MedAssets (MDAS) 10-Q 6 Nov 15 2015 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2015	Oct. 28, 2015
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2015
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	Q3
Trading Symbol	MDAS
Entity Registrant Name	MEDASSETS INC
Entity Central Index Key	1,254,419
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		59,287,313

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Current assets
Cash and cash equivalents	$ 0	$ 12,100
Accounts receivable, net of allowances of $2,558 and $2,641 as of September 30, 2015 and December 31, 2014, respectively	120,005	127,741
Deferred tax asset, current portion	5,683	5,782
Prepaid expenses and other current assets	25,138	30,557
Total current assets	150,826	176,180
Property and equipment, net	154,092	170,318
Other long term assets
Goodwill	1,058,414	1,058,414
Intangible assets, net	231,591	276,407
Other	31,851	37,477
Other long term assets	1,321,856	1,372,298
Total assets	1,626,774	1,718,796
Current liabilities
Accounts payable	19,014	26,910
Accrued revenue share obligation and rebates	93,769	91,864
Accrued payroll and benefits	42,013	32,784
Other accrued expenses	23,521	9,040
Deferred revenue, current portion	70,241	76,034
Current portion of notes payable	26,438	29,583
Current portion of finance obligation	315	294
Total current liabilities	275,311	266,509
Notes payable, less current portion	437,667	526,417
Bonds payable	325,000	325,000
Finance obligation, less current portion	8,236	8,475
Deferred revenue, less current portion	16,740	15,418
Deferred tax liability	107,403	116,607
Other long term liabilities	13,731	13,883
Total liabilities	$ 1,184,088	$ 1,272,309
Commitments and contingencies
Stockholders' equity
Common stock, $0.01 par value, 150,000,000 shares authorized; 62,872,000 and 59,266,000 shares issued and outstanding as of September 30, 2015 and 62,598,000 and 60,199,000 shares issued and outstanding as of December 31, 2014, respectively	$ 593	$ 602
Additional paid-in capital	683,012	694,235
Accumulated deficit	(240,919)	(248,350)
Total stockholders' equity	442,686	446,487
Total liabilities and stockholders' equity	$ 1,626,774	$ 1,718,796

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Statement of Financial Position [Abstract]
Allowances on accounts receivable	$ 2,558	$ 2,641
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares issued	62,872,000	62,598,000
Common stock, shares outstanding	59,266,000	60,199,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Revenue:
Administrative fees, net	$ 71,987	$ 70,788	$ 219,471	$ 217,125
Other service fees	117,981	104,917	346,502	304,862
Total net revenue	189,968	175,705	565,973	521,987
Operating expenses:
Cost of revenue (inclusive of depreciation expense of $1,001 and $1,094 for the three months ended September 30, 2015 and 2014, respectively; and $2,968 and $2,166 for the nine months ended September 30, 2015 and 2014, respectively)	48,003	42,439	138,060	120,231
Product development expenses	8,198	8,106	24,049	22,145
Selling and marketing expenses	17,120	14,273	60,480	50,187
General and administrative expenses	64,363	57,579	188,247	175,911
Restructuring, acquisition and integration-related expenses	5,027	3,010	10,022	4,707
Depreciation	13,691	11,845	40,589	35,247
Amortization of intangibles	14,829	13,936	44,816	41,989
Impairment of property and equipment	10,309		10,309
Total operating expenses	181,540	151,188	516,572	450,417
Operating income	8,428	24,517	49,401	71,570
Other income (expense):
Interest (expense)	(11,556)	(11,338)	(35,235)	(33,625)
Other (expense) income	(103)	273	(151)	362
(Loss) income before income taxes	(3,231)	13,452	14,015	38,307
Income tax (benefit) expense	(995)	5,712	6,584	16,293
Net (loss) income	$ (2,236)	$ 7,740	$ 7,431	$ 22,014
Basic and diluted (loss) income per share:
Basic net (loss) income per share	$ (0.04)	$ 0.13	$ 0.12	$ 0.37
Diluted net (loss) income per share	$ (0.04)	$ 0.13	$ 0.12	$ 0.36
Weighted average shares - basic	59,437	59,401	59,678	59,917
Weighted average shares - diluted	59,437	60,662	60,822	61,269

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Operations (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Income Statement [Abstract]
Depreciation expense	$ 1,001	$ 1,094	$ 2,968	$ 2,166

Condensed Consolidated Stateme6

Condensed Consolidated Statement of Stockholders' Equity (Unaudited) - 9 months ended Sep. 30, 2015 - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member]
Balances at Dec. 31, 2014	$ 446,487	$ 602	$ 694,235	$ (248,350)
Balances, Shares at Dec. 31, 2014		60,199,000
Issuance of common stock from stock option and SSAR exercises and restricted stock issuances, net	1,389	$ 5	1,384
Issuance of common stock from stock option and SSAR exercises and restricted stock issuances, net, Shares		477,000
Shares surrendered to pay taxes on vesting of restricted stock	(3,913)	$ (2)	(3,911)
Shares surrendered to pay taxes on vesting of restricted stock, shares		(203,000)
Stock compensation expense	16,721		16,721
Repurchase of common stock	$ (25,000)	$ (12)	(24,988)
Repurchase of common stock, shares	(1,207,384)	(1,207,000)
Tax deficit from equity award exercises, net	$ (429)		(429)
Net income	7,431			7,431
Balances at Sep. 30, 2015	$ 442,686	$ 593	$ 683,012	$ (240,919)
Balances, Shares at Sep. 30, 2015		59,266,000

Condensed Consolidated Stateme7

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Operating activities
Net income	$ 7,431	$ 22,014
Adjustments to reconcile income from continuing operations to net cash provided by operating activities:
Bad debt expense		100
Impairment of property and equipment	10,309
Depreciation	43,557	37,413
Amortization of intangibles	44,816	41,989
Loss on sale of assets	346	24
Noncash stock compensation expense	16,721	14,703
Excess tax benefit from exercise of equity awards	(543)	(1,788)
Amortization of debt issuance costs	2,916	2,829
Noncash interest expense, net	289	309
Deferred income tax benefit	(9,208)	(6,883)
Changes in assets and liabilities:
Accounts receivable	7,736	(13,204)
Prepaid expenses and other assets	5,419	1,552
Other long-term assets	713	386
Accounts payable	(7,886)	(4,348)
Accrued revenue share obligations and rebates	1,905	1,225
Accrued payroll and benefits	9,229	(13,068)
Other accrued expenses and long-term liabilities	14,329	4,195
Deferred revenue	(4,471)	8,604
Cash provided by operating activities	143,608	96,052
Investing activities
Purchases of property, equipment and software, net	(6,255)	(9,820)
Capitalized software development costs	(30,069)	(30,568)
Acquisitions, net of cash acquired		(138,233)
Cash used in investing activities	(36,324)	(178,621)
Financing activities
Borrowings from revolving credit facility		216,080
Repayment of notes payable	(24,896)	(21,625)
Repayment of revolving credit facility	(67,000)	(59,080)
Repayment of finance obligation	(507)	(507)
Debt issuance costs		(569)
Excess tax benefit from exercise of equity awards	543	1,788
Issuance of common stock, net	1,389	3,378
Purchase of treasury shares, including shares surrendered for tax withholdings	(28,913)	(45,793)
Cash (used in) provided by financing activities	(119,384)	93,672
Net (decrease) increase in cash and cash equivalents	(12,100)	11,103
Cash and cash equivalents, beginning of period	12,100	2,790
Cash and cash equivalents, end of period	$ 0	$ 13,893

