousands) Foreign Currency Translation Adjustments Unrealized Net Gains (Losses) on Available for Sale Securities Unrealized Net Gains (Losses) on Foreign Exchange Contracts Total Balance as of December 31, 2015 (1) $ (4,500 ) $ 0 $ 258 $ (4,242 ) Other comprehensive (loss) income before reclassifications (1,528 ) (56,420 ) 683 (57,265 ) Net losses (gains) reclassified from accumulated other comprehensive loss 0 0 (322 ) (322 ) Net other comprehensive (loss) income (1,528 ) (56,420 ) 361 (57,587 ) Balance as of December 31, 2016 (2) (6,028 ) (56,420 ) 619 (61,829 ) Other comprehensive (loss) income before reclassifications 3,352 (106,445 ) 1,697 (101,396 ) Net losses (gains) reclassified from accumulated other comprehensive loss 0 162,865 (1,625 ) 161,240 Net other comprehensive (loss) income 3,352 56,420 72 59,844 Balance as of December 31, 2017 (3) (2,676 ) 0 691 (1,985 ) Other comprehensive (loss) income before reclassifications (2,908 ) 0 (264 ) (3,172 ) Net losses (gains) reclassified from accumulated other comprehensive loss 0 0 (232 ) (232 ) Net other comprehensive (loss) income (2,908 ) 0 (496 ) (3,404 ) Balance as of December 31, 2018 (4) $ (5,584 ) $ 0 $ 195 $ (5,389 ) (1) (2) (3) (4)
Income Tax Effects Related to Components of Other Comprehensive Loss	The following tables reflect the tax effects allocated to each component of other comprehensive loss (“OCI”) Year Ended December 31, 2018 (In thousands) Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ (2,908 ) $ 0 $ (2,908 ) Derivatives qualifying as cash flow hedges: Foreign exchange contracts: Net (losses) gains arising during the period (357 ) 93 (264 ) Net (gains) losses reclassified into income (1) (516 ) 284 (232 ) Net change in unrealized (losses) gains on foreign exchange contracts (873 ) 377 (496 ) Net gain (loss) on cash flow hedges (873 ) 377 (496 ) Other comprehensive loss $ (3,781 ) $ 377 $ (3,404 ) (1) Year Ended December 31, 2017 (In thousands) Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ 3,352 $ 0 $ 3,352 Available for sale securities: Net gain arising during the period (106,506 ) 61 (106,445 ) Net gain reclassified into income 162,865 0 162,865 Net change in unrealized gains on available for sale securities 56,359 61 56,420 Derivatives qualifying as cash flow hedges: Foreign exchange contracts: Net gains (losses) arising during the period 2,776 (1,079 ) 1,697 Net (gains) losses reclassified into income (2,662 ) 1,037 (1,625 ) Net change in unrealized gains (losses) on foreign exchange contracts 114 (42 ) 72 Net gain (loss) on cash flow hedges 114 (42 ) 72 Other comprehensive loss $ 59,825 $ 19 $ 59,844 Year Ended December 31, 2016 (In thousands) Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ (1,528 ) $ 0 $ (1,528 ) Available for sale securities: Net gain arising during the period (56,359 ) (61 ) (56,420 ) Net gain reclassified into income 0 0 0 Net change in unrealized gains on available for sale securities (56,359 ) (61 ) (56,420 ) Derivatives qualifying as cash flow hedges: Foreign exchange contracts: Net gains (losses) arising during the period 1,128 (445 ) 683 Net (gains) losses reclassified into income (531 ) 209 (322 ) Net change in unrealized gains (losses) on foreign exchange contracts 597 (236 ) 361 Net gain (loss) on cash flow hedges 597 (236 ) 361 Other comprehensive loss $ (57,290 ) $ (297 ) $ (57,587 )

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2018
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Fair Value and Balance Sheet Locations	The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates: December 31, 2018 Asset Derivatives Liability Derivatives (In thousands) Balance Sheet Location Fair Value Balance Sheet Location Fair Value Derivatives qualifying as cash flow hedges: Foreign exchange contracts Prepaid expenses and other current assets $ 262 Accrued expenses $ 0 Derivatives not subject to hedge accounting: 1.25% Call Option Other assets 9,104 N/A 1.25% Embedded cash conversion option N/A Other liabilities 9,974 Total derivatives $ 9,366 $ 9,974 December 31, 2017 Asset Derivatives Liability Derivatives (In thousands) Balance Sheet Location Fair Value Balance Sheet Location Fair Value Derivatives qualifying as cash flow hedges: Foreign exchange contracts Prepaid expenses and other current assets $ 1,136 Accrued expenses $ 0 Derivatives not subject to hedge accounting: 1.25% Call Option Other assets 46,578 N/A 1.25% Embedded cash conversion option N/A Other liabilities 47,777 Total derivatives $ 47,714 $ 47,777 N/A –
Derivatives Instruments Designated as Cash Flow Hedges	The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive income (loss): Amount of Gain (Loss) Recognized in OCI (Effective Portion) Location of Gain (Loss) Reclassified from AOCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion) Year Ended December 31, Year Ended December 31, (In thousands) 2018 2017 2016 2018 2017 2016 Foreign exchange contracts $ (357 ) $ 2,776 $ 1,128 Cost of Revenue $ 165 $ 905 $ 165 Selling, general and administrative expenses 138 692 133 Research and development 214 1,065 233
Net Impact of Changes in Fair Value of Call Option and Embedded Cash Conversion Option	The following table shows the net impact of the changes in fair values of the 1.25% Call Option and 1.25% Notes embedded cash conversion option in the consolidated statements of operations: Year Ended December 31, (In thousands) 2018 2017 2016 1.25% Call Option $ (37,474 ) $ 29,498 $ (63,128 ) 1.25% Embedded cash conversion option 37,803 (30,118 ) 63,551 Net loss included in other income, net $ 329 $ (620 ) $ 423

Commitments (Tables)

Commitments (Tables)	12 Months Ended
	Dec. 31, 2018
Commitments And Contingencies Disclosure [Abstract]
Rent Expense	Total rent expense recognized, which consists of the base rental amount and other lessor charges when mandated in a lease agreement, was as follows: Year Ended December 31, (In thousands) 2018 2017 2016 Rent expense $ 28,677 $ 22,499 $ 18,113
Future Commitments under Capital and Operating Leases	Our future commitments under capital and operating leases are shown below. Future operating lease commitments are calculated using the base rental amount and foreign currency exchange rates in effect as of December 31, 2018. Capital Operating (In thousands) Leases Leases 2019 $ 1,351 $ 26,330 2020 422 22,394 2021 46 18,824 2022 14 17,493 2023 0 15,582 Thereafter 0 31,658 1,833 $ 132,281 Less amount representing interest (69 ) 1,764 Current maturities of capital lease obligations 996 Capital lease obligations, net of current maturities $ 768
Summary of Expense Incurred under Atos Agreement	Year Ended December 31, (In thousands) 2018 2017 2016 Expenses incurred under Atos agreement $ 55,903 $ 58,787 $ 62,266

Discontinued Operations (Tables

Discontinued Operations (Tables)	12 Months Ended
	Dec. 31, 2018
Netsmart [Member]
Summary of Discontinued Operations in Financial Statements	The following table summarizes Netsmart’s major classes of assets and liabilities as reported on the consolidated balance sheets as of December 31, 2017 as the balances were fully deconsolidated as of December 31, 2018: (In thousands) December 31, 2017 Carrying amounts of major classes of assets associated with Netsmart included as part of assets attributable to discontinued operations: Cash and cash equivalents $ 31,504 Accounts receivable, net 75,313 Prepaid expenses and other current assets 9,008 Total current assets attributable to Netsmart discontinued operations 115,825 Fixed assets, net 30,186 Software development costs, net 27,344 Intangible assets, net 391,299 Goodwill 712,206 Other assets 1,998 Total noncurrent assets attributable to Netsmart discontinued operations $ 1,163,033 Carrying amounts of major classes of liabilities associated with Netsmart included as part of liabilities attributable to discontinued operations: Accounts payable $ 11,834 Accrued expenses 8,115 Accrued compensation and benefits 16,560 Deferred revenue 68,256 Current maturities of non-recourse long-term debt - Netsmart 2,755 Current maturities of capital lease obligations 6,763 Total current liabilities attributable to Netsmart 114,283 Non-recourse long-term debt - Netsmart 625,193 Long-term capital lease obligations 4,758 Deferred revenue long-term 4,838 Deferred taxes, net 70,385 Other liabilities 2,342 Total noncurrent liabilities attributable to Netsmart $ 707,516 Redeemable convertible non-controlling interest attributable to discontinued operations $ 431,535 Non-controlling interest attributable to discontinued operations $ 48 The following table summarizes Netsmart’s major income and expense line items as reported in the consolidated statements of operations for the years ended December 31, 2018, 2017 and 2016: Year ended December 31, (In thousands) 2018 2017 2016 Major income and expense line items related to Netsmart: (1) Revenue: Software delivery, support and maintenance $ 214,065 $ 198,204 $ 104,319 Client services 131,166 110,430 59,511 Total revenue 345,231 308,634 163,830 Cost of revenue: Software delivery, support and maintenance 60,100 51,079 36,823 Client services 94,061 78,317 39,851 Amortization of software development and acquisition related assets 34,357 29,876 17,416 Total cost of revenue 188,518 159,272 94,090 Gross profit 156,713 149,362 69,740 Selling, general and administrative expenses 125,807 85,583 58,344 Research and development 25,315 17,937 9,372 Amortization of intangible and acquisition-related assets 24,029 16,409 9,963 (Loss) income from discontinued operations for the Netsmart sale before income taxes (18,438 ) 29,433 (7,939 ) Interest expense (59,541 ) (49,939 ) (38,663 ) Other income 101 925 258 Income tax benefit 22,933 45,253 18,123 (Loss) income from discontinued operations, net of tax for Netsmart $ (54,945 ) $ 25,672 $ (28,221 )
Horizon Clinicals and Series2000 [Member]
Summary of Discontinued Operations in Financial Statements	The following table summarizes the major classes of assets and liabilities of these discontinued solutions, as reported on the consolidated balance sheets as of December 31, 2018 and 2017: (In thousands) December 31, 2018 December 31, 2017 Carrying amounts of major classes of assets associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of assets attributable to discontinued operations: Accounts receivable, net $ 0 $ 8,196 Prepaid expenses and other current assets 0 3,080 Total current assets attributable to discontinued operations $ 0 $ 11,276 Carrying amounts of major classes of liabilities associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of liabilities attributable to discontinued operations: Accounts payable $ 0 $ 114 Accrued expenses 920 5,599 Accrued compensation and benefits 0 7,728 Deferred revenue 0 7,241 Other classes of liabilities that are not major 0 676 Total current liabilities attributable to discontinued operations $ 920 $ 21,358 The following table summarizes the major income and expense line items of these discontinued solutions, as reported in the consolidated statements of operations for the years ended December 31, 2018 and 2017: Year ended December 31, 2018 (In thousands) 2018 2017 Major income and expense line items relating to the Horizon Clinicals and Series2000 Revenue Cycle discontinued solutions: Revenue: Software delivery, support and maintenance $ 9,441 $ 10,949 Client services 404 1,044 Total revenue 9,845 11,993 Cost of revenue: Software delivery, support and maintenance 2,322 2,918 Client services 830 261 Total cost of revenue 3,152 3,179 Gross profit 6,693 8,814 Research and development 1,651 1,148 Income from discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle before income taxes 5,042 7,666 Income tax provision (1,311 ) (2,990 ) Income from discontinued operations, net of tax for Horizon Clinicals and Series2000 Revenue Cycle $ 3,731 $ 4,676

Business Segments (Tables)

Business Segments (Tables)	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Revenues and Income from Operations Related to Segment Within Reconciliation to Consolidated Amounts	Year Ended December 31, (In thousands) 2018 2017 2016 Revenue: Clinical and Financial Solutions $ 1,565,987 $ 1,337,030 $ 1,183,196 Population Health 190,706 173,809 177,394 Unallocated Amounts (6,731 ) (13,131 ) 25,479 Total revenue $ 1,749,962 $ 1,497,708 $ 1,386,069 Gross Profit: Clinical and Financial Solutions $ 663,005 $ 574,386 $ 496,595 Population Health 146,614 142,514 149,338 Unallocated Amounts (85,076 ) (84,101 ) (44,634 ) Total gross profit $ 724,543 $ 632,799 $ 601,299 Income (loss) from operations: Clinical and Financial Solutions $ 344,568 $ 335,005 $ 287,077 Population Health 100,118 112,577 123,685 Unallocated Amounts (537,738 ) (435,098 ) (343,052 ) Total income (loss) from operations $ (93,052 ) $ 12,484 $ 67,710

