Veradigm (MDRX) 10-Q 3 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	May 01, 2019
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Trading Symbol	MDRX
Entity Registrant Name	ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
Entity Central Index Key	0001124804
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		166,438,125

CONSOLIDATED BALANCE SHEETS (Un

CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 137,167	$ 174,243
Restricted cash	10,681	10,552
Accounts receivable, net of allowance of $39,214 and $50,406 as of March 31, 2019 and December 31, 2018, respectively	457,960	465,264
Contract assets	95,077	66,451
Prepaid expenses and other current assets	133,448	142,455
Total current assets	834,333	858,965
Fixed assets, net	115,564	121,913
Software development costs, net	219,047	209,660
Intangible assets, net	415,437	431,081
Goodwill	1,373,996	1,373,744
Deferred taxes, net	4,946	5,036
Contract assets - long-term	72,042	71,879
Right-of-use assets - operating leases	97,411	0
Other assets	109,632	109,206
Total assets	3,242,408	3,181,484
Current liabilities:
Accounts payable	80,585	73,166
Accrued expenses	108,773	107,068
Accrued compensation and benefits	61,500	100,076
Income tax payable	0	29,644
Deferred revenue	504,089	466,797
Current maturities of long-term debt	20,518	20,059
Current operating lease liabilities	24,154	0
Current liabilities attributable to discontinued operations	0	920
Total current liabilities	799,619	797,730
Long-term debt	766,240	647,539
Deferred revenue	13,089	15,984
Deferred taxes, net	58,366	58,470
Long-term operating lease liabilities	95,112	0
Other liabilities	53,865	81,334
Total liabilities	1,786,291	1,601,057
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of March 31, 2019 and December 31, 2018	0	0
Common stock: $0.01 par value, 349,000 shares authorized as of March 31, 2019 and December 31, 2018; 272,013 and 166,134 shares issued and outstanding as of March 31, 2019, respectively; 270,955 and 171,224 shares issued and outstanding as of December 31, 2018, respectively	2,719	2,709
Treasury stock: at cost, 105,879 and 99,731 shares as of March 31, 2019 and December 31, 2018, respectively	(525,613)	(460,543)
Additional paid-in capital	1,858,319	1,881,494
Retained earnings (accumulated deficit)	125,289	132,842
Accumulated other comprehensive loss	(4,597)	(5,389)
Total Allscripts Healthcare Solutions, Inc.'s stockholders' equity	1,456,117	1,551,113
Non-controlling interest	0	29,314
Total stockholders’ equity	1,456,117	1,580,427
Total liabilities and stockholders’ equity	$ 3,242,408	$ 3,181,484

CONSOLIDATED BALANCE SHEETS (_2

CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Statement Of Financial Position [Abstract]
Accounts receivable, allowance	$ 39,214	$ 50,406
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	272,013,000	270,955,000
Common stock, shares outstanding	166,134,000	171,224,000
Treasury stock at cost, shares	105,879,000	99,731,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue:
Revenue from contract with customers	$ 432,049	$ 433,722
Cost of revenue:
Amortization of software development and acquisition-related assets	28,222	25,959
Total cost of revenue	257,954	249,057
Gross profit	174,095	184,665
Selling, general and administrative expenses	100,245	119,937
Research and development	64,310	64,790
Asset impairment charges	98	0
Amortization of intangible and acquisition-related assets	6,797	6,639
Income (loss) from operations	2,645	(6,701)
Interest expense	(10,184)	(11,694)
Other income (loss), net	513	(35)
Loss on sale of businesses, net	0	(871)
Recovery (impairment) of long-term investments	1,045	(5,500)
Equity in net loss of unconsolidated investments	(64)	(61)
Loss from continuing operations before income taxes	(6,045)	(24,862)
Income tax provision	1,932	299
Loss from continuing operations, net of tax	(7,977)	(25,161)
Loss from discontinued operations	0	(5,016)
Income tax effect on discontinued operations	0	1,662
Loss from discontinued operations, net of tax	0	(3,354)
Net loss	(7,977)	(28,515)
Net loss attributable to non-controlling interests	424	790
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	0	(12,149)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (7,553)	$ (39,874)
Basic
Continuing operations	$ (0.04)	$ (0.14)
Discontinued operations	0	(0.08)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	(0.04)	(0.22)
Diluted
Continuing operations	(0.04)	(0.14)
Discontinued operations	0	(0.08)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ (0.04)	$ (0.22)
Software delivery, Support and Maintenance [Member]
Revenue:
Revenue from contract with customers	$ 275,512	$ 280,553
Cost of revenue:
Total cost of revenue	88,133	86,010
Client services [Member]
Revenue:
Revenue from contract with customers	156,537	153,169
Cost of revenue:
Total cost of revenue	$ 141,599	$ 137,088

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net loss	$ (7,977)	$ (28,515)
Other comprehensive (loss) income:
Foreign currency translation adjustments	695	123
Change in fair value of derivatives qualifying as cash flow hedges	132	(633)
Other comprehensive income (loss) before income tax (expense) benefit	827	(510)
Income tax (expense) benefit related to items in other comprehensive (loss) income	(35)	314
Total other comprehensive income (loss)	792	(196)
Comprehensive loss	(7,185)	(28,711)
Comprehensive loss attributable to non-controlling interests	424	790
Comprehensive (loss) income, net	$ (6,761)	$ (27,921)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock Issued [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Retained Earnings (Accumulated Deficit) [Member]	Accumulated Other Comprehensive Loss [Member]	Non-controlling interest [Member]
Beginning Balance, Shares at Dec. 31, 2017		269,335	(88,504)
Beginning Balance at Dec. 31, 2017	$ 1,160,072	$ 2,693	$ (322,735)	$ 1,781,059	$ (338,150)	$ (1,985)	$ 39,190
Stock-based compensation				9,935
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,266
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 13		(8,296)
Issuance of treasury stock, Shares			0
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations				(12,149)
Subsidiary issuance of common stock				(430)
Purchase of treasury stock, Shares			(4,144)
Purchase of treasury stock			$ (57,600)
Warrants issued				682
Net loss less net income attributable to non-controlling interests					(27,725)
ASC 606 implementation adjustments					46,604
Foreign currency translation adjustments, net	123					123
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						(319)
Acquisition of non-controlling interest				0			0
Net loss attributable to non-controlling interests	(790)						(790)
Ending Balance, Shares at Mar. 31, 2018		270,601	(92,648)
Ending Balance at Mar. 31, 2018	1,110,120	$ 2,706	$ (380,335)	1,770,801	(319,271)	(2,181)	38,400
Beginning Balance, Shares at Dec. 31, 2017		269,335	(88,504)
Beginning Balance at Dec. 31, 2017	$ 1,160,072	$ 2,693	$ (322,735)	1,781,059	(338,150)	(1,985)	39,190
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares	1,600
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
Stock-based compensation				11,394
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares	1,100	1,058
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 10		(5,338)
Issuance of treasury stock, Shares			0
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations				0
Subsidiary issuance of common stock				0
Purchase of treasury stock, Shares			(6,148)
Purchase of treasury stock			$ (65,070)
Warrants issued				682
Net loss less net income attributable to non-controlling interests					(7,553)
ASC 606 implementation adjustments					0
Foreign currency translation adjustments, net	$ 695					695
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						97
Acquisition of non-controlling interest				(29,913)			(28,890)
Net loss attributable to non-controlling interests	$ (424)						(424)
Ending Balance, Shares at Mar. 31, 2019	272,013	272,013	(105,879)
Ending Balance at Mar. 31, 2019	$ 1,456,117	$ 2,719	$ (525,613)	$ 1,858,319	$ 125,289	$ (4,597)	$ 0

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net loss	$ (7,977)	$ (28,515)
Less: Loss from discontinued operations	0	(3,354)
Loss from continuing operations	(7,977)	(25,161)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	50,126	47,948
Operating right-of-use asset amortization	5,320	0
Stock-based compensation expense	11,658	9,957
Deferred taxes	6	723
Asset impairment charges	98	0
(Recovery) impairment of long-term investments	(1,045)	5,500
Equity in net loss of unconsolidated investments	64	61
Loss on sale of businesses, net	0	871
Other income (losses), net	172	(941)
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable and contract assets, net	32,307	33,075
Prepaid expenses and other assets	3,658	(6,501)
Accounts payable	7,382	4,707
Accrued expenses	(4,847)	13,670
Accrued compensation and benefits	(39,525)	(18,610)
Deferred revenue	(17,107)	(13,894)
Other liabilities	1,380	2,910
Operating leases	(5,854)	0
Net cash provided by operating activities - continuing operations	35,816	54,315
Net cash (used in) provided by operating activities - discontinued operations	(30,000)	3,993
Net cash provided by operating activities	5,816	58,308
Cash flows from investing activities:
Capital expenditures	(4,847)	(7,508)
Capitalized software	(28,600)	(26,168)
Cash paid for business acquisitions, net of cash acquired	0	(107,212)
Sales (purchases) of equity securities, other investments and related intangible assets, net	32	0
Other proceeds from investing activities	5	37
Net cash used in investing activities - continuing operations	(33,410)	(140,851)
Net cash used in investing activities - discontinued operations	0	(8,961)
Net cash used in investing activities	(33,410)	(149,812)
Cash flows from financing activities:
Proceeds from sale or issuance of common stock	0	212
Taxes paid related to net share settlement of equity awards	(5,327)	(8,496)
Payments of lease obligations	(55)	(255)
Credit facility payments	(5,000)	0
Credit facility borrowings, net of issuance costs	120,000	145,843
Repurchase of common stock	(65,070)	(57,599)
Payment of acquisition financing obligations	0	(3,226)
Purchases of subsidiary shares owned by non-controlling interest	(54,064)	0
Net cash (used in) provided by financing activities - continuing operations	(9,516)	76,479
Net cash used in financing activities - discontinued operations	0	(3,766)
Net cash (used in) provided by financing activities	(9,516)	72,713
Effect of exchange rate changes on cash and cash equivalents	163	65
Net decrease in cash and cash equivalents	(36,947)	(18,726)
Cash, cash equivalents and restricted cash, beginning of period	184,795	162,498
Cash, cash equivalents and restricted cash, end of period	147,848	143,772
Less: Cash and cash equivalents included in current assets attributable to discontinued operations	0	(19,105)
Cash, cash equivalents and restricted cash, end of period, excluding discontinued operations	$ 147,848	$ 124,667

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	3 Months Ended
	Mar. 31, 2019
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. Unaudited Interim Financial Information The unaudited interim consolidated financial statements as of and for the three months ended March 31, 2019 and 2018 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make these unaudited interim consolidated financial statements not misleading. They should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2018 (our “Form 10-K”). Use of Estimates The preparation of consolidated financial statements in accordance with 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 the first quarter of 2019, we changed our reportable segments from Clinical and Financial Solutions, Population Health and Unallocated to Provider, Veradigm and Unallocated. The business units reported within the historical segments have been reallocated into the new segments. Refer to Note 15 “Business Segments” for further discussion on the impact of the change. Significant Accounting Policies We adopted Financial Accounting Standards Board (“FASB”) Accounting Standards Update No. 2016-02, “Leases (Topic 842)” (“ASU 2016-02”) on January 1, 2019 using the cumulative-effect adjustment transition method method requires us to recognize an adoption impact as a cumulative-effect adjustment to the January 1, 2019 retained earnings balance. tion. Recently Adopted Accounting Pronouncements In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities We adopted ASU 2017-12 on January 1, 2019 and the adoption did not have any effect on our consolidated financial statements. In June 2018, the FASB issued Accounting Standards Update No. 2018-07, “ Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting Accounting Pronouncements Not Yet Adopted 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” 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 We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, will have a material impact on our consolidated financial statements.