Business Description and Basis

Business Description and Basis of Presentation	9 Months Ended
	Sep. 30, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business Description and Basis of Presentation	1. BUSINESS DESCRIPTION AND BASIS OF PRESENTATION We provide technology-enabled products and services that, together, deliver solutions designed to reduce total cost of care, enhance operational efficiency, align clinical delivery with advance care coordination and improve revenue performance for hospitals, health systems and other ancillary healthcare providers. Our customer-specific solutions are designed to efficiently analyze detailed information across the spectrum of cost, operations, clinical delivery and reimbursement. Our solutions integrate with our customers’ existing operations and enterprise software systems and provide financial improvement with minimal upfront costs or capital expenditures. Our operations and customers are primarily located throughout the United States and to a limited extent, Canada. The accompanying unaudited condensed consolidated financial statements, and condensed consolidated balance sheet as of December 31, 2014, derived from audited financial statements, have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial reporting and as required by Regulation S-X, Rule 10-01 of the U.S. Securities and Exchange Commission (“SEC”). Accordingly, certain information and footnote disclosures required for complete financial statements are not included herein. In the opinion of management, all adjustments considered necessary for a fair presentation of the interim financial information, consisting of normal recurring adjustments, have been included. When preparing financial statements in conformity with GAAP, we must make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues, expenses and related disclosures at the date of the condensed consolidated financial statements. Actual results may differ materially from those estimates. Operating results for the three and nine months ended September 30, 2015 are not necessarily indicative of the results that may be expected for any other interim period or for the fiscal year ending December 31, 2015. The accompanying unaudited condensed consolidated financial statements and notes thereto should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2014 included in our annual report on Form 10-K as filed with the SEC on March 2, 2015 in addition to our quarterly reports filed on Form 10-Q for the periods after December 31, 2014. These financial statements include the accounts of MedAssets, Inc. and our wholly owned subsidiaries. All significant intercompany accounts have been eliminated in consolidation. Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with GAAP and pursuant to the rules and regulations of the SEC, requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results may differ materially from those estimates. We believe that the estimates, assumptions and judgments involved in revenue recognition, allowances for doubtful accounts and returns, product development costs, share-based payments, business combinations, impairment of goodwill, intangible assets and long-lived assets and accounting for income taxes have the greatest potential impact on our condensed consolidated financial statements. Cash and Cash Equivalents All of our highly liquid investments with original maturities of three months or less at the date of purchase are carried at cost (which approximates fair value) and are considered to be cash equivalents. Currently, our excess cash is voluntarily used to repay our swing line credit facility, if any, on a daily basis and applied against our revolving credit facility on a routine basis when our swing line credit facility is undrawn. In addition, we may periodically make voluntary repayments on our term loans. Cash and cash equivalents were zero and $12,100 as of September 30, 2015 and December 31, 2014, respectively. We had $85,000 and $152,000 outstanding on our revolving credit facility as of September 30, 2015 and December 31, 2014, respectively. In the event our cash balance is zero at the end of a period, any outstanding checks are recorded as accrued expenses. As of September 30, 2015, we reclassified approximately $8,431 of outstanding checks related to a book overdraft into other accrued expenses on the condensed consolidated balance sheet. This book overdraft amount has been included in operating activities within the condensed consolidated statement of cash flows. See Note 6 for immediately available cash under our revolving credit facility.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2015
Accounting Changes and Error Corrections [Abstract]
Recent Accounting Pronouncements	2. RECENT ACCOUNTING PRONOUNCEMENTS Business Combinations In September 2015, the Financial Accounting Standards Board (“FASB”) issued an accounting standard update relating to the accounting for business combinations. The amendments in this update require that an acquirer recognize adjustments to provisional amounts that are identified during the measurement period in the reporting period in which the adjustment amounts are determined. The amendments in this update require that the acquirer record, in the same period’s financial statements, the effect on earnings of changes in depreciation, amortization, or other income effects, if any, as a result of the change to the provisional amounts, calculated as if the accounting had been completed at the acquisition date. The amendments in this update require an entity to present separately on the face of the income statement or disclose in the notes the portion of the amount recorded in current-period earnings by line item that would have been recorded in previous reporting periods if the adjustment to the provisional amounts had been recognized as of the acquisition date. The update will be effective on January 1, 2016. Debt Issuance Costs In April 2015, the FASB issued an accounting standard update relating to simplifying the presentation of debt issuance costs. The amendments in this update require that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. The update will be effective on January 1, 2016. Going Concern In August 2014, the FASB issued an accounting standard update relating to disclosure of uncertainties about an entity’s ability to continue as a going concern. The update provides guidance about management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to provide related footnote disclosures in the event that there is such substantial doubt. The update will be effective on January 1, 2016. Share-Based Compensation In June 2014, the FASB issued an accounting standard update relating to reporting entities that grant their employees share-based payments in which the terms of the award provide that a performance target that affects vesting could be achieved after the requisite service period. This update requires that a performance target that affects vesting and that could be achieved after the requisite service period be treated as a performance condition. The update will be effective on January 1, 2016. Revenue Recognition In May 2014, the FASB issued an accounting standard update relating to revenue from contracts with customers, which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. The update will replace most existing revenue recognition guidance under GAAP when it becomes effective. The update was originally to be effective for us on January 1, 2017. In July 2015, the FASB approved a one year extension to the required implementation date. As a result, the update is effective for us on January 1, 2018. Early application is not permitted. The update permits the use of either the retrospective or cumulative effect transition method. We are evaluating the effect that the update will have on our consolidated financial statements and related disclosures. We have not yet selected a transition method nor have we determined the effect of the standard on our ongoing financial reporting.

Restructuring, Acquisition and

Restructuring, Acquisition and Integration-Related Expenses	9 Months Ended
	Sep. 30, 2015
Text Block [Abstract]
Restructuring, Acquisition and Integration-Related Expenses	3. RESTRUCTURING, ACQUISITION AND INTEGRATION-RELATED EXPENSES Restructuring Activities On September 28, 2015, we announced a cost reduction program in order to improve operating efficiency and align our cost structure with expected future net revenue. As part of this cost reduction program, we reduced our workforce by approximately 180 full-time employees. As a result, we incurred employee-related costs which represent one-time termination benefits, comprised principally of severance, benefit continuation costs, outplacement services and other associated costs. During the three months ended September 30, 2015 and 2014, we expensed total restructuring, acquisition and integration-related costs of $5,027 and $3,010, respectively. In addition to the cost reduction program described above, our management had previously approved and initiated a plan to restructure our operations that resulted in certain workforce reductions within the Company and changes in senior management. During the nine months ended September 30, 2015 and 2014, we expensed total restructuring, acquisition and integration-related costs of $10,022 (inclusive of $352 of acquisition-related expenses) and $4,707, respectively. These costs are included within the restructuring, acquisition and integration-related expenses line on the accompanying condensed consolidated statements of operations. During 2015, cash payments related to restructuring and acquisition-related activities were approximately $5,991. As of September 30, 2015, we had $6,104 in accrued liabilities for these costs of which $5,203 is expected to be paid over the next twelve months. The following table summarizes the activities related to the restructuring and other charges, as discussed above: Employee-related Other associated Total Restructuring Reserve Accrued, December 31, 2014 $ 1,918 $ 155 $ 2,073 Charges incurred 9,443 579 10,022 Cash payments (5,482 ) (509 ) (5,991 ) Accrued, September 30, 2015 $ 5,879 $ 225 $ 6,104

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 30, 2015
Property, Plant and Equipment [Abstract]
Property and Equipment	4. PROPERTY AND EQUIPMENT In connection with our business transformation plan, we made the strategic decision to eliminate certain capitalized software products within our Revenue Cycle Management segment. We assessed the recoverability of these products by comparing the net carrying value of the assets to their total undiscounted cash flows which indicated that the carrying amount may not be recoverable. As a result, we performed a fair value analysis using the income approach based on estimated discounted future cash flows to determine the fair value of the assets (level 3 non-recurring measurement). Our cash flow assumptions considered historical and forecasted revenue, operating costs and other relevant factors similar to those a market participant would use to assess fair value. Based on our analysis, for the three months ended September 30, 2015, we recorded a non-cash capitalized software impairment expense of $10,309 to adjust the assets’ carrying amount to their estimated fair value.

Deferred Revenue

Deferred Revenue	9 Months Ended
	Sep. 30, 2015
Deferred Revenue Disclosure [Abstract]
Deferred Revenue	5. DEFERRED REVENUE Deferred revenue consists of unrecognized revenue related to advanced customer billing or customer payments received prior to revenue being realized and earned. Substantially all of our deferred revenue consists of: (i) deferred administrative fees, net; (ii) deferred service fees; (iii) deferred software and implementation fees; and (iv) other deferred fees, including receipts for our annual customer and vendor meeting prior to the event. The following table summarizes the deferred revenue categories and balances as of: September 30, December 31, Software and SaaS implementation fees $ 48,564 $ 55,152 Service fees 23,148 19,241 Administrative fees 13,217 15,715 Other fees 2,052 1,344 Deferred revenue, total 86,981 91,452 Less: Deferred revenue, current portion (70,241 ) (76,034 ) Deferred revenue, non-current portion $ 16,740 $ 15,418 As of September 30, 2015 and December 31, 2014, deferred revenue included in our condensed consolidated balance sheets that was contingent upon meeting performance targets was $7,547 and $8,441, respectively. Advance billings on arrangements that include contingent performance targets are recorded in accounts receivable and deferred revenue when billed. Only certain contingent performance targets are billed in advance of meeting the target as determined by the customer arrangement.