Supplemental Disclosures (Table

Supplemental Disclosures (Tables)	12 Months Ended
	Dec. 31, 2018
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Supplemental Disclosures	The majority of the restricted cash balance as of December 31, 2018 represents the remaining balance of the escrow account established as part of the acquisition of Netsmart in 2016 to be used by Netsmart to facilitate the integration of our Homecare TM December 31, (In thousands) 2018 2017 Reconciliation of cash, cash equivalents and restricted cash: Cash and cash equivalents $ 174,243 $ 119,470 Restricted cash 10,552 11,524 Total cash, cash equivalents and restricted cash $ 184,795 $ 130,994 Year Ended December 31, (In thousands) 2018 2017 2016 Cash paid during the period for: Interest $ 28,888 $ 21,183 $ 14,989 Income taxes paid, net of tax refunds $ 10,108 $ 6,675 $ 5,466 Non-cash transactions: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations $ 48,594 $ 43,850 $ 28,536 Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement $ 0 $ 42,750 $ 0 Obligations incurred to purchase capitalized software or enter into capital leases $ 1,501 $ 1,897 $ 27,127 Contribution of assets in exchange for equity interest $ 4,000 $ 0 $ 0 Issuance of treasury stock to commercial partner $ 1,121 $ 334 $ 0
Accrued Expenses	Accrued expenses consist of the following: December 31, December 31, (In thousands) 2018 2017 Royalties, certain third-party product costs and licenses $ 26,371 $ 14,195 Other 79,701 63,605 Total accrued expenses $ 106,072 $ 77,800
Other Assets	Other assets consist of the following: December 31, December 31, (In thousands) 2018 2017 Reseller agreement with Nant Health, LLC $ 0 $ 22,252 Fair value of 1.25% Call Option 9,104 46,578 Long-term deferred hosting fees 20,805 0 Long-term prepaid commissions 32,660 32,938 Investments in non-marketable securities 37,040 30,013 Long-term deposits and other assets 9,597 15,070 Total other assets $ 109,206 $ 146,851

Geographic Information (Tables)

Geographic Information (Tables)	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Revenues by Geographic Area	Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below: Year Ended December 31, (In thousands) 2018 2017 2016 United States $ 1,697,178 $ 1,440,842 $ 1,336,799 Canada 15,377 15,818 18,694 Other international 37,407 41,048 30,576 Total $ 1,749,962 $ 1,497,708 $ 1,386,069
Long-Lived Assets by Geographic Area	A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below: December 31, December 31, (In thousands) 2018 2017 United States $ 111,836 $ 129,021 India 4,231 4,154 Israel 3,830 1,322 Canada 60 146 Other international 1,956 774 Total $ 121,913 $ 135,417

Quarterly Financial Informati_2

Quarterly Financial Information (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Summary of Quarterly Financial Information	The following tables contain a summary of our unaudited quarterly consolidated results of operations for our last eight fiscal quarters, which have been restated to illustrate Netsmart as a discontinued operation. Quarter Ended December 31, September 30, June 30, March 31, (In thousands, except per share amounts) 2018 2018 2018 (1) 2018 (1) Revenue $ 442,346 $ 432,430 $ 441,464 $ 433,722 Cost of revenue 254,187 254,478 267,697 249,057 Gross profit 188,159 177,952 173,767 184,665 Selling, general and administrative expenses 99,992 108,125 122,913 119,937 Research and development 66,096 63,032 74,491 64,790 Asset impairment charges 28,091 0 30,075 0 Goodwill impairment charge 13,466 0 0 0 Amortization of intangible and acquisition-related assets 6,957 6,609 6,382 6,639 (Loss) income from operations (26,443 ) 186 (60,094 ) (6,701 ) Interest expense (13,989 ) (13,251 ) (11,979 ) (11,695 ) Other income (loss), net 658 (536 ) (14 ) (34 ) Gain on sale of businesses, net 0 0 173,129 (871 ) Impairment of and losses on long-term investments 0 0 (9,987 ) (5,500 ) Equity in net (loss) income of unconsolidated investments (270 ) (177 ) 767 (61 ) (Loss) income from continuing operations before income taxes (40,044 ) (13,778 ) 91,822 (24,862 ) Income tax benefit (provision) 5,449 1,637 (7,256 ) (299 ) (Loss) income from continuing operations, net of tax (34,595 ) (12,141 ) 84,566 (25,161 ) Loss from discontinued operations (39,854 ) (13,857 ) (14,109 ) (5,016 ) Gain on sale of Netsmart 500,471 0 0 0 Income tax effect on discontinued operations (40,126 ) 2,152 3,815 1,662 Income (loss) from discontinued operations, net of tax 420,491 (11,705 ) (10,294 ) (3,354 ) Net income (loss) 385,896 (23,846 ) 74,272 (28,515 ) Less: Net loss attributable to non-controlling interest 1,033 4 2,700 790 Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations (12,148 ) (12,149 ) (12,148 ) (12,149 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 374,781 $ (35,991 ) $ 64,824 $ (39,874 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share: Basic Continuing operations $ (0.19 ) $ (0.07 ) $ 0.49 $ (0.14 ) Discontinued operations $ 2.36 $ (0.13 ) $ (0.13 ) $ (0.08 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 2.17 $ (0.20 ) $ 0.36 $ (0.22 ) Diluted Continuing operations $ (0.19 ) $ (0.07 ) $ 0.49 $ (0.14 ) Discontinued operations $ 2.33 $ (0.13 ) $ (0.13 ) $ (0.08 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 2.14 $ (0.20 ) $ 0.36 $ (0.22 ) Quarter Ended December 31, September 30, June 30, March 31, (In thousands, except per share amounts) 2017 (2) 2017 (2) 2017 2017 Revenue $ 436,411 $ 368,091 $ 350,150 $ 343,056 Cost of revenue 260,208 205,843 199,930 198,928 Gross profit 176,203 162,248 150,220 144,128 Selling, general and administrative expenses 123,113 93,790 91,033 92,752 Research and development 68,344 46,485 42,205 45,248 Amortization of intangible and acquisition-related assets 6,005 3,816 3,745 3,779 Income from operations (21,259 ) 18,157 13,237 2,349 Interest expense (11,594 ) (9,251 ) (8,279 ) (8,416 ) Other income (loss), net 160 (685 ) (222 ) 235 Impairment of and losses on long-term investments 0 (20,700 ) (144,590 ) 0 Equity in net loss of unconsolidated investments 115 449 (28 ) 285 Loss from continuing operations before income taxes (32,578 ) (12,030 ) (139,882 ) (5,547 ) Income tax benefit (provision) 9,973 (3) (1,962 ) (1,263 ) (1,234 ) Loss from continuing operations, net of tax (22,605 ) (13,992 ) (141,145 ) (6,781 ) Income from discontinued operations, net of tax 37,468 (3,470 ) (1,866 ) (1,784 ) Net income (loss) 14,863 (17,462 ) (143,011 ) (8,565 ) Less: Net loss (income) attributable to non-controlling interest 1,918 (163 ) 264 (453 ) Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations (10,963 ) (10,962 ) (10,963 ) (10,962 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders $ 5,818 $ (28,587 ) $ (153,710 ) $ (19,980 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share: Basic Continuing operations $ (0.12 ) $ (0.08 ) $ (0.78 ) $ (0.04 ) Discontinued operations $ 0.15 $ (0.08 ) $ (0.07 ) $ (0.07 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 0.03 $ (0.16 ) $ (0.85 ) $ (0.11 ) Diluted Continuing operations $ (0.12 ) $ (0.08 ) $ (0.78 ) $ (0.04 ) Discontinued operations $ 0.15 $ (0.08 ) $ (0.07 ) $ (0.07 ) Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share $ 0.03 $ (0.16 ) $ (0.85 ) $ (0.11 ) (1) Results of operations for the quarter include the results of operations of (i) Practice Fusion since February 13, 2018 and (ii) Health Grid since May 18, 2018. (2) Results of operations for the quarter include the results of operations of (i) the provider/ patient engagement solutions business of NantHealth, Inc. since August 25, 2017 and (ii) the EIS Business since October 2, 2017. (3)

Schedule of Revenue and Associa

Schedule of Revenue and Associated Cost of Revenue Recast Totals and Gross Profit Impact (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Amortization of software development and acquisition-related assets									102,876	84,725	71,215
Total cost of revenue	254,187	254,478	267,697	249,057	260,208	205,843	199,930	198,928	1,025,419	864,909	784,770
Total gross profit	188,159	177,952	173,767	184,665	176,203	162,248	150,220	144,128	724,543	632,799	601,299
Adjustment [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue					0	0	0	0		0	0
Amortization of software development and acquisition-related assets	0	0	0	0	0	0	0	0	0	0	0
Total cost of revenue	0	0	0	0	0	0	0	0	0	0	0
Total gross profit	0	0	0	0	0	0	0	0	0	0	0
Software delivery, Support and Maintenance [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue									1,128,263	958,187	899,299
Total cost of revenue									357,039	295,593	276,401
Software delivery, Support and Maintenance [Member] | Adjustment [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue					(4,703)	(5,119)	(4,239)	(4,270)		(18,331)	(8,734)
Total cost of revenue	(6,400)	(6,394)	(7,202)	(4,033)	(5,454)	(5,454)	(5,556)	(5,056)	(24,029)	(21,520)	(17,831)
Total gross profit	(6,400)	(6,394)	(7,202)	(4,033)	751	335	1,317	786	(24,029)	3,189	9,097
Client services [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue									621,699	539,521	486,770
Total cost of revenue									565,504	484,591	437,154
Client services [Member] | Adjustment [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue					4,703	5,119	4,239	4,270		18,331	8,734
Total cost of revenue	6,400	6,394	7,202	4,033	5,454	5,454	5,556	5,056	24,029	21,520	17,831
Total gross profit	$ 6,400	$ 6,394	$ 7,202	$ 4,033	$ (751)	$ (335)	$ (1,317)	$ (786)	$ 24,029	$ (3,189)	$ (9,097)

Basis of Presentation and Sig_4

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Sep. 30, 2017	Jun. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Basis Of Presentation And Significant Accounting Policies [Line Items]
Other-than-temporary impairments		$ 142,200,000	$ 0		$ 0
Capitalized software development costs			$ 113,308,000	$ 94,740,000	115,710,000
Percentage of revenues			No single client accounted for more than 10% of our revenue in the years ended December 31, 2018, 2017 and 2016.
Customer concentration			No client represented more than 10% of accounts receivable as of December 31, 2018 or 2017.
ASU 2016-02 [Member] | Adoption of ASU 2016-02 Estimated Values [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Right of use assets			$ 105,000,000
Lease liabilities			$ 125,000,000
Third-Party Software Purchases [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software development costs					44,000,000
Accrued Software Development Cost					$ 24,000,000
Minimum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life			3 years
Maximum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life			5 years
1.25% Cash Convertible Senior Notes [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Interest rate			1.25%
Nant Health, LLC [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Loss on disposition of available for sale instruments	$ (20,700,000)

Unamortized Balances of Capital

Unamortized Balances of Capitalized Software (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Software development costs	$ 317,637	$ 280,146
Less: accumulated amortization	(107,977)	(85,301)
Software development costs, net	$ 209,660	$ 194,845

Capitalized Software Developmen

Capitalized Software Development Costs, Write Offs Included in Asset Impairment Changes and Amortization of Capitalized Software Development Costs Included in Cost of Revenue (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Capitalized software development costs	$ 113,308	$ 94,740	$ 115,710
Write-offs and divestitures of capitalized software development costs	34,083	0	4,625
Amortization of capitalized software development costs	$ 64,409	$ 51,589	$ 40,764

Company Contributions to Employ

Company Contributions to Employee Benefit Plan (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Company contributions to employee benefit plans	$ 29,393	$ 18,861	$ 18,329

Revenue from Contracts with C_3

Revenue from Contracts with Customers - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)Revenue_Stream	Jan. 01, 2018USD ($)	Dec. 31, 2017USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams | Revenue_Stream	2
Deferred costs for fulfilment of contract	$ 20,805		$ 0
Total backlog	$ 3,900,000
Total backlog, percentage, year one	39.00%
Total backlog, percentage after year one	61.00%
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	$ 29,700
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	24,700
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 33,800
ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Deferred costs for fulfilment of contract		$ 5,500
ASC 606 | Minimum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	2 years
ASC 606 | Maximum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	6 years

Revenue from Contracts with C_4

Revenue from Contracts with Customers - Impact of Adoption on Previously Reported Condensed Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	$ 465,264		$ 492,560
Contract assets	66,451		0
Prepaid expenses and other current assets	142,455		106,455
Deferred revenue, current	466,797		478,574
Deferred revenue, long-term			19,208
Deferred taxes, net	58,470		23,258
Retained earnings (accumulated deficit)	132,842		$ (338,150)
ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net		$ 473,270
Contract assets		77,791
Prepaid expenses and other current assets		113,836
Deferred revenue, current		465,764
Deferred revenue, long-term		19,208
Deferred taxes, net		43,292
Retained earnings (accumulated deficit)		(279,492)
ASC 606 | Adjustments Due to ASC 606 [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	54,489	(19,290)
Contract assets	(66,451)	77,791
Prepaid expenses and other current assets	(7,719)	7,381
Deferred revenue, current	14,691	(12,810)
Deferred revenue, long-term		0
Deferred taxes, net	(27,195)	20,034
Retained earnings (accumulated deficit)	$ (79,056)	$ 58,658

Revenue from Contracts with C_5

Revenue from Contracts with Customers - Schedule of Comparison Between Reported Statements to Pro-forma Amounts in Effect of Previous Guidance - Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	$ 465,264		$ 492,560
Contract assets	66,451		0
Prepaid expenses and other current assets	142,455		106,455
Contract assets - long-term	71,879		0
Deferred revenue, current	466,797		478,574
Deferred taxes, net	58,470		23,258
Retained earnings (accumulated deficit)	132,842		$ (338,150)
ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net		$ 473,270
Contract assets		77,791
Prepaid expenses and other current assets		113,836
Deferred revenue, current		465,764
Deferred taxes, net		43,292
Retained earnings (accumulated deficit)		(279,492)
ASC 606 | Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	54,489	(19,290)
Contract assets	(66,451)	77,791
Prepaid expenses and other current assets	(7,719)	7,381
Contract assets - long-term	(71,879)
Deferred revenue, current	14,691	(12,810)
Deferred taxes, net	(27,195)	20,034
Retained earnings (accumulated deficit)	(79,056)	$ 58,658
Pro forma Under ASC 605 [Member] | ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	519,753
Contract assets	0
Prepaid expenses and other current assets	134,736
Contract assets - long-term	0
Deferred revenue, current	481,488
Deferred taxes, net	31,275
Retained earnings (accumulated deficit)	$ 53,786