Revenue from Contracts with Cus

Revenue from Contracts with Customers	3 Months Ended
	Mar. 31, 2019
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 some clients, we host the software applications licensed from us using our own or third-party servers. 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. At March 31, 2019 and 2018, we had capitalized costs to obtain or fulfill a contract of $22.7 million and $27.4 million, respectively, in Prepaid and other current assets and $32.0 million and $37.3 million, respectively, in Other assets. During the three months ended March 31, 2019 and 2018, we recognized $7.6 million and $8.1 million, respectively, of amortization expense related to such capitalized costs, which is included in selling, general and administrative expenses within the consolidated statements of operations. 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, 2019 Revenue related to deferred revenue balance at beginning of period $ 126,184 Revenue related to new performance obligations satisfied during the period 248,221 Revenue recognized under "right-to-invoice" expedient 55,923 Reimbursed travel expenses, shipping and other revenue 1,721 Total revenue $ 432,049 (In thousands) Three Months Ended March 31, 2018 Revenue related to deferred revenue balance at beginning of period $ 181,398 Revenue related to new performance obligations satisfied during the period 200,232 Revenue recognized under "right-to-invoice" expedient 49,403 Reimbursed travel expenses, shipping and other revenue 2,689 Total revenue $ 433,722 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 $4.0 billion as of March 31, 2019, of which we expect to recognize approximately 38% over the next 12 months, and the remaining 62% thereafter. 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. We disaggregate our revenue from contracts with customers Three Months Ended March 31 (In thousands) 2019 2018 Revenue: Recurring revenue $ 348,636 $ 352,660 Non-recurring revenue 83,413 81,062 Total revenue $ 432,049 $ 433,722 Three Months Ended March 31, 2019 (In thousands) Provider Veradigm Unallocated Total Software delivery, support and maintenance $ 237,355 $ 34,042 $ 4,115 $ 275,512 Client services 155,252 1,074 211 156,537 Total revenue $ 392,607 $ 35,116 $ 4,326 $ 432,049 Three Months Ended March 31, 2018 (In thousands) Provider Veradigm Unallocated Total Software delivery, support and maintenance $ 257,754 $ 21,415 $ 1,384 $ 280,553 Client services 152,670 1,392 (893 ) 153,169 Total revenue $ 410,424 $ 22,807 $ 491 $ 433,722

Leases

Leases	3 Months Ended
	Mar. 31, 2019
Lessee Disclosure [Abstract]
Leases	3. Leases We adopted ASU 2016-02 The new guidance required the recognition of leased arrangements on the balance sheet as a right-of-use assets and liabilities pertaining to the rights and obligations created by the leased assets. We determine whether an arrangement is a lease at inception. Assets leased under an operating lease arrangement are recorded in Right-of-use assets – operating leases and the associated lease liability is included in Current operating lease liabilities and Long-term operating lease liabilities within the consolidated balance sheets. Assets leased under finance lease arrangements are recorded within fixed assets and the associated lease liabilities are recorded within Accrued expenses and Other liabilities within the consolidated balance sheets. Right-of-use assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease right-of-use assets and liabilities are recognized at commencement date based on the present value of lease payments over the expected lease term. Since our lease arrangements do not provide an implicit rate, we use our incremental borrowing rate in conjunction with the market swap rate for the expected remaining lease team at commencement date for new leases, or as of January 1, 2019 for existing leases, in determining the present value of future lease payments. Our expected lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Operating lease expense is recognized on a straight-line basis over the lease term. We have elected the group of practical expedients under ASU 2016-02 to forego assessing upon adoption: (1) whether any expired contracts are or contain leases; (2) the lease classification for any existing or expired leases and (3) any indirect costs that would have qualified for capitalization for any existing leases. We have lease agreements with lease and non-lease components, which are generally accounted for separately except for real estate and vehicle leases, which we have elected to combine through a practical expedient under ASU 2016-02. Non-lease components for our leases typically comprise of executory costs, which under the practical expedient allows for all executory costs to be recorded as lease payments. Additionally, for certain equipment leases, we apply a portfolio approach to effectively record right-of-use assets and liabilities . Our operating leases mainly include office leases and our finance leases include office and computer equipment leases. Our leases have remaining lease terms of approximately 1 year to 10 years, some of which include options to extend the leases for up to 5 years, which may include options to terminate the leases within 1 year. Total costs associated with leased assets are as follows: (In thousands) Three months ended March 31, 2019 Operating lease cost (1) $ 6,717 Less: Sublease income (802 ) Total operating lease costs 5,915 Finance lease costs: Amortization of right-of-use assets (2) 51 Interest on lease liability (3) 3 Total finance lease costs $ 54 (1) Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statement of operations. (2) Amortization of finance right-of-use assets is recognized on a straight-line basis and is included in in Selling, general and administrative expenses within the consolidated statement of operations. (3) Interest on finance lease liabilities is recorded as Interest expense within the consolidated statement of operations . Supplemental information for operating and finance leases is as follows: (In thousands) Three months ended March 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 7,287 Operating cash flows from finance leases $ 3 Financing cash flows from finance leases $ 37 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 124,811 Finance leases $ 263 The balance sheet location and balances for operating and finance leases are as follows: (In thousands, except lease term and discount rate) March 31, 2019 Operating leases: Right-of-use assets - operating leases $ 97,411 Current operating lease liabilities $ 24,154 Long-term operating lease liabilities $ 95,112 Finance leases: Fixed assets, gross $ 524 Accumulated depreciation 286 Fixed assets, net $ 238 Current finance lease liabilities (1) $ 130 Long-term finance lease liabilities (2) $ 97 Weighted average remaining lease term (in years) Operating leases 6 Finance leases 2 Weighted average discount rate Operating leases 4.6 % Finance leases 5.0 % (1) Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets. (2) Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets. The future maturities of our leasing arrangements including lease and non-lease components are shown in the below table. The maturities are calculated using foreign currency exchange rates in effect as of March 31, 2019. March 31, 2019 (in thousands) Operating Leases Finance Leases Remainder of 2019 $ 22,128 $ 107 2020 24,839 85 2021 20,773 40 2022 19,205 6 2023 16,817 0 Thereafter 33,171 0 Total lease liabilities 136,933 238 Less: Amount representing interest (17,667 ) (11 ) Less: Short-term lease liabilities (24,154 ) (130 ) Total long-term lease liabilities $ 95,112 $ 97

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2019
Business Combinations [Abstract]
Business Combinations	4. Business Combinations On March 1, 2019, we acquired all of the outstanding minority interest in Pulse8, Inc., a healthcare analytics and technology company that provides business intelligence software solutions for health plans and at-risk providers to enable them to analyze their risk adjustment and quality management programs, for $53.8 million (subject to adjustments for net working capital and a contingency holdback), plus up to a $10.0 million earnout based upon revenue targets through 2019. We initially acquired a controlling stake in Pulse 8, Inc. on September 8, 2016. 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 three months ended March 31, 2019.

Fair Value Measurements and Lon

Fair Value Measurements and Long-term Investments	3 Months Ended
	Mar. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value Measurements and Long-term Investments	5. Fair Value Measurements and Long-term Investments Fair value measurements are based upon observable and unobservable inputs. Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities at the measurement date. Level 2: Inputs, other than quoted prices included in Level 1, are observable for the asset or liability, either directly or indirectly. Level 3: Unobservable inputs are significant to the fair value of the asset or liability, and include situations where there is little, if any, market activity for the asset or liability. 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 March 31, 2019 December 31, 2018 (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 $ 394 $ 0 $ 394 $ 0 $ 262 $ 0 $ 262 1.25% Call Option Other assets 0 0 3,030 3,030 0 0 9,104 9,104 Total assets $ 0 $ 394 $ 3,030 $ 3,424 $ 0 $ 262 $ 9,104 $ 9,366 Contingent consideration - current Accrued expenses 0 0 8,785 8,785 0 0 10,528 10,528 Contingent consideration - long-term Other liabilities 0 0 22,074 22,074 0 0 15,317 15,317 1.25% Embedded cash conversion option Other liabilities 0 0 3,525 3,525 0 0 9,974 9,974 Total liabilities $ 0 $ 0 $ 34,384 $ 34,384 $ 0 $ 0 $ 35,819 $ 35,819 The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at March 31, 2019 are summarized as follows: (In thousands) Contingent Consideration 1.25% Notes Call Spread Overlay Balance at December 31, 2018 25,845 (870 ) Additions 5,008 0 Fair value adjustments 6 375 Balance at March 31, 2019 $ 30,859 $ (495 ) Long-term Investments The following table summarizes our long-term 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 March 31, 2019 Cost March 31, 2019 December 31, 2018 Equity method investments (1) 5 $ 7,407 $ 10,604 $ 10,667 Cost method investments 8 37,874 26,935 25,923 Total long-term equity investments 13 $ 45,281 $ 37,539 $ 36,590 (1) Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag. As of March 31, 2019, it is not practicable to estimate the fair value of our non-marketable cost and equity method 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, the issuer’s subsequent or planned raises of capital, and observable price changes in orderly transactions. Recovery and Impairment of Long-term Investments During the three months ended March 31, 2019, we recovered $1.0 million from a third-party cost-method investment that we had previously impaired. Each quarter, management performs an assessment of each of our investments on an individual basis to determine if there have been any declines in fair value. As a result of this review, we recognized a non-cash impairment charge during the three months ended March 31, 2018 of $5.5 million related to one of our cost-method equity investments and a related note receivable, which had cost bases of $4.9 million and $2.6 million, respectively, prior to the impairment. Long-term Financial Liabilities Our long-term financial liabilities include amounts outstanding under our senior secured credit facility (as defined in Note 9, “Debt”), with carrying values that approximate fair value since the interest rates approximate current market rates. In addition, the carrying amount of our 1.25% Cash Convertible Senior Notes (the “1.25% Notes”) approximates fair value as of March 31, 2019, since the effective interest rate on the 1.25% Notes approximates current market rates. Refer to Note 9, “Debt,” for further information regarding our long-term financial liabilities.