Notes and Bonds Payable

Notes and Bonds Payable	9 Months Ended
	Sep. 30, 2015
Debt Disclosure [Abstract]
Notes and Bonds Payable	6. NOTES AND BONDS PAYABLE The balances of our notes and bonds payable are summarized as follows as of: September 30, December 31, Term A facility $ 206,576 $ 225,000 Term B facility 172,529 179,000 Revolving credit facility 85,000 152,000 Total notes payable 464,105 556,000 Bonds payable 325,000 325,000 Total notes and bonds payable 789,105 881,000 Less: current portions (26,438 ) (29,583 ) Total long-term notes and bonds payable $ 762,667 $ 851,417 Notes Payable As of September 30, 2015, our long-term notes payable consists of a Term A Facility, a Term B Facility and a revolving credit facility (inclusive of a swing line loan) under a credit agreement with JP Morgan Chase Bank, N.A and other financial institutions named therein, dated December 13, 2012 (as amended from time to time, the “Credit Agreement”), each with an outstanding balance of $206,576, $172,529 and $85,000, respectively. We have classified the $85,000 outstanding balance on our revolving credit facility as a long term liability given the maturity date of December 13, 2017. No amounts were drawn on our swing line loan and we made voluntary payments of $67,000 on our revolving credit facility, which resulted in $214,000 of availability under our revolving credit facility (after giving effect to $1,000 of outstanding but undrawn letters of credit on such date and the increase in the revolving credit facility as discussed below) as of September 30, 2015. During the nine months ended September 30, 2015, we made scheduled principal payments of $16,312 on our Term A Facility and Term B Facility in addition to payments of $7,833 relating to our 2014 excess cash flow payment ($4,362 on the Term A Facility and $3,471 on the Term B Facility). We also made a voluntary payment of $750 on the Term B Facility. The applicable weighted average interest rates (inclusive of the applicable bank margin) on our Term A Facility, Term B Facility and revolving credit facility at September 30, 2015 were 2.52%, 4.00% and 2.53%, respectively. On September 8, 2014, the Company entered into a First Increase Joinder to the Credit Agreement (the “First Increase Joinder”). The First Increase Joinder increased the revolving commitment amount under the Credit Agreement by $100,000 to $300,000. In connection with the First Increase Joinder, we incurred and capitalized approximately $615 of debt issuance costs which will be amortized into interest expense ratably over the remaining term of the revolving credit facility. The Credit Agreement contains certain customary negative covenants, including but not limited to, limitations on the incurrence of debt, limitations on liens, limitations on fundamental changes, limitations on asset sales and sale leasebacks, limitations on investments, limitations on dividends or distributions on, or redemptions of, equity interests, limitations on prepayments or redemptions of unsecured or subordinated debt, limitations on negative pledge clauses, limitations on transactions with affiliates and limitations on changes to the Company’s fiscal year. The Credit Agreement also includes maintenance covenants of maximum ratios of consolidated total indebtedness (subject to certain adjustments) to consolidated EBITDA (subject to certain adjustments) and minimum cash interest coverage ratios. The Credit Agreement contains certain customary representations and warranties, affirmative covenants and events of default, including but not limited to, payment defaults, breaches of representations and warranties, covenant defaults, cross-defaults to certain indebtedness, certain events of insolvency or bankruptcy, material judgments, certain events under ERISA, actual or asserted failures of any guaranty or security document supporting the credit agreement to be in full force and effect and changes of control. The Company was in compliance with these covenants as of September 30, 2015. We are also required to prepay our debt obligations based on an excess cash flow calculation for the applicable fiscal year which is determined in accordance with the terms of the Credit Agreement. Our current portion of notes payable does not include an amount with respect to any 2015 excess cash flow payment. We will reclassify a portion of our long-term notes payable to a current classification at such time that any 2015 excess cash flow payment becomes estimable. We will be required to make any necessary cash flow payment within the first quarter of 2016. All of the Company’s obligations under the Credit Agreement are unconditionally guaranteed by each of the Company’s existing and subsequently acquired or organized wholly owned restricted subsidiaries, except that the following subsidiaries do not and will not provide guarantees: (a) unrestricted subsidiaries, (b) subsidiaries with tangible assets and revenues each having a value of less than 2.5% of the consolidated tangible assets and consolidated revenues of the Company (provided that all such immaterial subsidiaries, on a consolidated basis, shall not account for more than 5.0% of the consolidated EBITDA of the Company), (c) any subsidiary prohibited by applicable law, rule or regulation from providing a guarantee or which would require governmental (including regulatory) consent or approval or which would result in adverse tax consequences and (d) not-for-profit subsidiaries. All of the Company’s obligations under the Credit Agreement are secured by substantially all of the Company’s assets and the assets of each guarantor (subject to certain exceptions), including but not limited to, (1) a perfected pledge of all of the equity securities of each direct wholly owned restricted subsidiary of the Company and of each subsidiary guarantor (which pledge, in the case of any foreign subsidiary, is limited to 65% of the equity securities of such foreign subsidiary) and (2) perfected security interests in, and mortgages on, substantially all tangible and intangible personal property and material fee-owned real property of the Company and each subsidiary guarantor (including but not limited to, accounts receivable, inventory, equipment, general intangibles (including contract rights), investment property, intellectual property, material intercompany notes and proceeds of the foregoing). Loans under the Credit Agreement must be prepaid under certain circumstances, including with proceeds from certain future debt issuances, asset sales and a portion of excess cash flow for the applicable fiscal year. Loans under the Credit Agreement may be voluntarily prepaid at any time, subject to customary LIBOR breakage costs. Bonds Payable The Company has an aggregate principal amount of $325,000 of 8% senior notes due 2018 (the “Notes”) outstanding that have been registered under the Securities Act of 1933, as amended. The Notes are guaranteed on a senior unsecured basis by each of our existing domestic subsidiaries and each of our future domestic restricted subsidiaries in each case that guarantees our obligations under the Credit Agreement. Each of the subsidiary guarantors is 100% owned by us. The guarantees by the subsidiary guarantors are full and unconditional and joint and several. We have no independent assets or operations, and any subsidiaries of ours other than the subsidiary guarantors are minor. The Notes and the guarantees are senior unsecured obligations of the Company and the subsidiary guarantors, respectively. The Notes were issued pursuant to an indenture dated as of November 16, 2010 (the “Indenture”) among the Company, its subsidiary guarantors and Wells Fargo Bank, N.A., as trustee. Pursuant to the Indenture, the Notes will mature on November 15, 2018 and bear 8% annual interest. Interest on the Notes is payable semi-annually in arrears on May 15 and November 15 of each year, beginning on May 15, 2011. The Indenture contains certain customary negative covenants, including but not limited to, limitations on the incurrence of debt, limitations on liens, limitations on consolidations or mergers, limitations on asset sales, limitations on certain restricted payments and limitations on transactions with affiliates. The Indenture does not contain any significant restrictions on the ability of the Company or any subsidiary guarantor to obtain funds from the Company or any other subsidiary guarantor by dividend or loan. The Indenture also contains customary events of default. The Company was in compliance with these covenants as of September 30, 2015. The Company has the option to redeem all or a part of the Notes, at the following redemption prices: Year Percentage 2015 102 % 2016 and thereafter 100 % The Notes also contain a redemption feature that would require the repurchase of 101% of the aggregate principal amount plus accrued and unpaid interest at the option of the holders upon a change in control. As of September 30, 2015, the Notes were trading at 102.3% of par value (Level 1). Debt Issuance Costs As of September 30, 2015, we had approximately $11,159 of debt issuance costs related to the Credit Agreement and Notes which will be amortized into interest expense generally using the effective interest method until the applicable maturity date. For the three months ended September 30, 2015 and 2014, we recognized $967 and $949, respectively, in interest expense related to the amortization of debt issuance costs. For the nine months ended September 30, 2015 and 2014, we recognized $2,916 and $2,829, respectively, in interest expense related to the amortization of debt issuance costs. Debt Maturity Table The following table summarizes our stated debt maturities and scheduled principal repayments as of September 30, 2015: Year Term A Term B Revolving Senior Total 2015(1) $ 4,688 $ 750 $ — $ — $ 5,438 2016 25,000 3,000 — — 28,000 2017 176,888 3,000 85,000 — 264,888 2018 — 3,000 — 325,000 328,000 2019 — 162,779 — — 162,779 $ 206,576 $ 172,529 $ 85,000 $ 325,000 $ 789,105 (1) Represents the remaining quarterly principal payments due during the fiscal year ending December 31, 2015 and the balance of the swing line component of our revolving credit facility, if any. (2) The Term B Facility matures on December 13, 2019; however, the facility will mature in full on May 15, 2018 if our outstanding senior notes have not been repaid or refinanced in full by such date. Total interest paid (net of amounts capitalized) on our notes and bonds payable during the nine months ended September 30, 2015 and 2014 was approximately $25,528 and $23,959, respectively.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2015
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	7. COMMITMENTS AND CONTINGENCIES Performance Targets In the ordinary course of contracting with our customers, we may agree to make some or all of our fees contingent upon the customer’s achievement of financial improvement targets from the use of our services and software. These contingent fees are not recognized as revenue until the customer confirms achievement of the performance targets. We generally receive customer acceptance as and when the performance targets are achieved. If we invoice contingent fees prior to customer confirmation that a performance target has been achieved, we record invoiced contingent fees as deferred revenue on our condensed consolidated balance sheets. Often, recognition of this revenue occurs in periods subsequent to the recognition of the associated costs. Legal Proceedings From time to time, we become involved in legal proceedings arising in the ordinary course of business. As of September 30, 2015, we are not presently involved in any legal proceedings, the outcome of which, if determined adversely to us, would have a material adverse effect on our business, operating results or financial condition.

Stockholders' Equity and Share-

Stockholders' Equity and Share-Based Compensation	9 Months Ended
	Sep. 30, 2015
Text Block [Abstract]
Stockholders' Equity and Share-Based Compensation	8. STOCKHOLDERS’ EQUITY AND SHARE-BASED COMPENSATION Common Stock During the nine months ended September 30, 2015, we issued approximately 506,000 shares of common stock in connection with employee stock option exercises, stock-settled stock appreciation rights (“SSARs”) exercises and the vesting of restricted stock units (“RSUs”) for net exercise proceeds of $1,389. During the nine months ended September 30, 2015, approximately 29,000 shares of restricted common stock were forfeited. During the nine months ended September 30, 2015, we received approximately 203,000 shares that were surrendered from equity awards holders to settle their associated minimum statutory tax liability of $3,913 from shares that vested during the year. Repurchase of Common Stock In February 2015, our Board of Directors authorized an extension to our existing share repurchase program until February 29, 2016 and increased the total dollar amount available for the repurchase of shares of our common stock to $100,000 subject to certain restrictions under our Credit Agreement and Indenture. As of September 30, 2015, we had approximately $32,230 available for repurchase under our existing share repurchase program. The following table shows the amount and cost of shares of common stock we repurchased for the three and nine months ended September 30, 2015 and 2014 under the share repurchase program. The repurchased shares have not been retired and constitute authorized shares that are issued but not outstanding. Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Number of shares repurchased 792,148 500 1,207,384 1,784,645 Cost of shares repurchased $ 16,412 $ 11 $ 25,000 $ 42,771 Share-Based Compensation As of September 30, 2015, we had restricted common stock, RSUs, SSARs and common stock option equity awards outstanding under three share-based compensation plans. As of September 30, 2015, we had approximately 4,017,000 shares reserved (inclusive of equity award forfeitures) and available for grant under the 2008 MedAssets, Inc. Long-Term Performance Incentive Plan (“LTPIP”). The total share-based compensation expense related to equity awards was $5,590 and $4,809 for the three months ended September 30, 2015 and 2014, respectively. The total income tax benefit recognized in the condensed consolidated statements of operations for share-based compensation arrangements related to equity awards was $2,088 and $1,793 for the three months ended September 30, 2015 and 2014, respectively. The total share-based compensation expense related to equity awards was $16,721 and $14,703 for the nine months ended September 30, 2015 and 2014, respectively. The total income tax benefit recognized in the condensed consolidated statements of operations for share-based compensation arrangements related to equity awards was $6,247 and $5,481 for the nine months ended September 30, 2015 and 2014, respectively. There were no capitalized share-based compensation expenses during the three and nine months ended September 30, 2015. Total share-based compensation expense (inclusive of restricted common stock, RSUs, SSARs and common stock options) for the three and nine months ended September 30, 2015 and 2014 as reflected in our condensed consolidated statements of operations is as follows: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Cost of revenue $ 1,565 $ 1,476 $ 4,715 $ 4,505 Product development 271 252 1,044 887 Selling and marketing 965 710 2,872 2,082 General and administrative 2,789 2,371 8,090 7,229 Total share-based compensation expense $ 5,590 $ 4,809 $ 16,721 $ 14,703 Employee Stock Purchase Plan In 2010, we established the MedAssets, Inc. Employee Stock Purchase Plan (the “Plan”). Under the Plan, eligible employees may purchase shares of our common stock at a discounted price through payroll deductions. The price per share of the common stock sold to participating employees will be 95% of the fair market value of our common stock on the applicable purchase date. The Plan requires that all stock purchased be held by participants for a period of 18 months from the purchase date. A total of 500,000 shares of our common stock are authorized for purchase under the Plan. For the nine months ended September 30, 2015 and 2014, we purchased approximately 27,000 shares and 22,000 shares of our common stock under the Plan which amounted to approximately $506 and $494, respectively. Equity Award Grants Information regarding equity awards for the nine months ended September 30, 2015 is as follows: Restricted Stock Unit Equity Awards During 2015, our Compensation Committee of our Board of Directors (the “Compensation Committee”) approved equity grants for certain eligible employees consisting of service-based and performance-based RSUs. The purpose of the equity grants are to assist the Company in attracting, retaining, motivating, and rewarding certain individuals of the Company. The equity grants are intended to promote the creation of long-term value for stockholders of the Company by closely aligning the interests of such individuals with those of the stockholders. A summary of the total approved equity grants during the nine months ended September 30, 2015 is as follows: Total RSUs Range of Grant RSUs - Service 816,261 $18.44 - $22.16 (1) RSUs - Performance 1,026,028 $18.44 - $22.16 (2) Total RSUs granted 1,842,289 (1) Service-based RSUs vest annually over three years of continuous service with the exception of certain equity awards granted to our Board that vest ratably each month through December 31, 2015; and (2) Performance-based RSUs generally vest annually over three years of continuous service provided the performance metric is achieved and consist of a net revenue and a non-GAAP adjusted earnings per share (“EPS”) performance metric. The Company must achieve a minimum net revenue and non-GAAP adjusted EPS threshold before any performance-based RSUs begin vesting. If the minimum threshold is not met, the equity award holders will forfeit those awards.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2015
Income Tax Disclosure [Abstract]
Income Taxes	9. INCOME TAXES Income tax expense recorded during the three and nine months ended September 30, 2015 reflected an effective income tax rate of 30.8% (tax benefit) and 47.0%, respectively. Income tax expense recorded during the three and nine months ended September 30, 2014 reflected an effective income tax rate of 42.5%.