Revenue from Contracts with C_6

Revenue from Contracts with Customers - Schedule of Comparison Between Reported Statements to Pro-forma Amounts in Effect of Previous Guidance - Statement of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Gross profit	188,159	177,952	173,767	184,665	176,203	162,248	150,220	144,128	724,543	632,799	601,299
Selling, general and administrative expenses	99,992	108,125	122,913	119,937	123,113	93,790	91,033	92,752	450,967	400,688	334,521
Loss from operations	(26,443)	186	(60,094)	(6,701)	(21,259)	18,157	13,237	2,349	(93,052)	12,484	67,710
Income (loss) from continuing operations before income taxes	(40,044)	(13,778)	91,822	(24,862)	(32,578)	(12,030)	(139,882)	(5,547)	13,138	(190,037)	31,560
Income tax (provision) benefit	5,449	1,637	(7,256)	(299)	9,973	(1,962)	(1,263)	(1,234)	(469)	5,514	(309)
Income (loss) from continuing operations	(34,595)	(12,141)	84,566	(25,161)	(22,605)	(13,992)	(141,145)	(6,781)	12,669	(184,523)	31,251
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 374,781	$ (35,991)	$ 64,824	$ (39,874)	$ 5,818	$ (28,587)	$ (153,710)	$ (19,980)	$ 363,740	$ (196,459)	$ (25,652)
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 2.17	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.07	$ (1.09)	$ (0.14)
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 2.14	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.04	$ (1.09)	$ (0.14)
ASC 606 | Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Gross profit									$ (26,906)
Selling, general and administrative expenses									(176)
Loss from operations									(26,730)
Income (loss) from continuing operations before income taxes									(27,559)
Income tax (provision) benefit									7,160
Income (loss) from continuing operations									(20,399)
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ (20,399)
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ (0.12)
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ (0.11)
Software delivery, Support and Maintenance [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									$ 1,128,263	$ 958,187	$ 899,299
Software delivery, Support and Maintenance [Member] | ASC 606 | Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									(21,780)
Client services [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									621,699	$ 539,521	$ 486,770
Client services [Member] | ASC 606 | Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									(6,185)
Pro forma Under ASC 605 [Member] | ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Gross profit									697,637
Selling, general and administrative expenses									450,791
Loss from operations									(119,782)
Income (loss) from continuing operations before income taxes									(14,421)
Income tax (provision) benefit									6,691
Income (loss) from continuing operations									(7,730)
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 343,341
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 1.95
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 1.93
Pro forma Under ASC 605 [Member] | Software delivery, Support and Maintenance [Member] | ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									$ 1,106,483
Pro forma Under ASC 605 [Member] | Client services [Member] | ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									$ 615,514

Revenue from Contract with Cust

Revenue from Contract with Customer - Summary of Revenue Recognized Related to Various Performance Obligations and Elected accounting Expedients (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 141,127	$ 153,151	$ 196,163	$ 181,398
Revenue related to new performance obligations satisfied during the period	237,963	225,641	180,001	200,232
Revenue recognized under "right-to-invoice" expedient	60,593	51,288	62,533	49,403
Reimbursed travel expenses, shipping and other revenue	2,663	2,350	2,767	2,689
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069

Revenue from Contracts with C_7

Revenue from Contracts with Customers - Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation Of Revenue [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									(6,731)	(13,131)	25,479
Clinical and Financial Solutions [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									1,565,987	1,337,030	1,183,196
Population Health [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									190,706	173,809	177,394
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Recurring revenue									967,990	802,080	752,084
Non-recurring revenue									160,273	156,107	147,215
Total revenue									1,128,263	958,187	899,299
Software delivery, Support and Maintenance [Member] | Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									1,844	(10,439)	23,088
Software delivery, Support and Maintenance [Member] | Clinical and Financial Solutions [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									958,144	808,611	710,679
Software delivery, Support and Maintenance [Member] | Population Health [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									168,275	160,015	165,532
Client services [Member]
Disaggregation Of Revenue [Line Items]
Recurring revenue									443,752	374,640	324,635
Non-recurring revenue									177,947	164,881	162,135
Total revenue									621,699	539,521	486,770
Client services [Member] | Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									(8,575)	(2,692)	2,391
Client services [Member] | Clinical and Financial Solutions [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									607,843	528,419	472,517
Client services [Member] | Population Health [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									$ 22,431	$ 13,794	$ 11,862

Business Combinations and Oth_3

Business Combinations and Other Investments - Acquisition of Health Grid - Additional Information (Detail) - USD ($)	May 18, 2018	Dec. 31, 2018	Feb. 13, 2018
Business Acquisition [Line Items]
Goodwill expected to be tax deductible		$ 0	$ 0
Health Grid [Member]
Business Acquisition [Line Items]
Date of acquisition	May 18, 2018
Purchase price in cash	$ 110,000,000
Purchase price transferred, initial payment	60,000,000
Pre-paid potential earnout payments	10,000,000
Potential earnout payments, fair value	23,915,000
Health Grid [Member] | Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		500,000
Health Grid [Member] | Level 3 [Member]
Business Acquisition [Line Items]
Potential earnout payments		23,900,000
Potential earnout payments, fair value		$ 23,900,000
Health Grid [Member] | Maximum [Member]
Business Acquisition [Line Items]
Potential earnout payments	50,000,000
Remaining potential payments	$ 40,000,000

Schedule of Consideration Trans

Schedule of Consideration Transaction (Detail) - USD ($) $ in Thousands	May 18, 2018	Feb. 13, 2018	Oct. 02, 2017	Aug. 25, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Health Grid [Member]
Business Acquisition [Line Items]
Aggregate purchase price	$ 60,000
First earnout payment paid by Allscripts	10,000
Fair value of contingent consideration payment	23,915
Closing purchase price adjustments	2,009
Aggregate purchase price	110,000
Add: Closing cash	1,783
Total consideration paid	$ 95,924
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Aggregate purchase price		$ 100,000
Add: Net working capital surplus		373
Less: Adjustment for assumed indebtedness		(1,684)
Add: Closing cash		14,951
Total consideration paid		$ 113,640
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Aggregate purchase price				$ 1,742
Add: Final net working capital surplus				1,022
Add: NantHealth common stock				42,750	$ 0	$ 42,750	$ 0
Less: Value assigned to modification of existing commercial agreement with NantHealth				(22,900)
Add: Closing cash				21
Total consideration paid				$ 22,614
EIS Business [Member]
Business Acquisition [Line Items]
Aggregate purchase price			$ 169,497
Add: Final net working capital surplus			1,331
Less: Assumption of restructuring indebtedness			(16,834)
Add: Closing cash			1,068
Total consideration paid			$ 185,000

Assets Acquired and Liabilities

Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	May 18, 2018	Feb. 13, 2018	Dec. 31, 2017	Oct. 02, 2017	Aug. 25, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 1,373,744			$ 1,292,747			$ 1,248,712
Health Grid [Member]
Business Acquisition [Line Items]
Cash and cash equivalents		$ 1,783
Accounts receivable, net		3,968
Prepaid expenses and other assets		185
Fixed assets		200
Intangible assets		41,000
Goodwill		53,953
Accounts payable and accrued expenses		(478)
Deferred revenue		(700)
Long-term deferred tax liability		(3,987)
Net assets acquired		$ 95,924
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Cash and cash equivalents			$ 14,951
Accounts receivable, net			13,328
Prepaid expenses and other assets			809
Fixed assets			1,764
Intangible assets			67,100
Goodwill			35,092
Other assets			42
Accounts payable and accrued expenses			(7,378)
Deferred revenue			(2,400)
Long-term deferred tax liability			(8,853)
Other liabilities			(815)
Net assets acquired			$ 113,640
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Cash and cash equivalents						$ 21
Accounts receivable, net						2,069
Prepaid expenses and other assets						1,735
Fixed assets						3,401
Intangible assets						12,400
Goodwill						13,466
Other assets						204
Accounts payable and accrued expenses						(1,477)
Deferred revenue						(9,205)
Net assets acquired						$ 22,614
EIS Business [Member]
Business Acquisition [Line Items]
Cash and cash equivalents					$ 1,068
Accounts receivable, net					72,996
Prepaid expenses and other assets					19,358
Fixed assets					9,808
Intangible assets					143,000
Goodwill					61,337
Other assets					1,601
Accounts payable and accrued expenses					(34,285)
Deferred revenue					(102,523)
Other liabilities					(2,863)
Net assets acquired					$ 169,497

Acquired Intangible Assets Amor

Acquired Intangible Assets Amortization (Detail) - USD ($) $ in Thousands	May 18, 2018	Feb. 13, 2018	Oct. 02, 2017	Aug. 25, 2017
Health Grid [Member]
Business Acquisition [Line Items]
Intangible assets	$ 41,000
Health Grid [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value	$ 28,000
Description	15 years
Health Grid [Member] | Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value	$ 13,000
Description	8 years
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Intangible assets		$ 67,100
Practice Fusion, Inc. [Member] | Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 14,800
Description		8 years
Practice Fusion, Inc. [Member] | Customer Relationships - Physician Practices [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 29,000
Description		15 years
Practice Fusion, Inc. [Member] | Customer Relationships - Pharmaceutical Partners [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 19,400
Description		20 years
Practice Fusion, Inc. [Member] | Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 3,900
Description		10 years
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Intangible assets				$ 12,400
NantHealth, Inc. [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 9,200
Description				19 years
NantHealth, Inc. [Member] | Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 3,000
Description				5 years
NantHealth, Inc. [Member] | Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 200
Description				5 years
EIS Business [Member]
Business Acquisition [Line Items]
Intangible assets			$ 143,000
EIS Business [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value			$ 80,800
Description			10 years
EIS Business [Member] | Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value			$ 58,400
Description			7 years
EIS Business [Member] | Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, fair value			$ 3,800
Description			7 years

Business Combinations and Oth_4

Business Combinations and Other Investments - Acquisition of Practice Fusion, Inc - Additional Information (Detail) - USD ($)	Feb. 13, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill expected to be tax deductible	$ 0	$ 0
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Date of acquisition	Feb. 13, 2018
Total consideration paid	$ 113,640,000
Practice Fusion, Inc. [Member] | Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		$ 1,200,000

Business Combinations and Oth_5

Business Combinations and Other Investments - Netsmart LLC Divestiture - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended				12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business	$ 0	$ 0	$ 173,129	$ (871)	$ 172,258	$ 0	$ 0
Netsmart [Member]
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business					500,500
Netsmart [Member] | Class A Common Units [Member]
Business Acquisition [Line Items]
Consideration for sale	$ 566,600				$ 566,600

Business Combinations and Oth_6

Business Combinations and Other Investments - Other Acquisitions and Divestitures - Additional Information (Detail) - USD ($)		Jun. 15, 2018	Apr. 02, 2018	Feb. 06, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Feb. 13, 2018
Business Acquisition [Line Items]
Acquisition of outstanding minority interest in third party		$ 6,900,000
Pre-tax gain (loss) on sale of business					$ 0	$ 0	$ 173,129,000	$ (871,000)	$ 172,258,000	$ 0	$ 0
Equity method investments	[1]				10,667,000				10,667,000	4,258,000
Cash paid for business acquisitions									177,233,000	169,823,000	99,837,000
Goodwill					1,373,744,000				1,373,744,000	$ 1,292,747,000	$ 1,248,712,000
Goodwill expected to be tax deductible					$ 0				$ 0			$ 0
Strategic Sourcing Business [Member]
Business Acquisition [Line Items]
Effective date of divestiture									March 15, 2018
Payment to acquire additional interest in a new entity									$ 2,700,000
Minority interest percentage					35.70%				35.70%
Equity method investments					$ 4,000,000				$ 4,000,000
Initial pre-tax loss on sale of business									900,000
Additional pre-tax loss on sale of business									$ 4,700,000
Cloud-based Analytics Software Platform Provider [Member]
Business Acquisition [Line Items]
Date of acquisition				Feb. 6, 2018
Cash paid for business acquisitions				$ 8,000,000
Goodwill				6,600,000
Accounts receivable, net				800,000
Liabilities assumed, deferred revenue				600,000
Liabilities assumed, deferred tax liabilities net				500,000
Goodwill expected to be tax deductible				0
Cloud-based Analytics Software Platform Provider [Member] | Technology-Based Intangible Assets
Business Acquisition [Line Items]
Intangible assets				1,100,000
Description									8 years
Cloud-based Analytics Software Platform Provider [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets				$ 600,000
Description									1 year
One Content Business [Member]
Business Acquisition [Line Items]
Date of divestiture			Apr. 2, 2018
Total consideration paid			$ 260,000,000
Pre-tax gain (loss) on sale of business									$ 177,900,000
[1]	(1)Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Business Combinations and Oth_7

Business Combinations and Other Investments - Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc. - Additional Information (Detail) - NantHealth, Inc. [Member] - USD ($) $ in Thousands	Aug. 25, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Date of acquisition		Aug. 25, 2017
Number of shares as consideration for asset purchase agreement	15,000,000
Aggregate consideration with a fair value	$ 42,750	$ 0	$ 42,750	$ 0

Business Combinations and Oth_8

Business Combinations and Other Investments - Acquisition of the Enterprise Information Solutions Business from McKesson Corporation - Additional Information (Detail) - EIS Business [Member] $ in Thousands	Oct. 02, 2017USD ($)Subsidiary	Dec. 31, 2017USD ($)
Business Acquisition [Line Items]
Number of wholly owned subsidiaries in which outstanding equity interest acquired | Subsidiary	2
Total consideration paid	$ 185,000
Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		$ 4,800

