IPC Healthcare (IPCM) 10-K 26 Feb 14 2013 FY Annual report Financial data

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
	Dec. 31, 2013	Feb. 17, 2014	Jun. 30, 2013
Document And Entity Information [Abstract]	'	'	'
Document Type	'10-K	'	'
Amendment Flag	'false	'	'
Document Period End Date	31-Dec-13	'	'
Document Fiscal Year Focus	'2013	'	'
Document Fiscal Period Focus	'FY	'	'
Trading Symbol	'IPCM	'	'
Entity Registrant Name	'IPC The Hospitalist Company, Inc.	'	'
Entity Central Index Key	'0001410471	'	'
Current Fiscal Year End Date	'--12-31	'	'
Entity Well-known Seasoned Issuer	'Yes	'	'
Entity Current Reporting Status	'Yes	'	'
Entity Voluntary Filers	'No	'	'
Entity Filer Category	'Large Accelerated Filer	'	'
Entity Common Stock, Shares Outstanding	'	17,062,161	'
Entity Public Float	'	'	$845,743,528

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:	'	'
Cash and cash equivalents	$25,010	$16,214
Accounts receivable, net	103,585	79,612
Insurance receivable for malpractice claims - current portion	11,653	9,719
Prepaid expenses and other current assets	19,378	17,284
Total current assets	159,626	122,829
Property and equipment, net	6,343	5,763
Goodwill	357,387	240,009
Other intangible assets, net	5,857	2,133
Deferred tax assets, net	0	250
Insurance receivable for malpractice claims - less current portion	20,599	17,074
Total assets	549,812	388,058
Current liabilities:	'	'
Accounts payable and accrued liabilities	5,486	4,257
Accrued compensation	35,639	28,615
Payable for practice acquisitions, current portion	32,430	29,038
Medical malpractice and self-insurance reserves, current portion	12,211	10,350
Deferred tax liabilities, current portion	969	1,506
Total current liabilities	86,735	73,766
Long-term debt	90,000	20,000
Medical malpractice and self-insurance reserves, less current portion	44,044	37,921
Payable for practice acquisitions, less current portion	8,289	0
Deferred tax liabilities, less current portion	5,762	0
Total liabilities	234,830	131,687
Stockholders' equity:	'	'
Preferred stock, $0.001 par value, 15,000,000 shares authorized, none issued	0	0
Common stock, $0.001 par value, 50,000,000 shares authorized, 17,015,580 and 16,694,215 shares issued and outstanding at December 31, 2013 and 2012, respectively	17	17
Additional paid-in capital	167,926	150,711
Retained earnings	147,039	105,643
Total stockholders' equity	314,982	256,371
Total liabilities and stockholders' equity	$549,812	$388,058

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parenthetical) (USD $)	Dec. 31, 2013	Dec. 31, 2012
Statement Of Financial Position [Abstract]	'	'
Preferred stock, par value	$0.00	$0.00
Preferred stock, shares authorized	15,000,000	15,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$0.00	$0.00
Common stock, shares authorized	50,000,000	50,000,000
Common stock, shares issued	17,015,580	16,694,215
Common stock, shares outstanding	17,015,580	16,694,215

Consolidated_Statements_Income

Consolidated Statements Income (USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Statement [Abstract]	'	'	'
Net revenue	$609,517	$523,485	$457,467
Operating expenses:	'	'	'
Cost of services-physician practice salaries, benefits and other	444,224	382,934	334,984
General and administrative	98,725	83,679	73,259
Net change in fair value of contingent consideration	-5,733	324	-1,002
Depreciation and amortization	4,681	3,911	3,192
Total operating expenses	541,897	470,848	410,433
Income from operations	67,620	52,637	47,034
Investment income	13	14	17
Interest expense	-540	-337	-185
Income before income taxes	67,093	52,314	46,866
Income tax provision	25,697	19,728	17,597
Net income	$41,396	$32,586	$29,269
Net income per share:	'	'	'
Basic	$2.46	$1.97	$1.79
Diluted	$2.39	$1.92	$1.74

Consolidated_Statements_of_Sto

Consolidated Statements of Stockholders' Equity (USD $)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]
In Thousands, except Share data
Beginning balance at Dec. 31, 2010	$174,465	$16	$130,661	$43,788
Beginning balance, shares at Dec. 31, 2010	'	16,287,377	'	'
Issuance of common stock	2,908	0	2,908	0
Issuance of common stock, shares	'	187,611	'	'
Stock-based compensation expense	4,783	0	4,783	0
Excess tax benefits from stock-based compensation	1,270	0	1,270	0
Tax deficiency and stock forfeiture related to stock-based compensation	-43	0	-43	0
Net income	29,269	0	0	29,269
Ending balance at Dec. 31, 2011	212,652	16	139,579	73,057
Ending balance, shares at Dec. 31, 2011	'	16,474,988	'	'
Issuance of common stock	3,860	1	3,859	0
Issuance of common stock, shares	'	219,227	'	'
Stock-based compensation expense	6,344	0	6,344	0
Excess tax benefits from stock-based compensation	988	0	988	0
Tax deficiency and stock forfeiture related to stock-based compensation	-59	0	-59	0
Net income	32,586	0	0	32,586
Ending balance at Dec. 31, 2012	256,371	17	150,711	105,643
Ending balance, shares at Dec. 31, 2012	16,694,215	16,694,215	'	'
Issuance of common stock	7,429	0	7,429	0
Issuance of common stock, shares	'	321,365	'	'
Stock-based compensation expense	7,355	0	7,355	0
Excess tax benefits from stock-based compensation	2,609	0	2,609	0
Tax deficiency and stock forfeiture related to stock-based compensation	-178	0	-178	0
Net income	41,396	0	0	41,396
Ending balance at Dec. 31, 2013	$314,982	$17	$167,926	$147,039
Ending balance, shares at Dec. 31, 2013	17,015,580	17,015,580	'	'

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Operating activities	'	'	'
Net income	$41,396	$32,586	$29,269
Adjustments to reconcile net income to net cash provided by operating activities:	'	'	'
Depreciation and amortization	4,681	3,911	3,192
Stock-based compensation expense	7,355	6,344	4,783
Tax liability reduction for uncertain tax positions	0	0	-23
Deferred income taxes	5,297	1,969	768
Changes in assets and liabilities:	'	'	'
Accounts receivable	-23,973	-11,602	-13,849
Prepaid expenses and other current assets	-2,094	-4,145	-3,467
Accounts payable and accrued expenses	1,229	295	210
Accrued compensation	6,455	6,975	2,168
Medical malpractice and self-insurance reserves, net	2,525	3,171	3,712
Accrued contingent consideration	-6,075	324	-1,002
Net cash provided by operating activities	36,796	39,828	25,761
Investing activities	'	'	'
Acquisitions of physician practices	-104,127	-62,605	-27,843
Purchase of property and equipment	-3,911	-3,609	-3,279
Net cash used in investing activities	-108,038	-66,214	-31,122
Financing activities	'	'	'
Proceeds from long-term debt	105,000	35,000	0
Repayments of long-term debt	-35,000	-15,000	0
Net proceeds from issuance of common stock	7,429	3,860	2,908
Excess tax benefits from stock-based compensation	2,609	988	1,270
Net cash provided by financing activities	80,038	24,848	4,178
Net increase (decrease) in cash and cash equivalents	8,796	-1,538	-1,183
Cash and cash equivalents, beginning of period	16,214	17,752	18,935
Cash and cash equivalents, end of period	25,010	16,214	17,752
Cash paid for:	'	'	'
Interest	513	251	187
Income taxes	17,227	17,805	15,789
Acquisitions of physician practices consisted of the following:	'	'	'
Acquired assets, net of assumed liabilities - goodwill, intangible and other	121,883	67,595	24,854
(Increase) decrease in payable for practice acquisitions, excluding change in fair value of accrued contingent consideration	-17,756	-4,990	2,989
Net cash paid for acquisitions	$104,127	$62,605	$27,843