(Loss) Income Per Share

(Loss) Income Per Share	9 Months Ended
	Sep. 30, 2015
Earnings Per Share [Abstract]
(Loss) Income Per Share	10. (LOSS) INCOME PER SHARE We calculate earnings per share (or “EPS”) in accordance with GAAP relating to earnings per share. Basic EPS is calculated by dividing reported net (loss) income by the weighted-average number of common shares outstanding for the reported period. Diluted EPS reflects the potential dilution that could occur if our stock options, SSARs, unvested restricted stock, RSUs and shares that were purchasable pursuant to our employee stock purchase plan were exercised and converted into our common shares during the reporting periods. A reconciliation of basic and diluted weighted average shares outstanding for basic and diluted EPS for the three and nine months ended September 30, 2015 and 2014 is as follows: Three Months Ended September 30, 2015 2014 Numerator for Basic and Diluted (Loss) Income Per Share: Net (loss) income $ (2,236 ) $ 7,740 Denominator for basic (loss) income per share weighted average shares 59,437,000 59,401,000 Effect of dilutive securities: Stock options — 195,000 SSARs — 288,000 Restricted stock and RSUs — 778,000 Denominator for diluted (loss) income per share - adjusted weighted average shares and assumed conversions 59,437,000 60,662,000 Basic (loss) income per share: Basic net (loss) income from continuing operations $ (0.04 ) $ 0.13 Diluted net (loss) income per share: Diluted net (loss) income from continuing operations $ (0.04 ) $ 0.13 Nine Months Ended September 30, 2015 2014 Numerator for Basic and Diluted Income Per Share: Net income $ 7,431 $ 22,014 Denominator for basic income per share weighted average shares 59,678,000 59,917,000 Effect of dilutive securities: Stock options 126,000 268,000 SSARs 190,000 299,000 Restricted stock and RSUs 828,000 785,000 Denominator for diluted income per share - adjusted weighted average shares and assumed conversions 60,822,000 61,269,000 Basic income per share: Basic net income from continuing operations $ 0.12 $ 0.37 Diluted net income per share: Diluted net income from continuing operations $ 0.12 $ 0.36 During the three months ended September 30, 2015, basic and diluted EPS are the same because potentially dilutive securities have been excluded from the calculation of diluted EPS given our net loss for the period. In addition, the effect of certain dilutive securities have been excluded because the impact is anti-dilutive as a result of certain securities being “out of the money” with strike prices greater than the average market price during the periods presented. The following table provides a summary of those potentially dilutive securities that have been excluded from the above calculation of diluted EPS: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 SSARs — 9,000 23,000 7,000

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2015
Segment Reporting [Abstract]
Segment Information	11. SEGMENT INFORMATION We manage our business through two reportable business segments, Spend and Clinical Resource Management (or “SCM”) and Revenue Cycle Management (or “RCM”). • Spend and Clinical Resource Management • Revenue Cycle Management GAAP relating to segment reporting defines reportable segments as components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker in deciding how to allocate resources and in assessing financial performance. The guidance indicates that financial information about segments should be reported on the same basis as that which is used by the chief operating decision maker in the analysis of performance and allocation of resources. Management of the Company, including our chief operating decision maker, uses what we refer to as Segment Adjusted EBITDA as its primary measure of profit or loss to assess segment performance and to determine the allocation of resources. We define Segment Adjusted EBITDA as segment net income (loss) before net interest expense, income tax expense (benefit), depreciation and amortization (“EBITDA”) as adjusted for other non-recurring, non-cash or non-operating items. Our chief operating decision maker uses Segment Adjusted EBITDA to facilitate a comparison of our operating performance on a consistent basis from period to period. Segment Adjusted EBITDA includes expenses associated with sales and marketing, general and administrative and product development activities specific to the operation of the segment. General and administrative corporate expenses that are not specific to the segments are not included in the calculation of Segment Adjusted EBITDA. These expenses include the costs to manage our corporate offices, interest expense on our credit facilities and expenses related to being a publicly-held company. All reportable segment revenues are presented net of inter-segment eliminations and represent revenues from external customers. The following tables present Segment Adjusted EBITDA and financial position information as utilized by our chief operating decision maker. A reconciliation of Segment Adjusted EBITDA to consolidated net income is included. General corporate expenses are included in the “Corporate” line item. “RCM” represents the Revenue Cycle Management segment and “SCM” represents the Spend and Clinical Resource Management segment. Other assets and liabilities are included to provide a reconciliation to total assets and total liabilities. The following tables represent our results of operations, by segment, for the three and nine months ended September 30, 2015 and 2014: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Revenue: SCM Net administrative fees $ 71,987 $ 70,788 $ 219,471 $ 217,125 Other service fees(1) 45,245 35,011 137,107 103,198 Total SCM net revenue 117,232 105,799 356,578 320,323 RCM Revenue cycle technology 48,051 47,189 141,554 138,889 Revenue cycle services 24,685 22,717 67,841 62,775 Total RCM net revenue 72,736 69,906 209,395 201,664 Total net revenue 189,968 175,705 565,973 521,987 Operating expenses: SCM 97,536 76,384 288,718 234,640 RCM 68,949 59,817 182,478 175,035 Corporate 15,055 14,987 45,376 40,742 Total operating expenses 181,540 151,188 516,572 450,417 Operating income (loss): SCM 19,696 29,415 67,860 85,683 RCM 3,787 10,089 26,917 26,629 Corporate (15,055 ) (14,987 ) (45,376 ) (40,742 ) Total operating income 8,428 24,517 49,401 71,570 Interest (expense) (11,556 ) (11,338 ) (35,235 ) (33,625 ) Other (expense) income (103 ) 273 (151 ) 362 (Loss) income before income taxes (3,231 ) 13,452 14,015 38,307 Income tax (benefit) expense (995 ) 5,712 6,584 16,293 Net (loss) income $ (2,236 ) $ 7,740 $ 7,431 $ 22,014 Segment Adjusted EBITDA SCM $ 43,227 $ 47,983 $ 134,693 $ 140,233 RCM 22,712 17,914 62,093 50,928 Total Segment Adjusted EBITDA $ 65,939 $ 65,897 $ 196,786 $ 191,161 Corporate (7,162 ) (6,429 ) (21,499 ) (20,652 ) Total Adjusted EBITDA(2) $ 58,777 $ 59,468 $ 175,287 $ 170,509 (1) Other service fees primarily consists of consulting, services and technology fees. (2) These are non-GAAP measures. See “Use of Non-GAAP Financial Measures” section for additional information. Nine Months Ended September 30, 2015 2014 Capital expenditures(1): SCM $ 13,775 $ 16,070 RCM 20,457 21,861 Corporate 2,092 2,457 Total $ 36,324 $ 40,388 (1) Capital expenditures consist of purchases of property and equipment and capitalized software development costs (internal and external use). September 30, December 31, Financial Position: Accounts receivable, net SCM $ 60,630 $ 74,337 RCM 59,375 53,129 Corporate — 275 Total accounts receivable, net 120,005 127,741 Other assets SCM 1,015,981 1,067,039 RCM 425,527 439,333 Corporate 65,261 84,683 Total other assets 1,506,769 1,591,055 Total assets $ 1,626,774 $ 1,718,796 SCM accrued revenue share obligation $ 93,769 $ 91,864 Deferred revenue SCM 46,003 51,958 RCM 40,978 39,494 Total deferred revenue 86,981 91,452 Notes payable 464,105 556,000 Bonds payable 325,000 325,000 Other liabilities SCM 34,246 36,938 RCM 20,903 23,952 Corporate 159,084 147,103 Total other liabilities 214,233 207,993 Total liabilities $ 1,184,088 $ 1,272,309 GAAP for segment reporting requires that the total of the reportable segments’ measures of profit or loss be reconciled to the Company’s consolidated operating results. The following table reconciles Segment Adjusted EBITDA to consolidated net income for the three and nine months ended September 30, 2015 and 2014: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 SCM Adjusted EBITDA $ 43,227 $ 47,983 $ 134,693 $ 140,233 RCM Adjusted EBITDA 22,712 17,914 62,093 50,928 Total Segment Adjusted EBITDA 65,939 65,897 196,786 191,161 Depreciation (10,132 ) (8,695 ) (29,369 ) (25,653 ) Depreciation (included in cost of revenue) (1,001 ) (1,094 ) (2,968 ) (2,166 ) Amortization of intangibles (14,829 ) (13,936 ) (44,816 ) (41,989 ) Income tax expense (14,267 ) (16,942 ) (47,112 ) (47,894 ) Impairment of property and equipment(1) (10,309 ) — (10,309 ) — Share-based compensation expense(2) (2,629 ) (2,399 ) (8,238 ) (7,740 ) Purchase accounting adjustments(3) (116 ) (94 ) (944 ) (94 ) Restructuring, acquisition and integration-related expenses(4) (3,607 ) (7 ) (5,733 ) (1,138 ) Total reportable segment net income 9,049 22,730 47,297 64,487 Corporate net loss (11,285 ) (14,990 ) (39,866 ) (42,473 ) Consolidated net (loss) income $ (2,236 ) $ 7,740 $ 7,431 $ 22,014 (1) Represents the impairment of intangibles relating to the elimination of certain capitalized software products within the RCM segment. (2) Represents non-cash share-based compensation to both employees and directors. We believe excluding this non-cash expense allows us to compare our operating performance without regard to the impact of share-based compensation, which varies from period to period based on amount and timing of grants. (3) Represents the effect on revenue of adjusting Sg2’s acquired deferred revenue balance to fair value at the acquisition date. (4) Represents the amount attributable to restructuring, acquisition and integration-related costs which may include costs such as severance, retention, salaries relating to redundant positions, certain performance-related salary-based compensation, operating infrastructure costs and facility consolidation costs.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2015
Fair Value Disclosures [Abstract]
Fair Value Measurements	12. FAIR VALUE MEASUREMENTS We measure fair value for financial instruments when a valuation is necessary, such as for impairment of long-lived and indefinite-lived assets when indicators of impairment exist in accordance with GAAP for fair value measurements and disclosures. This defines fair value, establishes a framework for measuring fair value and enhances disclosures about fair value measures required under other accounting pronouncements, but does not change existing guidance as to whether or not an instrument is carried at fair value. In estimating our fair value disclosures for financial instruments, we use the following methods and assumptions: • Cash and cash equivalents • Accounts receivable, net • Accounts payable and current liabilities • Notes payable • Bonds payable