Pro forma Results (Detail)

Pro forma Results (Detail) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)$ / shares
HealthMEDX, LLC [Member]
Business Acquisition [Line Items]
Revenue	$ 6,268
Net loss	(4,393)
EIS Business [Member]
Business Acquisition [Line Items]
Revenue	77,046
Net loss	(15,160)
Combined Entity [Member]
Business Acquisition [Line Items]
Revenue	1,768,530
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (192,653)
Loss per share, basic and diluted | $ / shares	$ (1.07)

Summary of Other Equity Investm

Summary of Other Equity Investments Included in Other Assets (Detail) $ in Thousands		12 Months Ended
		Dec. 31, 2018USD ($)Investment	Dec. 31, 2017USD ($)
Investments In Affiliates Subsidiaries Associates And Joint Ventures [Abstract]
Number of Investees | Investment	[1]	8
Equity method investments, Original Cost	[1]	$ 7,407
Equity method investments, Carrying Value	[1]	$ 10,667	$ 4,258
Cost method investments, Number of Investees | Investment		5
Cost method investments, Original Cost		$ 37,874
Cost method investments, Carrying Value		$ 25,923	22,020
Total equity investments, Number of Investees | Investment		13
Total equity investments, Original Cost		$ 45,281
Total equity investments, Carrying Value		$ 36,590	$ 26,278
[1]	(1)Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Business Combinations and Oth_9

Business Combinations and Other Investments - Other Acquisitions and Investments - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note	$ 16,934	$ 5,606	$ 21,185
2017 Convertible Note [Member]
Business Acquisition [Line Items]
Total consideration for non-marketable convertible note of a third party		2,600
Other Assets [Member] | 2017 Convertible Note [Member]
Business Acquisition [Line Items]
Convertible note carrying value		2,600
Cost Method Equity Investments [Member] | 2018 Convertible Note [Member]
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note	1,800
Cost Method Equity Investments [Member] | 2018 Business Acquisitions [Member]
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note	11,700
Cost Method Equity Investments [Member] | 2017 Business Acquisitions [Member]
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note		2,800
Cost Method Equity Investments [Member] | Other Assets [Member] | 2018 Convertible Note [Member]
Business Acquisition [Line Items]
Carrying value of investments	13,500
Cost Method Equity Investments [Member] | Other Assets [Member] | 2017 Business Acquisitions [Member]
Business Acquisition [Line Items]
Carrying values of cost method investments	$ 3,500	$ 2,800

Business Combinations and Ot_10

Business Combinations and Other Investments - Impairment of and Losses on Long-term Investments - Additional Information (Detail) - USD ($)	3 Months Ended								9 Months Ended	12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Impairment of long-term investments	$ 0	$ 0	$ 9,987,000	$ 5,500,000	$ 0	$ 20,700,000	$ 144,590,000	$ 0		$ 15,487,000	$ 165,290,000	$ 0
Other-than-temporary impairments							142,200,000			$ 0		$ 0
Available for sale marketable securities cost basis							$ 205,600,000
Loss on final disposition of securities						$ 20,700,000
Equity Securities [Member]
Business Acquisition [Line Items]
Other-than-temporary impairment charges on cost method equity investments									$ 2,100,000
Aggregate carrying value of cost method investments prior to impairment charges					$ 2,100,000						$ 2,100,000

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
1.25% Cash Convertible Senior Notes [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%
1.25% Call Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%	1.25%
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%
Health Grid [Member] | Level 3 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Outstanding contingent consideration value	$ 23.9

Summary of Financial Assets and

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 142,455	$ 106,455
Total assets	9,366	47,714
Total liabilities	35,819	54,813
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	262	1,136
Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	10,528	1,950
Other liabilities	15,317	5,086
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	9,974	47,777
Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	0	0
Total liabilities	0	0
Level 1 [Member] | Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Level 1 [Member] | Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Other liabilities	0	0
Level 1 [Member] | 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	262	1,136
Total liabilities	0	0
Level 2 [Member] | Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	262	1,136
Level 2 [Member] | Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Other liabilities	0	0
Level 2 [Member] | 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	9,104	46,578
Total liabilities	35,819	54,813
Level 3 [Member] | Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Level 3 [Member] | Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	10,528	1,950
Other liabilities	15,317	5,086
Level 3 [Member] | 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	9,974	47,777
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	9,104	46,578
1.25% Call Option [Member] | Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
1.25% Call Option [Member] | Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
1.25% Call Option [Member] | Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	$ 9,104	$ 46,578

Summary of Financial Assets a_2

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail)	Dec. 31, 2018	Dec. 31, 2017
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%	1.25%

Summary of Changes in Assets an

Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Contingent Consideration [Member]
Fair Value, Net Derivative Asset (Liability) and Contingent Consideration Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Beginning balance	$ 7,036	$ 5,285
Additions	24,551	1,923
Payments	(6,067)	(171)
Fair value adjustments	325	(1)
Ending balance	25,845	7,036
1.25% Cash Convertible Senior Notes [Member]
Fair Value, Net Derivative Asset (Liability) and Contingent Consideration Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Beginning balance	(1,199)	(579)
Additions	0	0
Payments	0	0
Fair value adjustments	329	(620)
Ending balance	$ (870)	$ (1,199)

Fixed Assets (Detail)

Fixed Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 401,116	$ 380,694
Less: Accumulated depreciation and amortization	(279,203)	(245,277)
Fixed assets, net	121,913	135,417
Computer Equipment and Software [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 332,826	316,537
Computer Equipment and Software [Member] | Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Computer Equipment and Software [Member] | Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	10 years
Facility Furniture, Fixtures and Equipment [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 21,300	23,923
Facility Furniture, Fixtures and Equipment [Member] | Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years
Facility Furniture, Fixtures and Equipment [Member] | Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	7 years
Leasehold Improvements [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 37,555	33,031
Estimated useful life (in years)	Shorter of 7 years or life of lease
Assets Under Capital Leases [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 9,435	7,203
Less: Accumulated depreciation and amortization	$ (7,300)	$ (5,800)
Assets Under Capital Leases [Member] | Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Assets Under Capital Leases [Member] | Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years

Fixed Assets - Additional Infor

Fixed Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 279,203	$ 245,277
Assets Under Capital Leases [Member]
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 7,300	$ 5,800

Depreciation and Amortization E

Depreciation and Amortization Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Abstract]
Fixed assets depreciation and amortization expense, including capital leases	$ 47,567	$ 40,717	$ 34,314

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,242,642	$ 1,187,893
Accumulated Amortization	(863,561)	(804,320)
Intangible Assets, Net	379,081	383,573
Registered trademarks	52,000	52,000
Goodwill	1,373,744	1,292,747	$ 1,248,712
Total	1,425,744	1,344,747
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	537,834	533,044
Accumulated Amortization	(401,093)	(365,828)
Intangible Assets, Net	136,741	167,216
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	704,808	654,849
Accumulated Amortization	(462,468)	(438,492)
Intangible Assets, Net	$ 242,340	$ 216,357

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Oct. 01, 2018	Jul. 01, 2018	Feb. 06, 2018	Jan. 01, 2018	Aug. 25, 2017
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill, impairments recorded	$ 0	$ 0	$ 13,466,000	$ 0	$ 0	$ 0	$ 13,466,000	$ 0	$ 0
Goodwill			1,373,744,000				1,373,744,000	1,292,747,000	1,248,712,000
Accumulated impairment losses associated with goodwill			13,500,000				13,500,000	0
Other additions							6,399,000	467,000
Goodwill reduction due to divestiture							32,306,000
Transfers							0
Strategic Sourcing Business [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill reduction due to divestiture							2,200,000
One Content Business [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill reduction due to divestiture							30,100,000
NantHealth, Inc. [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill, impairments recorded							13,500,000
Goodwill														$ 13,466,000
NantHealth, Inc. [Member] | Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Intangible asset impairment charges							2,200,000
Cloud-based Analytics Software Platform Provider [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill												$ 6,600,000
Other additions							6,400,000
Hospital and Health Systems [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Percentage of excess of fair value over carrying value											10.00%		10.00%
Goodwill													$ 511,200,000
Hospital and Health Systems [Member] | NantHealth, Inc. [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill										$ 516,800,000
Hospital and Health Systems [Member] | NantHealth, Inc. [Member] | Maximum [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Percentage of excess of fair value over carrying value										10.00%
NantHealth, Inc. [Member] | Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Intangible asset impairment charges							2,200,000
Clinical and Financial Solutions [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill, impairments recorded							0
Goodwill			$ 930,362,000				930,362,000	861,615,000	$ 843,837,000
Other additions							6,399,000	$ 420,000
Goodwill reduction due to divestiture							0
Transfers							2,904,000
Clinical and Financial Solutions [Member] | Strategic Sourcing Business [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Transfers							$ 2,900,000

Changes in Carrying Amount of G

Changes in Carrying Amount of Goodwill (Detail) - USD ($)	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Goodwill						$ 1,292,747,000	$ 1,292,747,000	$ 1,248,712,000
Additions arising from business acquisitions							95,444,000
Total increases due to measurement period adjustments:							32,165,000
Other additions							6,399,000	467,000
Total additions to goodwill							127,609,000	43,044,000
Divestitures							(32,306,000)
Foreign exchange translation							(840,000)	991,000
Goodwill impairment charge	$ 0	$ 0	$ (13,466,000)	$ 0	$ 0	0	(13,466,000)	0	$ 0
Transfers							0
Goodwill, net			1,373,744,000				1,373,744,000	1,292,747,000	1,248,712,000
NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions								13,350,000
Total increases due to measurement period adjustments:							116,000
Goodwill impairment charge							(13,500,000)
Enterprise Information Solutions [Member]
Goodwill [Line Items]
Total increases due to measurement period adjustments:							32,049,000	29,227,000
Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							35,092,000
Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							53,953,000
Clinical and Financial Solutions [Member]
Goodwill [Line Items]
Goodwill						861,615,000	861,615,000	843,837,000
Additions arising from business acquisitions							41,491,000
Total increases due to measurement period adjustments:							25,192,000
Other additions							6,399,000	420,000
Total additions to goodwill							66,683,000	16,787,000
Divestitures							0
Foreign exchange translation							(840,000)	991,000
Goodwill impairment charge							0
Transfers							2,904,000
Goodwill, net			930,362,000				930,362,000	861,615,000	843,837,000
Clinical and Financial Solutions [Member] | NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions								0
Total increases due to measurement period adjustments:							0
Clinical and Financial Solutions [Member] | Enterprise Information Solutions [Member]
Goodwill [Line Items]
Total increases due to measurement period adjustments:							25,192,000	16,367,000
Clinical and Financial Solutions [Member] | Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							35,092,000
Clinical and Financial Solutions [Member] | Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							0
Population Health [Member]
Goodwill [Line Items]
Goodwill						$ 431,132,000	431,132,000	404,875,000
Additions arising from business acquisitions							53,953,000
Total increases due to measurement period adjustments:							6,973,000
Other additions							0	47,000
Total additions to goodwill							60,926,000	26,257,000
Divestitures							(32,306,000)
Foreign exchange translation							0	0
Goodwill impairment charge							(13,466,000)
Transfers							(2,904,000)
Goodwill, net			$ 443,382,000				443,382,000	431,132,000	$ 404,875,000
Population Health [Member] | NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions								13,350,000
Total increases due to measurement period adjustments:							116,000
Population Health [Member] | Enterprise Information Solutions [Member]
Goodwill [Line Items]
Total increases due to measurement period adjustments:							6,857,000	$ 12,860,000
Population Health [Member] | Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							0
Population Health [Member] | Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							$ 53,953,000

Amortization Expense Related to

Amortization Expense Related to Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Finite Lived Intangible Assets [Line Items]
Amortization of software development and acquisition-related assets									$ 102,876	$ 84,725	$ 71,215
Amortization of intangible and acquisition-related assets	$ 6,957	$ 6,609	$ 6,382	$ 6,639	$ 6,005	$ 3,816	$ 3,745	$ 3,779	26,587	17,345	15,884
Total intangible amortization expense	$ 65,054				$ 50,482				65,054	50,482	46,335
Proprietary Technology [Member]
Finite Lived Intangible Assets [Line Items]
Amortization of software development and acquisition-related assets									$ 38,467	$ 33,137	$ 30,451

Estimated Future Amortization E

Estimated Future Amortization Expense for Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
2,019	$ 63,010
2,020	58,356
2,021	52,928
2,022	46,472
2,023	30,272
Thereafter	128,043
Intangible Assets, Net	$ 379,081	$ 383,573

Asset Impairment Charges - Addi

Asset Impairment Charges - Additional Information (Detail) - USD ($)	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Asset Impairment Charges [Line Items]
Asset impairment charges			$ 28,091,000	$ 0	$ 30,075,000	$ 0					$ 58,166,000	$ 0	$ 4,650,000
Non-cash asset impairment charges related to disposal of fixed assets											2,100,000
Goodwill impairment charge	$ 0	$ 0	13,466,000	0	0	0					13,466,000	0	0
Other than temporary impairment charges on long-term Investments			$ 0	$ 0	$ 9,987,000	$ 5,500,000	$ 0	$ 20,700,000	$ 144,590,000	$ 0	15,487,000	$ 165,290,000	0
Other charges													400,000
Cost Method Equity Investments [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges													2,100,000
NantHealth, Inc. [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges											22,900,000
Unamortized value assigned to modification of existing commercial agreement with Nanhealth											20,700,000
Goodwill impairment charge											13,500,000
Proprietary Technology [Member] | NantHealth, Inc. [Member]
Asset Impairment Charges [Line Items]
Write-down of intangible asset											2,200,000
Capitalized Software Development Projects [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges											$ 33,200,000		$ 2,200,000