Operations_and_Significant_Acc

Operations and Significant Accounting Policies	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]	'
Operations and Significant Accounting Policies	'
	Note 1. Operations and Significant Accounting Policies
	Business
	IPC The Hospitalist Company, Inc. and its subsidiaries (the “Company,” “IPC,” “we,” “us,” and “our”) is a national physician group practice company that operates and manages full-time hospitalist practices. Hospitalists focus on a patient’s care from the time of admission to discharge, working in close consultation with primary care physicians, other referring physicians and medical providers to coordinate the inpatient care delivery system and manage the entire inpatient episode of care. Our affiliated hospitalists practice in inpatient facilities, including acute care hospitals, long-term acute care facilities, specialty hospitals, psychiatric facilities and post-acute care facilities. The physicians are primarily full-time employees of our subsidiaries or consolidated Professional Medical Corporations, although part-time and temporary physicians are also employed or contracted on an as-needed basis. Also, unless otherwise expressly stated or the context otherwise requires, “our affiliated hospitalists” refer to physicians, nurse practitioners and physician assistants employed or contracted by either our wholly-owned subsidiaries or our Professional Medical Corporations. References to “practices” or “practice groups” refer to our Professional Medical Corporations and the wholly-owned subsidiaries of IPC that provide medical services, unless otherwise expressly stated or the context otherwise requires.
	Principles of Consolidation
	Our consolidated financial statements include the accounts of IPC The Hospitalist Company, Inc. and its wholly owned subsidiaries and our affiliated professional medical corporations, also called “affiliated professional organizations”, which we manage under long-term management agreements. Some states have laws that prohibit business entities, such as IPC, from practicing medicine, employing physicians to practice medicine, exercising control over medical decisions by physicians (collectively known as the corporate practice of medicine), or engaging in certain arrangements with physicians, such as fee-splitting. In states that have these restrictions, we operate by maintaining long-term management contracts with affiliated professional organizations, which are each owned and operated by physicians, and which employ or contract with additional physicians to provide hospitalist services. Under the management agreements, we provide and perform all non-medical management and administrative services, including financial management, information systems, marketing, risk management and administrative support. The management agreements have an initial term of 20 years and are automatically renewable for successive 10-year periods unless terminated by either party for cause. The management agreements are not terminable by the Professional Medical Corporations, except in the case of gross negligence, fraud, or other illegal acts by us, or bankruptcy of IPC.
	Through the management agreements and our relationship with the stockholders of the Professional Medical Corporations, we have exclusive authority over all non-medical decision making related to the ongoing business operations of the Professional Medical Corporations. Further, our rights under the management agreements are unilaterally salable or transferable. Based on the provisions of the agreements, we have determined that the Professional Medical Corporations are variable interest entities (VIE’s), and that we are the primary beneficiary because we have controls over the operations of these VIE’s, provide full financial and management support to them, and take all residual benefits and bear all residual losses from their operations. Consequently, we consolidate the revenue and expenses of the Professional Medical Corporations from the date of execution of the agreements. All intercompany balances and transactions have been eliminated in consolidation.
	Segment Reporting
	In accordance with U.S. generally accepted accounting principles (GAAP), the results of our operations are consolidated into a single reportable segment for purposes of presenting financial information.
	Revenue
	Net revenue consists of fees for medical services provided by our affiliated hospitalists under fee-for-service, case rate and other professional fee arrangements with various payors including Medicare, Medicaid, managed care organizations, insurance companies and hospitals. For the years ended December 31, total patient volume consisted of the following percentage from Medicare and Medicaid programs:
		2013			2012			2011
	Medicare and Medicaid patients		53	%		52	%		51	%
	Net revenue is reported in the period in which services are provided at amounts expected to be collected, which excludes contractual discounts and an estimate of uncollectible accounts. The process of estimating the ultimate amount of revenue to be collected is highly subjective and requires the application of our judgment based on many factors, including contractual reimbursement rates, payor mix, age of receivables, historical cash collection experience and other relevant information. We write off uncollectible accounts receivable from our billing system after reasonable collection efforts have been exhausted. The following amounts, which are excluded from our net revenues, represent an estimate of uncollectible patient copayments and deductible accounts related to patient services during the years ended December 31 (in thousands):
		2013			2012			2011
	Uncollectible accounts excluded from net revenue	$	15,274		$	14,611		$	13,539
	Use of Estimates
	The preparation of financial statements in conformity with GAAP requires us to make estimates and assumptions of the fair value of certain reported amounts of assets, liabilities, revenues and expenses at the date and for the periods that the financial statements are prepared. Significant estimates include the estimated net realizable value of accounts receivable, medical malpractice insurance receivable and payable for known claims, liabilities for claims incurred but not reported (IBNR) related to medical malpractice, fair value of contingent consideration related to business combinations and the analysis of goodwill for impairment.
	The process of estimating these assets and liabilities involves judgment decisions, which are subject to an inherent degree of uncertainty. Actual results could differ from those estimates.
	Fair Value of Financial Instruments
	Our consolidated balance sheets as of December 31, 2013 and 2012 included the following financial instruments: cash and cash equivalents, accounts receivable, accounts payable and accrued liabilities, payable for practice acquisitions and long-term debt. We consider the carrying amounts of cash and cash equivalents, accounts receivable and accounts payable and accrued liabilities to approximate their fair value because of the relatively short period of time between the origination of these instruments and their expected realization. The carrying amount of our long-term debt borrowed from our line of credit in December 2013 approximated its fair value at December 31, 2013. Pursuant to GAAP, we determine the fair value of our long-term borrowing using inputs that can be corroborated by observable market data, which is defined as a Level 2 input under GAAP’s fair value hierarchy.
	Our payable for practice acquisitions consisted of accrued contingent consideration for practice acquisitions, which is carried at fair value determined using the income approach with unobservable inputs defined as Level 3 inputs under GAAP. See Note 3 for more information.
	Cash and Cash Equivalents
	Our cash and cash equivalents consist of bank deposits, money market accounts and short-term securities with maturities of three months or less.
	Accounts Receivable and Concentrations of Credit Risk
	Accounts receivable primarily consists of amounts due from third-party payors, including government sponsored Medicare and Medicaid programs, and insurance companies, and amounts due from hospitals, and patients. Accounts receivable are recorded and stated at the amount expected to be collected. The following amounts which are excluded from our accounts receivable, represent an estimate of uncollectible accounts at December 31 (in thousands):
		2013			2012
	Allowance for uncollectible accounts	$	6,510		$	4,837
	Except with respect to the Medicare and Medicaid programs, concentrations of credit risk, which consist primarily of accounts receivable, is limited due to the large number of payors comprising our diverse payor mix and patient base. Geographically, approximately 59%, 60% and 62% of our net revenue in 2013, 2012 and 2011, respectively, was generated by our operations in five states: Arizona, Florida, Michigan, Missouri and Texas. As of December 31, accounts receivable from Medicare and Medicaid made up the following percentage of total net accounts receivable:
		2013			2012
	Percentage of receivables from Medicare and Medicaid		43	%		36	%
	Property and Equipment
	Property and equipment are stated on the basis of cost or fair value on the date of practice acquisition. Repairs and maintenance are charged to expense as incurred. Depreciation is provided using the straight-line method over the estimated useful lives of the assets. The depreciable life is generally three years for equipment and software, seven years for furniture, and the lesser of the useful life or lease period for leasehold improvements. At December 31, property and equipment consisted of the following (in thousands):
		2013			2012
	Furniture	$	2,803		$	2,491
	Computer equipment and software		19,685			16,226
	Office equipment		1,925			1,876
	Leasehold improvements		1,087			950
			25,500			21,543
	Less: Accumulated depreciation and amortization		(19,157	)		(15,780	)
		$	6,343		$	5,763
	For the years ended December 31, the following amounts were included in total depreciation and amortization expense (in thousands):
		2013			2012			2011
	Depreciation of property and equipment	$	3,377		$	2,968		$	2,277
	Goodwill and Other Intangible Assets
	We record acquired assets and liabilities and any contingent consideration at their acquisition-date fair values, and expense all transaction related costs under the acquisition method of accounting. Goodwill represents the excess of cost over the fair value of the net assets acquired. Other intangible assets primarily represent the fair value of hospital service contract agreements and non-compete agreements acquired in connection with certain asset purchase agreements. Goodwill and other indefinite-lived intangible assets are not amortized. Separable identified intangible assets that have finite lives are amortized over their useful lives.
	In addition to the initial consideration paid at the close of each business combination, the asset purchase agreements for certain completed practice acquisitions provide for additional future consideration to be paid, which is generally based upon the achievement of certain operating results of the acquired practices or the occurrence of certain events as of certain measurement dates. Pursuant to GAAP, the estimated fair value of contingent consideration is accrued at the acquisition-date. Subsequent changes, if any, to the estimated fair value of contingent consideration are recognized as part of on-going operations.
	We test goodwill for impairment on an annual basis as of October 1 of each year, as well as when events or changes in business conditions indicate that the carrying amount of goodwill may not be recoverable, at the entity level since we have only one reporting unit pursuant to GAAP. The testing for impairment is completed using a two-step test. The first step compares the fair value of our Company with its carrying amount. The fair value of our Company is derived using the market-multiple valuation approach, which is based on our peer group’s market capitalization computed using publicly available market quotes. The fair value from the market-multiple approach is used to derive the fair value of our Company. If the fair value of our Company is less than its carrying amount, a second step is performed to determine the amount of any impairment loss. We review our finite-lived intangible assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. During 2013, 2012 and 2011, no impairment indicators were present and no impairment was recognized.
	The changes in the carrying amount of goodwill for the years ended December 31, 2013and 2012 are as follows (in thousands):
		2013			2012
	Goodwill—beginning balance at January 1	$	240,009		$	173,688
	Goodwill acquired during year		119,437			66,321
	Goodwill adjustment for prior year transactions		(2,059	)		0
	Goodwill—ending balance at December 31	$	357,387		$	240,009
	At December 31, other intangible assets consist of the following (in thousands):
		2013			2012
	Non-compete agreements	$	2,126		$	1,916
	Hospital contracts		10,088			5,270
	Trade name		70			70
			12,284			7,256
	Less: Accumulated amortization		(6,427	)		(5,123	)
		$	5,857		$	2,133
	For the years ended December 31, the following amortization of other intangible assets was included in total depreciation and amortization expenses (in thousands):
		2013			2012			2011
Amortization of other intangible assets	$	1,304		$	943		$	915
Other intangible assets are being amortized over their estimated useful lives which range from three to six years and have a weighted average remaining useful life of 3.5 years at December 31, 2013. Future estimated aggregate amortization expenses are as follows (in thousands):
2014	$	1,454
2015		973
2016		685
2017		569
2018		469
Thereafter		1,707
	$	5,857
Medical Malpractice Liability Insurance
We maintain medical malpractice insurance coverage that indemnifies us and our employed health-care professionals on a claims-made basis. Our claims-made coverage covers those claims reported during the policy period, which ends December 31 of each year, on a first dollar coverage up to our policy limits on new claims reported during the policy period. In December 2013, we renewed our annual professional liability insurance policy for 2014 effective January 1, 2014 under the same terms as our 2013 policy. We expect to be able to continue to obtain coverage in future years; however, there can be no assurance that we will obtain substantially similar coverage as is provided under the 2014 policy at acceptable costs and on favorable terms upon expiration.
We record our medical malpractice reserves, on an undiscounted basis, for claims incurred and reported and claims incurred but not reported during the policy period, based on actuarial loss projections using historical loss patterns. For claims incurred and reported, an insurance receivable from our carrier has been recorded pursuant to GAAP.
Total accrued medical malpractice reserves and related insurance receivables at December 31 were as follows (in thousands):
	2013											2012
	Assets			Liabilities								Assets		Liabilities
	Insurance			Claims			IBNR			Total		Insurance		Claims		IBNR		Total
	Receivable			Reserve			Reserve			Liabilities		Receivable		Reserve		Reserve		Liabilities
Current Portion	$	11,653		$	11,653			558			12,211	$	9,719	$	9,846		504		10,350
Long-term Portion		20,599			20,599			23,445			44,044		17,074		17,074		20,847		37,921
Total	$	32,252		$	32,252			24,003			56,255	$	26,793	$	26,920		21,351		48,271
Reclassifications
Certain prior year amounts have been reclassified to conform to the current year presentation.

Business_Acquisitions

Business Acquisitions	12 Months Ended
	Dec. 31, 2013
Business Combinations [Abstract]	'
Business Acquisitions	'
	Note 2. Business Acquisitions
	For practice acquisitions, we recognize all of the assets acquired, liabilities assumed and any contingent consideration at the acquisition-date fair value and expense all transaction related costs.
	During 2013, we completed the acquisition of 19 hospitalist physician practices. In connection with these acquisitions, we recorded goodwill and other identifiable intangible assets consisting of physician and hospital agreements. Goodwill represents the potential business synergy from the combined operations of our existing and acquired practices through an expanded national network of providers, improved managed care contracting, improved collections, identification of growth initiatives and cost savings based upon the significant infrastructure we have developed. Amounts recorded as goodwill and identifiable intangible assets are not amortizable for GAAP financial reporting purpose but are amortized for tax purposes over 15 years.
	In addition to the initial consideration paid at the close of each transaction, the asset purchase agreements for 16 of the 19 acquisitions completed during 2013 provide for contingent consideration to be paid, which is generally based upon the achievement of certain operating results of the acquired practices or the acquisition of certain other hospitalist practices as of certain measurement dates. These additional payments are not contingent upon the future employment of the sellers. The estimated fair value of contingent consideration related to transactions is recognized at the acquisition-date. Subsequent changes, if any, to the estimated fair value of contingent consideration are recognized as part of on-going operations. In 2013, the net decrease in the fair value of contingent consideration was $5.7 million. The contingent consideration for eight acquisitions completed during the three months ended December 31, 2013 was recorded on a provisional basis pending completion of the valuation studies as of the acquisition dates.
	We estimate the fair value of contingent consideration to be paid based on discounted projected earnings of the acquired practices as of certain measurement dates. The discount rate that we use consists of a risk-free U.S. Treasury bond yield plus a Company specific credit spread which we believe is acceptable by willing market participants.
	The following table summarizes the total amounts recorded during the years ended December 31, related to the acquisition of hospitalist practices (in thousands):
			2013			2012
	Acquired assets, net of assumed liabilities—paid and accrued:
	Goodwill—current year transactions		$	119,437		$	66,321
	Other intangible assets			5,028			1,264
	Fixed assets			46			10
	Total acquired assets—current year			124,511			67,595
	Assumed accrued compensation liabiities			(569	)		0
	Goodwill—adjustment for prior year transactions			(2,059	)		0
				121,883			67,595
	Cash paid for acquisitions:
	Current year transactions			(91,322	)		(40,014	)
	Contingent consideration			(12,601	)		(22,565	)
	Other—prior year transactions			(204	)		(26	)
	Total cash paid for acquisitions			(104,127	)		(62,605	)
	Change in fair value of contingent consideration:
	Net change in fair value of contingent consideration—recognized			(5,733	)		324
	Net change in fair value of contingent consideration— paid			(342	)		0
	Net change in fair value of contingent consideration			(6,075	)		324
	Net change in payable for practice acquisitions			11,681			5,314
	Payable for practice acquisitions, beginning of period			29,038			23,724
	Payable for practice acquisitions, end of period		$	40,719		$	29,038
	During the fourth quarter of 2012, we acquired six practices and in addition to the closing payments, we recorded accrued contingent consideration on a provisional basis pending completion of the valuation studies as of the acquisition date. The valuation studies were completed in 2013, resulting in a reduction of $2,059,000 of the accrued contingent consideration and the corresponding reduction to goodwill, which was recorded in 2013 as adjustment for prior year transactions.
	Our 2013 practice acquisition includes the hospitalist operations and related assets acquired from Steward Health Care System LLC and its wholly-owned medical group, Steward Medical Group, Inc. (Steward) on September 1, 2013. We acquired the Steward hospitalist operations and related assets located in Massachusetts for a purchase price of $45.0 million. In connection with the Steward acquisition, we recorded goodwill of $42.6 million, identifiable intangible assets of $2.4 million and accrued compensation of $452,000.
	Our 2013 practice acquisition also includes the hospitalist operations and related assets acquired from four affiliated entities: Park Avenue Health Care Management, LLC; Park Avenue Medical Associates, PC; Park Avenue Medical Associates, LLC; and Geriatric Services, PC (collectively, “Park Avenue”) on December 11, 2013. We acquired the Park Avenue operations and related assets located in White Plains, New York for an estimated purchase price of $39.7 million. In connection with the Park Avenue acquisition, we recorded goodwill of $37.4 million, identifiable intangible assets of $2.3 million, fixed assets of $31,000, accrued compensation of $117,000 and accrued contingent consideration of $19.9 million which is based upon the achievement of certain operating results of the acquired practices and the acquisition of certain other hospitalist practices as of certain measurement dates. The accrued consideration is recorded on a provisional basis pending completion of the valuation studies as of the acquisition date. The acquisition represents a new market for the Company in the New York metropolitan area, as well as an expansion of our existing operations in Connecticut and Massachusetts.
	The results of operations of the 19 practices acquired in 2013 are included in our consolidated financial statements from the respective dates of acquisition, which include the revenue and net income of approximately $8.1 million and $0.5 million, respectively, from Steward’s operations and approximately $1.3 million and $0.1 million, respectively, from Park Avenue’s operations.
	The following unaudited pro forma information presents the consolidated results of operations of our company as if the Steward and Park Avenue acquisitions had occurred on January 1, 2012 (in thousands except for per share data):
			2013			2012
	Net revenue		$	658,674		$	582,042
	Net income (1)		$	43,981		$	35,821
	Net income per share (2)
	Basic		$	2.62		$	2.16
	Diluted		$	2.54		$	2.11
	Weighted average shares outstanding
	Basic			16,811,571			16,578,994
	Diluted			17,314,759			16,968,145
	Effective Tax Rate (1)			38.3	%		37.7	%
	-1	The comparison of net income per share is affected by the change in the effective tax rate, which was 38.3% for 2013 as compared with 37.7% for 2012.
	-2	The comparison of net income is affected by the changes in the numbers of weighted average shares outstanding in each period. The basic and diluted weighted average shares for 2013 were 16.8 million and 17.3 million, respectively, as compared with 16.6 million and 17.0 million, respectively, for 2012.
	The pro forma results do not necessarily represent results which would have occurred if the Steward and Park Avenue acquisitions had taken place at the beginning of 2012, nor are they indicative of the results of future operations.

Fair_Value_Measurement

Fair Value Measurement	12 Months Ended
	Dec. 31, 2013
Fair Value Disclosures [Abstract]	'
Fair Value Measurement	'
	Note 3. Fair Value Measurement
	Some of our assets and liabilities are measured and recorded at fair value, which is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (an exit price). The established fair value hierarchy distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (Levels 1 and 2) and the reporting entity’s own assumptions about market participant assumptions (Level 3). This hierarchy is used to measure fair value as follows:
		•		Level 1 inputs utilize quoted prices in active markets for identical assets or liabilities.
		•		Level 2 inputs include quoted prices for similar assets and liabilities in active markets; quoted prices in markets that are not active; and other inputs that are observable or can be corroborated by observable market data for the asset or liability.
		•		Level 3 inputs are unobservable inputs for the asset or liability that are supported by little or no market activity.
	The following table presents our liabilities measured at fair value on a recurring basis as of December 31, 2013 and 2012 (in thousands):
	Accrued contingent consideration (included in		Quoted Price In			Significant Other			Significant		Total Balance
	payable for practice acquisitions)		Active Markets for			Observable Inputs			Unobservable
			Identical Instruments			(Level 2)			Inputs
			(Level 1)						(Level 3)
	2013		$	0		$	0		$	40,719	$	40,719
	2012		$	0		$	0		$	28,834	$	28,834
	The following table presents a reconciliation for our liabilities measured at fair value on a recurring basis using significant unobservable inputs (level 3) for the years ended December 31, 2013 and 2012 (dollars in thousands):
	Accrued contingent consideration		2013			2012
	Beginning balance		$	28,834		$	23,624
	Addition through acquisition transactions			32,620			27,451
	Adjustment for prior year transactions			(2,059	)		0
	Change in fair value recognized			(5,733	)		324
	Change in fair value paid			(342	)		0
	Payments			(12,601	)		(22,565	)
	Ending balance		$	40,719		$	28,834
	The fair value of our accrued contingent consideration is determined using widely accepted valuation techniques, which include the income approach for estimating future consideration to be paid based on projected earnings of our acquired practices as of specified measurement dates. The income approach involves the use of a probability-weighted discounted cash flow model based on significant inputs not observable in the market. The significant inputs include a discount rate of 2.5%, 100% probability of achieving the estimated projected earnings, and 25% to 90% probability of the acquisition of certain other hospitalist practices.
	Because our accrued contingent consideration is generally based on a certain multiple of earnings of the acquired practices during a specified measurement period, a relatively small change in such projected earnings may result in a material change to the fair value of such contingent consideration liability with a corresponding adjustment to income from operations. We reassess our projected earnings and the related fair value of our accrued contingent consideration for practice acquisitions on a quarterly basis.