Related Party Transaction

Related Party Transaction	9 Months Ended
	Sep. 30, 2015
Related Party Transactions [Abstract]
Related Party Transaction	13. RELATED PARTY TRANSACTION We had an agreement with John Bardis, formerly our chief executive officer, for the use of an airplane owned by JJB Aviation, LLC, a limited liability company owned by Mr. Bardis. We paid Mr. Bardis at market-based rates for the use of the airplane for business purposes. The audit committee of the board of directors reviews such usage of the airplane annually. During the nine months ended September 30, 2015 and 2014, we incurred charges of zero and $1,013, respectively, related to transactions with Mr. Bardis. On February 17, 2015, the Company entered into a Transition and Consulting Agreement (the “Transition Agreement”) with Mr. Bardis in connection with Mr. Bardis’s resignation from his positions with the Company. Pursuant to the Transition Agreement, the Company’s agreement to use the airplane owned by JJB Aviation, LLC was terminated effective as of January 1, 2015.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2015
Subsequent Events [Abstract]
Subsequent Events	14. SUBSEQUENT EVENTS We have evaluated subsequent events for recognition or disclosure in the condensed consolidated financial statements filed on Form 10-Q with the SEC and no events have occurred that require disclosure, except for the following: On November 1, 2015, the Company entered into an Agreement and Plan of Merger (the “ Merger Agreement”) with Magnitude Parent Holdings, LLC, a Delaware limited liability company (“Parent”), and Magnitude Acquisition Corp., a Delaware corporation (“Merger Sub”). Pursuant to the Merger Agreement and subject to the satisfaction or waiver of the conditions set forth therein, Merger Sub will be merged with and into the Company, with the Company continuing as the surviving corporation and a wholly owned subsidiary of Parent (the “Merger”). Parent and Merger Sub were formed by affiliates of Pamplona Capital Management LLP (“Sponsor”). Refer to the Current Report on Form 8-K filed on November 2, 2015 for additional details.

Business Description and Basi22

Business Description and Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with GAAP and pursuant to the rules and regulations of the SEC, requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results may differ materially from those estimates. We believe that the estimates, assumptions and judgments involved in revenue recognition, allowances for doubtful accounts and returns, product development costs, share-based payments, business combinations, impairment of goodwill, intangible assets and long-lived assets and accounting for income taxes have the greatest potential impact on our condensed consolidated financial statements.
Cash and Cash Equivalents	Cash and Cash Equivalents All of our highly liquid investments with original maturities of three months or less at the date of purchase are carried at cost (which approximates fair value) and are considered to be cash equivalents. Currently, our excess cash is voluntarily used to repay our swing line credit facility, if any, on a daily basis and applied against our revolving credit facility on a routine basis when our swing line credit facility is undrawn. In addition, we may periodically make voluntary repayments on our term loans. Cash and cash equivalents were zero and $12,100 as of September 30, 2015 and December 31, 2014, respectively. We had $85,000 and $152,000 outstanding on our revolving credit facility as of September 30, 2015 and December 31, 2014, respectively. In the event our cash balance is zero at the end of a period, any outstanding checks are recorded as accrued expenses. As of September 30, 2015, we reclassified approximately $8,431 of outstanding checks related to a book overdraft into other accrued expenses on the condensed consolidated balance sheet. This book overdraft amount has been included in operating activities within the condensed consolidated statement of cash flows. See Note 6 for immediately available cash under our revolving credit facility.

Restructuring, Acquisition an23

Restructuring, Acquisition and Integration-Related Expenses (Tables)	9 Months Ended
	Sep. 30, 2015
Text Block [Abstract]
Summary of Activities Related to Restructuring and Other Charges	The following table summarizes the activities related to the restructuring and other charges, as discussed above: Employee-related Other associated Total Restructuring Reserve Accrued, December 31, 2014 $ 1,918 $ 155 $ 2,073 Charges incurred 9,443 579 10,022 Cash payments (5,482 ) (509 ) (5,991 ) Accrued, September 30, 2015 $ 5,879 $ 225 $ 6,104

Deferred Revenue (Tables)

Deferred Revenue (Tables)	9 Months Ended
	Sep. 30, 2015
Deferred Revenue Disclosure [Abstract]
Summary of Deferred Revenue	The following table summarizes the deferred revenue categories and balances as of: September 30, December 31, Software and SaaS implementation fees $ 48,564 $ 55,152 Service fees 23,148 19,241 Administrative fees 13,217 15,715 Other fees 2,052 1,344 Deferred revenue, total 86,981 91,452 Less: Deferred revenue, current portion (70,241 ) (76,034 ) Deferred revenue, non-current portion $ 16,740 $ 15,418

Notes and Bonds Payable (Tables

Notes and Bonds Payable (Tables)	9 Months Ended
	Sep. 30, 2015
Debt Disclosure [Abstract]
Summary of Notes and Bonds Payable	The balances of our notes and bonds payable are summarized as follows as of: September 30, December 31, Term A facility $ 206,576 $ 225,000 Term B facility 172,529 179,000 Revolving credit facility 85,000 152,000 Total notes payable 464,105 556,000 Bonds payable 325,000 325,000 Total notes and bonds payable 789,105 881,000 Less: current portions (26,438 ) (29,583 ) Total long-term notes and bonds payable $ 762,667 $ 851,417
Percentage of Redemption Prices	The Company has the option to redeem all or a part of the Notes, at the following redemption prices: Year Percentage 2015 102 % 2016 and thereafter 100 %
Debt Maturities and Scheduled Principal Repayments	The following table summarizes our stated debt maturities and scheduled principal repayments as of September 30, 2015: Year Term A Term B Revolving Senior Total 2015(1) $ 4,688 $ 750 $ — $ — $ 5,438 2016 25,000 3,000 — — 28,000 2017 176,888 3,000 85,000 — 264,888 2018 — 3,000 — 325,000 328,000 2019 — 162,779 — — 162,779 $ 206,576 $ 172,529 $ 85,000 $ 325,000 $ 789,105 (1) Represents the remaining quarterly principal payments due during the fiscal year ending December 31, 2015 and the balance of the swing line component of our revolving credit facility, if any. (2) The Term B Facility matures on December 13, 2019; however, the facility will mature in full on May 15, 2018 if our outstanding senior notes have not been repaid or refinanced in full by such date.