Summary of Non-Cash Asset Impai

Summary of Non-Cash Asset Impairment Charges (Detail) - USD ($)	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Asset Impairment Charges [Abstract]
Asset impairment charges			$ 28,091,000	$ 0	$ 30,075,000	$ 0					$ 58,166,000	$ 0	$ 4,650,000
Goodwill impairment charge	$ 0	$ 0	13,466,000	0	0	0					13,466,000	0	0
Impairment of long-term investments			$ 0	$ 0	$ 9,987,000	$ 5,500,000	$ 0	$ 20,700,000	$ 144,590,000	$ 0	$ 15,487,000	$ 165,290,000	$ 0

Debt Outstanding Excluding Capi

Debt Outstanding Excluding Capital Lease Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2018		Dec. 31, 2017
Debt Instrument [Line Items]
Principal Balance	$ 695,748		$ 973,750
Unamortized Discount and Debt Issuance Costs	28,150		39,338
Net Carrying Amount	667,598		934,412
Principal Balance, Current	20,538		28,125
Unamortized Discount and Debt Issuance Costs, Current	479		438
Net Carrying Amount, Current	20,059		27,687
Principal Balance, Noncurrent	675,210		945,625
Unamortized Discount and Debt Issuance Costs, Noncurrent	27,671		38,900
Net Carrying Amount, Noncurrent	647,539		906,725
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Principal Balance	345,000	[1]	345,000
Unamortized Discount and Debt Issuance Costs	22,112		35,978
Net Carrying Amount	322,888		309,022
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Principal Balance	350,000		628,750
Unamortized Discount and Debt Issuance Costs	6,038		3,360
Net Carrying Amount	343,962		625,390
Other Debt [Member]
Debt Instrument [Line Items]
Principal Balance	748		0
Unamortized Discount and Debt Issuance Costs	0		0
Net Carrying Amount	$ 748		$ 0
[1]	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

Interest Expense (Detail)

Interest Expense (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Total interest expense	$ 13,989	$ 13,251	$ 11,979	$ 11,695	$ 11,594	$ 9,251	$ 8,279	$ 8,416	$ 50,914	$ 37,540	$ 29,478
Convertible Senior Notes and Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Interest expense									35,366	23,001	15,556
Amortization of discounts and debt issuance costs									15,548	14,539	13,922
Total interest expense									$ 50,914	$ 37,540	$ 29,478

Interest Expense Related to 1.2

Interest Expense Related to 1.25% Cash Convertible Senior Notes (Detail) - 1.25% Cash Convertible Senior Notes [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Coupon interest at 1.25%	$ 4,312	$ 4,312	$ 4,312
Amortization of discounts and debt issuance costs	13,867	13,208	12,585
Total interest expense related to the 1.25% Notes	$ 18,179	$ 17,520	$ 16,897

Debt - Additional Information (

Debt - Additional Information (Detail)	Feb. 15, 2018USD ($)	Jun. 18, 2013USD ($)$ / shares	Jun. 30, 2013USD ($)	Dec. 31, 2018USD ($)$ / shares		Dec. 31, 2013USD ($)	Dec. 31, 2017USD ($)	Sep. 30, 2015USD ($)
Debt Instrument [Line Items]
Maximum percentage of foreign subsidiary capital stock guaranteeing credit facility				65.00%
Debt instrument principal amount				$ 695,748,000			$ 973,750,000
Payments for 1.25% Call Option			$ 82,800,000
Proceeds from issuance of warrants, net of issuance costs			51,200,000
Net cash payment for 1.25% Notes call spread overlay			$ 31,600,000
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Initial margin for borrowings	1.00%
Credit facility borrowing capacity, amount available				899,200,000
Senior Secured Revolving Facility [Member] | Eurocurrency Rate [Member]
Debt Instrument [Line Items]
Initial margin for borrowings	2.00%
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount				$ 350,000,000			628,750,000
Senior Secured Credit Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Interest coverage ratio				350.00%
Senior Secured Credit Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Leverage ratio				425.00%
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument principal amount				$ 350,000,000
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Debt instrument principal amount				$ 345,000,000	[1]		$ 345,000,000
Debt instrument, interest rate, effective percentage		5.40%
Debt instrument principal amount		$ 345,000,000
Proceeds from debt		$ 305,100,000
Interest payment, terms				Interest on the 1.25% Notes is payable semiannually in arrears on January 1st and July 1st of each year
Debt, Maturity date		Jul. 1, 2020		Jul. 1, 2020
Debt instrument convertible, principal amount		$ 1,000
Convertible number of equity instrument		58.1869
Conversion price per common stock | $ / shares		$ 17.19		$ 17.19
Repurchase percentage on principal		100.00%
Fair value liability of embedded cash conversion option		$ 82,800,000
Convertible debt instrument remaining discount amortization period				1 year 6 months
Interest rate				1.25%
Debt Instrument, fees and aggregate cost		8,400,000
Debt instrument capitalized amount		$ 8,300,000
Deferred charges capitalized amount outstanding				$ 1,800,000
Accrued and unpaid interest				$ 2,200,000
Payments for 1.25% Call Option						$ 82,800,000
1.25% Cash Convertible Senior Notes [Member] | Condition One [Member]
Debt Instrument [Line Items]
Threshold trading days				20 days
Threshold consecutive trading days				30 days
Debt instrument conversion price percentage				130.00%
1.25% Cash Convertible Senior Notes [Member] | Condition Two [Member]
Debt Instrument [Line Items]
Threshold trading days				5 days
Threshold consecutive trading days				5 days
Debt instrument conversion price percentage				98.00%
Debt instrument convertible, principal amount				$ 1,000
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity	$ 400,000,000							$ 250,000,000
Senior secured credit facilities term, years	5 years
Line of credit facility, frequency of payments				The Term Loan is repayable in quarterly installments, which commenced on June 30, 2018.
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity	$ 900,000,000							550,000,000
Senior secured credit facilities term, years	5 years
Credit facility, maximum borrowing capacity, foreign currencies	$ 100,000,000
Letter of Credit [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance of letters of credit	50,000,000
Line of Credit [Member]
Debt Instrument [Line Items]
Portion of facility available for issuance of swingline loans	10,000,000
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Aggregate amount of additional credit facilities authorized	$ 600,000,000							$ 300,000,000
Second Amended Credit Agreement [Member] | Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount				$ 0
Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Letters of credit outstanding				$ 800,000
Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member] | United States dollars [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, effective percentage				4.52%
Second Amended Credit Agreement [Member] | Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument principal amount				$ 350,000,000
Second Amended Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	0.50%
Second Amended Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	1.25%
Second Amended Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	1.50%
Second Amended Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	2.25%
Second Amended Credit Agreement [Member] | LIBOR Rate [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread				2.00%
2015 Credit Agreement [Member] | Senior Secured Credit Facility [Member] | Minimum [Member] | Covenant On Potential Acquisition [Member]
Debt Instrument [Line Items]
Consideration paid for acquisitions				$ 100,000,000
2015 Credit Agreement [Member] | Senior Secured Credit Facility [Member] | Maximum [Member] | Covenant On Potential Acquisition [Member]
Debt Instrument [Line Items]
Leverage ratio				450.00%
2015 Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	0.00%
2015 Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	1.25%
2015 Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	1.00%
2015 Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Senior secured credit facility interest rate spread	2.25%
[1]	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

Summary of Future Debt Payments

Summary of Future Debt Payments (Detail) - USD ($) $ in Thousands		Dec. 31, 2018		Dec. 31, 2017
Debt Instrument [Line Items]
Total		$ 695,748		$ 973,750
2,019		20,538
2,020		372,710
2,021		30,000
2,022		37,500
2,023		235,000
Thereafter		0
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total		345,000	[1]	345,000
2,019	[1]	0
2,020	[1]	345,000
2,021	[1]	0
2,022	[1]	0
2,023	[1]	0
Thereafter	[1]	0
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Total		350,000
2,019		20,000
2,020		27,500
2,021		30,000
2,022		37,500
2,023		235,000
Thereafter		0
Other Debt [Member]
Debt Instrument [Line Items]
Total		748		$ 0
2,019		538
2,020		210
2,021		0
2,022		0
2,023		0
Thereafter		$ 0
[1]	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

Summary of Future Debt Paymen_2

Summary of Future Debt Payments (Parenthetical) (Detail)	Jun. 18, 2013	Dec. 31, 2018
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Maturity date	Jul. 1, 2020	Jul. 1, 2020

Geographic Breakdown of Income

Geographic Breakdown of Income (Loss) Before Income Tax Benefits (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
United States									$ 14,045	$ (190,053)	$ 33,027
Foreign									(907)	16	(1,467)
Income (loss) from continuing operations before income taxes	$ (40,044)	$ (13,778)	$ 91,822	$ (24,862)	$ (32,578)	$ (12,030)	$ (139,882)	$ (5,547)	$ 13,138	$ (190,037)	$ 31,560

Components of Provision (Benefi

Components of Provision (Benefit) for Income Taxes (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Current tax provision, Federal									$ 838	$ 407	$ 372
Current tax provision, State									737	1,796	625
Current tax provision, Foreign									5,015	5,091	3,857
Current tax provision									6,590	7,294	4,854
Deferred tax provision, Federal									(5,781)	2,800	(3,784)
Deferred tax provision, State									236	(12,695)	116
Deferred tax provision, Foreign									(576)	(2,913)	(877)
Deferred tax provision									(6,121)	(12,808)	(4,545)
Income tax (benefit) provision	$ (5,449)	$ (1,637)	$ 7,256	$ 299	$ (9,973)	$ 1,962	$ 1,263	$ 1,234	$ 469	$ (5,514)	$ 309

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Statutory tax rate	21.00%	35.00%	35.00%
Net operating loss carryforwards expiry beginning period	2,019
Provisional income tax expense		$ 15,300
Tax expense resulting from remeasurement deferred tax balance		10,100
Tax expense on accumulated foreign subsidiary earnings resulted from reduced federal rate		5,200
Tax holiday savings		$ 400	$ 700
Diluted earnings per share, increase	$ 0.01	$ 0.01	$ 0.01
Partial tax holiday period	5 years
Tax savings impact	$ 500
Unrecognized tax benefits	19,821	$ 10,939	$ 10,616	$ 11,777
Increase in unrecognized tax benefits	8,977	640	570
Estimated increase in income tax benefit	19,600	100
Unrecognized tax benefits, accrued interest and penalties	198	741
Other Tax Expense (Benefit)	1,800
Valuation allowance	$ (5,208)	47,959	$ (17,504)
Cumulative operating income loss period considered	3 years
Unvested Stock Compensation of Covered Officers [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	$ 4,700
Capital Loss Carryforward [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	42,700	42,700
Credit Carryforwards [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	22,100
Capital Loss And Credit Carryforwards [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	64,800
Credit Carryforwards and Net Operating Loss Carryforwards [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance		5,300
Netsmart [Member] | Capital Loss And Credit Carryforwards [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Valuation allowance	$ 55,300
India [Member] | Partially Expire [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Tax holiday expiration date	2,012
India [Member] | Fully Expire [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Tax holiday expiration date	2,017
State [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Net operating loss carryforwards	$ 2,000	4,000
State [Member] | Netsmart [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Increase in unrecognized tax benefits	$ 7,700
State [Member] | Minimum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,007
State [Member] | Maximum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,018
Israeli [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Net operating loss carryforwards	$ 49,000
Foreign Country [Member] | Canada [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,018
Foreign Country [Member] | Minimum [Member] | India [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,013
Foreign Country [Member] | Maximum [Member] | India [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,018
Federal [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Net operating loss carryforwards	$ 164,000	$ 179,000
Federal [Member] | Minimum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,015
Federal [Member] | Maximum [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Income tax examination, remaining tax years	2,018

Taxes Computed at Statutory Fed

Taxes Computed at Statutory Federal Income Tax Rate Reconciled to Provision for Income Taxes (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
United States federal tax at statutory rate									$ 2,759	$ (66,523)	$ 10,869
Non-deductible acquisition and reorganization expenses									291	0	1,400
Research credits									(6,185)	(3,200)	(2,700)
Change in unrecognized tax benefits									3	395	(692)
State income taxes, net of federal benefit									715	(7,121)	1,931
Compensation									3,213	2,950	651
Meals and entertainment									616	991	1,085
Impact of foreign operations									3,627	730	2,847
Provision-to-Return adjustments									(2,140)	(1,413)	(1,116)
Deemed Dividends									373	1,289	887
Dividends Accrued or Received									0	0	2,198
Federal, state and local rate changes									0	185	344
US Tax reform impact									0	10,189	0
One time Mandatory Repatriation Toll Charge									0	5,155	0
Non-deductible items									34	33	51
Noncontrolling interest									951	0	0
True-up of prior year income of Consolidated Investment									913	0	0
Valuation allowance									(5,208)	47,959	(17,504)
Other									507	2,867	58
Income tax (benefit) provision	$ (5,449)	$ (1,637)	$ 7,256	$ 299	$ (9,973)	$ 1,962	$ 1,263	$ 1,234	$ 469	$ (5,514)	$ 309

Components of Deferred Tax Asse

Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets
Accruals and reserves, net	$ 31,565	$ 23,658
Allowance for doubtful accounts	11,378	6,014
Stock-based compensation, net	10,595	10,442
Deferred revenue	8,160	11,502
Net operating loss carryforwards	36,649	41,428
Capital loss carryforwards	0	42,702
Research and development tax credit	899	32,907
AMT credits	0	7,538
Other	10,784	11,108
Less: Valuation Allowance	(18,734)	(79,594)
Total deferred tax assets	91,296	107,705
Deferred tax liabilities
Prepaid expense	(6,733)	(6,166)
Property and equipment, net	(7,442)	(8,464)
Acquired intangibles, net	(129,879)	(111,112)
Other	(676)	(647)
Total deferred tax liabilities	(144,730)	(126,389)
Net deferred tax liabilities	$ (53,434)	$ (18,684)