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Shareholders' Equity	6. Stockholders' Equity Stock-based Compensation Expense Stock-based compensation expense recognized during the three months ended March 31, 2019 and 2018 is included in our consolidated statements of operations as shown in the below table. 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. No stock-based compensation costs were capitalized during the three months ended March 31, 2019 and 2018. Three Months Ended March 31, (In thousands) 2019 2018 Cost of revenue: Software delivery, support and maintenance $ 513 $ 596 Client services 1,093 1,408 Total cost of revenue 1,606 2,004 Selling, general and administrative expenses 8,325 6,132 Research and development 2,877 2,807 Total stock-based compensation expense $ 12,808 $ 10,943 Allscripts Long-Term Incentive Plan We measure stock-based compensation expense at the grant date based on the fair value of the award. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures. We recognize the expense for performance-based and market-based share awards over the vesting period under the accelerated attribution method, net of estimated forfeitures. In addition, 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 and performance-based restricted stock units is measured at the underlying closing share price of our common stock on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. No stock options were granted during the three months ended March 31, 2019 and 2018. We granted stock-based awards as follows: Three Months Ended March 31, 2019 Weighted-Average Grant Date (In thousands, except per share amounts) Shares Fair Value Service-based restricted stock units 1,040 $ 10.72 Market-based restricted stock units with a service condition 700 $ 11.74 1,740 $ 11.13 During the three months ended March 31, 2019 and the year ended December 31, 2018, 1.1 million and 1.6 million shares of common stock, respectively, were issued in connection with the exercise of options and the release of restrictions on stock awards. Net Share-settlements Upon vesting, restricted stock units are generally net share-settled 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 and awards that vested during the three months ended March 31, 2019 and 2018 were net-share settled such that we withheld shares with fair value equivalent to the employees’ minimum statutory obligation for the applicable income and other employment taxes, and remitted the cash to the appropriate taxing authorities. Total payments for the employees' minimum statutory tax obligations to the taxing authorities are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld for the three months ended March 31, 2019 and 2018 were 508 thousand and 609 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 as a result of the vesting. 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 6.1 million shares of our common stock under the 2018 Program for a total of $64.9 million during the three months ended March 31, 2019. The approximate dollar value of shares that may yet be purchased under the 2018 Program is $148.1 million as of March 31, 2019. We repurchased 4.1 million shares of our common stock under the 2016 Program for a total of $57.6 million during the three months ended March 31, 2018.

Earnings (Loss) Per Share

Earnings (Loss) Per Share	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	7. 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 (loss) 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: Three Months Ended March 31, (In thousands, except per share amounts) 2019 2018 Basic earnings (loss) per Common Share: Loss from continuing operations, net of tax $ (7,977 ) $ (25,161 ) Net loss attributable to non-controlling interests 424 790 Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (24,371 ) Loss from discontinued operations, net of tax $ 0 $ (3,354 ) Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations 0 (12,149 ) Net loss from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 0 (15,503 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (39,874 ) Weighted-average common shares outstanding 169,957 179,882 Basic earnings (loss) from continuing operations per Common Share $ (0.04 ) $ (0.14 ) Basic income from discontinued operations per Common Share 0.00 (0.08 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ (0.04 ) $ (0.22 ) Diluted earnings (loss) per Common Share: Loss from continuing operations, net of tax $ (7,977 ) $ (25,161 ) Net loss attributable to non-controlling interests 424 790 Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (24,371 ) Loss from discontinued operations, net of tax $ 0 $ (3,354 ) Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations 0 (12,149 ) Net loss from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 0 (15,503 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (39,874 ) Weighted-average common shares outstanding 169,957 179,882 Plus: Dilutive effect of stock options, restricted stock unit awards and warrants 0 0 Weighted-average common shares outstanding assuming dilution 169,957 179,882 Diluted earnings (loss) from continuing operations per Common Share $ (0.04 ) $ (0.14 ) Diluted income from discontinued operations per Common Share 0.00 (0.08 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ (0.04 ) $ (0.22 ) Due to the net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders for the three months ended March 31, 2019 and 2018, we used basic weighted-average common shares outstanding in the calculation of diluted loss per share for those periods, 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: Three Months Ended March 31, (In thousands) 2019 2018 Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation 26,738 23,208

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	8. Goodwill and Intangible Assets Goodwill and intangible assets consist of the following: March 31, 2019 December 31, 2018 Gross Gross Carrying Accumulated Intangible Carrying Accumulated Intangible (In thousands) Amount Amortization Assets, Net Amount Amortization Assets, Net Intangibles subject to amortization: Proprietary technology $ 537,952 $ (410,154 ) $ 127,798 $ 537,834 $ (401,093 ) $ 136,741 Customer contracts and relationships 704,965 (469,326 ) 235,639 704,808 (462,468 ) 242,340 Total $ 1,242,917 $ (879,480 ) $ 363,437 $ 1,242,642 $ (863,561 ) $ 379,081 Intangibles not subject to amortization: Registered trademarks $ 52,000 $ 52,000 Goodwill 1,373,996 1,373,744 Total $ 1,425,996 $ 1,425,744 Changes in the carrying amounts of goodwill by reportable segment for the three months ended March 31, 2019 were as follows: (In thousands) Provider Veradigm Total Balance as of December 31, 2018 $ 1,254,284 $ 119,460 $ 1,373,744 Foreign exchange translation 252 0 252 Balance as of March 31, 2019 $ 1,254,536 $ 119,460 $ 1,373,996 There are $13.5 million in accumulated impairment losses associated with our goodwill as of March 31, 2019 and December 31, 2018.

Debt

Debt	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Debt	9. Debt Debt outstanding, excluding lease obligations, consists of the following: March 31, 2019 December 31, 2018 (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 $ 18,534 $ 326,466 $ 345,000 $ 22,112 $ 322,888 Senior Secured Credit Facility 465,000 5,660 459,340 350,000 6,038 343,962 Other debt 952 0 952 748 0 748 Total debt $ 810,952 $ 24,194 $ 786,758 $ 695,748 $ 28,150 $ 667,598 Less: Debt payable within one year 20,952 434 20,518 20,538 479 20,059 Total long-term debt, less current maturities $ 790,000 $ 23,760 $ 766,240 $ 675,210 $ 27,671 $ 647,539 Interest expense consists of the following: Three Months Ended March 31, (In thousands) 2019 2018 Interest expense $ 6,229 $ 7,938 Amortization of discounts and debt issuance costs 3,955 3,756 Total interest expense $ 10,184 $ 11,694 Interest expense related to the 1.25% Cash Convertible Senior Notes (the “1.25% Notes”), included in the table above, consists of the following: Three Months Ended March 31, (In thousands) 2019 2018 Coupon interest at 1.25% 1,078 $ 1,078 Amortization of discounts and debt issuance costs 3,577 3,407 Total interest expense related to the 1.25% Notes $ 4,655 $ 4,485 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 Second Amended Credit Agreement provides for a $400 million senior secured term loan (the “Term Loan”) and a $900 million senior secured revolving facility (the “Revolving Facility”), each with a five-year term. The Term Loan is repayable in quarterly installments, which began on June 30, 2018. A total of up to $50 million of the Revolving Facility is available for the issuance of letters of credit, up to $10 million of the Revolving Facility is available for swingline loans, and up to $100 million of the Revolving Facility could be borrowed under certain foreign currencies. As of March 31, 2019, $345 million under the Term Loan, $120 million under the Revolving Facility, and $0.8 million in letters of credit were outstanding under the Second Amended Credit Agreement. As of March 31, 2019, the interest rate on the borrowings under the Second Amended Credit Agreement was LIBOR plus 2.00%, which totaled 4.50%. We were in compliance with all covenants under the Second Amended Credit Agreement as of March 31, 2019. As of March 31, 2019, we had $899.2 million available, net of outstanding letters of credit, under our Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of our Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings. 1.25% Cash Convertible Senior Notes As of March 31, 2019, the if-converted value of the 1.25% Notes did not exceed the 1.25% Notes’ principal amount. The following table summarizes future debt payment obligations as of March 31, 2019: (In thousands) Total Remainder of 2019 2020 2021 2022 2023 Thereafter 1.25% Cash Convertible Senior Notes (1) $ 345,000 $ 0 $ 345,000 $ 0 $ 0 $ 0 $ 0 Term Loan 345,000 15,000 27,500 30,000 37,500 235,000 0 Revolving Facility (2) 120,000 0 0 0 0 120,000 0 Other debt 952 952 0 0 0 0 0 Total debt $ 810,952 $ 15,952 $ 372,500 $ 30,000 $ 37,500 $ 355,000 $ 0 (1) (2)

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes We account for income taxes under FASB Accounting Standards Codification 740, Income Taxes Three Months Ended March 31, (In thousands) 2019 2018 Loss from continuing operations before income taxes $ (6,045 ) $ (24,862 ) Income tax provision $ (1,932 ) $ (299 ) Effective tax rate (32.0 %) (1.2 %) Our provision for income taxes differs from the tax computed at the U.S. federal statutory income tax rate due primarily to permanent differences, income attributable to foreign jurisdictions taxed at different rates, state taxes, tax credits and certain discrete items. Our effective tax rate for the three months ended March 31, 2019, compared with the prior year comparable period, differs primarily due to higher tax shortfalls associated with stock-based compensation reflected in the provision for the three months ended March 31, 2019 and valuation allowance of $10.7 million recorded in the three months ended March 31, 2018. In evaluating our ability to recover our deferred tax assets within the jurisdictions from which they arise, we consider all available evidence, including scheduled reversals of deferred tax liabilities, tax-planning strategies, and results of recent operations. In evaluating the objective evidence that historical results provide, we consider three years of cumulative operating income (loss). During the three months ended March 31, 2019, we recorded immaterial impacts for valuation allowances. Our unrecognized income tax benefits were $20.8 million and $19.8 million as of March 31, 2019 and December 31, 2018, respectively. If any portion of our unrecognized tax benefits is recognized, it could impact our effective tax rate. The tax reserves are reviewed periodically and adjusted in light of changing facts and circumstances, such as progress of tax audits, lapse of applicable statutes of limitations, and changes in tax law.

Derivative Financial Instrument

Derivative Financial Instruments	3 Months Ended
	Mar. 31, 2019
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments	11. Derivative Financial Instruments The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates: March 31, 2019 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 $ 394 Accrued expenses $ 0 Derivatives not subject to hedge accounting: 1.25% Call Option Other assets 3,030 N/A 1.25% Embedded cash conversion option N/A Other liabilities 3,525 Total derivatives $ 3,424 $ 3,525 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 N/A – We define “N/A” as disclosure not being applicable 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 March 31, 2019, there were 9 forward contracts outstanding that were staggered to mature monthly starting in April 2019 and ending in December 2019. In the future, we may enter into additional forward contracts to increase the amount of hedged monthly INR expenses or initiate hedges for monthly periods beyond December 2019. As of March 31, 2019, the notional amount for each of the outstanding forward contracts was 160 million INR, or the equivalent of $2.3 million, based on the exchange rate between the United States dollar and the INR in effect as of March 31, 2019. These amounts also approximate the forecasted future INR expenses we target to hedge in any one month in the future. As of March 31, 2019, we estimate that $0.4 million of net unrealized derivative gains included in AOCI will be reclassified into income within the next 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 loss: Amount of Gain (Loss) Recognized in OCI Amount of Gain (Loss) Reclassified from AOCI into Income (In thousands) Three Months Ended March 31, 2019 Location of Gain (Loss) Reclassified from AOCI into Income Three Months Ended March 31, 2019 Foreign exchange contracts $ 151 Cost of Revenue $ 7 Selling, general and administrative expenses 5 Research and development $ 7 Amount of Gain (Loss) Recognized in OCI Amount of Gain (Loss) Reclassified from AOCI into Income (In thousands) Three Months Ended March 31, 2018 Location of Gain (Loss) Reclassified from AOCI into Income Three Months Ended March 31, 2018 Foreign exchange contracts $ (78 ) Cost of Revenue $ 189 Selling, general and administrative expenses 144 Research and development $ 222 1.25% Call Option In June 2013, concurrent with the issuance of the 1.25% Notes, we entered into privately negotiated hedge transactions with certain of the initial purchasers of the 1.25% Notes (collectively, the “1.25% Call Option”). 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. 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. The 1.25% Call Option does not qualify for hedge accounting treatment. Therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of operations in Other income, 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 below, we expect the net effect of those two derivative instruments on our earnings 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 reported in our consolidated statements of operations in Other income, 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. The following table shows the net impact of the changes in fair values of the 1.25% Call Option and the 1.25% Notes’ embedded cash conversion option in the consolidated statements of operations: Three Months Ended March 31, (In thousands) 2019 2018 1.25% Call Option $ (6,074 ) $ (21,168 ) 1.25% Embedded cash conversion option 6,449 21,331 Net loss included in other income, net $ 375 $ 163