Stockholders' Equity and Shar26

Stockholders' Equity and Share-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2015
Text Block [Abstract]
Summary of Amount and Cost of Shares of Common Stock Repurchased	The following table shows the amount and cost of shares of common stock we repurchased for the three and nine months ended September 30, 2015 and 2014 under the share repurchase program. The repurchased shares have not been retired and constitute authorized shares that are issued but not outstanding. Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Number of shares repurchased 792,148 500 1,207,384 1,784,645 Cost of shares repurchased $ 16,412 $ 11 $ 25,000 $ 42,771
Summary of Total Share-Based Compensation Expense	Total share-based compensation expense (inclusive of restricted common stock, RSUs, SSARs and common stock options) for the three and nine months ended September 30, 2015 and 2014 as reflected in our condensed consolidated statements of operations is as follows: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Cost of revenue $ 1,565 $ 1,476 $ 4,715 $ 4,505 Product development 271 252 1,044 887 Selling and marketing 965 710 2,872 2,082 General and administrative 2,789 2,371 8,090 7,229 Total share-based compensation expense $ 5,590 $ 4,809 $ 16,721 $ 14,703
Summary of Total Approved Equity Grants	A summary of the total approved equity grants during the nine months ended September 30, 2015 is as follows: Total RSUs Range of Grant RSUs - Service 816,261 $18.44 - $22.16 (1) RSUs - Performance 1,026,028 $18.44 - $22.16 (2) Total RSUs granted 1,842,289 (1) Service-based RSUs vest annually over three years of continuous service with the exception of certain equity awards granted to our Board that vest ratably each month through December 31, 2015; and (2) Performance-based RSUs generally vest annually over three years of continuous service provided the performance metric is achieved and consist of a net revenue and a non-GAAP adjusted earnings per share (“EPS”) performance metric. The Company must achieve a minimum net revenue and non-GAAP adjusted EPS threshold before any performance-based RSUs begin vesting. If the minimum threshold is not met, the equity award holders will forfeit those awards.

(Loss) Income Per Share (Tables

(Loss) Income Per Share (Tables)	9 Months Ended
	Sep. 30, 2015
Earnings Per Share [Abstract]
Reconciliation of Basic and Diluted Weighted Average Shares Outstanding	A reconciliation of basic and diluted weighted average shares outstanding for basic and diluted EPS for the three and nine months ended September 30, 2015 and 2014 is as follows: Three Months Ended September 30, 2015 2014 Numerator for Basic and Diluted (Loss) Income Per Share: Net (loss) income $ (2,236 ) $ 7,740 Denominator for basic (loss) income per share weighted average shares 59,437,000 59,401,000 Effect of dilutive securities: Stock options — 195,000 SSARs — 288,000 Restricted stock and RSUs — 778,000 Denominator for diluted (loss) income per share - adjusted weighted average shares and assumed conversions 59,437,000 60,662,000 Basic (loss) income per share: Basic net (loss) income from continuing operations $ (0.04 ) $ 0.13 Diluted net (loss) income per share: Diluted net (loss) income from continuing operations $ (0.04 ) $ 0.13 Nine Months Ended September 30, 2015 2014 Numerator for Basic and Diluted Income Per Share: Net income $ 7,431 $ 22,014 Denominator for basic income per share weighted average shares 59,678,000 59,917,000 Effect of dilutive securities: Stock options 126,000 268,000 SSARs 190,000 299,000 Restricted stock and RSUs 828,000 785,000 Denominator for diluted income per share - adjusted weighted average shares and assumed conversions 60,822,000 61,269,000 Basic income per share: Basic net income from continuing operations $ 0.12 $ 0.37 Diluted net income per share: Diluted net income from continuing operations $ 0.12 $ 0.36
Summary of Potentially Dilutive Securities	The following table provides a summary of those potentially dilutive securities that have been excluded from the above calculation of diluted EPS: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 SSARs — 9,000 23,000 7,000

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2015
Segment Reporting [Abstract]
Financial Information of Business Segments	The following tables represent our results of operations, by segment, for the three and nine months ended September 30, 2015 and 2014: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 Revenue: SCM Net administrative fees $ 71,987 $ 70,788 $ 219,471 $ 217,125 Other service fees(1) 45,245 35,011 137,107 103,198 Total SCM net revenue 117,232 105,799 356,578 320,323 RCM Revenue cycle technology 48,051 47,189 141,554 138,889 Revenue cycle services 24,685 22,717 67,841 62,775 Total RCM net revenue 72,736 69,906 209,395 201,664 Total net revenue 189,968 175,705 565,973 521,987 Operating expenses: SCM 97,536 76,384 288,718 234,640 RCM 68,949 59,817 182,478 175,035 Corporate 15,055 14,987 45,376 40,742 Total operating expenses 181,540 151,188 516,572 450,417 Operating income (loss): SCM 19,696 29,415 67,860 85,683 RCM 3,787 10,089 26,917 26,629 Corporate (15,055 ) (14,987 ) (45,376 ) (40,742 ) Total operating income 8,428 24,517 49,401 71,570 Interest (expense) (11,556 ) (11,338 ) (35,235 ) (33,625 ) Other (expense) income (103 ) 273 (151 ) 362 (Loss) income before income taxes (3,231 ) 13,452 14,015 38,307 Income tax (benefit) expense (995 ) 5,712 6,584 16,293 Net (loss) income $ (2,236 ) $ 7,740 $ 7,431 $ 22,014 Segment Adjusted EBITDA SCM $ 43,227 $ 47,983 $ 134,693 $ 140,233 RCM 22,712 17,914 62,093 50,928 Total Segment Adjusted EBITDA $ 65,939 $ 65,897 $ 196,786 $ 191,161 Corporate (7,162 ) (6,429 ) (21,499 ) (20,652 ) Total Adjusted EBITDA(2) $ 58,777 $ 59,468 $ 175,287 $ 170,509 (1) Other service fees primarily consists of consulting, services and technology fees. (2) These are non-GAAP measures. See “Use of Non-GAAP Financial Measures” section for additional information. Nine Months Ended September 30, 2015 2014 Capital expenditures(1): SCM $ 13,775 $ 16,070 RCM 20,457 21,861 Corporate 2,092 2,457 Total $ 36,324 $ 40,388 (1) Capital expenditures consist of purchases of property and equipment and capitalized software development costs (internal and external use). September 30, December 31, Financial Position: Accounts receivable, net SCM $ 60,630 $ 74,337 RCM 59,375 53,129 Corporate — 275 Total accounts receivable, net 120,005 127,741 Other assets SCM 1,015,981 1,067,039 RCM 425,527 439,333 Corporate 65,261 84,683 Total other assets 1,506,769 1,591,055 Total assets $ 1,626,774 $ 1,718,796 SCM accrued revenue share obligation $ 93,769 $ 91,864 Deferred revenue SCM 46,003 51,958 RCM 40,978 39,494 Total deferred revenue 86,981 91,452 Notes payable 464,105 556,000 Bonds payable 325,000 325,000 Other liabilities SCM 34,246 36,938 RCM 20,903 23,952 Corporate 159,084 147,103 Total other liabilities 214,233 207,993 Total liabilities $ 1,184,088 $ 1,272,309
Segment Adjusted EBITDA to Consolidated Net Income	The following table reconciles Segment Adjusted EBITDA to consolidated net income for the three and nine months ended September 30, 2015 and 2014: Three Months Ended September 30, Nine Months Ended September 30, 2015 2014 2015 2014 SCM Adjusted EBITDA $ 43,227 $ 47,983 $ 134,693 $ 140,233 RCM Adjusted EBITDA 22,712 17,914 62,093 50,928 Total Segment Adjusted EBITDA 65,939 65,897 196,786 191,161 Depreciation (10,132 ) (8,695 ) (29,369 ) (25,653 ) Depreciation (included in cost of revenue) (1,001 ) (1,094 ) (2,968 ) (2,166 ) Amortization of intangibles (14,829 ) (13,936 ) (44,816 ) (41,989 ) Income tax expense (14,267 ) (16,942 ) (47,112 ) (47,894 ) Impairment of property and equipment(1) (10,309 ) — (10,309 ) — Share-based compensation expense(2) (2,629 ) (2,399 ) (8,238 ) (7,740 ) Purchase accounting adjustments(3) (116 ) (94 ) (944 ) (94 ) Restructuring, acquisition and integration-related expenses(4) (3,607 ) (7 ) (5,733 ) (1,138 ) Total reportable segment net income 9,049 22,730 47,297 64,487 Corporate net loss (11,285 ) (14,990 ) (39,866 ) (42,473 ) Consolidated net (loss) income $ (2,236 ) $ 7,740 $ 7,431 $ 22,014 (1) Represents the impairment of intangibles relating to the elimination of certain capitalized software products within the RCM segment. (2) Represents non-cash share-based compensation to both employees and directors. We believe excluding this non-cash expense allows us to compare our operating performance without regard to the impact of share-based compensation, which varies from period to period based on amount and timing of grants. (3) Represents the effect on revenue of adjusting Sg2’s acquired deferred revenue balance to fair value at the acquisition date. (4) Represents the amount attributable to restructuring, acquisition and integration-related costs which may include costs such as severance, retention, salaries relating to redundant positions, certain performance-related salary-based compensation, operating infrastructure costs and facility consolidation costs.