Debt

Debt	12 Months Ended
	Dec. 31, 2013
Debt Disclosure [Abstract]	'
Debt	'
	Note 4. Debt
	On October 23, 2013, we executed an amendment to our Credit Facility, which provides a revolving line of credit of $125.0 million and contains an “accordion” feature that allows an increase of up to $25.0 million to the Credit Facility with lender approval. The Credit Facility has a maturity date of August 4, 2016 and is available for working capital, practice acquisitions, capital expenditures and general business expenses. As of December 31, 2013, we had borrowings of $90.0 million and letters of credit of $0.3 million outstanding, and $34.7 million available under the Credit Facility.
	The revolving line of credit is limited by a formula based on a certain multiple times the trailing twelve months of earnings before interest, taxes, depreciation, amortization and certain non-cash items. Interest rate options for each borrowing under the Credit Facility, to be selected by us at the time of each borrowing, include either LIBOR plus 0.75% to 1.75%, or the lender’s prime rate plus 0% to 0.75%, both based on a leverage ratio. We pay an unused commitment fee equal to 0.25% per annum on the difference between the revolving line capacity and the average balance outstanding during the year. Outstanding amounts advanced to us under the revolving line of credit are repayable on or before the maturity date.
	The amended Credit Facility is guaranteed by our subsidiaries and affiliated Professional Medical Corporations and limited liability companies, and is secured by substantially all of our and our guarantors’ tangible and intangible assets. The Credit Facility includes various customary financial covenants and restrictions, as well as customary remedies for our lenders following an event of default. As of December 31, 2013, we were in compliance with such financial covenants and restrictions.
	Interest costs and unused commitment fees related to our debt and Credit Facility for the years ended December 31 are comprised of the following (in thousands):
		2013		2012		2011
	Interest expense	$	391	$	153	$	61
	Unused commitment fees		149		184		124
	Total interest expense	$	540	$	337	$	185

Income_Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2013
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	Note 5. Income Taxes
	The following table represents the current and deferred income tax provision for federal and state income taxes attributable to operations (in thousands):
		2013			2012			2011
	Current:
	Federal	$	18,178		$	15,388		$	14,712
	State		2,222			2,312			2,117
	Total current(1)		20,400			17,700			16,829
	Deferred:
	Federal		4,322			1,997			1,240
	State		975			31			(472	)
	Total deferred		5,297			2,028			768
	Total provision	$	25,697		$	19,728		$	17,597
	(1)    Current tax provision excludes tax benefit from stock compensation recorded to additional paid-in capital in the amount of:	$	(2,609	)	$	(988	)	$	(1,270	)
	A reconciliation of the provision for income taxes compared with U.S. statutory tax rates for the years ended December 31 is shown below:
		2013			2012			2011
	Statutory federal tax provision		35	%		35	%		35	%
	Increase (decrease) in taxes resulting from:
	State tax net of federal benefit		3.1	%		2.91	%		2.29	%
	Change in valuation allowance		0.05	%		(0.22	)%		0.12	%
	Permanent differences and other		0.15	%		0.01	%		0.19	%
	Recognition of tax benefits for uncertain positions		0	%		0	%		(0.05	)%
	Income tax provision		38.3	%		37.7	%		37.55	%
	In 2013, there was an increase in the overall effective tax rate primarily due to a change in state tax laws in November 2012. In 2012, there was an increase in the state effective tax rate primarily related to recording a partial valuation allowance attributable to certain state credit carryforwards.
	Deferred income taxes reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. At December 31, the significant components of our deferred tax assets and liabilities consisted of the following (in thousands):
		2013			2012
	Deferred tax assets:
	Net operating loss (NOL) carryforwards	$	575		$	625
	Allowance for uncollectible accounts		2,562			1,908
	Compensation accruals		1,564			1,354
	Accrued IBNR claims		9,445			8,473
	Stock-based compensation		6,611			5,148
	State taxes and credits		3,604			2,202
	Other		492			158
	Total deferred tax assets		24,853			19,868
	Less: Valuation allowance		(2,746	)		(1,229	)
	Deferred tax assets, net		22,107			18,639
	Deferred tax liabilities:
	Prepaid insurance		(5,349	)		(4,709	)
	Depreciation and amortization		(23,489	)		(15,186	)
	Total deferred tax liabilities		(28,838	)		(19,895	)
	Total net deferred tax liability	$	(6,731	)	$	(1,256	)
	We evaluate the recoverability of our deferred tax assets based on operations. The Company evaluated the positive and negative evidence related to their ability to utilize certain state credit carry forwards and concluded it is not more likely than not the credits will be fully utilized. California passed a tax law change in November, 2012 that reduced the Company’s annual credit utilization. Given this law change and considering all other available information, a partial valuation allowance of $2,385,000 was determined to be necessary. In addition, there is a valuation allowance related to consolidated Professional Medical Corporations that file separate tax returns for which the realization of the deferred tax asset is not more likely than not to be utilized. There is a net deferred tax liability at December 31, 2013 due to an increase in tax amortization of goodwill which has an indefinite reversal pattern.
	As of December 31, 2013 we have federal NOL carryforwards of $1,483,000 which begin to expire in 2019, and state NOL carryforwards of $1,301,000, which begin to expire in 2020. Federal NOLs of $586,000 incurred before 2000 are subject to an annual change of ownership limitation of approximately $195,000 per Internal Revenue Code Section 382 and applicable state statutes, which may limit our ability to utilize a portion of these losses.
	As of December 31, 2013 we have state credit carryforwards of $3,328,000 which expire on December 31, 2024. A partial valuation allowance of $2,385,000 has been recorded against these credits due to the uncertainty of utilization.
	At December 31, 2013 we had no gross unrecognized tax benefits (UTB).
	Following is a tabular reconciliation of the gross UTB activity during 2013, 2012 and 2011 (in thousands):
	Reconciliation of Gross Unrecognized Tax Benefits	2013			2012			2011
	Beginning Balance, excluding interest and penalties of $0, $0 and $10, respectively	$	0		$	66		$	88
	Increases - tax positions taken in prior years		0			0			0
	Decreases - tax provisions taken in prior years		0			0			0
	Current year tax positions		0			0			0
	Settlements		0			0			0
	Expiring NOL		0			(66	)		0
	Lapse of statute of limitations		0			0			(22	)
	Ending Balance, excluding interest and penalties of $0, $0 and $0, respectively	$	0		$	0		$	66
	Our accounting policy is to include interest and penalties related to uncertain tax positions in income tax expense. As of December 31, 2013 we did not have any accrued interest and penalties related to uncertain tax positions.
	The tax years 2009 to 2012 remain open to examination by the major taxing jurisdictions to which we are subject. The statute of limitations for tax years 1999 to 2008 has expired, except that the tax year 1999 is subject to adjustment of net operating losses by the Internal Revenue Service. We are subject to taxation in the United States and various state jurisdictions. The Company is currently subject to one U.S. federal tax examination and one state tax examination for the tax year of 2011 and 2009, respectively. The outcome of such examination cannot be predicted with certainty; however, we believe that the ultimate resolution will not have a material effect on our financial position, results of operations, or cash flows.

Defined_Contribution_Plan

Defined Contribution Plan	12 Months Ended
	Dec. 31, 2013
Postemployment Benefits [Abstract]	'
Defined Contribution Plan	'
	Note 6. Defined Contribution Plan
	Substantially all of our employees are eligible to participate in the IPC The Hospitalist Company, Inc. 401(k) Plan (the Plan). According to the Plan, we contribute half of the participant’s contributions when they are no greater than 7% of the participant’s annual compensation. The vesting period of our contribution is one year. After 60 days following an employee’s date of hire, all new-hires are automatically enrolled in the Plan. Employees that are automatically enrolled have 60 days to opt out of the Plan and to receive a refund of any contributions made in that period. We fund contributions as accrued. For the years ended December 31, expense recognized in connection with our contributions was (in thousands):
		2013		2012		2011
	Employer contribution to defined contribution plan	$	8,728	$	7,484	$	6,382

StockBased_Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Stock-Based Compensation	'
	Note 7. Stock-Based Compensation
	At December 31, 2013, we had a stock-based employee compensation program, for which we had reserved a total of 4,943,170 common shares for issuance. Under our 2012 Equity Participation Plan (Equity Plan), which was approved by our stockholders on June 7, 2012, a total of 1,422,130 shares of our common stock were available for issuance and no new awards will be issued under any previous equity participation plans. As of December 31, 2013, there were 1,136,012 shares of our common stock available for future grants under our Equity Plan, which included the canceled and forfeited shares issued under previous equity participation plans.
	All option awards granted during 2013, 2012 and 2011 were issued with exercise prices equal to the closing price of our common stock on the NASDAQ Global Select Market on the dates of the grant. The options under the Equity Plan generally vest over a four-year period from date of grant, and options terminate on the 10th anniversary of the agreement date for all grants issued before January 1, 2013 and on the 7th anniversary of the agreement date for all grants issued after December 31, 2012. Restricted stock awards generally vest over a four-year period from date of the award. Performance stock awards generally vest over two to three years from date of the award based on the expected level of achievement of certain operational goals that will be obtained and adjusted as appropriate to reflect actual shares issued.
	Stock-based compensation expense is recognized over the period when the options, restricted stock awards, performance stock awards and our employee stock purchase plan shares vest, which is included in total general and administrative expenses. The following table summarizes the components of stock-based compensation expense recognized in our Consolidated Statement of Income for 2013, 2012 and 2011 (in thousands):
		2013			2012			2011
	Total stock-based compensation expense	$	7,355		$	6,344		$	4,783
	Tax benefit from stock-based compensation expense		(2,817	)		(2,392	)		(1,796	)
	Total stock-based compensation expense, net of tax	$	4,538		$	3,952		$	2,987
	As of December 31, 2013, total unrecognized compensation costs related to non-vested stock-based compensation arrangements granted under our Equity Plan and the weighted-average period of years expected to recognize those costs are as follows (dollars in thousands).
		Total Unrecognized			Weighted-Average
		Compensation Cost			Remaining Contractual
					Term
					(Years)
	Stock option	$	4,169			1.72
	Restricted stock	$	4,817			1.82
	The fair value of each option grant is estimated on the date of the grant using the Black-Scholes option-pricing model based on the following weighted-average assumptions:
		For Years Ended December 31,
		2013			2012			2011
	Risk-free interest rate		0.67	%		1.21	%		2.39	%
	Expected volatility		40.07	%		39.86	%		39.24	%
	Expected option life (in years)		4.4			6.16			6.17
	Expected dividend yield		0	%		0	%		0	%
	The risk-free interest rate is based on the implied yield currently available on U.S. Treasury zero coupon issues. The expected volatility is largely based on the volatility of our stock price. The expected option life of each award granted was calculated using the “simplified method” in accordance with GAAP.
	The grant date fair value of each restricted stock award or performance stock award is based on the closing stock price on the grant date of the award as reported by NASDAQ Global Select Market.
	The following table summarizes the stock option activity in our Equity Plan during the year ended December 31, 2013.
		Shares			Weighted-			Weighted-			Aggregate		Weighted-
					Average			Average			Intrinsic Value		Average Fair
					Exercise Price			Remaining					Value
								Contractual
								Term
								(Years)			(in 000’s)
	Options outstanding as of December 31, 2012		1,630,921		$	28.36							$	11.95
	Changes during period:
	Granted		45,823			41.82								14.04
	Exercised		(290,204	)		22.26								10.17
	Cancelled/Forfeited		(3,668	)		38.19								15.9
	Expired		(2,447	)		1.66								0.56
	Options outstanding as of December 31, 2013		1,380,425		$	30.12			6.12		$	40,412	$	12.56
	Options exercisable as of December 31, 2013		1,107,712		$	27.58			5.79		$	35,240	$	11.57
	The total intrinsic value of stock options exercised during the year ended December 31, 2013 was $8,566,000.
	The following table summarizes the restricted stock award and performance stock award activities in our Equity Plan during the year ended December 31, 2013.
					(Years)			(in 000’s)
	Restricted/performance stock awards outstanding as of December 31, 2012		101,940								$	38.03
	Changes during period:
	Granted		126,012									42.05
	Released		(14,539	)								39.68
	Cancelled/Forfeited		(1,000	)								42.12
	Restricted/performance stock awards outstanding as of December 31, 2013		212,413			1.28		$	12,615		$	40.29

Employee_Stock_Purchase_Plan

Employee Stock Purchase Plan	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]	'
Employee Stock Purchase Plan	'
	Note 8. Employee Stock Purchase Plan
	We have a nonqualified employee stock purchase plan (ESPP), which authorizes the issuance of up to an aggregate of 306,250 shares of our common stock to eligible employees who meet the service requirements. At the end of each annual offering period under the plan, an automatic purchase of our common stock is made on behalf of the plan’s participants. Eligible employees may purchase common stock through payroll deductions in amounts from $500 to $10,000 per year. Employees may reduce or suspend deductions during the year or withdraw from the plan during the year and receive a refund of their deductions. Stock purchases are made at a price equal to 85% of the fair market value (i.e., closing price of our common stock on the NASDAQ Global Select Market) of a share of our common stock on the first or last day of the offering period, whichever is lower.
	For the years ended December 31, the stock-based compensation expense relating to the ESPP was included in general and administrative expenses as follows (in thousands):
		2013		2012		2011
	Stock-based compensation expense related to ESPP	$	329	$	309	$	299