Other Comprehensive Income

Other Comprehensive Income	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Other Comprehensive Income	12. Other Comprehensive Income Accumulated Other Comprehensive Loss Changes in the balances of each component included in 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 on Foreign Exchange Contracts Total Balance as of December 31, 2018 (1) $ (5,584 ) $ 195 $ (5,389 ) Other comprehensive income (loss) before reclassifications 695 111 806 Net (gains) losses reclassified from accumulated other comprehensive loss 0 (14 ) (14 ) Net other comprehensive loss 695 97 792 Balance as of March 31, 2019 (2) $ (4,889 ) $ 292 $ (4,597 ) (1) Net of taxes of $68 thousand for unrealized net gains on foreign exchange contract derivatives and $149 thousand arising from the revaluation of tax effects included in accumulated other comprehensive income. (2) Net of taxes of $102 thousand for unrealized net losses on foreign exchange contract derivatives. (In thousands) Foreign Currency Translation Adjustments Unrealized Net Gains on Foreign Exchange Contracts Total Balance as of December 31, 2017 (1) $ (2,676 ) $ 691 $ (1,985 ) Other comprehensive income (loss) before reclassifications 123 (58 ) 65 Net (gains) losses reclassified from accumulated other comprehensive loss 0 (261 ) (261 ) Net other comprehensive income 123 (319 ) (196 ) Balance as of March 31, 2018 (2) $ (2,553 ) $ 372 $ (2,181 ) (1) (2) Income Tax Effects Related to Components of Other Comprehensive Income (Loss) The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”): Three Months Ended March 31, 2019 2018 (In thousands) Before-Tax Amount Tax Effect Net Amount Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ 695 $ 0 $ 695 $ 123 $ 0 $ 123 Foreign exchange contracts: Net (losses) gains arising during the period 151 (40 ) 111 (78 ) 20 (58 ) Net losses (gains) reclassified into income (1) (19 ) 5 (14 ) (555 ) 294 (261 ) Net change in unrealized (losses) gains on foreign exchange contracts 132 (35 ) 97 (633 ) 314 (319 ) Net (loss) gain on cash flow hedges 132 (35 ) 97 (633 ) 314 (319 ) Other comprehensive (loss) income $ 827 $ (35 ) $ 792 $ (510 ) $ 314 $ (196 ) (1) Tax effects for the three months ended March 31, 2018 149 thousand arising from the revaluation of tax effects included in accumulated other comprehensive income at December 31, 2017.

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2019
Commitments And Contingencies Disclosure [Abstract]
Contingencies	13. 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 or settled by us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that and subsequent reporting periods 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 for each alleged violation of the TCPA, treble damages if the Court finds the violations to be willful, knowing or intentional, and injunctive and other relief. Allscripts answered the complaint denying all material allegations and asserting a number of affirmative defenses, as well as counterclaims for breach of a license agreement. On March 31, 2016, plaintiff filed its motion for class certification. On May 31, 2016, we filed our opposition to plaintiff’s motion for class certification, and simultaneously moved for summary judgment on all of plaintiff’s claims. On June 2, 2017, an order was entered denying class certification and, accordingly, the case will not proceed on a class-wide basis. 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. 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 another CID and Health Insurance Portability and Accountability Act (“HIPAA”) subpoenas. In March 2019, Practice Fusion received a grand jury subpoena in connection with a related criminal investigation. The document and information requests received by Practice Fusion relate to both the certification Practice Fusion obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program and Practice Fusion’s compliance with the Anti-Kickback Statute and HIPAA as it relates to certain business practices engaged in by Practice Fusion. Practice Fusion continues to produce documents and information in response to these various requests. On January 25, 2018, a complaint was filed in Surfside Non-Surgical Orthopedics, P.A. v. Allscripts Healthcare Solutions, Inc.

Discontinued Operations

Discontinued Operations	3 Months Ended
	Mar. 31, 2019
Discontinued Operations And Disposal Groups [Abstract]
Discontinued Operations	14. Discontinued Operations Netsmart On December 31, 2018, we sold all of the Class A Common Units of Netsmart LLC, a Delaware limited liability company (“Netsmart”) held by the Company. 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. The following table summarizes Netsmart’s major income and expense line items as reported in the consolidated statements of operations for the three months ended March 31, 2018: Three Months Ended (In thousands) March 31, 2018 Major income and expense line items related to Netsmart: Revenue: Software delivery, support and maintenance $ 49,213 Client services 30,991 Total revenue 80,204 Cost of revenue: Software delivery, support and maintenance 14,367 Client services 21,713 Amortization of software development and acquisition related assets 7,814 Total cost of revenue 43,894 Gross profit 36,310 Selling, general and administrative expenses 23,133 Research and development 5,187 Amortization of intangible and acquisition-related assets 5,609 Income from discontinued operations for the Netsmart sale before income taxes 2,381 Interest expense (13,351 ) Other loss (12 ) Income tax benefit 3,213 Loss from discontinued operations, net of tax for Netsmart $ (7,769 ) Horizon Clinicals and Series2000 Revenue Cycle Two of the product offerings (Horizon Clinicals and Series2000 Revenue Cycle) acquired with the Enterprise Information Solutions (the “EIS Business”) business combination 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, 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 have transitioned to other platforms. No disposal gains or losses were recognized during the 2018 fiscal year related to these discontinued operations. We had $0.9 million of accrued expenses associated with the Horizon Clinicals and Series2000 Revenue Cycle businesses on the consolidated balance sheets as of December 31, 2018. The following table summarizes the major classes of line items constituting income (loss) of the discontinued operations specifically with the sunset businesses of Horizon Clinicals and Series2000 Revenue Cycle, as reported in the consolidated statements of operations for the three months ended March 31, 2018: Three Months Ended (In thousands) March 31, 2018 Major classes of line items constituting pretax profit (loss) of discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle: Revenue: Software delivery, support and maintenance $ 9,804 Client services 492 Total revenue 10,296 Cost of revenue: Software delivery, support and maintenance 2,463 Client services 743 Total cost of revenue 3,206 Gross profit 7,090 Research and development 1,124 Income from discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle before income taxes 5,966 Income tax provision (1,551 ) Income from discontinued operations, net of tax for Horizon Clinicals and Series2000 Revenue Cycle $ 4,415

Business Segments

Business Segments	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Business Segments	15. 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 three months ended March 31, 2019, we realigned our reporting structure as a result of the divestiture of our investment in Netsmart on December 31, 2018, the evolution of the healthcare IT industry and our increased focus on the payer and life sciences market. As a result, we changed the presentation of our reportable segments to Provider and Veradigm. The new Provider segment is comprised of our core integrated clinical software applications, financial management and patient engagement solutions targeted at clients across the entire continuum of care. The new Veradigm segment primarily focuses on the payer and life sciences market. These changes to our reportable segments had no impact on operating segments. The segment disclosures below for the three months ended March 31, 2018, have been revised to conform to the current year presentation. As of March 31, 2019, we had eight operating segments, which are aggregated into two reportable segments. The Provider reportable segment includes the Hospitals and Health Systems, Ambulatory, CarePort, FollowMyHealth ® TM 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, expenses not reflective of our core business and transaction-related costs, and non-cash asset impairment charges from the operating segment data provided to our CODM. Expenses not reflective of our core business 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, all of which are centrally managed, and (ii) revenue and the associated cost from the resale of certain ancillary products, primarily hardware. We do not track our assets by segment. Three Months Ended March 31, (In thousands) 2019 2018 Revenue: Provider $ 392,607 $ 410,424 Veradigm 35,116 22,807 Unallocated Amounts 4,326 491 Total revenue $ 432,049 $ 433,722 Gross Profit: Provider $ 165,818 $ 185,729 Veradigm 22,434 15,130 Unallocated Amounts (14,157 ) (16,194 ) Total gross profit $ 174,095 $ 184,665 Income (loss) from operations: Provider $ 100,274 $ 107,140 Veradigm 8,319 5,032 Unallocated Amounts (105,948 ) (118,873 ) Total income (loss) from operations $ 2,645 $ (6,701 )

Supplemental Disclosures

Supplemental Disclosures	3 Months Ended
	Mar. 31, 2019
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Supplemental Disclosures	16. Supplemental Disclosures Supplemental Consolidated Statements of Cash Flows Information The majority of the restricted cash balance as of March 31, 2019 and 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 Allscripts’ former Homecare TM March 31, (In thousands) 2019 2018 Reconciliation of cash, cash equivalents and restricted cash: Cash and cash equivalents $ 137,167 $ 111,999 Restricted cash 10,681 12,668 Total cash, cash equivalents and restricted cash $ 147,848 $ 124,667 Three Months Ended March 31, (In thousands) 2019 2018 Supplemental non-cash information: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operation $ 0 $ 12,149 Contribution of assets in exchange for equity interest $ 0 $ 4,000

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2019
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.
Unaudited Interim Financial Information	Unaudited Interim Financial Information The unaudited interim consolidated financial statements as of and for the three months ended March 31, 2019 and 2018 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make these unaudited interim consolidated financial statements not misleading. They should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2018 (our “Form 10-K”).
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in accordance with 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 the first quarter of 2019, we changed our reportable segments from Clinical and Financial Solutions, Population Health and Unallocated to Provider, Veradigm and Unallocated. The business units reported within the historical segments have been reallocated into the new segments. Refer to Note 15 “Business Segments” for further discussion on the impact of the change.
Significant Accounting Policies	Significant Accounting Policies We adopted Financial Accounting Standards Board (“FASB”) Accounting Standards Update No. 2016-02, “Leases (Topic 842)” (“ASU 2016-02”) on January 1, 2019 using the cumulative-effect adjustment transition method method requires us to recognize an adoption impact as a cumulative-effect adjustment to the January 1, 2019 retained earnings balance. tion.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities We adopted ASU 2017-12 on January 1, 2019 and the adoption did not have any effect on our consolidated financial statements. In June 2018, the FASB issued Accounting Standards Update No. 2018-07, “ Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting
Accounting Pronouncements Not Yet Adopted	Accounting Pronouncements Not Yet Adopted 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” 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 We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, will have a material impact on our consolidated financial statements.
Revenue Recognition	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.