Deferred Tax Assets (Liabilitie

Deferred Tax Assets (Liabilities) Classified in Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Non-current deferred tax assets, net	$ 5,036	$ 4,574
Non-current deferred tax liabilities, net	(58,470)	(23,258)
Net deferred tax liabilities	$ (53,434)	$ (18,684)

Change in the Amount of Unrecog

Change in the Amount of Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Unrecognized tax benefit, beginning balance	$ 10,939	$ 10,616	$ 11,777
Increases for tax positions related to the current year	8,977	640	570
Decreases for tax positions related to prior years	0	(146)	0
Increases for tax positions related to prior years	367	153	104
Increases acquired in business acquisitions	540	0	0
Foreign currency translation	(5)	10	(1)
Reductions due to lapsed statute of limitations	(997)	(334)	(1,834)
Unrecognized tax benefit, ending balance	$ 19,821	$ 10,939	$ 10,616

Recognized Interest and Penalti

Recognized Interest and Penalties Related to Uncertain Tax Positions (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Interest and penalties included in the provision for income taxes	$ 543	$ 446	$ 6

Amount of Interest and Penaltie

Amount of Interest and Penalties Included in Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Interest and penalties included in the liability for uncertain tax positions	$ 198	$ 741

Stock-Based Compensation Expens

Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock based compensation expense	$ 39,331	$ 39,465	$ 38,346
Cost of revenue [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock based compensation expense	6,181	7,363	8,488
Cost of revenue [Member] | Software delivery, Support and Maintenance [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock based compensation expense	2,184	2,879	4,125
Cost of revenue [Member] | Client services [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock based compensation expense	3,997	4,484	4,363
Selling, General and Administrative Expenses [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock based compensation expense	24,213	23,497	21,829
Research and development [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock based compensation expense	$ 8,937	$ 8,605	$ 8,029

Stock Award Plan - Additional I

Stock Award Plan - Additional Information (Detail) - USD ($) $ / shares in Units, shares in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense included in provision for income taxes	$ 4,900,000
Capitalized stock-based compensation costs	0	$ 0	$ 0
Unrecognized compensation cost	$ 61,300,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	2 years 4 months 24 days
Common stock shares reserved for issuance under future share-based awards	4,900
Shares settled for tax withholding	695	606	648
Stock options, contractual terms	7 years
Aggregate intrinsic value of stock options outstanding	$ 0
Aggregate intrinsic value of stock options exercisable	$ 0
Share price	$ 9.64
Employee Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Payroll deductions	20.00%
Offering price percentage	15.00%
Shares purchased under the ESPP	1,600	1,000
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual fair value limit on shares purchased	$ 25,000
Service-based share awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 50,900,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	2 years 7 months 6 days
Share based compensation award vesting period	4 years
Deferred share units awarded to directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based compensation award vesting period	1 year
Awards Granted Under Financial Performance [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based compensation award vesting period	3 years
Awards Granted Under Financial Performance [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based compensation award vesting period	4 years
Performance-Based Share Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 1,200,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	1 year
Market-Based Share Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost	$ 9,200,000
Unrecognized compensation expense expected to recognized over weighted-average period, in years	1 year 9 months 18 days
Share based compensation award vesting period	3 years

Activity for Restricted Stock U

Activity for Restricted Stock Units (Detail) - Restricted Stock Unit [Member] - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Shares
Shares, Unvested restricted stock units, beginning balance	7,259	6,247	5,379
Shares, Awarded	4,024	3,690	3,480
Shares, Vested	(2,222)	(1,835)	(2,095)
Shares, Forfeited	(1,111)	(843)	(517)
Shares, Unvested restricted stock units, ending balance	7,950	7,259	6,247
Weighted-Average Grant Date Fair Value
Weighted-Average Grant Date Fair Value, Unvested restricted stock units, beginning balance	$ 12.57	$ 13.54	$ 14.15
Weighted-Average Grant Date Fair Value, Awarded	13.25	12.52	12.88
Weighted-Average Grant Date Fair Value, Vested	13.03	13.74	13.84
Weighted-Average Grant Date Fair Value, Forfeited	12.43	16.97	14.30
Weighted-Average Grant Date Fair Value, Unvested restricted stock units, ending balance	$ 12.81	$ 12.57	$ 13.54

Stock Options Outstanding (Deta

Stock Options Outstanding (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Options Outstanding
Options Outstanding, beginning balance	1,635,000	1,903,000	2,343,000
Options Outstanding, options granted	0	0	0
Options Outstanding, options exercised	(92,000)	(108,000)	(6,000)
Options Outstanding, options forfeited	(211,000)	(160,000)	(434,000)
Options Outstanding, ending balance	1,331,686	1,635,000	1,903,000
Weighted-Average Exercise Price
Weighted-average exercise price, beginning balance	$ 13.85	$ 13.95	$ 14.24
Weighted-average exercise price, options granted	0	0	0
Weighted-average exercise price, options exercised	14.01	14.01	14.01
Weighted-average exercise price, options forfeited	14.74	15	15.51
Weighted-average exercise price, ending balance	$ 13.69	$ 13.85	$ 13.95
Options Exercisable
Options Exercisable	1,331,686	1,635,000	1,431,000	1,282,000
Weighted-Average Exercise Price, Exercisable	$ 13.69	$ 13.85	$ 13.98	$ 14.52

Stock Option Activity (Detail)

Stock Option Activity (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Total intrinsic value of stock options exercised	$ 69	$ 45	$ 1
Total fair value of share awards vested	$ 28,954	$ 25,220	$ 26,892

Stock Option Awards (Detail)

Stock Option Awards (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Schedule Of Stock Options [Line Items]
Number of options Outstanding	1,331,686	1,635,000	1,903,000	2,343,000
Weighted-Average Exercise Price, Outstanding	$ 13.69	$ 13.85	$ 13.95	$ 14.24
Number of options exercisable	1,331,686	1,635,000	1,431,000	1,282,000
Weighted-Average Exercise Price, Exercisable	$ 13.69	$ 13.85	$ 13.98	$ 14.52
$12.72 to $14.01 [Member]
Schedule Of Stock Options [Line Items]
Range of exercise prices, lower limit	12.72
Range of exercise prices, upper limit	$ 14.01
Number of options Outstanding	1,323,447
Weighted-Average Exercise Price, Outstanding	$ 13.69
Number of options exercisable	1,323,447
Weighted-Average Exercise Price, Exercisable	$ 13.69
$14.78 to $15.22 [Member]
Schedule Of Stock Options [Line Items]
Range of exercise prices, lower limit	14.78
Range of exercise prices, upper limit	$ 15.22
Number of options Outstanding	8,239
Weighted-Average Exercise Price, Outstanding	$ 14.81
Number of options exercisable	8,239
Weighted-Average Exercise Price, Exercisable	$ 14.81

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail)	Jun. 30, 2016Installment$ / sharesshares	Dec. 31, 2018USD ($)$ / shares	Dec. 31, 2018USD ($)$ / sharesshares	Dec. 31, 2018USD ($)Installment$ / sharesshares	Dec. 31, 2017USD ($)$ / sharesshares	Dec. 31, 2016USD ($)	Aug. 02, 2018USD ($)	Nov. 17, 2016USD ($)	Dec. 31, 2014$ / shares	Jun. 30, 2013shares
Class Of Stock [Line Items]
Common stock repurchased, amount | $				$ 138,928,000	$ 12,077,000	$ 121,241,000
Common stock, par value | $ / shares		$ 0.01	$ 0.01	$ 0.01	$ 0.01
Warrant Issued to Commercial Partner [Member]
Class Of Stock [Line Items]
Number of warrants issued										1,500,000
Number of installments | Installment				4
Number of warrants vesting annually				375,000
Warrant expiration period				2020-06
Warrants value | $		$ 10,200,000	$ 10,200,000	$ 10,200,000
Warrants vesting period				4 years
Initial exercise price of warrant per share | $ / shares		$ 12.94	$ 12.94	$ 12.94
1.25% Warrants [Member]
Class Of Stock [Line Items]
Number of warrants issued										20,100,000
Initial exercise price of warrant per share | $ / shares									$ 23.135
Warrants issued | $				$ 51,200,000	$ 51,200,000
Warrant expiration term				The 1.25% Warrants expire over a period of 70 trading days beginning on October 1, 2020 and are exercisable only upon expiration. Additionally, if the market value per share of our common stock exceeds the strike price of the 1.25% Warrants on any trading day during the 70 trading day measurement period, we will, for each such trading day, be obligated to issue to the counterparties a number of shares equal in value to the product of the amount by which such market value exceeds such strike price and 1/70th of the aggregate number of shares of our common stock underlying the 1.25% Warrants transactions, subject to a share delivery cap.
Warrant expiration period					70 days
Warrant expiration beginning period					Oct. 1, 2020
Customary Anti-Dilution Adjustments [Member] | Warrant Issued to Commercial Partner [Member]
Class Of Stock [Line Items]
Number of installments | Installment	4
Number of warrants vesting annually	750,000
Warrant expiration period	2026-06
Warrants value | $		$ 11,000,000	$ 11,000,000	$ 11,000,000
Warrants vesting period				4 years
Case 1 [Member] | Customary Anti-Dilution Adjustments [Member] | Warrant Issued to Commercial Partner [Member]
Class Of Stock [Line Items]
Number of warrants issued	900,000
Common stock, par value | $ / shares	$ 0.01
Sale of common stock, price per share | $ / shares	$ 12.47
Case 2 [Member] | Customary Anti-Dilution Adjustments [Member] | Warrant Issued to Commercial Partner [Member]
Class Of Stock [Line Items]
Number of warrants issued	1,000,000
Sale of common stock, price per share | $ / shares	$ 14.34
Case 3 [Member] | Customary Anti-Dilution Adjustments [Member] | Warrant Issued to Commercial Partner [Member]
Class Of Stock [Line Items]
Number of warrants issued	1,100,000
Sale of common stock, price per share | $ / shares	$ 15.59
November 2016 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount | $								$ 200,000,000
Common stock repurchased, shares			7,700,000		1,000,000
Common stock repurchased, amount | $			$ 101,900,000		$ 12,100,000
August 2018 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount | $							$ 250,000,000
Common stock repurchased, shares				3.6
Common stock repurchased, amount | $		$ 37,000,000

Calculations of Earnings (Loss)

Calculations of Earnings (Loss) Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Basic Income (Loss) per Common Share:
Income (loss) from continuing operations	$ (34,595)	$ (12,141)	$ 84,566	$ (25,161)	$ (22,605)	$ (13,992)	$ (141,145)	$ (6,781)	$ 12,669	$ (184,523)	$ 31,251
Less: Net loss (income) attributable to non-controlling interests	1,033	4	2,700	790	1,918	(163)	264	(453)	4,527	1,566	(146)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders									17,196	(182,957)	31,105
Income (loss) from discontinued operations, net of tax									395,138	30,348	(28,221)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	(12,148)	(12,149)	(12,148)	(12,149)	(10,963)	(10,962)	(10,963)	(10,962)	(48,594)	(43,850)	(28,536)
Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders									346,544	(13,502)	(56,757)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 374,781	$ (35,991)	$ 64,824	$ (39,874)	$ 5,818	$ (28,587)	$ (153,710)	$ (19,980)	$ 363,740	$ (196,459)	$ (25,652)
Weighted-average common shares outstanding									176,038	180,830	186,188
Basic Income (Loss) from continuing operations per Common Share	$ (0.19)	$ (0.07)	$ 0.49	$ (0.14)	$ (0.12)	$ (0.08)	$ (0.78)	$ (0.04)	$ 0.10	$ (1.02)	$ 0.17
Basic Income (Loss) from discontinued operations per Common Share	2.36	(0.13)	(0.13)	(0.08)	0.15	(0.08)	(0.07)	(0.07)	1.97	(0.07)	(0.31)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ 2.17	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.07	$ (1.09)	$ (0.14)
Diluted Income (Loss) per Common Share:
Income (loss) from continuing operations, net of tax									$ 12,669	$ (184,523)	$ 31,251
Less: Net loss (income) attributable to non-controlling interests	$ 1,033	$ 4	$ 2,700	$ 790	$ 1,918	$ (163)	$ 264	$ (453)	4,527	1,566	(146)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders									17,196	(182,957)	31,105
Less: Income (loss) from discontinued operations	420,491	(11,705)	(10,294)	(3,354)	37,468	(3,470)	(1,866)	(1,784)	395,138	30,348	(28,221)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	$ 12,148	$ 12,149	$ 12,148	$ 12,149	$ 10,963	$ 10,962	$ 10,963	$ 10,962	48,594	43,850	28,536
Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders									346,544	(13,502)	(56,757)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 363,740	$ (196,459)	$ (25,652)
Weighted-average common shares outstanding									176,038	180,830	186,188
Dilutive effect of stock options, restricted stock unit awards and warrants									2,491	0	0
Weighted-average common shares outstanding assuming dilution									178,529	180,830	186,188
Diluted Income (Loss) from continuing operations per Common Share	$ (0.19)	$ (0.07)	$ 0.49	$ (0.14)	$ (0.12)	$ (0.08)	$ (0.78)	$ (0.04)	$ 0.10	$ (1.02)	$ 0.17
Diluted Income (Loss) from discontinued operations per Common Share	2.33	(0.13)	(0.13)	(0.08)	0.15	(0.08)	(0.07)	(0.07)	1.94	(0.07)	(0.31)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ 2.14	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.04	$ (1.09)	$ (0.14)