Earnings_Per_Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2013
Earnings Per Share [Abstract]	'
Earnings Per Share	'
	Note 9. Earnings Per Share
	Basic net income per share is calculated by dividing net income for the period by the weighted-average number of common shares outstanding during the period. Diluted net income per share is calculated by dividing net income for the period by the weighted average number of shares outstanding during the period plus the dilutive effect of our outstanding stock awards and shares issuable under our employee stock purchase plan using the treasury stock method.
	The calculations of basic and diluted net income per share for the years ended December 31 are as follows (dollar in thousands, except for per share data):
		2013		2012		2011
	Basic:
	Net income attributable to common stockholders	$	41,396	$	32,586	$	29,269
	Weighted average number of common shares outstanding		16,811,571		16,578,994		16,387,903
	Basic net income per share attributable to common stockholders	$	2.46	$	1.97	$	1.79
	Diluted:
	Net income attributable to common stockholders	$	41,396	$	32,586	$	29,269
	Weighted average number of common shares outstanding		16,811,571		16,578,994		16,387,903
	Weighted average number of dilutive common share equivalents from options to purchase common stock		503,188		389,151		433,935
	Common shares and common share equivalents		17,314,759		16,968,145		16,821,838
	Diluted net income per share	$	2.39	$	1.92	$	1.74
	Outstanding stock options, which have an exercise price above market or which are anti-dilutive under the treasury stock method, are excluded from our diluted computation. As of December 31, the excluded stock options were as follows:
		2013		2012		2011
	Stock options excluded from diluted shares computation		28,194		430,489		257,094

Commitments_and_Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2013
Commitments And Contingencies Disclosure [Abstract]	'
Commitments and Contingencies	'
	Note 10. Commitments and Contingencies
	Leases
	We lease certain buildings and equipment under operating leases. Certain building leases contain renewal options. Future minimum rental payments required under operating leases that have initial or remaining non-cancelable leases as of December 31, 2012, are as follows (in thousands):
	2014	$	4,334
	2015		4,047
	2016		3,569
	2017		3,067
	2018		2,815
	Thereafter		1,828
		$	19,660
	We do not have contingent rent and sub-lease agreements. Rent expense recorded for years ended December 31 was as follows (in thousands):
		2013		2012		2011
	Total rent expense	$	3,595	$	3,330	$	3,162
	Regulatory Matters
	Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusion from the Medicare and Medicaid programs. We believe that we are in compliance with all applicable laws and regulations. However, we did receive a civil investigative demand (CID) issued in 2010 by the Department of Justice (DOJ) as discussed under “Government Inquiry” section below.
	We operate in certain states regulated under corporate practice of medicine laws and we believe that we are in compliance with all such laws.
	Legal
	In the ordinary course of our business, we become involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services provided by our affiliated physicians. We may also become subject to other lawsuits, which could involve significant claims and/or significant defense costs.
	Based upon our review of pending actions and proceedings, we believe that the outcome of such legal actions and proceedings will not have a material adverse effect on our business, financial condition, results of operations, or cash flows. The outcome of such actions and proceedings, however, cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on our business, financial condition, results of operations, or cash flows in a future period.
	Government Inquiry
	On June 7, 2010, we received a civil investigative demand (CID) issued by the Department of Justice (DOJ), U.S. Attorney’s Office for the Northern District of Illinois. The CID requested information concerning claims that we have submitted to Medicare and Medicaid. The CID covered the period from January 1, 2003, through June 4, 2010, and requested production of a range of documents relating to our Medicare and Medicaid participation, physician arrangements, operations, billings and compliance programs. We believe we have a strong compliance focus, and that we operate with appropriate billing policies, procedures, provider training, and compliance programs and controls. We produced responsive documents and have been in contact with representatives of the DOJ who informed us that the inquiry related to a qui tam whistleblower action filed under court seal in the U.S. District Court for the Northern District of Illinois (Chicago). We also were informed that several state attorneys general were examining our Medicaid claims in coordination with the DOJ.
	On December 6, 2013, the U.S. District Court partially lifted the seal on the civil False Claims Act case related to this investigation. The unsealed portions of the Court docket include the whistleblower’s Complaint, which contains allegations of improper billing to Medicare and Medicaid, a Notice of Election to Intervene filed by the federal government and a Notice of Election to Decline Intervention filed by the State of Illinois and 12 other states that participated in the investigation. We have cooperated with the government’s investigation and continue to have discussions with the federal government regarding its investigation and the related case.
	It is not possible to predict when this matter may be resolved or what impact, if any, the outcome of this matter might have on our consolidated financial position, results of operations, or cash flows.
	Liability Insurance
	Although we currently maintain liability insurance policies on a claims-made basis, which are intended to cover malpractice liability and certain other claims, the coverage must be renewed annually, and may not continue to be available to us in future years at acceptable costs, and on favorable terms. In addition to the known incidents occurring through December 31, 2013 that have resulted in the assertion of claims, we cannot be certain that our insurance coverage will be adequate to cover liabilities arising out of claims asserted against us in the future where the outcomes of such claims are unfavorable.
	We believe that the ultimate resolution of all pending claims, including liabilities in excess of our insurance coverage, will not have a material adverse effect on our financial position, results of operations or cash flows; however, there can be no assurance that future claims will not have a material adverse effect on our business.

Quarterly_Results_of_Operation

Quarterly Results of Operations	12 Months Ended
	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]	'
Quarterly Results of Operations	'
	Note 11. Quarterly Results of Operations (unaudited)
	Following is a summary of our quarterly results of operations for the years ended December 31, 2013 and 2012 (dollars in thousands, except for per share data):
			Dec 31,			Sep 30,			Jun 30,			Mar 31,			Dec 31,			Sep 30,			Jun 30,			Mar 31,
			2013			2013			2013			2013			2012			2012			2012			2012
	Net revenue		$	161,600		$	149,073		$	145,753		$	153,091		$	137,569		$	127,651		$	128,472		$	129,793
	Income from operations			15,658			14,791			20,032			17,139			13,950			12,368			12,630			13,689
	Investment income			1			7			3			2			3			3			4			4
	Interest expense			(217	)		(109	)		(99	)		(115	)		(85	)		(78	)		(92	)		(82	)
	Income before income taxes			15,442			14,689			19,936			17,026			13,868			12,293			12,542			13,611
	Income tax provision			5,915			5,626			7,635			6,521			5,419			4,501			4,703			5,105
	Net income		$	9,527		$	9,063		$	12,301		$	10,505		$	8,449		$	7,792		$	7,839		$	8,506
	Per share data:
	Net income per share(1):
	Basic		$	0.56		$	0.54		$	0.73		$	0.63		$	0.51		$	0.47		$	0.47		$	0.52
	Diluted		$	0.54		$	0.52		$	0.71		$	0.61		$	0.5		$	0.46		$	0.46		$	0.5
	Weighted average shares:
	Basic			16,937,646			16,839,069			16,763,325			16,703,369			16,647,295			16,616,866			16,545,600			16,505,047
	Diluted			17,516,086			17,368,426			17,228,173			17,125,940			17,062,431			17,060,848			16,931,098			16,860,655
	-1	Earnings per share are computed independently for each of the quarters presented and therefore may not sum to the total for the year.

Subsequent_Events

Subsequent Events	12 Months Ended
	Dec. 31, 2013
Subsequent Events [Abstract]	'
Subsequent Events	'
	Note 12. Subsequent Events (unaudited)
	Subsequent to December 31, 2013, we completed one practice acquisition.

Schedule_II_Valuation_and_Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2013
Valuation And Qualifying Accounts [Abstract]	'
Schedule II: Valuation and Qualifying Accounts	'
	SCHEDULE II: VALUATION AND QUALIFYING ACCOUNTS
		Years Ended December 31,
		2013			2012			2011
		(in thousands)
	Allowance for uncollectible accounts were as follows:
	Balance at beginning of year	$	4,837		$	4,831		$	2,904
	Amount charged against operating revenue		15,274			14,611			13,539
	Accounts receivable write-offs (net of recovery)		(13,601	)		(14,605	)		(11,612	)
	Balance at end of year	$	6,510		$	4,837		$	4,831