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	3 Months Ended
	Mar. 31, 2019
Revenue From Contract With Customer [Abstract]
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, 2019 Revenue related to deferred revenue balance at beginning of period $ 126,184 Revenue related to new performance obligations satisfied during the period 248,221 Revenue recognized under "right-to-invoice" expedient 55,923 Reimbursed travel expenses, shipping and other revenue 1,721 Total revenue $ 432,049 (In thousands) Three Months Ended March 31, 2018 Revenue related to deferred revenue balance at beginning of period $ 181,398 Revenue related to new performance obligations satisfied during the period 200,232 Revenue recognized under "right-to-invoice" expedient 49,403 Reimbursed travel expenses, shipping and other revenue 2,689 Total revenue $ 433,722
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: Three Months Ended March 31 (In thousands) 2019 2018 Revenue: Recurring revenue $ 348,636 $ 352,660 Non-recurring revenue 83,413 81,062 Total revenue $ 432,049 $ 433,722
Disaggregation of Revenue by Product Line and Segment	Three Months Ended March 31, 2019 (In thousands) Provider Veradigm Unallocated Total Software delivery, support and maintenance $ 237,355 $ 34,042 $ 4,115 $ 275,512 Client services 155,252 1,074 211 156,537 Total revenue $ 392,607 $ 35,116 $ 4,326 $ 432,049 Three Months Ended March 31, 2018 (In thousands) Provider Veradigm Unallocated Total Software delivery, support and maintenance $ 257,754 $ 21,415 $ 1,384 $ 280,553 Client services 152,670 1,392 (893 ) 153,169 Total revenue $ 410,424 $ 22,807 $ 491 $ 433,722

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2019
Lessee Disclosure [Abstract]
Summary of Total Costs Associated with Leased Assets	Total costs associated with leased assets are as follows: (In thousands) Three months ended March 31, 2019 Operating lease cost (1) $ 6,717 Less: Sublease income (802 ) Total operating lease costs 5,915 Finance lease costs: Amortization of right-of-use assets (2) 51 Interest on lease liability (3) 3 Total finance lease costs $ 54 (1) Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statement of operations. (2) Amortization of finance right-of-use assets is recognized on a straight-line basis and is included in in Selling, general and administrative expenses within the consolidated statement of operations. (3) Interest on finance lease liabilities is recorded as Interest expense within the consolidated statement of operations .
Supplemental Information for Operating and Finance Leases	Supplemental information for operating and finance leases is as follows: (In thousands) Three months ended March 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 7,287 Operating cash flows from finance leases $ 3 Financing cash flows from finance leases $ 37 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 124,811 Finance leases $ 263
Summary of Balance Sheet Location and Balances for Operating and Finance Leases	The balance sheet location and balances for operating and finance leases are as follows: (In thousands, except lease term and discount rate) March 31, 2019 Operating leases: Right-of-use assets - operating leases $ 97,411 Current operating lease liabilities $ 24,154 Long-term operating lease liabilities $ 95,112 Finance leases: Fixed assets, gross $ 524 Accumulated depreciation 286 Fixed assets, net $ 238 Current finance lease liabilities (1) $ 130 Long-term finance lease liabilities (2) $ 97 Weighted average remaining lease term (in years) Operating leases 6 Finance leases 2 Weighted average discount rate Operating leases 4.6 % Finance leases 5.0 % (1) Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets. (2) Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets.
Summary of Future Maturities of Lease and Non-Lease Components	The future maturities of our leasing arrangements including lease and non-lease components are shown in the below table. The maturities are calculated using foreign currency exchange rates in effect as of March 31, 2019. March 31, 2019 (in thousands) Operating Leases Finance Leases Remainder of 2019 $ 22,128 $ 107 2020 24,839 85 2021 20,773 40 2022 19,205 6 2023 16,817 0 Thereafter 33,171 0 Total lease liabilities 136,933 238 Less: Amount representing interest (17,667 ) (11 ) Less: Short-term lease liabilities (24,154 ) (130 ) Total long-term lease liabilities $ 95,112 $ 97

Fair Value Measurements and L_2

Fair Value Measurements and Long-term Investments (Tables)	3 Months Ended
	Mar. 31, 2019
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 March 31, 2019 December 31, 2018 (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 $ 394 $ 0 $ 394 $ 0 $ 262 $ 0 $ 262 1.25% Call Option Other assets 0 0 3,030 3,030 0 0 9,104 9,104 Total assets $ 0 $ 394 $ 3,030 $ 3,424 $ 0 $ 262 $ 9,104 $ 9,366 Contingent consideration - current Accrued expenses 0 0 8,785 8,785 0 0 10,528 10,528 Contingent consideration - long-term Other liabilities 0 0 22,074 22,074 0 0 15,317 15,317 1.25% Embedded cash conversion option Other liabilities 0 0 3,525 3,525 0 0 9,974 9,974 Total liabilities $ 0 $ 0 $ 34,384 $ 34,384 $ 0 $ 0 $ 35,819 $ 35,819
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 March 31, 2019 are summarized as follows: (In thousands) Contingent Consideration 1.25% Notes Call Spread Overlay Balance at December 31, 2018 25,845 (870 ) Additions 5,008 0 Fair value adjustments 6 375 Balance at March 31, 2019 $ 30,859 $ (495 )
Summary of Long-term Equity Investments Included in Other Assets	The following table summarizes our long-term 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 March 31, 2019 Cost March 31, 2019 December 31, 2018 Equity method investments (1) 5 $ 7,407 $ 10,604 $ 10,667 Cost method investments 8 37,874 26,935 25,923 Total long-term equity investments 13 $ 45,281 $ 37,539 $ 36,590 (1) Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Stock-Based Compensation Expense	Three Months Ended March 31, (In thousands) 2019 2018 Cost of revenue: Software delivery, support and maintenance $ 513 $ 596 Client services 1,093 1,408 Total cost of revenue 1,606 2,004 Selling, general and administrative expenses 8,325 6,132 Research and development 2,877 2,807 Total stock-based compensation expense $ 12,808 $ 10,943
Stock-Based Awards Granted	We granted stock-based awards as follows: Three Months Ended March 31, 2019 Weighted-Average Grant Date (In thousands, except per share amounts) Shares Fair Value Service-based restricted stock units 1,040 $ 10.72 Market-based restricted stock units with a service condition 700 $ 11.74 1,740 $ 11.13

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Calculations of Earnings (Loss) Per Share	The calculations of earnings (loss) per share are as follows: Three Months Ended March 31, (In thousands, except per share amounts) 2019 2018 Basic earnings (loss) per Common Share: Loss from continuing operations, net of tax $ (7,977 ) $ (25,161 ) Net loss attributable to non-controlling interests 424 790 Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (24,371 ) Loss from discontinued operations, net of tax $ 0 $ (3,354 ) Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations 0 (12,149 ) Net loss from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 0 (15,503 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (39,874 ) Weighted-average common shares outstanding 169,957 179,882 Basic earnings (loss) from continuing operations per Common Share $ (0.04 ) $ (0.14 ) Basic income from discontinued operations per Common Share 0.00 (0.08 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ (0.04 ) $ (0.22 ) Diluted earnings (loss) per Common Share: Loss from continuing operations, net of tax $ (7,977 ) $ (25,161 ) Net loss attributable to non-controlling interests 424 790 Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (24,371 ) Loss from discontinued operations, net of tax $ 0 $ (3,354 ) Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations 0 (12,149 ) Net loss from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders 0 (15,503 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders $ (7,553 ) $ (39,874 ) Weighted-average common shares outstanding 169,957 179,882 Plus: Dilutive effect of stock options, restricted stock unit awards and warrants 0 0 Weighted-average common shares outstanding assuming dilution 169,957 179,882 Diluted earnings (loss) from continuing operations per Common Share $ (0.04 ) $ (0.14 ) Diluted income from discontinued operations per Common Share 0.00 (0.08 ) Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share $ (0.04 ) $ (0.22 )
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: Three Months Ended March 31, (In thousands) 2019 2018 Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation 26,738 23,208

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and intangible assets consist of the following: March 31, 2019 December 31, 2018 Gross Gross Carrying Accumulated Intangible Carrying Accumulated Intangible (In thousands) Amount Amortization Assets, Net Amount Amortization Assets, Net Intangibles subject to amortization: Proprietary technology $ 537,952 $ (410,154 ) $ 127,798 $ 537,834 $ (401,093 ) $ 136,741 Customer contracts and relationships 704,965 (469,326 ) 235,639 704,808 (462,468 ) 242,340 Total $ 1,242,917 $ (879,480 ) $ 363,437 $ 1,242,642 $ (863,561 ) $ 379,081 Intangibles not subject to amortization: Registered trademarks $ 52,000 $ 52,000 Goodwill 1,373,996 1,373,744 Total $ 1,425,996 $ 1,425,744
Changes in Carrying Amount of Goodwill	Changes in the carrying amounts of goodwill by reportable segment for the three months ended March 31, 2019 were as follows: (In thousands) Provider Veradigm Total Balance as of December 31, 2018 $ 1,254,284 $ 119,460 $ 1,373,744 Foreign exchange translation 252 0 252 Balance as of March 31, 2019 $ 1,254,536 $ 119,460 $ 1,373,996

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Instrument [Line Items]
Debt Outstanding Excluding Lease Obligations	Debt outstanding, excluding lease obligations, consists of the following: March 31, 2019 December 31, 2018 (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 $ 18,534 $ 326,466 $ 345,000 $ 22,112 $ 322,888 Senior Secured Credit Facility 465,000 5,660 459,340 350,000 6,038 343,962 Other debt 952 0 952 748 0 748 Total debt $ 810,952 $ 24,194 $ 786,758 $ 695,748 $ 28,150 $ 667,598 Less: Debt payable within one year 20,952 434 20,518 20,538 479 20,059 Total long-term debt, less current maturities $ 790,000 $ 23,760 $ 766,240 $ 675,210 $ 27,671 $ 647,539
Interest Expense	Interest expense consists of the following: Three Months Ended March 31, (In thousands) 2019 2018 Interest expense $ 6,229 $ 7,938 Amortization of discounts and debt issuance costs 3,955 3,756 Total interest expense $ 10,184 $ 11,694
Summary of Future Debt Payment Obligations	The following table summarizes future debt payment obligations as of March 31, 2019: (In thousands) Total Remainder of 2019 2020 2021 2022 2023 Thereafter 1.25% Cash Convertible Senior Notes (1) $ 345,000 $ 0 $ 345,000 $ 0 $ 0 $ 0 $ 0 Term Loan 345,000 15,000 27,500 30,000 37,500 235,000 0 Revolving Facility (2) 120,000 0 0 0 0 120,000 0 Other debt 952 952 0 0 0 0 0 Total debt $ 810,952 $ 15,952 $ 372,500 $ 30,000 $ 37,500 $ 355,000 $ 0 (1) (2)
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 (the “1.25% Notes”), included in the table above, consists of the following: Three Months Ended March 31, (In thousands) 2019 2018 Coupon interest at 1.25% 1,078 $ 1,078 Amortization of discounts and debt issuance costs 3,577 3,407 Total interest expense related to the 1.25% Notes $ 4,655 $ 4,485

Income Taxes (Tables)