Business Description and Basi29

Business Description and Basis of Presentation - Additional Information (Detail) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014	Sep. 30, 2014	Dec. 31, 2013
Change in Accounting Estimate [Line Items]
Cash and cash equivalents	$ 0	$ 12,100	$ 13,893	$ 2,790
Outstanding balance on revolving credit facility	437,667	526,417
Reclassification of outstanding checks into other accrued expenses	8,431
Revolving Credit Facility [Member]
Change in Accounting Estimate [Line Items]
Outstanding balance on revolving credit facility	$ 85,000	$ 152,000

Restructuring, Acquisition an30

Restructuring, Acquisition and Integration-Related Expenses - Additional Information (Detail) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015USD ($)	Sep. 30, 2014USD ($)	Sep. 30, 2015USD ($)	Sep. 30, 2014USD ($)	Sep. 28, 2015Employees
Restructuring And Acquisition Integration Charges [Abstract]
Restructuring, acquisition and integration-related expenses	$ 5,027	$ 3,010	$ 10,022	$ 4,707
Number of employees terminated for cost reduction | Employees					180
Acquisition related expense			352	$ 352
Cash payments			5,991
Restructuring reserve accrued liabilities			6,104
Restructuring reserve current	$ 5,203		$ 5,203

Restructuring, Acquisition an31

Restructuring, Acquisition and Integration-Related Expenses - Summary of Activities Related to Restructuring and Other Charges (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Restructuring Cost and Reserve [Line Items]
Accrued, December 31, 2014			$ 2,073
Charges incurred	$ 5,027	$ 3,010	10,022	$ 4,707
Cash payments			(5,991)
Accrued, September 30, 2015	6,104		6,104
Employee-related Costs [Member]
Restructuring Cost and Reserve [Line Items]
Accrued, December 31, 2014			1,918
Charges incurred			9,443
Cash payments			(5,482)
Accrued, September 30, 2015	5,879		5,879
Other Associated Costs [Member]
Restructuring Cost and Reserve [Line Items]
Accrued, December 31, 2014			155
Charges incurred			579
Cash payments			(509)
Accrued, September 30, 2015	$ 225		$ 225

Property and Equipment - Additi

Property and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2015
Property, Plant and Equipment [Line Items]
Impairment of property and equipment	$ 10,309	$ 10,309
Non-cash Capitalized Software [Member]
Property, Plant and Equipment [Line Items]
Impairment of property and equipment	$ 10,309

Deferred Revenue - Summary of D

Deferred Revenue - Summary of Deferred Revenue (Detail) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Deferred Revenue Arrangement [Line Items]
Deferred revenue, total	$ 86,981	$ 91,452
Less: Deferred revenue, current portion	(70,241)	(76,034)
Deferred revenue, non-current portion	16,740	15,418
Software and SaaS Implementation Fees [Member]
Deferred Revenue Arrangement [Line Items]
Deferred revenue, total	48,564	55,152
Service Fees [Member]
Deferred Revenue Arrangement [Line Items]
Deferred revenue, total	23,148	19,241
Administrative Fees [Member]
Deferred Revenue Arrangement [Line Items]
Deferred revenue, total	13,217	15,715
Other Fees [Member]
Deferred Revenue Arrangement [Line Items]
Deferred revenue, total	$ 2,052	$ 1,344

Deferred Revenue - Additional I

Deferred Revenue - Additional Information (Detail) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Text Block [Abstract]
Contingent deferred revenue	$ 7,547	$ 8,441

Notes and Bonds Payable - Summa

Notes and Bonds Payable - Summary of Notes and Bonds Payable (Detail) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Total notes payable	$ 464,105	$ 556,000
Bonds payable	325,000	325,000
Total notes and bonds payable	789,105	881,000
Total notes and bonds payable	789,105	881,000
Less: current portions	(26,438)	(29,583)
Total long-term notes and bonds payable	762,667	851,417
Term A Facility [Member]
Debt Instrument [Line Items]
Total notes payable	206,576	225,000
Total notes and bonds payable	206,576
Total notes and bonds payable	206,576
Term B Facility [Member]
Debt Instrument [Line Items]
Total notes payable	172,529	179,000
Total notes and bonds payable	172,529
Total notes and bonds payable	172,529
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Total notes payable	85,000	$ 152,000
Total notes and bonds payable	85,000
Total notes and bonds payable	$ 85,000

Notes and Bonds Payable - Addit

Notes and Bonds Payable - Additional Information (Detail) - USD ($)	Sep. 08, 2014	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014
Debt Instrument [Line Items]
Total notes payable		$ 464,105,000		$ 464,105,000		$ 556,000,000
Outstanding balance on revolving credit facility		437,667,000		437,667,000		526,417,000
Amount drawn on swing line loan		0		0
Outstanding letter of credit under credit facility		214,000,000		214,000,000
Letters of credit outstanding amount		1,000,000		1,000,000
Increase in revolving committed amount under Credit Agreement	$ 100,000,000
Revolving committed amount under Credit Agreement	300,000,000
Debt issuance costs	$ 615,000			11,159,000
Amortization of debt issuance costs		967,000	$ 949,000	2,916,000	$ 2,829,000
Total interest paid, net of amounts capitalized				25,528,000	$ 23,959,000
Term A Facility [Member]
Debt Instrument [Line Items]
Total notes payable		$ 206,576,000		206,576,000		225,000,000
Notes payable current				$ 4,362,000
Weighted average interest rate of senior term loan facility		2.52%		2.52%
Term B Facility [Member]
Debt Instrument [Line Items]
Total notes payable		$ 172,529,000		$ 172,529,000		179,000,000
Voluntary payments				750,000
Notes payable current				$ 3,471,000
Weighted average interest rate of senior term loan facility		4.00%		4.00%
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Total notes payable		$ 85,000,000		$ 85,000,000		152,000,000
Outstanding balance on revolving credit facility		$ 85,000,000		85,000,000		$ 152,000,000
Voluntary payments				$ 67,000,000
Weighted average interest rate of senior term loan facility		2.53%		2.53%
Credit Agreement [Member]
Debt Instrument [Line Items]
Notes payable current				$ 7,833,000
Guarantor Subsidiaries [Member]
Debt Instrument [Line Items]
Percentage owned by subsidiary guarantor		100.00%		100.00%
Maximum [Member]
Debt Instrument [Line Items]
Percentage of consolidated tangible assets and revenues of subsidiaries not providing guarantees				2.50%
Percentage of consolidated earnings before interest taxes depreciation and amortization on consolidated basis of immaterial subsidiaries not providing guarantees				5.00%
Percentage of pledged equity securities of foreign subsidiary				65.00%
Senior Notes Due 2018 [Member]
Debt Instrument [Line Items]
Principal amount of senior notes		$ 325,000,000		$ 325,000,000
Percentage of interest rate on bonds payable		8.00%		8.00%
Maturity date of debt instrument				Nov. 15, 2018
Repurchase percentage of aggregate principal amount plus accrued and unpaid interest				101.00%
Percentage of par value on senior notes				102.30%
Term Facility [Member]
Debt Instrument [Line Items]
Scheduled principal payments				$ 16,312,000

Notes and Bonds Payable - Perce

Notes and Bonds Payable - Percentage of Redemption Prices (Detail) - Senior Notes Due 2018 [Member]	9 Months Ended
	Sep. 30, 2015
Debt Instrument, Redemption, Period One [Member]
Debt Instrument [Line Items]
Percentage of redemption prices	102.00%
Debt Instrument, Redemption, Period Two [Member]
Debt Instrument [Line Items]
Percentage of redemption prices	100.00%

Notes and Bonds Payable - Debt

Notes and Bonds Payable - Debt Maturities and Scheduled Principal Repayments (Detail) - USD ($) $ in Thousands	Sep. 30, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Principal Payment in 2015	$ 5,438
Principal Payment in 2016	28,000
Principal Payment in 2017	264,888
Principal Payment in 2018	328,000
Principal Payment in 2019	162,779
Total notes and bonds payable	789,105	$ 881,000
Term A Facility [Member]
Debt Instrument [Line Items]
Principal Payment in 2015	4,688
Principal Payment in 2016	25,000
Principal Payment in 2017	176,888
Total notes and bonds payable	206,576
Term B Facility [Member]
Debt Instrument [Line Items]
Principal Payment in 2015	750
Principal Payment in 2016	3,000
Principal Payment in 2017	3,000
Principal Payment in 2018	3,000
Principal Payment in 2019	162,779
Total notes and bonds payable	172,529
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Principal Payment in 2017	85,000
Total notes and bonds payable	85,000
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Principal Payment in 2018	325,000
Total notes and bonds payable	$ 325,000

Stockholders' Equity and Shar39

Stockholders' Equity and Share-Based Compensation - Additional Information (Detail)	1 Months Ended	3 Months Ended		9 Months Ended		12 Months Ended
	Feb. 28, 2015USD ($)	Sep. 30, 2015USD ($)shares	Sep. 30, 2014USD ($)	Sep. 30, 2015USD ($)Plansshares	Sep. 30, 2014USD ($)shares	Dec. 31, 2010
Equity [Line Items]
Aggregate exercise price of stock issued in connection with exercise of stock options				$ 1,389,000
Associated minimum statutory tax liability, shares surrendered				3,913,000
Expiration date of share repurchase program	Feb. 29, 2016
Stock Repurchase Program, authorized amount	$ 100,000,000
Stock Repurchase Program, available for repurchase		$ 32,230,000		$ 32,230,000
Number of share-based compensation plans | Plans				3
Shares reserved under 2008 equity incentive plan available for grant | shares		4,017,000		4,017,000
Total share-based compensation expense		$ 5,590,000	$ 4,809,000	$ 16,721,000	$ 14,703,000
Income tax benefit recognized from equity awards		2,088,000	$ 1,793,000	6,247,000	5,481,000
Capitalized share-based compensation expenses		$ 0		0
Shares of common stock purchased, amount				$ 506,000	$ 494,000
Restricted Stock [Member]
Equity [Line Items]
Forfeited, Shares | shares				29,000
Restricted shares that were surrendered from equity awards holders | shares				203,000
Associated minimum statutory tax liability, shares surrendered				$ 3,913,000
SSARs Awards [Member]
Equity [Line Items]
Approximate stock issued in connection with exercise of stock options | shares				506,000
Aggregate exercise price of stock issued in connection with exercise of stock options				$ 1,389,000
Employee Stock Purchase Plan [Member]
Equity [Line Items]
Shares reserved under 2008 equity incentive plan available for grant | shares		500,000		500,000
Percentage of price per share of the common stock sold to participating employees						95.00%
Period required for holding stock purchases as per the plan				18 months
Shares of common stock purchased | shares				27,000	22,000

Stockholders' Equity and Shar40

Stockholders' Equity and Share-Based Compensation - Summary of Amount and Cost of Common Stock Repurchased (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Equity [Abstract]
Number of shares repurchased	792,148	500	1,207,384	1,784,645
Cost of shares repurchased	$ 16,412	$ 11	$ 25,000	$ 42,771