Anti-Dilutive Stock Options, Re

Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share (Detail) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share [Abstract]
Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation	26,175	26,515	25,277

Components of Accumulated Other

Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	$ 1,120,882
Other comprehensive (loss) income before reclassifications	(3,172)	$ (101,396)	$ (57,265)
Net losses (gains) reclassified from accumulated other comprehensive loss	(232)	161,240	(322)
Total other comprehensive (loss) income	(3,404)	59,844	(57,587)
Balance at the end of the period	1,551,113	1,120,882
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	(2,676)	(6,028)	(4,500)
Other comprehensive (loss) income before reclassifications	(2,908)	3,352	(1,528)
Net losses (gains) reclassified from accumulated other comprehensive loss	0	0	0
Total other comprehensive (loss) income	(2,908)	3,352	(1,528)
Balance at the end of the period	(5,584)	(2,676)	(6,028)
Unrealized Net Gains (Losses) on Available for Sale Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	0	(56,420)	0
Other comprehensive (loss) income before reclassifications	0	(106,445)	(56,420)
Net losses (gains) reclassified from accumulated other comprehensive loss	0	162,865	0
Total other comprehensive (loss) income	0	56,420	(56,420)
Balance at the end of the period	0	0	(56,420)
Derivatives Qualifying as Cash Flow Hedges [Member] | Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	691	619	258
Other comprehensive (loss) income before reclassifications	(264)	1,697	683
Net losses (gains) reclassified from accumulated other comprehensive loss	(232)	(1,625)	(322)
Total other comprehensive (loss) income	(496)	72	361
Balance at the end of the period	195	691	619
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	(1,985)	(61,829)	(4,242)
Balance at the end of the period	$ (5,389)	$ (1,985)	$ (61,829)

Components of Accumulated Oth_2

Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - Foreign Exchange Contract [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)	$ 68	$ 445
Revaluation of tax effects	$ 149
Unrealized Net Gains (Losses) on Marketable Securities and Foreign Exchange Contracts [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)			$ 463	$ 166

Income Tax Effects Related to C

Income Tax Effects Related to Components of Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accumulated Other Comprehensive Income Loss [Line Items]
Foreign currency translation adjustments, Before-Tax Amount	$ (2,908)	$ 3,352	$ (1,528)
Net change in unrealized (losses) gains on available for sale securities, Before-Tax Amount	0	56,359	(56,359)
Derivatives qualifying as cash flow hedges, net gain (loss), Before-Tax Amount	(873)	114	597
Other comprehensive loss, Before-Tax Amount	(3,781)	59,825	(57,290)
Foreign currency translation adjustments, Tax Effect	0	0	0
Other comprehensive loss, Tax Effect	377	19	(297)
Foreign currency translation adjustments, Net	(2,908)	3,352	(1,528)
Other comprehensive loss, Net	(3,404)	59,844	(57,587)
Unrealized Net Gains (Losses) on Available for Sale Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Available for sale securities, net gain (loss) arising during the period, Before-Tax Amount		(106,506)	(56,359)
Available for sale securities, net (gain) loss reclassified into income, Before-Tax Amount		162,865	0
Net change in unrealized (losses) gains on available for sale securities, Before-Tax Amount		56,359	(56,359)
Available for sale securities, net gain (loss) arising during the period, Tax Effect		61	(61)
Available for sale securities, net (gain) loss reclassified into income, Tax Effect		0	0
Net change in unrealized (losses) gains on available for sale securities, Tax Effect		61	(61)
Available for sale securities, net gain (loss) arising during the period, Net		(106,445)	(56,420)
Available for sale securities, net (gain) loss reclassified into income, Net		162,865	0
Net change in unrealized (losses) gains on available for sale securities, Net		56,420	(56,420)
Other comprehensive loss, Net	0	56,420	(56,420)
Derivatives Qualifying as Cash Flow Hedges [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Derivatives qualifying as cash flow hedges, net gain (loss), Before-Tax Amount	(873)	114	597
Derivatives qualifying as cash flow hedges, net gain (loss), Tax Effect	377	(42)	(236)
Derivatives qualifying as cash flow hedges, net gain (loss), Net	(496)	72	361
Derivatives Qualifying as Cash Flow Hedges [Member] | Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Before-Tax Amount	(357)	2,776	1,128
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Before-Tax Amount	(516)	(2,662)	(531)
Derivatives qualifying as cash flow hedges, net gain (loss), Before-Tax Amount	(873)	114	597
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Tax Effect	93	(1,079)	(445)
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Tax Effect	284	1,037	209
Derivatives qualifying as cash flow hedges, net gain (loss), Tax Effect	377	(42)	(236)
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Net	(264)	1,697	683
Derivatives qualifying as cash flow hedges, net (gains) losses reclassified into income, Net	(232)	(1,625)	(322)
Derivatives qualifying as cash flow hedges, net gain (loss), Net	(496)	72	361
Other comprehensive loss, Net	$ (496)	$ 72	$ 361

Income Tax Effects Related to_2

Income Tax Effects Related to Components of Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)	$ 68	$ 445

Fair Value and Balance Sheet Lo

Fair Value and Balance Sheet Locations - (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Derivatives Fair Value [Line Items]
Derivative asset, fair value	$ 9,366	$ 47,714
Derivative liability, fair value	9,974	47,777
1.25% Call Option [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	9,104	46,578
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Prepaid Expenses and Other Current Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	262	1,136
Designated as Hedging Instrument [Member] | Foreign Exchange Contract [Member] | Accrued expenses [Member]
Derivatives Fair Value [Line Items]
Derivative liability, fair value	0	0
Not Designated as Hedging Instrument [Member] | 1.25% Call Option [Member] | Other Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	9,104	46,578
Not Designated as Hedging Instrument [Member] | 1.25% Embedded Cash Conversion Option [Member] | Other Liabilities [Member]
Derivatives Fair Value [Line Items]
Derivative liability, fair value	$ 9,974	$ 47,777

Derivative Financial Instrume_3

Derivative Financial Instruments - Additional Information (Detail)	1 Months Ended	12 Months Ended
	Jun. 30, 2013USD ($)	Dec. 31, 2018USD ($)Derivative$ / shares	Dec. 31, 2013USD ($)	Dec. 31, 2018INR (₨)Derivative	Dec. 31, 2017	Jun. 18, 2013USD ($)$ / shares
Derivative [Line Items]
Purchase of call option related to 1.25% senior cash convertible notes	$ 82,800,000
1.25% Call Option [Member]
Derivative [Line Items]
Debt instrument interest rate		1.25%		1.25%	1.25%
1.25% Cash Convertible Senior Notes [Member]
Derivative [Line Items]
Purchase of call option related to 1.25% senior cash convertible notes			$ 82,800,000
Conversion price per common stock | $ / shares		$ 17.19				$ 17.19
Fair value liability of embedded cash conversion option						$ 82,800,000
Debt instrument interest rate		1.25%		1.25%
Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Number of contracts | Derivative		12		12
Derivative notional amount outstanding		$ 2,300,000		₨ 160,000,000
Amount of Gain (Loss) Recognized in AOCI (Effective Portion)		0
Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)		0
Unrealized derivatives gains included in other comprehensive (loss) income reclassified into income		$ 300,000
Estimated period of unrealized gains included in AOCI reclassified into income		12 months
Foreign Exchange Forward Contracts [Member] | Minimum [Member]
Derivative [Line Items]
Date of contracts mature		Jan. 31, 2019
Foreign Exchange Forward Contracts [Member] | Maximum [Member]
Derivative [Line Items]
Date of contracts mature		Dec. 31, 2019
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative [Line Items]
Debt instrument interest rate		1.25%		1.25%
1.25% Notes Embedded Cash Conversion Option [Member] | Level 3 [Member] | Fair Value Measurements, Recurring [Member]
Derivative [Line Items]
Fair value liability of embedded cash conversion option						$ 82,800,000

Derivatives Instruments Designa

Derivatives Instruments Designated as Cash Flow Hedges - (Detail) - Cash Flow Hedging [Member] - Foreign Exchange Contract [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Derivative Instruments Gain Loss [Line Items]
Derivatives qualifying as cash flow hedges, net gains (losses) arising during the period, Before-Tax Amount	$ (357)	$ 2,776	$ 1,128
Cost of revenue [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	165	905	165
Selling, General and Administrative Expenses [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	138	692	133
Research and development [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	$ 214	$ 1,065	$ 233

Net Impact of Changes in Fair V

Net Impact of Changes in Fair Value of Call Option and Embedded Cash Conversion Option - (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Derivative Instruments Gain Loss [Line Items]
Net loss included in other income, net	$ 329	$ (620)	$ 423
1.25% Call Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net loss included in other income, net	(37,474)	29,498	(63,128)
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net loss included in other income, net	$ 37,803	$ (30,118)	$ 63,551

Rent Expense (Detail)

Rent Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Commitments And Contingencies Disclosure [Abstract]
Rent expense	$ 28,677	$ 22,499	$ 18,113

Future Commitments under Capita

Future Commitments under Capital and Operating Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Capital Leases, 2019	$ 1,351
Capital Leases, 2020	422
Capital Leases, 2021	46
Capital Leases, 2022	14
Capital Leases, 2023	0
Capital Leases, thereafter	0
Capital Leases, total	1,833
Capital Leases, less amount representing interest	(69)
Capital Leases, future minimum payments, present value of net minimum payments	1,764
Capital Leases, Current maturities of capital lease obligations	996	$ 1,102
Capital lease obligations, net of current maturities	768	$ 2,347
Operating Leases, 2019	26,330
Operating Leases, 2020	22,394
Operating Leases, 2021	18,824
Operating Leases, 2022	17,493
Operating Leases, 2023	15,582
Operating Leases, Thereafter	31,658
Operating Leases, Total	$ 132,281

Commitments - Additional Inform

Commitments - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2018USD ($)
Commitments And Contingencies Disclosure [Abstract]
Private cloud hosting service support agreement expiry	2,023
Private cloud hosting service support agreement extension term	2 years
Base annual payment obligation for data center and hosting services	$ 30
Base annual payment obligation for data center and hosting services by the end of 2023	$ 25

Summary of Expense Incurred und

Summary of Expense Incurred under Atos Agreement (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Long Term Purchase Commitment [Line Items]
Expenses incurred under Atos agreement	$ 254,187	$ 254,478	$ 267,697	$ 249,057	$ 260,208	$ 205,843	$ 199,930	$ 198,928	$ 1,025,419	$ 864,909	$ 784,770
Atos [Member]
Long Term Purchase Commitment [Line Items]
Expenses incurred under Atos agreement									$ 55,903	$ 58,787	$ 62,266

Discontinued Operations - Addit

Discontinued Operations - Additional Information (Detail)	9 Months Ended	12 Months Ended
	Dec. 31, 2018USD ($)Offering	Dec. 31, 2018USD ($)
Netsmart [Member] | Class A Common Units [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Sale price	$ 566,600,000	$ 566,600,000
Horizon Clinicals and Series2000 [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Number of product offerings acquired | Offering	2
Gain (Loss) on disposal of discontinued solutions before tax		$ 0

Summary of Major Classes of Ass

Summary of Major Classes of Assets and Liabilities Reported on Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Carrying amounts of major classes of assets included as part of assets attributable to discontinued operations:
Total current assets attributable to discontinued operations	$ 0	$ 127,101
Carrying amounts of major classes of liabilities included as part of liabilities attributable to discontinued operations:
Total current liabilities attributable to discontinued operations	920	135,641
Total noncurrent liabilities attributable to discontinued operations	0	707,516
Redeemable convertible non-controlling interest attributable to discontinued operations	0	431,535
Netsmart [Member]
Carrying amounts of major classes of assets included as part of assets attributable to discontinued operations:
Cash and cash equivalents		31,504
Accounts receivable, net		75,313
Prepaid expenses and other current assets		9,008
Total current assets attributable to discontinued operations		115,825
Fixed assets, net		30,186
Software development costs, net		27,344
Intangible assets, net		391,299
Goodwill		712,206
Other assets		1,998
Total noncurrent assets attributable to discontinued operations		1,163,033
Carrying amounts of major classes of liabilities included as part of liabilities attributable to discontinued operations:
Accounts payable		11,834
Accrued expenses		8,115
Accrued compensation and benefits		16,560
Deferred revenue		68,256
Current maturities of non-recourse long-term debt - Netsmart		2,755
Current maturities of capital lease obligations		6,763
Total current liabilities attributable to discontinued operations		114,283
Non-recourse long-term debt - Netsmart		625,193
Long-term capital lease obligations		4,758
Deferred revenue long-term		4,838
Deferred taxes, net		70,385
Other liabilities		2,342
Total noncurrent liabilities attributable to discontinued operations		707,516
Redeemable convertible non-controlling interest attributable to discontinued operations		431,535
Non-controlling interest attributable to discontinued operations		48
Horizon Clinicals and Series2000 [Member]
Carrying amounts of major classes of assets included as part of assets attributable to discontinued operations:
Accounts receivable, net	0	8,196
Prepaid expenses and other current assets	0	3,080
Total current assets attributable to discontinued operations	0	11,276
Carrying amounts of major classes of liabilities included as part of liabilities attributable to discontinued operations:
Accounts payable	0	114
Accrued expenses	920	5,599
Accrued compensation and benefits	0	7,728
Deferred revenue	0	7,241
Other classes of liabilities that are not major	0	676
Total current liabilities attributable to discontinued operations	$ 920	$ 21,358