Income Taxes (Tables)	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Effective Tax Rates	Three Months Ended March 31, (In thousands) 2019 2018 Loss from continuing operations before income taxes $ (6,045 ) $ (24,862 ) Income tax provision $ (1,932 ) $ (299 ) Effective tax rate (32.0 %) (1.2 %)

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2019
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: March 31, 2019 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 $ 394 Accrued expenses $ 0 Derivatives not subject to hedge accounting: 1.25% Call Option Other assets 3,030 N/A 1.25% Embedded cash conversion option N/A Other liabilities 3,525 Total derivatives $ 3,424 $ 3,525 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
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 loss: Amount of Gain (Loss) Recognized in OCI Amount of Gain (Loss) Reclassified from AOCI into Income (In thousands) Three Months Ended March 31, 2019 Location of Gain (Loss) Reclassified from AOCI into Income Three Months Ended March 31, 2019 Foreign exchange contracts $ 151 Cost of Revenue $ 7 Selling, general and administrative expenses 5 Research and development $ 7 Amount of Gain (Loss) Recognized in OCI Amount of Gain (Loss) Reclassified from AOCI into Income (In thousands) Three Months Ended March 31, 2018 Location of Gain (Loss) Reclassified from AOCI into Income Three Months Ended March 31, 2018 Foreign exchange contracts $ (78 ) Cost of Revenue $ 189 Selling, general and administrative expenses 144 Research and development $ 222
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 the 1.25% Notes’ embedded cash conversion option in the consolidated statements of operations: Three Months Ended March 31, (In thousands) 2019 2018 1.25% Call Option $ (6,074 ) $ (21,168 ) 1.25% Embedded cash conversion option 6,449 21,331 Net loss included in other income, net $ 375 $ 163

Other Comprehensive Income (Tab

Other Comprehensive Income (Tables)	3 Months Ended
	Mar. 31, 2019
Equity [Abstract]
Components of Accumulated Other Comprehensive Loss	Changes in the balances of each component included in 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 on Foreign Exchange Contracts Total Balance as of December 31, 2018 (1) $ (5,584 ) $ 195 $ (5,389 ) Other comprehensive income (loss) before reclassifications 695 111 806 Net (gains) losses reclassified from accumulated other comprehensive loss 0 (14 ) (14 ) Net other comprehensive loss 695 97 792 Balance as of March 31, 2019 (2) $ (4,889 ) $ 292 $ (4,597 ) (1) Net of taxes of $68 thousand for unrealized net gains on foreign exchange contract derivatives and $149 thousand arising from the revaluation of tax effects included in accumulated other comprehensive income. (2) Net of taxes of $102 thousand for unrealized net losses on foreign exchange contract derivatives. (In thousands) Foreign Currency Translation Adjustments Unrealized Net Gains on Foreign Exchange Contracts Total Balance as of December 31, 2017 (1) $ (2,676 ) $ 691 $ (1,985 ) Other comprehensive income (loss) before reclassifications 123 (58 ) 65 Net (gains) losses reclassified from accumulated other comprehensive loss 0 (261 ) (261 ) Net other comprehensive income 123 (319 ) (196 ) Balance as of March 31, 2018 (2) $ (2,553 ) $ 372 $ (2,181 ) (1) (2)
Income Tax Effects Related to Components of Other Comprehensive Income (Loss)	The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”): Three Months Ended March 31, 2019 2018 (In thousands) Before-Tax Amount Tax Effect Net Amount Before-Tax Amount Tax Effect Net Amount Foreign currency translation adjustments $ 695 $ 0 $ 695 $ 123 $ 0 $ 123 Foreign exchange contracts: Net (losses) gains arising during the period 151 (40 ) 111 (78 ) 20 (58 ) Net losses (gains) reclassified into income (1) (19 ) 5 (14 ) (555 ) 294 (261 ) Net change in unrealized (losses) gains on foreign exchange contracts 132 (35 ) 97 (633 ) 314 (319 ) Net (loss) gain on cash flow hedges 132 (35 ) 97 (633 ) 314 (319 ) Other comprehensive (loss) income $ 827 $ (35 ) $ 792 $ (510 ) $ 314 $ (196 ) (1) Tax effects for the three months ended March 31, 2018 149 thousand arising from the revaluation of tax effects included in accumulated other comprehensive income at December 31, 2017.

Discontinued Operations (Tables

Discontinued Operations (Tables)	3 Months Ended
	Mar. 31, 2019
Netsmart [Member]
Summary of Discontinued Operations in Financial Statements	The following table summarizes Netsmart’s major income and expense line items as reported in the consolidated statements of operations for the three months ended March 31, 2018: Three Months Ended (In thousands) March 31, 2018 Major income and expense line items related to Netsmart: Revenue: Software delivery, support and maintenance $ 49,213 Client services 30,991 Total revenue 80,204 Cost of revenue: Software delivery, support and maintenance 14,367 Client services 21,713 Amortization of software development and acquisition related assets 7,814 Total cost of revenue 43,894 Gross profit 36,310 Selling, general and administrative expenses 23,133 Research and development 5,187 Amortization of intangible and acquisition-related assets 5,609 Income from discontinued operations for the Netsmart sale before income taxes 2,381 Interest expense (13,351 ) Other loss (12 ) Income tax benefit 3,213 Loss from discontinued operations, net of tax for Netsmart $ (7,769 )
Horizon Clinicals and Series2000 [Member]
Summary of Discontinued Operations in Financial Statements	The following table summarizes the major classes of line items constituting income (loss) of the discontinued operations specifically with the sunset businesses of Horizon Clinicals and Series2000 Revenue Cycle, as reported in the consolidated statements of operations for the three months ended March 31, 2018: Three Months Ended (In thousands) March 31, 2018 Major classes of line items constituting pretax profit (loss) of discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle: Revenue: Software delivery, support and maintenance $ 9,804 Client services 492 Total revenue 10,296 Cost of revenue: Software delivery, support and maintenance 2,463 Client services 743 Total cost of revenue 3,206 Gross profit 7,090 Research and development 1,124 Income from discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle before income taxes 5,966 Income tax provision (1,551 ) Income from discontinued operations, net of tax for Horizon Clinicals and Series2000 Revenue Cycle $ 4,415

Business Segments (Tables)

Business Segments (Tables)	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Revenues and Income from Operations Related to Segment Within Reconciliation to Consolidated Amounts	Three Months Ended March 31, (In thousands) 2019 2018 Revenue: Provider $ 392,607 $ 410,424 Veradigm 35,116 22,807 Unallocated Amounts 4,326 491 Total revenue $ 432,049 $ 433,722 Gross Profit: Provider $ 165,818 $ 185,729 Veradigm 22,434 15,130 Unallocated Amounts (14,157 ) (16,194 ) Total gross profit $ 174,095 $ 184,665 Income (loss) from operations: Provider $ 100,274 $ 107,140 Veradigm 8,319 5,032 Unallocated Amounts (105,948 ) (118,873 ) Total income (loss) from operations $ 2,645 $ (6,701 )

Supplemental Disclosures (Table

Supplemental Disclosures (Tables)	3 Months Ended
	Mar. 31, 2019
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Supplemental Disclosures	The majority of the restricted cash balance as of March 31, 2019 and 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 Allscripts’ former Homecare TM March 31, (In thousands) 2019 2018 Reconciliation of cash, cash equivalents and restricted cash: Cash and cash equivalents $ 137,167 $ 111,999 Restricted cash 10,681 12,668 Total cash, cash equivalents and restricted cash $ 147,848 $ 124,667 Three Months Ended March 31, (In thousands) 2019 2018 Supplemental non-cash information: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operation $ 0 $ 12,149 Contribution of assets in exchange for equity interest $ 0 $ 4,000

Revenue from Contracts with C_3

Revenue from Contracts with Customers - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)Revenue_Stream	Mar. 31, 2018USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams | Revenue_Stream	2
Total backlog	$ 4,000
Total backlog, percentage, year one	38.00%
Total backlog, percentage after year one	62.00%
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	$ 7.6	$ 8.1
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	22.7	27.4
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 32	$ 37.3

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
	Mar. 31, 2019	Mar. 31, 2018
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 126,184	$ 181,398
Revenue related to new performance obligations satisfied during the period	248,221	200,232
Revenue recognized under "right-to-invoice" expedient	55,923	49,403
Reimbursed travel expenses, shipping and other revenue	1,721	2,689
Total revenue	$ 432,049	$ 433,722

Revenue from Contracts with C_4

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
	Mar. 31, 2019	Mar. 31, 2018
Disaggregation Of Revenue [Line Items]
Recurring revenue	$ 348,636	$ 352,660
Non-recurring revenue	83,413	81,062
Total revenue	432,049	433,722
Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	4,326	491
Provider [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	392,607	410,424
Veradigm [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	35,116	22,807
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	275,512	280,553
Software delivery, Support and Maintenance [Member] | Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	4,115	1,384
Software delivery, Support and Maintenance [Member] | Provider [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	237,355	257,754
Software delivery, Support and Maintenance [Member] | Veradigm [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	34,042	21,415
Client services [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	156,537	153,169
Client services [Member] | Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	211	(893)
Client services [Member] | Provider [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	155,252	152,670
Client services [Member] | Veradigm [Member] | Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue	$ 1,074	$ 1,392

Leases - Additional Information

Leases - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019
Minimum [Member]
Lessee Lease Description [Line Items]
Operating and Finance leases, remaining lease terms	1 year
Maximum [Member]
Lessee Lease Description [Line Items]
Operating and Finance leases, remaining lease terms	10 years
Operating leases, options to extend leases term	5 years
Finance leases, options to extend leases term	5 years
Operating and Finance leases, options to terminate leases term	1 year

Leases - Summary of Total Costs

Leases - Summary of Total Costs Associated with Leased Assets (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Leases [Abstract]
Operating lease cost	$ 6,717	[1]
Less: Sublease income	(802)
Total operating lease costs	5,915
Finance lease costs:
Amortization of right-of-use assets	51	[2]
Interest on lease liability	3	[3]
Total finance lease costs	$ 54
[1]	Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statement of operations.
[2]	Amortization of finance right-of-use assets is recognized on a straight-line basis and is included in in Selling, general and administrative expenses within the consolidated statement of operations.
[3]	Interest on finance lease liabilities is recorded as Interest expense within the consolidated statement of operations.

Leases - Supplemental Informati

Leases - Supplemental Information for Operating and Finance Leases (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 7,287
Operating cash flows from finance leases	3
Financing cash flows from finance leases	37
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	124,811
Finance leases	$ 263

Leases - Summary of Balance She

Leases - Summary of Balance Sheet Location and Balances for Operating and Finance Leases (Detail) - USD ($) $ in Thousands		Mar. 31, 2019	Dec. 31, 2018
Operating leases:
Right-of-use assets - operating leases		$ 97,411	$ 0
Current operating lease liabilities		24,154	0
Long-term operating lease liabilities		95,112	0
Finance leases:
Fixed assets, net		115,564	$ 121,913
Current finance lease liabilities	[1]	$ 130
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]		us-gaap:AccruedLiabilitiesCurrent
Long-term finance lease liabilities	[2]	$ 97
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]		us-gaap:OtherLiabilitiesNoncurrent
Weighted average remaining lease term (in years)
Operating leases		6 years
Finance leases		2 years
Weighted average discount rate
Operating leases		4.60%
Finance leases		5.00%
Finance Leases [Member]
Finance leases:
Fixed assets, gross		$ 524
Accumulated depreciation		286
Fixed assets, net		$ 238
[1]	Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets.
[2]	Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets.