Stockholders' Equity and Shar41

Stockholders' Equity and Share-Based Compensation - Summary of Total Share-Based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	$ 5,590	$ 4,809	$ 16,721	$ 14,703
Cost of Revenue [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	1,565	1,476	4,715	4,505
Product development expenses [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	271	252	1,044	887
Selling and marketing expenses [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	965	710	2,872	2,082
General and administrative expenses [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	$ 2,789	$ 2,371	$ 8,090	$ 7,229

Stockholders' Equity and Shar42

Stockholders' Equity and Share-Based Compensation - Summary of Total Approved Equity Grants (Detail)	9 Months Ended
	Sep. 30, 2015$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total RSUs | shares	1,842,289
RSUs - Service [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total RSUs | shares	816,261
Vesting period	3 years
RSUs - Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total RSUs | shares	1,026,028
Vesting period	3 years
Minimum [Member] | RSUs - Service [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of Grant Date Fair Values	$ 18.44
Minimum [Member] | RSUs - Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of Grant Date Fair Values	18.44
Maximum [Member] | RSUs - Service [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of Grant Date Fair Values	22.16
Maximum [Member] | RSUs - Performance [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Range of Grant Date Fair Values	$ 22.16

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail)	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Income Tax Disclosure [Abstract]
Effective income tax rate, expense (benefit)	(30.80%)	42.50%	47.00%	42.50%

(Loss) Income Per Share - Recon

(Loss) Income Per Share - Reconciliation of Basic and Diluted Weighted Average Shares Outstanding (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Numerator for Basic and Diluted (Loss) Income Per Share:
Net (loss) income	$ (2,236)	$ 7,740	$ 7,431	$ 22,014
Denominator for basic (loss) income per share weighted average shares	59,437,000	59,401,000	59,678,000	59,917,000
Effect of dilutive securities:
Stock options		195,000	126,000	268,000
SSARs		288,000	190,000	299,000
Restricted stock and RSUs		778,000	828,000	785,000
Denominator for diluted (loss) income per share - adjusted weighted average shares and assumed conversions	59,437,000	60,662,000	60,822,000	61,269,000
Basic (loss) income per share:
Basic net (loss) income from continuing operations	$ (0.04)	$ 0.13	$ 0.12	$ 0.37
Diluted net (loss) income per share:
Diluted net (loss) income from continuing operations	$ (0.04)	$ 0.13	$ 0.12	$ 0.36

(Loss) Income Per Share - Summa

(Loss) Income Per Share - Summary of Potentially Dilutive Securities (Detail) - shares	3 Months Ended	9 Months Ended
	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
SSARs [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive securities excluded from calculation of diluted EPS	9,000	23,000	7,000

Segment Information - Additiona

Segment Information - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2015Segment
Segment Reporting [Abstract]
Number of reportable business segments	2

Segment Information - Financial

Segment Information - Financial Information of Business Segments (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014	Dec. 31, 2014
Revenue:
Net administrative fees	$ 71,987	$ 70,788	$ 219,471	$ 217,125
Other service fees	117,981	104,917	346,502	304,862
Total net revenue	189,968	175,705	565,973	521,987
Operating expenses:
Total operating expenses	181,540	151,188	516,572	450,417
Operating income (loss):
Total operating income (loss)	8,428	24,517	49,401	71,570
Interest (expense)	(11,556)	(11,338)	(35,235)	(33,625)
Other (expense) income	(103)	273	(151)	362
(Loss) income before income taxes	(3,231)	13,452	14,015	38,307
Income tax (benefit) expense	(995)	5,712	6,584	16,293
Net (loss) income	(2,236)	7,740	7,431	22,014
Segment Adjusted EBITDA
Total Adjusted EBITDA	58,777	59,468	175,287	170,509
Capital expenditures:
Total Capital expenditures			36,324	40,388
Accounts receivable, net
Total accounts receivable, net	120,005		120,005		$ 127,741
Other assets
Total other assets	1,506,769		1,506,769		1,591,055
Total assets	1,626,774		1,626,774		1,718,796
Accrued revenue share obligation and rebates	93,769		93,769		91,864
Deferred revenue
Total deferred revenue	86,981		86,981		91,452
Notes payable	464,105		464,105		556,000
Bonds payable	325,000		325,000		325,000
Other liabilities
Total other liabilities	214,233		214,233		207,993
Total liabilities	1,184,088		1,184,088		1,272,309
Operating Segments [Member]
Operating income (loss):
Net (loss) income	9,049	22,730	47,297	64,487
Segment Adjusted EBITDA
Total Adjusted EBITDA	65,939	65,897	196,786	191,161
Deferred revenue
Total deferred revenue	86,981		86,981		91,452
Notes payable	464,105		464,105		556,000
Bonds payable	325,000		325,000		325,000
Corporate, Non-Segment [Member]
Operating expenses:
Total operating expenses	15,055	14,987	45,376	40,742
Operating income (loss):
Total operating income (loss)	(15,055)	(14,987)	(45,376)	(40,742)
Net (loss) income	(11,285)	(14,990)	(39,866)	(42,473)
Segment Adjusted EBITDA
Total Adjusted EBITDA	(7,162)	(6,429)	(21,499)	(20,652)
Capital expenditures:
Total Capital expenditures			2,092	2,457
Accounts receivable, net
Total accounts receivable, net					275
Other assets
Total other assets	65,261		65,261		84,683
Other liabilities
Total other liabilities	159,084		159,084		147,103
SCM [Member] | Operating Segments [Member]
Revenue:
Net administrative fees	71,987	70,788	219,471	217,125
Other service fees	45,245	35,011	137,107	103,198
Total net revenue	117,232	105,799	356,578	320,323
Operating expenses:
Total operating expenses	97,536	76,384	288,718	234,640
Operating income (loss):
Total operating income (loss)	19,696	29,415	67,860	85,683
Segment Adjusted EBITDA
Total Adjusted EBITDA	43,227	47,983	134,693	140,233
Capital expenditures:
Total Capital expenditures			13,775	16,070
Accounts receivable, net
Total accounts receivable, net	60,630		60,630		74,337
Other assets
Total other assets	1,015,981		1,015,981		1,067,039
Accrued revenue share obligation and rebates	93,769		93,769		91,864
Deferred revenue
Total deferred revenue	46,003		46,003		51,958
Other liabilities
Total other liabilities	34,246		34,246		36,938
RCM [Member] | Operating Segments [Member]
Revenue:
Revenue cycle technology	48,051	47,189	141,554	138,889
Revenue cycle services	24,685	22,717	67,841	62,775
Total net revenue	72,736	69,906	209,395	201,664
Operating expenses:
Total operating expenses	68,949	59,817	182,478	175,035
Operating income (loss):
Total operating income (loss)	3,787	10,089	26,917	26,629
Segment Adjusted EBITDA
Total Adjusted EBITDA	22,712	$ 17,914	62,093	50,928
Capital expenditures:
Total Capital expenditures			20,457	$ 21,861
Accounts receivable, net
Total accounts receivable, net	59,375		59,375		53,129
Other assets
Total other assets	425,527		425,527		439,333
Deferred revenue
Total deferred revenue	40,978		40,978		39,494
Other liabilities
Total other liabilities	$ 20,903		$ 20,903		$ 23,952

Segment Information - Segment A

Segment Information - Segment Adjusted Ebitda Consolidated Net Income (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014	Sep. 30, 2015	Sep. 30, 2014
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Total Segment Adjusted EBITDA	$ 58,777	$ 59,468	$ 175,287	$ 170,509
Depreciation			(43,557)	(37,413)
Net (loss) income	(2,236)	7,740	7,431	22,014
Depreciation (included in cost of revenue)	(1,001)	(1,094)	(2,968)	(2,166)
Amortization of intangibles	(14,829)	(13,936)	(44,816)	(41,989)
Income tax expense	995	(5,712)	(6,584)	(16,293)
Impairment of property and equipment	(10,309)		(10,309)
Total share-based compensation expense	(5,590)	(4,809)	(16,721)	(14,703)
Restructuring, acquisition and integration-related expenses	(5,027)	(3,010)	(10,022)	(4,707)
Operating Segments [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Total Segment Adjusted EBITDA	65,939	65,897	196,786	191,161
Net (loss) income	9,049	22,730	47,297	64,487
Segment Reporting Reconciling Items [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Depreciation	(10,132)	(8,695)	(29,369)	(25,653)
Depreciation (included in cost of revenue)	(1,001)	(1,094)	(2,968)	(2,166)
Amortization of intangibles	(14,829)	(13,936)	(44,816)	(41,989)
Income tax expense	(14,267)	(16,942)	(47,112)	(47,894)
Impairment of property and equipment	(10,309)		(10,309)
Total share-based compensation expense	(2,629)	(2,399)	(8,238)	(7,740)
Purchase accounting adjustments	(116)	(94)	(944)	(94)
Restructuring, acquisition and integration-related expenses	(3,607)	(7)	(5,733)	(1,138)
Corporate, Non-Segment [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Total Segment Adjusted EBITDA	(7,162)	(6,429)	(21,499)	(20,652)
Net (loss) income	(11,285)	(14,990)	(39,866)	(42,473)
SCM [Member] | Operating Segments [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Total Segment Adjusted EBITDA	43,227	47,983	134,693	140,233
RCM [Member] | Operating Segments [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Total Segment Adjusted EBITDA	$ 22,712	$ 17,914	$ 62,093	$ 50,928

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2015
Senior Notes Due 2018 [Member]
Fair Value, Concentration of Risk, Financial Statement Captions [Line Items]
Percentage of par value on senior notes	102.30%

Related Party Transaction - Add

Related Party Transaction - Additional Information (Detail) - USD ($)	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2014
Former Chief Executive Officer [Member]
Related Party Transaction [Line Items]
Charges incurred with respect to transactions with Mr. Bardis	$ 0	$ 1,013,000