Summary of Major Income and Exp

Summary of Major Income and Expense Line Items Reported in Consolidated Statements of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cost of revenue:
(Loss) income from discontinued operations before income taxes	$ (39,854)	$ (13,857)	$ (14,109)	$ (5,016)					$ (72,836)	$ (11,915)	$ (46,344)
Income tax benefit (provision)	(40,126)	2,152	3,815	1,662					(32,497)	42,263	18,123
Income (loss) from discontinued operations, net of tax	$ 420,491	$ (11,705)	$ (10,294)	$ (3,354)	$ 37,468	$ (3,470)	$ (1,866)	$ (1,784)	395,138	30,348	(28,221)
Netsmart [Member]
Revenue:
Total revenue									345,231	308,634	163,830
Cost of revenue:
Total cost of revenue									188,518	159,272	94,090
Amortization of software development and acquisition related assets									34,357	29,876	17,416
Gross profit									156,713	149,362	69,740
Selling, general and administrative expenses									125,807	85,583	58,344
Research and development									25,315	17,937	9,372
Amortization of intangible and acquisition-related assets									24,029	16,409	9,963
(Loss) income from discontinued operations before income taxes									(18,438)	29,433	(7,939)
Interest expense									(59,541)	(49,939)	(38,663)
Other income									101	925	258
Income tax benefit (provision)									22,933	45,253	18,123
Income (loss) from discontinued operations, net of tax									(54,945)	25,672	(28,221)
Horizon Clinicals and Series2000 [Member]
Revenue:
Total revenue									9,845	11,993
Cost of revenue:
Total cost of revenue									3,152	3,179
Gross profit									6,693	8,814
Research and development									1,651	1,148
(Loss) income from discontinued operations before income taxes									5,042	7,666
Income tax benefit (provision)									(1,311)	(2,990)
Income (loss) from discontinued operations, net of tax									3,731	4,676
Software delivery, Support and Maintenance [Member] | Netsmart [Member]
Revenue:
Total revenue									214,065	198,204	104,319
Cost of revenue:
Total cost of revenue									60,100	51,079	36,823
Software delivery, Support and Maintenance [Member] | Horizon Clinicals and Series2000 [Member]
Revenue:
Total revenue									9,441	10,949
Cost of revenue:
Total cost of revenue									2,322	2,918
Client services [Member] | Netsmart [Member]
Revenue:
Total revenue									131,166	110,430	59,511
Cost of revenue:
Total cost of revenue									94,061	78,317	$ 39,851
Client services [Member] | Horizon Clinicals and Series2000 [Member]
Revenue:
Total revenue									404	1,044
Cost of revenue:
Total cost of revenue									$ 830	$ 261

Business Segments - Additional

Business Segments - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018Segment	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments | Segment	2
Number of operating segments | Segment	8
Clinical and Financial Solutions [Member]
Segment Reporting Information [Line Items]
Increase in gross profit		$ 3,000,000	$ 2,000,000
Increase in operating income loss		38,000,000	44,000,000
Population Health [Member]
Segment Reporting Information [Line Items]
Increase in gross profit		0	0
Increase in operating income loss		$ 1,000,000	$ 2,000,000
Number of operating segments | Segment	3

Revenues and Income from Operat

Revenues and Income from Operations Related to Segment Within Reconciliation to Consolidated Amounts (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Segment Reporting Information [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Gross profit	188,159	177,952	173,767	184,665	176,203	162,248	150,220	144,128	724,543	632,799	601,299
Income (loss) from operations	$ (26,443)	$ 186	$ (60,094)	$ (6,701)	$ (21,259)	$ 18,157	$ 13,237	$ 2,349	(93,052)	12,484	67,710
Unallocated Amounts [Member]
Segment Reporting Information [Line Items]
Total revenue									(6,731)	(13,131)	25,479
Gross profit									(85,076)	(84,101)	(44,634)
Income (loss) from operations									(537,738)	(435,098)	(343,052)
Clinical and Financial Solutions [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
Total revenue									1,565,987	1,337,030	1,183,196
Gross profit									663,005	574,386	496,595
Income (loss) from operations									344,568	335,005	287,077
Population Health [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
Total revenue									190,706	173,809	177,394
Gross profit									146,614	142,514	149,338
Income (loss) from operations									$ 100,118	$ 112,577	$ 123,685

Supplemental Disclosures (Detai

Supplemental Disclosures (Detail) - USD ($) $ in Thousands	Aug. 25, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents		$ 174,243				$ 119,470				$ 174,243	$ 119,470
Restricted cash		10,552				11,524				10,552	11,524
Total cash, cash equivalents and restricted cash		184,795				130,994				184,795	130,994	$ 71,546
Interest										28,888	21,183	14,989
Income taxes paid, net of tax refunds										10,108	6,675	5,466
Non-cash transactions:
Obligations incurred to purchase capitalized software or enter into capital leases										1,501	1,897	27,127
Contribution of assets in exchange for equity interest										4,000	0	0
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations		$ 12,148	$ 12,149	$ 12,148	$ 12,149	$ 10,963	$ 10,962	$ 10,963	$ 10,962	48,594	43,850	28,536
Issuance of treasury stock										1,121	334	0
NantHealth, Inc. [Member]
Non-cash transactions:
Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement	$ 42,750									$ 0	$ 42,750	$ 0

Accrued Expenses (Detail)

Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Payables And Accruals [Abstract]
Royalties, certain third-party product costs and licenses	$ 26,371	$ 14,195
Other	79,701	63,605
Total accrued expenses	$ 106,072	$ 77,800

Supplemental Disclosures - Addi

Supplemental Disclosures - Additional Information (Detail)	Dec. 31, 2018
Supplemental Disclosures [Abstract]
Maximum percentage accounted by individual expenses of total current liabilities	5.00%

Other Assets (Detail)

Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Other Assets Noncurrent [Line Items]
Total other assets	$ 109,206	$ 146,851
Derivative asset, fair value	9,366	47,714
Long-term deferred hosting fees	20,805	0
Long-term prepaid commissions	32,660	32,938
Investments in non-marketable securities	37,040	30,013
Long-term deposits and other assets	9,597	15,070
Nant Health, LLC [Member]
Other Assets Noncurrent [Line Items]
Total other assets	0	22,252
1.25% Call Option [Member]
Other Assets Noncurrent [Line Items]
Derivative asset, fair value	$ 9,104	$ 46,578

Other Assets (Parenthetical) (D

Other Assets (Parenthetical) (Detail)	Dec. 31, 2018	Dec. 31, 2017
1.25% Call Option [Member]
Other Assets Noncurrent [Line Items]
Debt instrument interest rate	1.25%	1.25%

Revenues by Geographic Area (De

Revenues by Geographic Area (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Schedule Of Revenues From External Customers [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
United States [Member]
Schedule Of Revenues From External Customers [Line Items]
Total revenue									1,697,178	1,440,842	1,336,799
Canada [Member]
Schedule Of Revenues From External Customers [Line Items]
Total revenue									15,377	15,818	18,694
Other International [Member]
Schedule Of Revenues From External Customers [Line Items]
Total revenue									$ 37,407	$ 41,048	$ 30,576

Long-Lived Assets by Geographic

Long-Lived Assets by Geographic Area (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	$ 121,913	$ 135,417
United States [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	111,836	129,021
India [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	4,231	4,154
Israel [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	3,830	1,322
Canada [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	60	146
Other International [Member]
Long-Lived Assets by Geographical Areas [Line Items]
Long lived assets	$ 1,956	$ 774

Contingencies - Additional Info

Contingencies - Additional Information (Detail)	May 01, 2012USD ($)
Commitments And Contingencies Disclosure [Abstract]
Plaintiff sought amount for each alleged violation	$ 500

Quarterly Financial Informati_3

Quarterly Financial Information (Unaudited) (Detail) - USD ($)	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Revenue			$ 442,346,000	$ 432,430,000	$ 441,464,000	$ 433,722,000	$ 436,411,000	$ 368,091,000	$ 350,150,000	$ 343,056,000	$ 1,749,962,000	$ 1,497,708,000	$ 1,386,069,000
Cost of revenue			254,187,000	254,478,000	267,697,000	249,057,000	260,208,000	205,843,000	199,930,000	198,928,000	1,025,419,000	864,909,000	784,770,000
Gross profit			188,159,000	177,952,000	173,767,000	184,665,000	176,203,000	162,248,000	150,220,000	144,128,000	724,543,000	632,799,000	601,299,000
Selling, general and administrative expenses			99,992,000	108,125,000	122,913,000	119,937,000	123,113,000	93,790,000	91,033,000	92,752,000	450,967,000	400,688,000	334,521,000
Research and development			66,096,000	63,032,000	74,491,000	64,790,000	68,344,000	46,485,000	42,205,000	45,248,000	268,409,000	202,282,000	178,534,000
Asset impairment charges			28,091,000	0	30,075,000	0					58,166,000	0	4,650,000
Goodwill impairment charge	$ 0	$ 0	13,466,000	0	0	0					13,466,000	0	0
Amortization of intangible and acquisition-related assets			6,957,000	6,609,000	6,382,000	6,639,000	6,005,000	3,816,000	3,745,000	3,779,000	26,587,000	17,345,000	15,884,000
(Loss) income from operations			(26,443,000)	186,000	(60,094,000)	(6,701,000)	(21,259,000)	18,157,000	13,237,000	2,349,000	(93,052,000)	12,484,000	67,710,000
Interest expense			(13,989,000)	(13,251,000)	(11,979,000)	(11,695,000)	(11,594,000)	(9,251,000)	(8,279,000)	(8,416,000)	(50,914,000)	(37,540,000)	(29,478,000)
Other income (loss), net			658,000	(536,000)	(14,000)	(34,000)	160,000	(685,000)	(222,000)	235,000	74,000	(512,000)	829,000
Gain on sale of businesses, net			0	0	173,129,000	(871,000)					172,258,000	0	0
Impairment of and losses on long-term investments			0	0	(9,987,000)	(5,500,000)	0	(20,700,000)	(144,590,000)	0	(15,487,000)	(165,290,000)	0
Equity in net (loss) income of unconsolidated investments			(270,000)	(177,000)	767,000	(61,000)	115,000	449,000	(28,000)	285,000	259,000	821,000	(7,501,000)
Income (loss) from continuing operations before income taxes			(40,044,000)	(13,778,000)	91,822,000	(24,862,000)	(32,578,000)	(12,030,000)	(139,882,000)	(5,547,000)	13,138,000	(190,037,000)	31,560,000
Income tax (provision) benefit			5,449,000	1,637,000	(7,256,000)	(299,000)	9,973,000	(1,962,000)	(1,263,000)	(1,234,000)	(469,000)	5,514,000	(309,000)
Income (loss) from continuing operations, net of tax			(34,595,000)	(12,141,000)	84,566,000	(25,161,000)	(22,605,000)	(13,992,000)	(141,145,000)	(6,781,000)	12,669,000	(184,523,000)	31,251,000
Loss from discontinued operations			(39,854,000)	(13,857,000)	(14,109,000)	(5,016,000)					(72,836,000)	(11,915,000)	(46,344,000)
Gain on sale of Netsmart			500,471,000	0	0	0					500,471,000	0	0
Income tax effect on discontinued operations			(40,126,000)	2,152,000	3,815,000	1,662,000					(32,497,000)	42,263,000	18,123,000
Income (loss) from discontinued operations, net of tax			420,491,000	(11,705,000)	(10,294,000)	(3,354,000)	37,468,000	(3,470,000)	(1,866,000)	(1,784,000)	395,138,000	30,348,000	(28,221,000)
Net income (loss)			385,896,000	(23,846,000)	74,272,000	(28,515,000)	14,863,000	(17,462,000)	(143,011,000)	(8,565,000)	407,807,000	(154,175,000)	3,030,000
Less: Net loss (income) attributable to non-controlling interests			1,033,000	4,000	2,700,000	790,000	1,918,000	(163,000)	264,000	(453,000)	4,527,000	1,566,000	(146,000)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations			(12,148,000)	(12,149,000)	(12,148,000)	(12,149,000)	(10,963,000)	(10,962,000)	(10,963,000)	(10,962,000)	(48,594,000)	(43,850,000)	(28,536,000)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders			$ 374,781,000	$ (35,991,000)	$ 64,824,000	$ (39,874,000)	$ 5,818,000	$ (28,587,000)	$ (153,710,000)	$ (19,980,000)	$ 363,740,000	$ (196,459,000)	$ (25,652,000)
Basic
Continuing operations			$ (0.19)	$ (0.07)	$ 0.49	$ (0.14)	$ (0.12)	$ (0.08)	$ (0.78)	$ (0.04)	$ 0.10	$ (1.02)	$ 0.17
Discontinued operations			2.36	(0.13)	(0.13)	(0.08)	0.15	(0.08)	(0.07)	(0.07)	1.97	(0.07)	(0.31)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share			2.17	(0.20)	0.36	(0.22)	0.03	(0.16)	(0.85)	(0.11)	2.07	(1.09)	(0.14)
Diluted
Continuing operations			(0.19)	(0.07)	0.49	(0.14)	(0.12)	(0.08)	(0.78)	(0.04)	0.10	(1.02)	0.17
Discontinued operations			2.33	(0.13)	(0.13)	(0.08)	0.15	(0.08)	(0.07)	(0.07)	1.94	(0.07)	(0.31)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share			$ 2.14	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.04	$ (1.09)	$ (0.14)

Schedule II - Valuation And Qua

Schedule II - Valuation And Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Valuation And Qualifying Accounts [Abstract]
Beginning Balance	$ 31,386	$ 28,655	$ 31,266
Charged to Expenses/Against Revenue	21,156	7,384	6,979
Deferred Revenue Reclassification	5,512	1,482	661
Write-Offs, Net of Recoveries	(7,648)	(6,135)	(10,251)
Ending Balance	$ 50,406	$ 31,386	$ 28,655