Leases - Summary of Future Matu

Leases - Summary of Future Maturities of Lease and Non-Lease Components (Detail) - USD ($) $ in Thousands		Mar. 31, 2019	Dec. 31, 2018
Operating Leases [Abstract]
Operating Leases, Remainder of 2019		$ 22,128
Operating Leases, 2020		24,839
Operating Leases, 2021		20,773
Operating Leases, 2022		19,205
Operating Leases, 2023		16,817
Operating Leases, Thereafter		33,171
Operating Leases, Total lease liabilities		136,933
Operating Leases, Less: Amount representing interest		(17,667)
Operating Leases, Less: Short-term lease liabilities		(24,154)	$ 0
Operating Leases, Total long-term lease liabilities		95,112	$ 0
Finance Leases [Abstract]
Finance Leases, Remainder of 2019		107
Finance Leases, 2020		85
Finance Leases, 2021		40
Finance Leases, 2022		6
Finance Leases, 2023		0
Finance Leases, Thereafter		0
Finance Leases, Total lease liabilities		238
Finance Leases, Less: Amount representing interest		(11)
Finance Leases, Less: Short-term lease liabilities	[1]	(130)
Finance Leases, Total long-term lease liabilities	[2]	$ 97
[1]	Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets.
[2]	Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets.

Business Combinations - Additio

Business Combinations - Additional Information (Detail) - Pulse8, Inc. [Member] $ in Millions	Mar. 01, 2019USD ($)
Business Acquisition [Line Items]
Acquisition of outstanding minority interest	$ 53.8
Maximum [Member]
Business Acquisition [Line Items]
Potential earnout payments	$ 10

Summary of Financial Assets and

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 133,448	$ 142,455
Total assets	3,424	9,366
Total liabilities	34,384	35,819
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	394	262
Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	8,785	10,528
Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	22,074	15,317
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	3,525	9,974
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 Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Level 1 [Member] | Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
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	394	262
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	394	262
Level 2 [Member] | Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Level 2 [Member] | Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
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	3,030	9,104
Total liabilities	34,384	35,819
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 Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	8,785	10,528
Level 3 [Member] | Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	22,074	15,317
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	3,525	9,974
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	3,030	9,104
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	$ 3,030	$ 9,104

Summary of Financial Assets a_2

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail)	Mar. 31, 2019
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%

Summary of Changes in Assets an

Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Contingent Consideration [Member]
Fair Value, Net Derivative Asset (Liability) and Contingent Consideration Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Balance at December 31, 2018	$ 25,845
Additions	5,008
Fair value adjustments	6
Balance at March 31, 2019	30,859
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]
Balance at December 31, 2018	(870)
Additions	0
Fair value adjustments	375
Balance at March 31, 2019	$ (495)

Summary of Long-term Equity Inv

Summary of Long-term Equity Investments Included in Other Assets (Detail) $ in Thousands		3 Months Ended
		Mar. 31, 2019USD ($)Investment	Dec. 31, 2018USD ($)
Fair Value Disclosures [Abstract]
Equity method investments, Number of Investees | Investment	[1]	5
Cost method investments, Number of Investees | Investment		8
Total long-term equity investments, Number of Investees | Investment		13
Equity method investments, Original Cost	[1]	$ 7,407
Cost method investments, Original Cost		37,874
Total long-term equity investments, Original Cost		45,281
Equity method investments, Carrying Value		10,604	$ 10,667
Cost method investments, Carrying Value		26,935	25,923
Total long-term equity investments, Carrying Value		$ 37,539	$ 36,590
[1]	Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Fair Value Measurements and L_3

Fair Value Measurements and Long-term Investments - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Impairment recoveries	$ 1,000
Non-cash impairment charges of investments	$ (1,045)	$ 5,500
Cost basis of cost-method equity investments		4,900
Cost basis of note receivable prior to impairment		$ 2,600
1.25% Cash Convertible Senior Notes [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Aug. 02, 2018	Nov. 17, 2016
Class Of Stock [Line Items]
Capitalized stock-based compensation costs	$ 0	$ 0
Stock options granted	0	0
Share issued, exercise of options and release of stock awards	1,100,000		1,600,000
Shares settled for tax withholding	508,000	609,000
Common stock repurchased, amount	$ 65,070,000	$ 57,599,000
November 2016 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount					$ 200,000,000
Common stock repurchased, shares		4,100,000
Common stock repurchased, amount		$ 57,600,000
August 2018 Stock Repurchase Program [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount				$ 250,000,000
Common stock repurchased, shares	6.1
Common stock repurchased, amount	$ 64,900,000
Stock repurchase program, shares yet to be purchased	$ 148,100,000

Stock-Based Compensation Expens

Stock-Based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 12,808	$ 10,943
Cost of revenue [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	1,606	2,004
Cost of revenue [Member] | Software delivery, Support and Maintenance [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	513	596
Cost of revenue [Member] | Client services [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	1,093	1,408
Selling, General and Administrative Expenses [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	8,325	6,132
Research and development [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 2,877	$ 2,807

Stock-Based Awards Granted (Det

Stock-Based Awards Granted (Detail) shares in Thousands	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted | shares	1,740
Weighted-Average Grant Date Fair Value, granted | $ / shares	$ 11.13
Service-Based Restricted Stock Units [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted | shares	1,040
Weighted-Average Grant Date Fair Value, granted | $ / shares	$ 10.72
Market-Based Restricted Stock Units with a Service Condition [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted | shares	700
Weighted-Average Grant Date Fair Value, granted | $ / shares	$ 11.74

Calculations of Earnings (Loss)

Calculations of Earnings (Loss) Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Basic earnings (loss) per Common Share:
Loss from continuing operations, net of tax	$ (7,977)	$ (25,161)
Net loss attributable to non-controlling interests	424	790
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	(7,553)	(24,371)
Loss from discontinued operations, net of tax	0	(3,354)
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	0	(12,149)
Net loss from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	0	(15,503)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (7,553)	$ (39,874)
Weighted-average common shares outstanding	169,957	179,882
Basic earnings (loss) from continuing operations per Common Share	$ (0.04)	$ (0.14)
Basic income from discontinued operations per Common Share	0	(0.08)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ (0.04)	$ (0.22)
Diluted earnings (loss) per Common Share:
Loss from continuing operations, net of tax	$ (7,977)	$ (25,161)
Net loss attributable to non-controlling interests	424	790
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	(7,553)	(24,371)
Loss from discontinued operations, net of tax	0	(3,354)
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	0	(12,149)
Net loss from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	0	(15,503)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (7,553)	$ (39,874)
Weighted-average common shares outstanding	169,957	179,882
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants	0	0
Weighted-average common shares outstanding assuming dilution	169,957	179,882
Diluted earnings (loss) from continuing operations per Common Share	$ (0.04)	$ (0.14)
Diluted income from discontinued operations per Common Share	0	(0.08)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ (0.04)	$ (0.22)

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	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Earnings Per Share [Abstract]
Shares subject to anti-dilutive stock options, restricted stock unit awards and warrants excluded from calculation	26,738	23,208

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,242,917	$ 1,242,642
Accumulated Amortization	(879,480)	(863,561)
Intangible Assets, Net	363,437	379,081
Registered trademarks	52,000	52,000
Goodwill	1,373,996	1,373,744
Total	1,425,996	1,425,744
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	537,952	537,834
Accumulated Amortization	(410,154)	(401,093)
Intangible Assets, Net	127,798	136,741
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	704,965	704,808
Accumulated Amortization	(469,326)	(462,468)
Intangible Assets, Net	$ 235,639	$ 242,340

Changes in Carrying Amount of G

Changes in Carrying Amount of Goodwill (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Goodwill [Line Items]
Goodwill	$ 1,373,744
Foreign exchange translation	252
Goodwill, net	1,373,996
Provider [Member]
Goodwill [Line Items]
Goodwill	1,254,284
Foreign exchange translation	252
Goodwill, net	1,254,536
Veradigm [Member]
Goodwill [Line Items]
Goodwill	119,460
Foreign exchange translation	0
Goodwill, net	$ 119,460

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2019	Dec. 31, 2018
Goodwill And Intangible Assets Disclosure [Abstract]
Accumulated impairment losses associated with goodwill	$ 13.5	$ 13.5

Debt Outstanding Excluding Leas

Debt Outstanding Excluding Lease Obligations (Detail) - USD ($) $ in Thousands	Mar. 31, 2019		Dec. 31, 2018
Debt Instrument [Line Items]
Principal Balance	$ 810,952		$ 695,748
Unamortized Discount and Debt Issuance Costs	24,194		28,150
Net Carrying Amount	786,758		667,598
Principal Balance, Current	20,952		20,538
Unamortized Discount and Debt Issuance Costs, Current	434		479
Net Carrying Amount, Current	20,518		20,059
Principal Balance, Noncurrent	790,000		675,210
Unamortized Discount and Debt Issuance Costs, Noncurrent	23,760		27,671
Net Carrying Amount, Noncurrent	766,240		647,539
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Principal Balance	345,000	[1]	345,000
Unamortized Discount and Debt Issuance Costs	18,534		22,112
Net Carrying Amount	326,466		322,888
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Principal Balance	465,000		350,000
Unamortized Discount and Debt Issuance Costs	5,660		6,038
Net Carrying Amount	459,340		343,962
Other Debt [Member]
Debt Instrument [Line Items]
Principal Balance	952		748
Unamortized Discount and Debt Issuance Costs	0		0
Net Carrying Amount	$ 952		$ 748
[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
	Mar. 31, 2019	Mar. 31, 2018
Debt Instrument [Line Items]
Total interest expense	$ 10,184	$ 11,694
Convertible Senior Notes and Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Interest expense	6,229	7,938
Amortization of discounts and debt issuance costs	3,955	3,756
Total interest expense	$ 10,184	$ 11,694

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	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Debt Instrument [Line Items]
Coupon interest at 1.25%	$ 1,078	$ 1,078
Amortization of discounts and debt issuance costs	3,577	3,407
Total interest expense related to the 1.25% Notes	$ 4,655	$ 4,485

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($)	Feb. 15, 2018	Mar. 31, 2019		Dec. 31, 2018
Debt Instrument [Line Items]
Debt instrument principal amount		$ 810,952,000		$ 695,748,000
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument principal amount		345,000,000
Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, amount available		899,200,000
Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount		465,000,000		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
Interest rate		1.25%
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 Revolving Facility [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity	$ 900,000,000
Senior secured credit facilities term, years	5 years
Credit facility, maximum borrowing capacity, foreign currencies	$ 100,000,000
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity	$ 400,000,000
Senior secured credit facilities term, years	5 years
Line of credit facility, frequency of payments		The Term Loan is repayable in quarterly installments, which began on June 30, 2018.
Second Amended Credit Agreement [Member] | Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument principal amount		$ 345,000,000
Second Amended Credit Agreement [Member] | Senior Secured Revolving Facility [Member]
Debt Instrument [Line Items]
Debt instrument principal amount		$ 120,000,000
Second Amended Credit Agreement [Member] | Senior Secured Revolving Facility [Member] | United States dollars [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, effective percentage		4.50%
Second Amended Credit Agreement [Member] | Senior Secured Revolving Facility [Member] | LIBOR Rate [Member]
Debt Instrument [Line Items]
Debt instrument, variable interest rate		2.00%
Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Letters of credit outstanding		$ 800,000
[1]	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