Operations_and_Significant_Acc1

Operations and Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]	'
Business	'
	Business
	IPC The Hospitalist Company, Inc. and its subsidiaries (the “Company,” “IPC,” “we,” “us,” and “our”) is a national physician group practice company that operates and manages full-time hospitalist practices. Hospitalists focus on a patient’s care from the time of admission to discharge, working in close consultation with primary care physicians, other referring physicians and medical providers to coordinate the inpatient care delivery system and manage the entire inpatient episode of care. Our affiliated hospitalists practice in inpatient facilities, including acute care hospitals, long-term acute care facilities, specialty hospitals, psychiatric facilities and post-acute care facilities. The physicians are primarily full-time employees of our subsidiaries or consolidated Professional Medical Corporations, although part-time and temporary physicians are also employed or contracted on an as-needed basis. Also, unless otherwise expressly stated or the context otherwise requires, “our affiliated hospitalists” refer to physicians, nurse practitioners and physician assistants employed or contracted by either our wholly-owned subsidiaries or our Professional Medical Corporations. References to “practices” or “practice groups” refer to our Professional Medical Corporations and the wholly-owned subsidiaries of IPC that provide medical services, unless otherwise expressly stated or the context otherwise requires.
Principles of Consolidation	'
	Principles of Consolidation
	Our consolidated financial statements include the accounts of IPC The Hospitalist Company, Inc. and its wholly owned subsidiaries and our affiliated professional medical corporations, also called “affiliated professional organizations”, which we manage under long-term management agreements. Some states have laws that prohibit business entities, such as IPC, from practicing medicine, employing physicians to practice medicine, exercising control over medical decisions by physicians (collectively known as the corporate practice of medicine), or engaging in certain arrangements with physicians, such as fee-splitting. In states that have these restrictions, we operate by maintaining long-term management contracts with affiliated professional organizations, which are each owned and operated by physicians, and which employ or contract with additional physicians to provide hospitalist services. Under the management agreements, we provide and perform all non-medical management and administrative services, including financial management, information systems, marketing, risk management and administrative support. The management agreements have an initial term of 20 years and are automatically renewable for successive 10-year periods unless terminated by either party for cause. The management agreements are not terminable by the Professional Medical Corporations, except in the case of gross negligence, fraud, or other illegal acts by us, or bankruptcy of IPC.
	Through the management agreements and our relationship with the stockholders of the Professional Medical Corporations, we have exclusive authority over all non-medical decision making related to the ongoing business operations of the Professional Medical Corporations. Further, our rights under the management agreements are unilaterally salable or transferable. Based on the provisions of the agreements, we have determined that the Professional Medical Corporations are variable interest entities (VIE’s), and that we are the primary beneficiary because we have controls over the operations of these VIE’s, provide full financial and management support to them, and take all residual benefits and bear all residual losses from their operations. Consequently, we consolidate the revenue and expenses of the Professional Medical Corporations from the date of execution of the agreements. All intercompany balances and transactions have been eliminated in consolidation.
Segment Reporting	'
	Segment Reporting
	In accordance with U.S. generally accepted accounting principles (GAAP), the results of our operations are consolidated into a single reportable segment for purposes of presenting financial information.
Revenue	'
	Revenue
	Net revenue consists of fees for medical services provided by our affiliated hospitalists under fee-for-service, case rate and other professional fee arrangements with various payors including Medicare, Medicaid, managed care organizations, insurance companies and hospitals. For the years ended December 31, total patient volume consisted of the following percentage from Medicare and Medicaid programs:
		2013			2012			2011
	Medicare and Medicaid patients		53	%		52	%		51	%
	Net revenue is reported in the period in which services are provided at amounts expected to be collected, which excludes contractual discounts and an estimate of uncollectible accounts. The process of estimating the ultimate amount of revenue to be collected is highly subjective and requires the application of our judgment based on many factors, including contractual reimbursement rates, payor mix, age of receivables, historical cash collection experience and other relevant information. We write off uncollectible accounts receivable from our billing system after reasonable collection efforts have been exhausted. The following amounts, which are excluded from our net revenues, represent an estimate of uncollectible patient copayments and deductible accounts related to patient services during the years ended December 31 (in thousands):
		2013			2012			2011
	Uncollectible accounts excluded from net revenue	$	15,274		$	14,611		$	13,539
Use of Estimates	'
	Use of Estimates
	The preparation of financial statements in conformity with GAAP requires us to make estimates and assumptions of the fair value of certain reported amounts of assets, liabilities, revenues and expenses at the date and for the periods that the financial statements are prepared. Significant estimates include the estimated net realizable value of accounts receivable, medical malpractice insurance receivable and payable for known claims, liabilities for claims incurred but not reported (IBNR) related to medical malpractice, fair value of contingent consideration related to business combinations and the analysis of goodwill for impairment.
	The process of estimating these assets and liabilities involves judgment decisions, which are subject to an inherent degree of uncertainty. Actual results could differ from those estimates.
Fair Value of Financial Instruments	'
	Fair Value of Financial Instruments
	Our consolidated balance sheets as of December 31, 2013 and 2012 included the following financial instruments: cash and cash equivalents, accounts receivable, accounts payable and accrued liabilities, payable for practice acquisitions and long-term debt. We consider the carrying amounts of cash and cash equivalents, accounts receivable and accounts payable and accrued liabilities to approximate their fair value because of the relatively short period of time between the origination of these instruments and their expected realization. The carrying amount of our long-term debt borrowed from our line of credit in December 2013 approximated its fair value at December 31, 2013. Pursuant to GAAP, we determine the fair value of our long-term borrowing using inputs that can be corroborated by observable market data, which is defined as a Level 2 input under GAAP’s fair value hierarchy.
	Our payable for practice acquisitions consisted of accrued contingent consideration for practice acquisitions, which is carried at fair value determined using the income approach with unobservable inputs defined as Level 3 inputs under GAAP. See Note 3 for more information.
Cash and Cash Equivalents	'
	Cash and Cash Equivalents
	Our cash and cash equivalents consist of bank deposits, money market accounts and short-term securities with maturities of three months or less.
Accounts Receivable and Concentrations of Credit Risk	'
	Accounts Receivable and Concentrations of Credit Risk
	Accounts receivable primarily consists of amounts due from third-party payors, including government sponsored Medicare and Medicaid programs, and insurance companies, and amounts due from hospitals, and patients. Accounts receivable are recorded and stated at the amount expected to be collected. The following amounts which are excluded from our accounts receivable, represent an estimate of uncollectible accounts at December 31 (in thousands):
		2013			2012
	Allowance for uncollectible accounts	$	6,510		$	4,837
	Except with respect to the Medicare and Medicaid programs, concentrations of credit risk, which consist primarily of accounts receivable, is limited due to the large number of payors comprising our diverse payor mix and patient base. Geographically, approximately 59%, 60% and 62% of our net revenue in 2013, 2012 and 2011, respectively, was generated by our operations in five states: Arizona, Florida, Michigan, Missouri and Texas. As of December 31, accounts receivable from Medicare and Medicaid made up the following percentage of total net accounts receivable:
		2013			2012
	Percentage of receivables from Medicare and Medicaid		43	%		36	%
Property and Equipment	'
	Property and Equipment
	Property and equipment are stated on the basis of cost or fair value on the date of practice acquisition. Repairs and maintenance are charged to expense as incurred. Depreciation is provided using the straight-line method over the estimated useful lives of the assets. The depreciable life is generally three years for equipment and software, seven years for furniture, and the lesser of the useful life or lease period for leasehold improvements. At December 31, property and equipment consisted of the following (in thousands):
		2013			2012
	Furniture	$	2,803		$	2,491
	Computer equipment and software		19,685			16,226
	Office equipment		1,925			1,876
	Leasehold improvements		1,087			950
			25,500			21,543
	Less: Accumulated depreciation and amortization		(19,157	)		(15,780	)
		$	6,343		$	5,763
	For the years ended December 31, the following amounts were included in total depreciation and amortization expense (in thousands):
		2013			2012			2011
	Depreciation of property and equipment	$	3,377		$	2,968		$	2,277
Goodwill and Other Intangible Assets	'
	Goodwill and Other Intangible Assets
	We record acquired assets and liabilities and any contingent consideration at their acquisition-date fair values, and expense all transaction related costs under the acquisition method of accounting. Goodwill represents the excess of cost over the fair value of the net assets acquired. Other intangible assets primarily represent the fair value of hospital service contract agreements and non-compete agreements acquired in connection with certain asset purchase agreements. Goodwill and other indefinite-lived intangible assets are not amortized. Separable identified intangible assets that have finite lives are amortized over their useful lives.
	In addition to the initial consideration paid at the close of each business combination, the asset purchase agreements for certain completed practice acquisitions provide for additional future consideration to be paid, which is generally based upon the achievement of certain operating results of the acquired practices or the occurrence of certain events as of certain measurement dates. Pursuant to GAAP, the estimated fair value of contingent consideration is accrued at the acquisition-date. Subsequent changes, if any, to the estimated fair value of contingent consideration are recognized as part of on-going operations.
	We test goodwill for impairment on an annual basis as of October 1 of each year, as well as when events or changes in business conditions indicate that the carrying amount of goodwill may not be recoverable, at the entity level since we have only one reporting unit pursuant to GAAP. The testing for impairment is completed using a two-step test. The first step compares the fair value of our Company with its carrying amount. The fair value of our Company is derived using the market-multiple valuation approach, which is based on our peer group’s market capitalization computed using publicly available market quotes. The fair value from the market-multiple approach is used to derive the fair value of our Company. If the fair value of our Company is less than its carrying amount, a second step is performed to determine the amount of any impairment loss. We review our finite-lived intangible assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. During 2013, 2012 and 2011, no impairment indicators were present and no impairment was recognized.
	The changes in the carrying amount of goodwill for the years ended December 31, 2013and 2012 are as follows (in thousands):
		2013			2012
	Goodwill—beginning balance at January 1	$	240,009		$	173,688
	Goodwill acquired during year		119,437			66,321
	Goodwill adjustment for prior year transactions		(2,059	)		0
	Goodwill—ending balance at December 31	$	357,387		$	240,009
	At December 31, other intangible assets consist of the following (in thousands):
		2013			2012
	Non-compete agreements	$	2,126		$	1,916
	Hospital contracts		10,088			5,270
	Trade name		70			70
			12,284			7,256
	Less: Accumulated amortization		(6,427	)		(5,123	)
		$	5,857		$	2,133
	For the years ended December 31, the following amortization of other intangible assets was included in total depreciation and amortization expenses (in thousands):
		2013			2012			2011
	Amortization of other intangible assets	$	1,304		$	943		$	915
	Other intangible assets are being amortized over their estimated useful lives which range from three to six years and have a weighted average remaining useful life of 3.5 years at December 31, 2013. Future estimated aggregate amortization expenses are as follows (in thousands):
	2014	$	1,454
	2015		973
	2016		685
	2017		569
	2018		469
	Thereafter		1,707
		$	5,857
Medical Malpractice Liability Insurance	'
	Medical Malpractice Liability Insurance
	We maintain medical malpractice insurance coverage that indemnifies us and our employed health-care professionals on a claims-made basis. Our claims-made coverage covers those claims reported during the policy period, which ends December 31 of each year, on a first dollar coverage up to our policy limits on new claims reported during the policy period. In December 2013, we renewed our annual professional liability insurance policy for 2014 effective January 1, 2014 under the same terms as our 2013 policy. We expect to be able to continue to obtain coverage in future years; however, there can be no assurance that we will obtain substantially similar coverage as is provided under the 2014 policy at acceptable costs and on favorable terms upon expiration.
	We record our medical malpractice reserves, on an undiscounted basis, for claims incurred and reported and claims incurred but not reported during the policy period, based on actuarial loss projections using historical loss patterns. For claims incurred and reported, an insurance receivable from our carrier has been recorded pursuant to GAAP.
	Total accrued medical malpractice reserves and related insurance receivables at December 31 were as follows (in thousands):
		2013											2012
		Assets			Liabilities								Assets		Liabilities
		Insurance			Claims			IBNR			Total		Insurance		Claims		IBNR		Total
		Receivable			Reserve			Reserve			Liabilities		Receivable		Reserve		Reserve		Liabilities
	Current Portion	$	11,653		$	11,653			558			12,211	$	9,719	$	9,846		504		10,350
	Long-term Portion		20,599			20,599			23,445			44,044		17,074		17,074		20,847		37,921
	Total	$	32,252		$	32,252			24,003			56,255	$	26,793	$	26,920		21,351		48,271
Reclassifications	'
	Reclassifications
	Certain prior year amounts have been reclassified to conform to the current year presentation.

Operations_and_Significant_Acc2

Operations and Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]	'
Schedule of Medicare and Medicaid Percentage of Total Patient Volume	'
	For the years ended December 31, total patient volume consisted of the following percentage from Medicare and Medicaid programs:
		2013			2012			2011
	Medicare and Medicaid patients		53	%		52	%		51	%
Schedule of Amount Excluded from Revenues that Represents Uncollectible Patient Copayment and Deductible Amounts	'
	The following amounts, which are excluded from our net revenues, represent an estimate of uncollectible patient copayments and deductible accounts related to patient services during the years ended December 31 (in thousands):
		2013			2012			2011
	Uncollectible accounts excluded from net revenue	$	15,274		$	14,611		$	13,539
Schedule of Amount Excluded from Accounts Receivable that Represents Estimated Uncollectible Accounts	'
	The following amounts which are excluded from our accounts receivable, represent an estimate of uncollectible accounts at December 31 (in thousands):
		2013			2012
	Allowance for uncollectible accounts	$	6,510		$	4,837
Schedule of Medicare and Medicaid Percentage of Total Net Accounts Receivable	'
	As of December 31, accounts receivable from Medicare and Medicaid made up the following percentage of total net accounts receivable:
		2013			2012
	Percentage of receivables from Medicare and Medicaid		43	%		36	%
Schedule of Property and Equipment	'
	At December 31, property and equipment consisted of the following (in thousands):
		2013			2012
	Furniture	$	2,803		$	2,491
	Computer equipment and software		19,685			16,226
	Office equipment		1,925			1,876
	Leasehold improvements		1,087			950
			25,500			21,543
	Less: Accumulated depreciation and amortization		(19,157	)		(15,780	)
		$	6,343		$	5,763
Schedule of Depreciation and Amortization Expenses of Property and Equipment	'
	For the years ended December 31, the following amounts were included in total depreciation and amortization expense (in thousands):
		2013			2012			2011
	Depreciation of property and equipment	$	3,377		$	2,968		$	2,277
Schedule of Changes in Carrying Amount of Goodwill	'
	The changes in the carrying amount of goodwill for the years ended December 31, 2013and 2012 are as follows (in thousands):
		2013			2012
	Goodwill—beginning balance at January 1	$	240,009		$	173,688
	Goodwill acquired during year		119,437			66,321
	Goodwill adjustment for prior year transactions		(2,059	)		0
	Goodwill—ending balance at December 31	$	357,387		$	240,009
Schedule of Other Intangible Assets	'
	At December 31, other intangible assets consist of the following (in thousands):
		2013			2012
	Non-compete agreements	$	2,126		$	1,916
	Hospital contracts		10,088			5,270
	Trade name		70			70
			12,284			7,256
	Less: Accumulated amortization		(6,427	)		(5,123	)
		$	5,857		$	2,133
Schedule of Amortization Expenses of Other Intangible Assets	'
	For the years ended December 31, the following amortization of other intangible assets was included in total depreciation and amortization expenses (in thousands):
		2013			2012			2011
	Amortization of other intangible assets	$	1,304		$	943		$	915
Schedule of Future Estimated Aggregate Amortization Expenses	'
	Future estimated aggregate amortization expenses are as follows (in thousands):
	2014	$	1,454
	2015		973
	2016		685
	2017		569
	2018		469
	Thereafter		1,707
		$	5,857
Schedule of Total Accrued Medical Malpractice Reserves and Related Insurance Receivables	'
	Total accrued medical malpractice reserves and related insurance receivables at December 31 were as follows (in thousands):
		2013											2012
		Assets			Liabilities								Assets		Liabilities
		Insurance			Claims			IBNR			Total		Insurance		Claims		IBNR		Total
		Receivable			Reserve			Reserve			Liabilities		Receivable		Reserve		Reserve		Liabilities
	Current Portion	$	11,653		$	11,653			558			12,211	$	9,719	$	9,846		504		10,350
	Long-term Portion		20,599			20,599			23,445			44,044		17,074		17,074		20,847		37,921
	Total	$	32,252		$	32,252			24,003			56,255	$	26,793	$	26,920		21,351		48,271

Business_Acquisitions_Tables

Business Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2013
Business Combinations [Abstract]	'
Schedule of Acquisition of Hospitalist Practices	'
	The following table summarizes the total amounts recorded during the years ended December 31, related to the acquisition of hospitalist practices (in thousands):
			2013			2012
	Acquired assets, net of assumed liabilities—paid and accrued:
	Goodwill—current year transactions		$	119,437		$	66,321
	Other intangible assets			5,028			1,264
	Fixed assets			46			10
	Total acquired assets—current year			124,511			67,595
	Assumed accrued compensation liabiities			(569	)		0
	Goodwill—adjustment for prior year transactions			(2,059	)		0
				121,883			67,595
	Cash paid for acquisitions:
	Current year transactions			(91,322	)		(40,014	)
	Contingent consideration			(12,601	)		(22,565	)
	Other—prior year transactions			(204	)		(26	)
	Total cash paid for acquisitions			(104,127	)		(62,605	)
	Change in fair value of contingent consideration:
	Net change in fair value of contingent consideration—recognized			(5,733	)		324
	Net change in fair value of contingent consideration— paid			(342	)		0
	Net change in fair value of contingent consideration			(6,075	)		324
	Net change in payable for practice acquisitions			11,681			5,314
	Payable for practice acquisitions, beginning of period			29,038			23,724
	Payable for practice acquisitions, end of period		$	40,719		$	29,038
Schedule of Pro Forma Information of Consolidated Results of Operations	'
	The following unaudited pro forma information presents the consolidated results of operations of our company as if the Steward and Park Avenue acquisitions had occurred on January 1, 2012 (in thousands except for per share data):
			2013			2012
	Net revenue		$	658,674		$	582,042
	Net income (1)		$	43,981		$	35,821
	Net income per share (2)
	Basic		$	2.62		$	2.16
	Diluted		$	2.54		$	2.11
	Weighted average shares outstanding
	Basic			16,811,571			16,578,994
	Diluted			17,314,759			16,968,145
	Effective Tax Rate (1)			38.3	%		37.7	%
	-1	The comparison of net income per share is affected by the change in the effective tax rate, which was 38.3% for 2013 as compared with 37.7% for 2012.
	-2	The comparison of net income is affected by the changes in the numbers of weighted average shares outstanding in each period. The basic and diluted weighted average shares for 2013 were 16.8 million and 17.3 million, respectively, as compared with 16.6 million and 17.0 million, respectively, for 2012.