Summary of Future Debt Payment

Summary of Future Debt Payment Obligations (Detail) - USD ($) $ in Thousands		Mar. 31, 2019		Dec. 31, 2018
Debt Instrument [Line Items]
Total		$ 810,952		$ 695,748
Remainder of 2019		15,952
2020		372,500
2021		30,000
2022		37,500
2023		355,000
Thereafter		0
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Total		345,000	[1]	345,000
Remainder of 2019	[1]	0
2020	[1]	345,000
2021	[1]	0
2022	[1]	0
2023	[1]	0
Thereafter	[1]	0
Senior Secured Term Loan [Member]
Debt Instrument [Line Items]
Total		345,000
Remainder of 2019		15,000
2020		27,500
2021		30,000
2022		37,500
2023		235,000
Thereafter		0
Other Debt [Member]
Debt Instrument [Line Items]
Total		952		$ 748
Remainder of 2019		952
2020		0
2021		0
2022		0
2023		0
Thereafter		0
Revolving Facility [Member]
Debt Instrument [Line Items]
Total	[2]	120,000
Remainder of 2019	[2]	0
2020	[2]	0
2021	[2]	0
2022	[2]	0
2023	[2]	120,000
Thereafter	[2]	$ 0
[1]	Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.
[2]	Assumes no additional borrowings after March 31, 2019, payment of any required periodic installments of principal and that all drawn amounts are repaid upon maturity.

Summary of Future Debt Payments

Summary of Future Debt Payments (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2019
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Maturity date	Jul. 1, 2020

Effective Tax Rates (Detail)

Effective Tax Rates (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Loss from continuing operations before income taxes	$ (6,045)	$ (24,862)
Income tax provision	$ (1,932)	$ (299)
Effective tax rate	(32.00%)	(1.20%)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018
Income Tax Disclosure [Abstract]
Valuation allowance			$ 10.7
Cumulative operating income loss period considered	3 years
Unrecognized income tax benefits	$ 20.8	$ 19.8

Fair Value and Balance Sheet Lo

Fair Value and Balance Sheet Locations - (Detail) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Derivatives Fair Value [Line Items]
Derivative asset, fair value	$ 3,424	$ 9,366
Derivative liability, fair value	3,525	9,974
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	394	262
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	3,030	9,104
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	$ 3,525	$ 9,974

Derivative Financial Instrume_3

Derivative Financial Instruments - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019USD ($)Derivative	Mar. 31, 2019INR (₨)Derivative	Jun. 18, 2013USD ($)
1.25% Call Option [Member]
Derivative [Line Items]
Debt instrument interest rate	1.25%	1.25%
Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Number of contracts | Derivative	9	9
Derivative notional amount outstanding	$ 2,300,000	₨ 160,000,000
Unrealized derivatives gains included in other comprehensive (loss) income reclassified into income	$ 400,000
Estimated period of unrealized gains included in AOCI reclassified into income	12 months
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
Minimum [Member] | Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Date of contracts mature	Apr. 30, 2019
Maximum [Member] | Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Date of contracts mature	Dec. 31, 2019

Derivatives Instruments Designa

Derivatives Instruments Designated as Cash Flow Hedges - (Detail) - Cash Flow Hedging [Member] - Foreign Exchange Contract [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Recognized in OCI	$ 151	$ (78)
Cost of revenue [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	7	189
Selling, General and Administrative Expenses [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	5	144
Research and development [Member]
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Income	$ 7	$ 222

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	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Derivative Instruments Gain Loss [Line Items]
Net loss included in other income, net	$ 375	$ 163
1.25% Call Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net loss included in other income, net	(6,074)	(21,168)
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative Instruments Gain Loss [Line Items]
Net loss included in other income, net	$ 6,449	$ 21,331

Components of Accumulated Other

Components of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	$ 1,551,113
Other comprehensive income (loss) before reclassifications	806	$ 65
Net (gains) losses reclassified from accumulated other comprehensive loss	(14)	(261)
Total other comprehensive income (loss)	792	(196)
Balance at the end of the period	1,456,117
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	(5,584)	(2,676)
Other comprehensive income (loss) before reclassifications	695	123
Net (gains) losses reclassified from accumulated other comprehensive loss	0	0
Total other comprehensive income (loss)	695	123
Balance at the end of the period	(4,889)	(2,553)
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	195	691
Other comprehensive income (loss) before reclassifications	111	(58)
Net (gains) losses reclassified from accumulated other comprehensive loss	(14)	(261)
Total other comprehensive income (loss)	97	(319)
Balance at the end of the period	292	372
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Balance at the beginning of the period	(5,389)	(1,985)
Balance at the end of the period	$ (4,597)	$ (2,181)

Components of Accumulated Oth_2

Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - Foreign Exchange Contract [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)	$ (102)	$ (131)	$ 68	$ 445
Revaluation of tax effects	$ 149	$ 149

Income Tax Effects Related to C

Income Tax Effects Related to Components of Other Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Accumulated Other Comprehensive Income Loss [Line Items]
Foreign currency translation adjustments, Before-Tax Amount	$ 695	$ 123
Derivatives qualifying as cash flow hedges, net (loss) gain, Before-Tax Amount	132	(633)
Other comprehensive (loss) income, Before-Tax Amount	827	(510)
Foreign currency translation adjustments, Tax Effect	0	0
Other comprehensive (loss) income, Tax Effect	(35)	314
Foreign currency translation adjustments, Net	695	123
Other comprehensive (loss) income, Net	792	(196)
Derivatives Qualifying as Cash Flow Hedges [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Derivatives qualifying as cash flow hedges, net (loss) gain, Before-Tax Amount	132	(633)
Derivatives qualifying as cash flow hedges, net losses (gains), Tax Effect	(35)	314
Derivatives qualifying as cash flow hedges, net (loss) gain, Net	97	(319)
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 (losses) gains arising during the period, Before-Tax Amount	151	(78)
Derivatives qualifying as cash flow hedges, net losses (gains) reclassified into income, Before-Tax Amount	(19)	(555)
Derivatives qualifying as cash flow hedges, net (loss) gain, Before-Tax Amount	132	(633)
Derivatives qualifying as cash flow hedges, net (losses) gains arising during the period, Tax Effect	(40)	20
Derivatives qualifying as cash flow hedges, net losses (gains) reclassified into income, Tax Effect	5	294
Derivatives qualifying as cash flow hedges, net losses (gains), Tax Effect	(35)	314
Derivatives qualifying as cash flow hedges, net (losses) gains arising during the period, Net	111	(58)
Derivatives qualifying as cash flow hedges, net losses (gains) reclassified into income, Net	(14)	(261)
Derivatives qualifying as cash flow hedges, net (loss) gain, Net	97	(319)
Other comprehensive (loss) income, Net	$ 97	$ (319)

Income Tax Effects Related to_2

Income Tax Effects Related to Components of Other Comprehensive Income (Loss) (Parenthetical) (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Revaluation of tax effects	$ 149	$ 149

Contingencies - Additional Info

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

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
	Mar. 31, 2019	Mar. 31, 2018
Cost of revenue:
Income from discontinued operations before income taxes	$ 0	$ (5,016)
Income tax benefit (provision)	0	1,662
Loss from discontinued operations, net of tax	$ 0	(3,354)
Netsmart [Member]
Revenue:
Total revenue		80,204
Cost of revenue:
Total cost of revenue		43,894
Amortization of software development and acquisition related assets		7,814
Gross profit		36,310
Selling, general and administrative expenses		23,133
Research and development		5,187
Amortization of intangible and acquisition-related assets		5,609
Income from discontinued operations before income taxes		2,381
Interest expense		(13,351)
Other loss		(12)
Income tax benefit (provision)		3,213
Loss from discontinued operations, net of tax		(7,769)
Netsmart [Member] | Software delivery, Support and Maintenance [Member]
Revenue:
Total revenue		49,213
Cost of revenue:
Total cost of revenue		14,367
Netsmart [Member] | Client services [Member]
Revenue:
Total revenue		30,991
Cost of revenue:
Total cost of revenue		$ 21,713

Discontinued Operations - Addit

Discontinued Operations - Additional Information (Detail) - Horizon Clinicals and Series2000 [Member]	9 Months Ended	12 Months Ended
	Dec. 31, 2018USD ($)Offering	Dec. 31, 2018USD ($)
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 operations before tax		$ 0
Accrued expenses	$ 900,000	$ 900,000

Summary of Major Classes of Lin

Summary of Major Classes of Line Items Constituting Income (Loss) of Discontinued Operations (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cost of revenue:
Income from discontinued operations before income taxes	$ 0	$ (5,016)
Income tax benefit (provision)	0	1,662
Loss from discontinued operations, net of tax	$ 0	(3,354)
Horizon Clinicals and Series2000 [Member]
Revenue:
Total revenue		10,296
Cost of revenue:
Total cost of revenue		3,206
Gross profit		7,090
Research and development		1,124
Income from discontinued operations before income taxes		5,966
Income tax benefit (provision)		(1,551)
Loss from discontinued operations, net of tax		4,415
Horizon Clinicals and Series2000 [Member] | Software delivery, Support and Maintenance [Member]
Revenue:
Total revenue		9,804
Cost of revenue:
Total cost of revenue		2,463
Horizon Clinicals and Series2000 [Member] | Client services [Member]
Revenue:
Total revenue		492
Cost of revenue:
Total cost of revenue		$ 743

Business Segments - Additional

Business Segments - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2019Segment
Segment Reporting [Abstract]
Number of reportable segments	2
Number of operating segments	8

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
	Mar. 31, 2019	Mar. 31, 2018
Segment Reporting Information [Line Items]
Revenue	$ 432,049	$ 433,722
Gross Profit	174,095	184,665
Income (loss) from operations	2,645	(6,701)
Unallocated Amounts [Member]
Segment Reporting Information [Line Items]
Revenue	4,326	491
Gross Profit	(14,157)	(16,194)
Income (loss) from operations	(105,948)	(118,873)
Provider [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
Revenue	392,607	410,424
Gross Profit	165,818	185,729
Income (loss) from operations	100,274	107,140
Veradigm [Member] | Operating Segments [Member]
Segment Reporting Information [Line Items]
Revenue	35,116	22,807
Gross Profit	22,434	15,130
Income (loss) from operations	$ 8,319	$ 5,032

Supplemental Disclosures (Detai

Supplemental Disclosures (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$ 137,167	$ 111,999	$ 174,243
Restricted cash	10,681	12,668	$ 10,552
Total cash, cash equivalents and restricted cash	147,848	124,667
Supplemental non-cash information:
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operation	0	12,149
Contribution of assets in exchange for equity interest	0	4,000
Netsmart [Member]
Supplemental non-cash information:
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operation	$ 0	$ 12,149