Fair_Value_Measurement_Tables

Fair Value Measurement (Tables)	12 Months Ended
	Dec. 31, 2013
Fair Value Disclosures [Abstract]	'
Liabilities Measured at Fair Value on Recurring Basis	'
	The following table presents our liabilities measured at fair value on a recurring basis as of December 31, 2013 and 2012 (in thousands):
	Accrued contingent consideration (included in	Quoted Price In			Significant Other			Significant		Total Balance
	payable for practice acquisitions)	Active Markets for			Observable Inputs			Unobservable
		Identical Instruments			(Level 2)			Inputs
		(Level 1)						(Level 3)
	2013	$	0		$	0		$	40,719	$	40,719
	2012	$	0		$	0		$	28,834	$	28,834
Rollforward for Liabilities Measured at Fair Value on Recurring Basis Using Significant Unobservable Inputs	'
	The following table presents a reconciliation for our liabilities measured at fair value on a recurring basis using significant unobservable inputs (level 3) for the years ended December 31, 2013 and 2012 (dollars in thousands):
	Accrued contingent consideration	2013			2012
	Beginning balance	$	28,834		$	23,624
	Addition through acquisition transactions		32,620			27,451
	Adjustment for prior year transactions		(2,059	)		0
	Change in fair value recognized		(5,733	)		324
	Change in fair value paid		(342	)		0
	Payments		(12,601	)		(22,565	)
	Ending balance	$	40,719		$	28,834

Debt_Tables

Debt (Tables)	12 Months Ended
	Dec. 31, 2013
Debt Disclosure [Abstract]	'
Schedule of Interest Costs and Unused Commitment Fees Related to Debt and Credit Facility	'
	Interest costs and unused commitment fees related to our debt and Credit Facility for the years ended December 31 are comprised of the following (in thousands):
		2013		2012		2011
	Interest expense	$	391	$	153	$	61
	Unused commitment fees		149		184		124
	Total interest expense	$	540	$	337	$	185

Income_Taxes_Tables

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2013
Income Tax Disclosure [Abstract]	'
Schedule of Current and Deferred Income Tax Provision	'
	The following table represents the current and deferred income tax provision for federal and state income taxes attributable to operations (in thousands):
		2013			2012			2011
	Current:
	Federal	$	18,178		$	15,388		$	14,712
	State		2,222			2,312			2,117
	Total current(1)		20,400			17,700			16,829
	Deferred:
	Federal		4,322			1,997			1,240
	State		975			31			(472	)
	Total deferred		5,297			2,028			768
	Total provision	$	25,697		$	19,728		$	17,597
	(1)    Current tax provision excludes tax benefit from stock compensation recorded to additional paid-in capital in the amount of:	$	(2,609	)	$	(988	)	$	(1,270	)
Schedule of Reconciliation of Provision for Income Taxes Compared with U.S. Statutory Tax Rates	'
	A reconciliation of the provision for income taxes compared with U.S. statutory tax rates for the years ended December 31 is shown below:
		2013			2012			2011
	Statutory federal tax provision		35	%		35	%		35	%
	Increase (decrease) in taxes resulting from:
	State tax net of federal benefit		3.1	%		2.91	%		2.29	%
	Change in valuation allowance		0.05	%		(0.22	)%		0.12	%
	Permanent differences and other		0.15	%		0.01	%		0.19	%
	Recognition of tax benefits for uncertain positions		0	%		0	%		(0.05	)%
	Income tax provision		38.3	%		37.7	%		37.55	%
Schedule of Significant Components of Deferred Tax Assets and Liabilities	'
	At December 31, the significant components of our deferred tax assets and liabilities consisted of the following (in thousands):
		2013			2012
	Deferred tax assets:
	Net operating loss (NOL) carryforwards	$	575		$	625
	Allowance for uncollectible accounts		2,562			1,908
	Compensation accruals		1,564			1,354
	Accrued IBNR claims		9,445			8,473
	Stock-based compensation		6,611			5,148
	State taxes and credits		3,604			2,202
	Other		492			158
	Total deferred tax assets		24,853			19,868
	Less: Valuation allowance		(2,746	)		(1,229	)
	Deferred tax assets, net		22,107			18,639
	Deferred tax liabilities:
	Prepaid insurance		(5,349	)		(4,709	)
	Depreciation and amortization		(23,489	)		(15,186	)
	Total deferred tax liabilities		(28,838	)		(19,895	)
	Total net deferred tax liability	$	(6,731	)	$	(1,256	)
Schedule of Reconciliation of Gross Unrecognized Tax Benefits	'
	Following is a tabular reconciliation of the gross UTB activity during 2013, 2012 and 2011 (in thousands):
	Reconciliation of Gross Unrecognized Tax Benefits	2013			2012			2011
	Beginning Balance, excluding interest and penalties of $0, $0 and $10, respectively	$	0		$	66		$	88
	Increases - tax positions taken in prior years		0			0			0
	Decreases - tax provisions taken in prior years		0			0			0
	Current year tax positions		0			0			0
	Settlements		0			0			0
	Expiring NOL		0			(66	)		0
	Lapse of statute of limitations		0			0			(22	)
	Ending Balance, excluding interest and penalties of $0, $0 and $0, respectively	$	0		$	0		$	66

Defined_Contribution_Plan_Tabl

Defined Contribution Plan (Tables)	12 Months Ended
	Dec. 31, 2013
Postemployment Benefits [Abstract]	'
Schedule of Expense Recognized in Connection with Employer Contributions	'
	For the years ended December 31, expense recognized in connection with our contributions was (in thousands):
		2013		2012		2011
	Employer contribution to defined contribution plan	$	8,728	$	7,484	$	6,382

StockBased_Compensation_Tables

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Components of Stock-Based Compensation Expense Recognized in Consolidated Statement of Income	'
	The following table summarizes the components of stock-based compensation expense recognized in our Consolidated Statement of Income for 2013, 2012 and 2011 (in thousands):
		2013			2012			2011
	Total stock-based compensation expense	$	7,355		$	6,344		$	4,783
	Tax benefit from stock-based compensation expense		(2,817	)		(2,392	)		(1,796	)
	Total stock-based compensation expense, net of tax	$	4,538		$	3,952		$	2,987
Schedule of Unrecognized Compensation Costs Related to Non-Vested Stock-Based Compensation Arrangements Granted under Equity Plan and Weighted-Average Period of Years Expected to Recognize Those Costs	'
	As of December 31, 2013, total unrecognized compensation costs related to non-vested stock-based compensation arrangements granted under our Equity Plan and the weighted-average period of years expected to recognize those costs are as follows (dollars in thousands).
		Total Unrecognized			Weighted-Average
		Compensation Cost			Remaining Contractual
					Term
					(Years)
	Stock option	$	4,169			1.72
	Restricted stock	$	4,817			1.82
Schedule of Fair Value of Each Option Grant Estimated on Date of Grant Using Black-Scholes Option-Pricing Model	'
	The fair value of each option grant is estimated on the date of the grant using the Black-Scholes option-pricing model based on the following weighted-average assumptions:
		For Years Ended December 31,
		2013			2012			2011
	Risk-free interest rate		0.67	%		1.21	%		2.39	%
	Expected volatility		40.07	%		39.86	%		39.24	%
	Expected option life (in years)		4.4			6.16			6.17
	Expected dividend yield		0	%		0	%		0	%
Summary of Stock Option Activity in Equity Plan	'
	The following table summarizes the stock option activity in our Equity Plan during the year ended December 31, 2013.
		Shares			Weighted-			Weighted-			Aggregate		Weighted-
					Average			Average			Intrinsic Value		Average Fair
					Exercise Price			Remaining					Value
								Contractual
								Term
								(Years)			(in 000’s)
	Options outstanding as of December 31, 2012		1,630,921		$	28.36							$	11.95
	Changes during period:
	Granted		45,823			41.82								14.04
	Exercised		(290,204	)		22.26								10.17
	Cancelled/Forfeited		(3,668	)		38.19								15.9
	Expired		(2,447	)		1.66								0.56
	Options outstanding as of December 31, 2013		1,380,425		$	30.12			6.12		$	40,412	$	12.56
	Options exercisable as of December 31, 2013		1,107,712		$	27.58			5.79		$	35,240	$	11.57
Summary of Restricted Stock Award and Performance Stock Award Activities in Equity Plan	'
	The following table summarizes the restricted stock award and performance stock award activities in our Equity Plan during the year ended December 31, 2013.
					(Years)			(in 000’s)
	Restricted/performance stock awards outstanding as of December 31, 2012		101,940								$	38.03
	Changes during period:
	Granted		126,012									42.05
	Released		(14,539	)								39.68
	Cancelled/Forfeited		(1,000	)								42.12
	Restricted/performance stock awards outstanding as of December 31, 2013		212,413			1.28		$	12,615		$	40.29

Employee_Stock_Purchase_Plan_T

Employee Stock Purchase Plan (Tables)	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]	'
Schedule of Stock-Based Compensation Expense Related to ESPP	'
	For the years ended December 31, the stock-based compensation expense relating to the ESPP was included in general and administrative expenses as follows (in thousands):
		2013		2012		2011
	Stock-based compensation expense related to ESPP	$	329	$	309	$	299

Earnings_Per_Share_Tables

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2013
Earnings Per Share [Abstract]	'
Schedule of Basic and Diluted Net Income Per Share	'
	The calculations of basic and diluted net income per share for the years ended December 31 are as follows (dollar in thousands, except for per share data):
		2013		2012		2011
	Basic:
	Net income attributable to common stockholders	$	41,396	$	32,586	$	29,269
	Weighted average number of common shares outstanding		16,811,571		16,578,994		16,387,903
	Basic net income per share attributable to common stockholders	$	2.46	$	1.97	$	1.79
	Diluted:
	Net income attributable to common stockholders	$	41,396	$	32,586	$	29,269
	Weighted average number of common shares outstanding		16,811,571		16,578,994		16,387,903
	Weighted average number of dilutive common share equivalents from options to purchase common stock		503,188		389,151		433,935
	Common shares and common share equivalents		17,314,759		16,968,145		16,821,838
	Diluted net income per share	$	2.39	$	1.92	$	1.74
Schedule of Stock Options Which Have Exercise Price Above Market or Which are Anti-Dilutive under Treasury Stock Method	'
	Outstanding stock options, which have an exercise price above market or which are anti-dilutive under the treasury stock method, are excluded from our diluted computation. As of December 31, the excluded stock options were as follows:
		2013		2012		2011
	Stock options excluded from diluted shares computation		28,194		430,489		257,094

Commitments_and_Contingencies_

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2013
Commitments And Contingencies Disclosure [Abstract]	'
Schedule of Future Minimum Rental Payments	'
	Future minimum rental payments required under operating leases that have initial or remaining non-cancelable leases as of December 31, 2012, are as follows (in thousands):
	2014	$	4,334
	2015		4,047
	2016		3,569
	2017		3,067
	2018		2,815
	Thereafter		1,828
		$	19,660
Schedule of Rent Expense	'
	We do not have contingent rent and sub-lease agreements. Rent expense recorded for years ended December 31 was as follows (in thousands):
		2013		2012		2011
	Total rent expense	$	3,595	$	3,330	$	3,162

Quarterly_Results_of_Operation1

Quarterly Results of Operations (Tables)	12 Months Ended
	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]	'
Summary of Quarterly Results of Operations	'
	Following is a summary of our quarterly results of operations for the years ended December 31, 2013 and 2012 (dollars in thousands, except for per share data):
			Dec 31,			Sep 30,			Jun 30,			Mar 31,			Dec 31,			Sep 30,			Jun 30,			Mar 31,
			2013			2013			2013			2013			2012			2012			2012			2012
	Net revenue		$	161,600		$	149,073		$	145,753		$	153,091		$	137,569		$	127,651		$	128,472		$	129,793
	Income from operations			15,658			14,791			20,032			17,139			13,950			12,368			12,630			13,689
	Investment income			1			7			3			2			3			3			4			4
	Interest expense			(217	)		(109	)		(99	)		(115	)		(85	)		(78	)		(92	)		(82	)
	Income before income taxes			15,442			14,689			19,936			17,026			13,868			12,293			12,542			13,611
	Income tax provision			5,915			5,626			7,635			6,521			5,419			4,501			4,703			5,105
	Net income		$	9,527		$	9,063		$	12,301		$	10,505		$	8,449		$	7,792		$	7,839		$	8,506
	Per share data:
	Net income per share(1):
	Basic		$	0.56		$	0.54		$	0.73		$	0.63		$	0.51		$	0.47		$	0.47		$	0.52
	Diluted		$	0.54		$	0.52		$	0.71		$	0.61		$	0.5		$	0.46		$	0.46		$	0.5
	Weighted average shares:
	Basic			16,937,646			16,839,069			16,763,325			16,703,369			16,647,295			16,616,866			16,545,600			16,505,047
	Diluted			17,516,086			17,368,426			17,228,173			17,125,940			17,062,431			17,060,848			16,931,098			16,860,655
	-1	Earnings per share are computed independently for each of the quarters presented and therefore may not sum to the total for the year.

Operations_and_Significant_Acc3

Operations and Significant Accounting Policies - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Schedule Of Accounting Policies [Line Items]	'	'	'
Initial term period of management agreements in years	'20 years	'	'
Renewal term period of agreements in years	'10 years	'	'
Depreciable life in years	'3.5 years	'	'
Goodwill impairment	$0	$0	$0
Net Revenue [Member] | Geographic Concentration Risk [Member]	'	'	'
Schedule Of Accounting Policies [Line Items]	'	'	'
Net revenue percentage within Arizona, Florida, Michigan, Missouri and Texas	59.00%	60.00%	62.00%
Minimum [Member]	'	'	'
Schedule Of Accounting Policies [Line Items]	'	'	'
Other intangible assets estimated useful life, maximum years	'3 years	'	'
Maximum [Member]	'	'	'
Schedule Of Accounting Policies [Line Items]	'	'	'
Other intangible assets estimated useful life, maximum years	'6 years	'	'
Equipment and software [Member]	'	'	'
Schedule Of Accounting Policies [Line Items]	'	'	'
Depreciable life in years	'three	'	'
Furniture [Member]	'	'	'
Schedule Of Accounting Policies [Line Items]	'	'	'
Depreciable life in years	'seven	'	'
Leasehold improvements [Member]	'	'	'
Schedule Of Accounting Policies [Line Items]	'	'	'
Depreciable life in years	'lesser of the useful life or lease period	'	'

Operations_and_Significant_Acc4

Operations and Significant Accounting Policies - Schedule of Medicare and Medicaid Percentage of Total Patient Volume (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Accounting Policies [Abstract]	'	'	'
Medicare and Medicaid patients	53.00%	52.00%	51.00%

Operations_and_Significant_Acc5

Operations and Significant Accounting Policies - Schedule of Amount Excluded from Revenues that Represents Uncollectible Patient Copayment and Deductible Amounts (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Accounting Policies [Abstract]	'	'	'
Uncollectible accounts excluded from net revenue	$15,274	$14,611	$13,539

Operations_and_Significant_Acc6

Operations and Significant Accounting Policies - Schedule of Amount Excluded from Accounts Receivable that Represents Estimated Uncollectible Accounts (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Receivables [Abstract]	'	'
Allowance for uncollectible accounts	$6,510	$4,837

Operations_and_Significant_Acc7

Operations and Significant Accounting Policies - Schedule of Medicare and Medicaid Percentage of Total Net Accounts Receivable (Detail)	Dec. 31, 2013	Dec. 31, 2012
Accounting Policies [Abstract]	'	'
Percentage of receivables from Medicare and Medicaid	43.00%	36.00%

Operations_and_Significant_Acc8

Operations and Significant Accounting Policies - Schedule of Property and Equipment (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Property Plant And Equipment [Abstract]	'	'
Furniture	$2,803	$2,491
Computer equipment and software	19,685	16,226
Office equipment	1,925	1,876
Leasehold improvements	1,087	950
Property and equipment, gross	25,500	21,543
Less: Accumulated depreciation and amortization	-19,157	-15,780
Property and equipment, net total	$6,343	$5,763

Operations_and_Significant_Acc9

Operations and Significant Accounting Policies - Schedule of Depreciation and Amortization Expenses of Property and Equipment (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Statement Of Financial Position [Abstract]	'	'	'
Depreciation of property and equipment	$3,377	$2,968	$2,277

Recovered_Sheet1

Operations and Significant Accounting Policies - Schedule of Changes in Carrying Amount of Goodwill (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Business Combinations [Abstract]	'	'
Goodwill-beginning balance	$240,009	$173,688
Goodwill acquired during year	119,437	66,321
Goodwill-adjustment for prior year transactions	-2,059	0
Goodwill-ending balance	$357,387	$240,009

Recovered_Sheet2

Operations and Significant Accounting Policies - Schedule of Other Intangible Assets (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Statement Of Financial Position [Abstract]	'	'
Non-compete agreements	$2,126	$1,916
Hospital contracts	10,088	5,270
Trade name	70	70
Other intangible assets, gross	12,284	7,256
Less: Accumulated amortization	-6,427	-5,123
Other intangible assets, net	$5,857	$2,133

Recovered_Sheet3

Operations and Significant Accounting Policies - Schedule of Amortization Expenses of Other Intangible Assets (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Goodwill And Intangible Assets Disclosure [Abstract]	'	'	'
Amortization of other intangible assets	$1,304	$943	$915

Recovered_Sheet4

Operations and Significant Accounting Policies - Schedule of Future Estimated Aggregate Amortization Expenses (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013
Goodwill And Intangible Assets Disclosure [Abstract]	'
2014	$1,454
2015	973
2016	685
2017	569
2018	469
Thereafter	1,707
Future estimated aggregate amortization expenses, total	$5,857

Recovered_Sheet5

Operations and Significant Accounting Policies - Schedule of Total Accrued Medical Malpractice Reserves and Related Insurance Receivables (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Health Care Organizations [Abstract]	'	'
Insurance Receivable, Current Portion	$11,653	$9,719
Insurance Receivable, Long-term Portion	20,599	17,074
Insurance Receivable, Total	32,252	26,793
Claims Reserve, Current Portion	11,653	9,846
Claims Reserve, Long-term Portion	20,599	17,074
Claims Reserve, Total	32,252	26,920
IBNR Reserve, Current Portion	558	504
IBNR Reserve, Long-term Portion	23,445	20,847
IBNR Reserve, Total	24,003	21,351
Total Liabilities, Current Portion	12,211	10,350
Total Liabilities, Long-term Portion	44,044	37,921
Total Liabilities	$56,255	$48,271

Business_Acquisitions_Addition

Business Acquisitions - Additional Information (Detail) (USD $)	3 Months Ended								12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
	Hospitalist				Hospitalist				Hospitalist
Business Acquisition [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Number of hospitalist physician practices acquired	8	'	'	'	6	'	'	'	19	'	'
Period in which identifiable intangible assets amortized for tax purposes, years	'	'	'	'	'	'	'	'	'15 years	'	'
Number of hospitalist physician practices acquisitions completed	'	'	'	'	'	'	'	'	16	'	'
Accrued contingent consideration	'	'	'	'	'	'	'	'	$5,700,000	'	'
Goodwill acquired	'	'	'	'	'	'	'	'	119,437,000	66,321,000	'
Accrued compensation	35,639,000	'	'	'	28,615,000	'	'	'	35,639,000	28,615,000	'
Fixed assets	'	'	'	'	'	'	'	'	46,000	10,000	'
Net income	9,527,000	9,063,000	12,301,000	10,505,000	8,449,000	7,792,000	7,839,000	8,506,000	41,396,000	32,586,000	29,269,000
Adjustment [Member]	'	'	'	'	'	'	'	'	'	'	'
Business Acquisition [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Accrued contingent consideration	'	'	'	'	'	'	'	'	2,059,000	'	'
Steward Medical Group, Inc [Member]	'	'	'	'	'	'	'	'	'	'	'
Business Acquisition [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Business acquisition, purchase price	45,000,000	'	'	'	'	'	'	'	45,000,000	'	'
Goodwill acquired	'	'	'	'	'	'	'	'	42,600,000	'	'
Identifiable intangible assets acquired	'	'	'	'	'	'	'	'	2,400,000	'	'
Accrued compensation	452,000	'	'	'	'	'	'	'	452,000	'	'
Revenue	'	'	'	'	'	'	'	'	8,100,000	'	'
Net income	'	'	'	'	'	'	'	'	500,000	'	'
Park Avenue Health Care [Member]	'	'	'	'	'	'	'	'	'	'	'
Business Acquisition [Line Items]	'	'	'	'	'	'	'	'	'	'	'
Business acquisition, purchase price	39,700,000	'	'	'	'	'	'	'	39,700,000	'	'
Goodwill acquired	'	'	'	'	'	'	'	'	37,400,000	'	'
Identifiable intangible assets acquired	'	'	'	'	'	'	'	'	2,300,000	'	'
Accrued compensation	117,000	'	'	'	'	'	'	'	117,000	'	'
Fixed assets	'	'	'	'	'	'	'	'	31,000	'	'
Number of affiliated entities	'	'	'	'	'	'	'	'	4	'	'
Accrued contingent consideration	19,900,000	'	'	'	'	'	'	'	19,900,000	'	'
Revenue	'	'	'	'	'	'	'	'	1,300,000	'	'
Net income	'	'	'	'	'	'	'	'	$100,000	'	'

Business_Acquisitions_Schedule

Business Acquisitions - Schedule of Acquisition of Hospitalist Practices (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Acquired assets, net of assumed liabilities-paid and accrued:	'	'	'
Goodwill-current year transactions	$119,437	$66,321	'
Other intangible assets	5,028	1,264	'
Fixed assets	46	10	'
Total acquired assets-current year	124,511	67,595	'
Assumed accrued compensation liabilities	-569	0	'
Goodwill-adjustment for prior year transactions	-2,059	0	'
Total acquired assets	121,883	67,595	24,854
Cash paid for acquisitions:	'	'	'
Current year transactions	-91,322	-40,014	'
Contingent consideration	-12,601	-22,565	'
Other-prior year transactions	-204	-26	'
Total cash paid for acquisitions	-104,127	-62,605	-27,843
Change in fair value of contingent consideration:	'	'	'
Net change in fair value of contingent consideration-recognized	-5,733	324	'
Net change in fair value of contingent consideration- paid	-342	0	'
Net change in fair value of contingent consideration	-6,075	324	-1,002
Net change in payable for practice acquisitions	11,681	5,314	'
Payable for practice acquisitions, beginning of period	29,038	23,724	'
Payable for practice acquisitions, end of period	$40,719	$29,038	$23,724

Business_Acquisitions_Schedule1

Business Acquisitions - Schedule of Pro Forma Information of Consolidated Results of Operations (Detail) (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Business Acquisition Pro Forma Information [Abstract]	'	'	'
Net revenue	$658,674	$582,042	'
Net income	$43,981	$35,821	'
Net income per share	'	'	'
Basic	$2.62	$2.16	'
Diluted	$2.54	$2.11	'
Weighted average shares outstanding	'	'	'
Basic	16,811,571	16,578,994	'
Diluted	17,314,759	16,968,145	'
Effective Tax Rate	38.30%	37.70%	37.55%

Business_Acquisitions_Schedule2

Business Acquisitions - Schedule of Pro Forma Information of Consolidated Results of Operations (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Business Acquisition Pro Forma Information [Abstract]	'	'	'
Effective Tax Rate	38.30%	37.70%	37.55%
Basic	16,811,571	16,578,994	'
Diluted	17,314,759	16,968,145	'

Fair_Value_Measurement_Liabili

Fair Value Measurement - Liabilities Measured at Fair Value on Recurring Basis (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Accrued contingent consideration (included in payable for practice acquisitions)	$40,719	$28,834
Quoted Price In Active Markets for Identical Instruments (Level 1) [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Accrued contingent consideration (included in payable for practice acquisitions)	0	0
Significant Other Observable Inputs (Level 2) [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Accrued contingent consideration (included in payable for practice acquisitions)	0	0
Significant Unobservable Inputs (Level 3) [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Accrued contingent consideration (included in payable for practice acquisitions)	$40,719	$28,834

Fair_Value_Measurement_Rollfor

Fair Value Measurement - Rollforward for Liabilities Measured at Fair Value on Recurring Basis Using Significant Unobservable Inputs (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Fair Value Assets Measured On Recurring Basis [Line Items]	'	'
Goodwill-adjustment for prior year transactions	$2,059	$0
Change in fair value recognized	-5,733	324
Change in fair value paid	342	0
Payments	-12,601	-22,565
Significant Unobservable Inputs (Level 3) [Member]	'	'
Fair Value Assets Measured On Recurring Basis [Line Items]	'	'
Beginning balance	28,834	23,624
Addition through acquisition transactions	32,620	27,451
Goodwill-adjustment for prior year transactions	-2,059	0
Change in fair value recognized	-5,733	324
Change in fair value paid	-342	0
Payments	-12,601	-22,565
Ending balance	$40,719	$28,834

Fair_Value_Measurement_Additio

Fair Value Measurement - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]	'
Discount rate on significant inputs	2.50%
Probability of achieving estimated projected earnings	100.00%
Minimum [Member]	'
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]	'
Probability of acquisition of certain other hospitalist practices	25.00%
Maximum [Member]	'
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]	'
Probability of acquisition of certain other hospitalist practices	90.00%

Debt_Additional_Information_De

Debt - Additional Information (Detail) (USD $)	12 Months Ended					0 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Oct. 23, 2013
		LIBOR [Member]	LIBOR [Member]	Lender's prime rate [Member]	Lender's prime rate [Member]	Line of Credit Facility Amended [Member]
		Minimum [Member]	Maximum [Member]	Minimum [Member]	Maximum [Member]
Line of Credit Facility [Line Items]	'	'	'	'	'	'
Revolving line of credit borrowing capacity	'	'	'	'	'	$125
Additional borrowing capacity under revolving line of credit facility	'	'	'	'	'	25
Maturity date of Credit Facility	'	'	'	'	'	4-Aug-16
Amount provided by credit agreement	90	'	'	'	'	'
Letters of credit amount outstanding	0.3	'	'	'	'	'
Remaining amount available under revolving line of credit facility	$34.70	'	'	'	'	'
Interest rate terms	'Interest rate options for each borrowing under the Credit Facility, to be selected by us at the time of each borrowing, include either LIBOR plus 0.75% to 1.75%, or the lender's prime rate plus 0% to 0.75%, both based on a leverage ratio.	'	'	'	'	'
Variable interest rate, percentage in addition to base rate	'	0.75%	1.75%	0.00%	0.75%	'
Percentage of unused commitment fee, per annum	0.25%	'	'	'	'	'

Debt_Schedule_of_Interest_Cost

Debt - Schedule of Interest Costs and Unused Commitment Fees Related to Debt and Credit Facility (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Debt Disclosure [Abstract]	'	'	'	'	'	'	'	'	'	'	'
Interest expense	'	'	'	'	'	'	'	'	$391	$153	$61
Unused commitment fees	'	'	'	'	'	'	'	'	149	184	124
Total interest expense	$217	$109	$99	$115	$85	$78	$92	$82	$540	$337	$185

Income_Taxes_Schedule_of_Curre

Income Taxes - Schedule of Current and Deferred Income Tax Provision (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Current:	'	'	'	'	'	'	'	'	'	'	'
Federal	'	'	'	'	'	'	'	'	$18,178	$15,388	$14,712
State	'	'	'	'	'	'	'	'	2,222	2,312	2,117
Total current	'	'	'	'	'	'	'	'	20,400	17,700	16,829
Deferred:	'	'	'	'	'	'	'	'	'	'	'
Federal	'	'	'	'	'	'	'	'	4,322	1,997	1,240
State	'	'	'	'	'	'	'	'	975	31	-472
Total deferred	'	'	'	'	'	'	'	'	5,297	2,028	768
Total provision	$5,915	$5,626	$7,635	$6,521	$5,419	$4,501	$4,703	$5,105	$25,697	$19,728	$17,597

Income_Taxes_Schedule_of_Curre1

Income Taxes - Schedule of Current and Deferred Income Tax Provision (Parenthetical) (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]	'	'	'
Current tax provision excludes tax benefit from stock compensation recorded to additional paid-in capital in the amount of	($2,609)	($988)	($1,270)

Income_Taxes_Schedule_of_Recon

Income Taxes - Schedule of Reconciliation of Provision for Income Taxes Compared with U.S. Statutory Tax Rates (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]	'	'	'
Statutory federal tax provision	35.00%	35.00%	35.00%
State tax net of federal benefit	3.10%	2.91%	2.29%
Change in valuation allowance	0.05%	-0.22%	0.12%
Permanent differences and other	0.15%	0.01%	0.19%
Recognition of tax benefits for uncertain positions	0.00%	0.00%	-0.05%
Income tax provision	38.30%	37.70%	37.55%

Income_Taxes_Schedule_of_Signi

Income Taxes - Schedule of Significant Components of Deferred Tax Assets and Liabilities (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Income Tax Disclosure [Abstract]	'	'
Net operating loss (NOL) carryforwards	$575	$625
Allowance for uncollectible accounts	2,562	1,908
Compensation accruals	1,564	1,354
Accrued IBNR claims	9,445	8,473
Stock-based compensation	6,611	5,148
State taxes and credits	3,604	2,202
Other	492	158
Total deferred tax assets	24,853	19,868
Less: Valuation allowance	-2,746	-1,229
Deferred tax assets, net	22,107	18,639
Prepaid insurance	-5,349	-4,709
Depreciation and amortization	-23,489	-15,186
Total deferred tax liabilities	-28,838	-19,895
Total net deferred tax liability	($6,731)	($1,256)

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2013
					Federal [Member]	State [Member]	Federal NOL before 2000 [Member]	California [Member]
Income Taxes Disclosure [Line Items]	'	'	'	'	'	'	'	'
Credit carry forwards partial valuation allowance	$2,385,000	'	'	'	'	'	'	'
Net operating loss carryforwards	'	'	'	'	1,483,000	1,301,000	586,000	'
Operating loss carryforwards, expiration date	'	'	'	'	'2019	'2020	'	'
Operating loss carryforwards, annual change of ownership limitation	'	'	'	'	'	'	195,000	'
California enterprise zone credit carryforwards	'	'	'	'	'	'	'	3,328,000
Credit carry forwards expiration date	'	'	'	'	'	'	'	31-Dec-24
Gross unrecognized tax benefits	0	0	66,000	88,000	'	'	'	'
Interest and penalties related to uncertain tax positions	$0	'	'	'	'	'	'	'

Income_Taxes_Schedule_of_Recon1

Income Taxes - Schedule of Reconciliation of Gross Unrecognized Tax Benefits (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]	'	'	'
Beginning Balance, excluding interest and penalties	$0	$66	$88
Increases - tax positions taken in prior years	0	0	0
Decreases - tax provisions taken in prior years	0	0	0
Current year tax positions	0	0	0
Settlements	0	0	0
Expiring NOL	0	-66	0
Lapse of statute of limitations	0	0	-22
Ending Balance, excluding interest and penalties	$0	$0	$66

Income_Taxes_Schedule_of_Recon2

Income Taxes - Schedule of Reconciliation of Gross Unrecognized Tax Benefits (Parenthetical) (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Income Tax Disclosure [Abstract]	'	'	'	'
Gross Unrecognized Tax Benefit, excluding interest and penalties expense	$0	$0	$0	$10

Defined_Contribution_Plan_Addi

Defined Contribution Plan - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013
Compensation And Retirement Disclosure [Abstract]	'
Maximum percentage of participant's annual compensation eligible for employer matching	7.00%
Employer contribution, vesting period, in years	'1 year
Number of days to opt out of defined contribution plan to receive refund of contributions	'60 days

Defined_Contribution_Plan_Sche

Defined Contribution Plan - Schedule of Expense Recognized in Connection with Employer Contributions (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Compensation And Retirement Disclosure [Abstract]	'	'	'
Employer contribution to defined contribution plan	$8,728	$7,484	$6,382

StockBased_Compensation_Additi

Stock-Based Compensation - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Jun. 07, 2012
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Common shares reserved for issuance under stock-based employee compensation program	4,943,170	'
Common stock available for issuance under Equity Plan	1,136,012	1,422,130
Vesting period, in years	'1 year	'
Total intrinsic value of stock option exercised	$8,566,000	'
Stock option [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Vesting period, in years	'4 years	'
Restricted Stock [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Vesting period, in years	'4 years	'
Performance stock awards [Member] | Minimum [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Vesting period, in years	'2 years	'
Performance stock awards [Member] | Maximum [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Vesting period, in years	'3 years	'

StockBased_Compensation_Compon

Stock-Based Compensation - Components of Stock-Based Compensation Expense Recognized in Consolidated Statement of Income (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'
Total stock-based compensation expense	$7,355	$6,344	$4,783
General and administrative expenses [Member]	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'
Total stock-based compensation expense	7,355	6,344	4,783
Tax benefit from stock-based compensation expense	-2,817	-2,392	-1,796
Total stock-based compensation expense, net of tax	$4,538	$3,952	$2,987

StockBased_Compensation_Schedu

Stock-Based Compensation - Schedule of Unrecognized Compensation Costs Related to Non-Vested Stock-Based Compensation Arrangements Granted under Equity Plan and Weighted-Average Period of Years Expected to Recognize Those Costs (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013
Stock option [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Total Unrecognized Compensation Cost	$4,169
Weighted-Average Remaining Contractual Term (Years)	'1 year 8 months 19 days
Restricted stock [Member]	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Total Unrecognized Compensation Cost	$4,817
Weighted-Average Remaining Contractual Term (Years)	'1 year 9 months 26 days

StockBased_Compensation_Schedu1

Stock-Based Compensation - Schedule of Fair Value of Each Option Grant Estimated on Date of Grant Using Black-Scholes Option-Pricing Model (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'	'	'
Risk-free interest rate	0.67%	1.21%	2.39%
Expected volatility	40.07%	39.86%	39.24%
Expected option life (in years)	'4 years 4 months 24 days	'6 years 1 month 28 days	'6 years 2 months 1 day
Expected dividend yield	0.00%	0.00%	0.00%

StockBased_Compensation_Summar

Stock-Based Compensation - Summary of Stock Option Activity in Equity Plan (Detail) (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Shares, Options outstanding as of December 31, 2012	1,630,921
Shares, Granted	45,823
Shares, Exercised	-290,204
Shares, Cancelled/Forfeited	-3,668
Shares, Expired	-2,447
Shares, Options outstanding as of December 31, 2013	1,380,425
Shares, Options exercisable as of December 31, 2013	1,107,712
Weighted-Average Exercise Price, Options outstanding as of December 31, 2012	$28.36
Weighted-Average Exercise Price, Granted	$41.82
Weighted-Average Exercise Price, Exercised	$22.26
Weighted-Average Exercise Price, Cancelled/Forfeited	$38.19
Weighted-Average Exercise Price, Expired	$1.66
Weighted-Average Exercise Price, Options outstanding as of December 31, 2013	$30.12
Weighted-Average Exercise Price, Options exercisable as of December 31, 2013	$27.58
Weighted-Average Remaining Contractual Term, Options outstanding as of December 31, 2013 (Years)	'6 years 1 month 13 days
Weighted-Average Remaining Contractual Term, Options exercisable as of December 31, 2013 (Years)	'5 years 9 months 15 days
Aggregate Intrinsic Value, Options outstanding as of December 31, 2013	$40,412
Aggregate Intrinsic Value, Options exercisable as of December 31, 2013	$35,240
Weighted-Average Fair Value, Options outstanding as of December 31, 2012	$11.95
Weighted-Average Fair Value, Granted	$14.04
Weighted-Average Fair Value, Exercised	$10.17
Weighted-Average Fair Value, Cancelled/Forfeited	$15.90
Weighted-Average Fair Value, Expired	$0.56
Weighted-Average Fair Value, Options outstanding as of December 31, 2013	$12.56
Weighted-Average Fair Value, Options exercisable as of December 31, 2013	$11.57

StockBased_Compensation_Summar1

Stock-Based Compensation - Summary of Restricted Stock Award and Performance Stock Award Activities in Equity Plan (Detail) (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Restricted/performance stock awards outstanding as of December 31, 2012	101,940
Shares, Granted	126,012
Shares, Released	-14,539
Shares, Cancelled/Forfeited	-1,000
Restricted/performance stock awards outstanding as of December 31, 2013	212,413
Weighted-Average Remaining Contractual Term, Restricted/performance stock awards outstanding as of December 31, 2013 (Years)	'1 year 3 months 11 days
Aggregate Intrinsic Value, Restricted/performance stock awards outstanding as of December 31, 2013	$12,615
Weighted-Average Fair Value, Restricted/performance stock awards outstanding as of December 31, 2012	$38.03
Weighted-Average Fair Value, Granted	$42.05
Weighted-Average Fair Value, Released	$39.68
Weighted-Average Fair Value, Cancelled/Forfeited	$42.12
Weighted-Average Fair Value, Restricted/performance stock awards outstanding as of December 31, 2013	$40.29

Employee_Stock_Purchase_Plan_A

Employee Stock Purchase Plan - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013
Employee Stock Purchase Plan [Line Items]	'
Common stock authorized for issuance to eligible employees	306,250
Stock purchase price as a percentage of fair market value	85.00%
Minimum [Member]	'
Employee Stock Purchase Plan [Line Items]	'
Purchase of common stock as through payroll deductions, per year	500
Maximum [Member]	'
Employee Stock Purchase Plan [Line Items]	'
Purchase of common stock as through payroll deductions, per year	10,000

Employee_Stock_Purchase_Plan_S

Employee Stock Purchase Plan - Schedule of Stock-Based Compensation Expense Related to ESPP (Detail) (Employee stock purchase plan [Member], USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Employee stock purchase plan [Member]	'	'	'
Schedule Of Stock Based Compensation Costs [Line Items]	'	'	'
Stock-based compensation expense related to ESPP	$329	$309	$299

Earnings_Per_Share_Schedule_of

Earnings Per Share - Schedule of Basic and Diluted Net Income Per Share (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Basic:	'	'	'	'	'	'	'	'	'	'	'
Net income attributable to common stockholders	$9,527	$9,063	$12,301	$10,505	$8,449	$7,792	$7,839	$8,506	$41,396	$32,586	$29,269
Weighted average number of common shares outstanding	16,937,646	16,839,069	16,763,325	16,703,369	16,647,295	16,616,866	16,545,600	16,505,047	16,811,571	16,578,994	16,387,903
Basic net income per share attributable to common stockholders	$0.56	$0.54	$0.73	$0.63	$0.51	$0.47	$0.47	$0.52	$2.46	$1.97	$1.79
Diluted:	'	'	'	'	'	'	'	'	'	'	'
Net income attributable to common stockholders	$9,527	$9,063	$12,301	$10,505	$8,449	$7,792	$7,839	$8,506	$41,396	$32,586	$29,269
Weighted average number of common shares outstanding	16,937,646	16,839,069	16,763,325	16,703,369	16,647,295	16,616,866	16,545,600	16,505,047	16,811,571	16,578,994	16,387,903
Weighted average number of dilutive common share equivalents from options to purchase common stock	'	'	'	'	'	'	'	'	503,188	389,151	433,935
Common shares and common share equivalents	17,516,086	17,368,426	17,228,173	17,125,940	17,062,431	17,060,848	16,931,098	16,860,655	17,314,759	16,968,145	16,821,838
Diluted net income per share	$0.54	$0.52	$0.71	$0.61	$0.50	$0.46	$0.46	$0.50	$2.39	$1.92	$1.74

Earnings_Per_Share_Schedule_of1

Earnings Per Share - Schedule of Stock Options Which Have Exercise Price Above Market or Which are Anti-Dilutive under Treasury Stock Method (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Earnings Per Share [Abstract]	'	'	'
Stock options excluded from diluted shares computation	28,194	430,489	257,094

Commitments_and_Contingencies_1

Commitments and Contingencies - Schedule of Future Minimum Rental Payments (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified
Commitments And Contingencies Disclosure [Abstract]	'
2014	$4,334
2015	4,047
2016	3,569
2017	3,067
2018	2,815
Thereafter	1,828
Future minimum rental payments, Total	$19,660

Commitments_and_Contingencies_2

Commitments and Contingencies - Schedule of Rent Expense (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Commitments And Contingencies Disclosure [Abstract]	'	'	'
Total rent expense	$3,595	$3,330	$3,162

Quarterly_Results_of_Operation2

Quarterly Results of Operations - Summary of Quarterly Results of Operations (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Statement [Abstract]	'	'	'	'	'	'	'	'	'	'	'
Net revenue	$161,600	$149,073	$145,753	$153,091	$137,569	$127,651	$128,472	$129,793	$609,517	$523,485	$457,467
Income from operations	15,658	14,791	20,032	17,139	13,950	12,368	12,630	13,689	67,620	52,637	47,034
Investment income	1	7	3	2	3	3	4	4	13	14	17
Interest expense	-217	-109	-99	-115	-85	-78	-92	-82	-540	-337	-185
Income before income taxes	15,442	14,689	19,936	17,026	13,868	12,293	12,542	13,611	67,093	52,314	46,866
Income tax provision	5,915	5,626	7,635	6,521	5,419	4,501	4,703	5,105	25,697	19,728	17,597
Net income	$9,527	$9,063	$12,301	$10,505	$8,449	$7,792	$7,839	$8,506	$41,396	$32,586	$29,269
Net income per share, Basic	$0.56	$0.54	$0.73	$0.63	$0.51	$0.47	$0.47	$0.52	$2.46	$1.97	$1.79
Net income per share, Diluted	$0.54	$0.52	$0.71	$0.61	$0.50	$0.46	$0.46	$0.50	$2.39	$1.92	$1.74
Weighted average shares: Basic	16,937,646	16,839,069	16,763,325	16,703,369	16,647,295	16,616,866	16,545,600	16,505,047	16,811,571	16,578,994	16,387,903
Weighted average shares: Diluted	17,516,086	17,368,426	17,228,173	17,125,940	17,062,431	17,060,848	16,931,098	16,860,655	17,314,759	16,968,145	16,821,838

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail)	3 Months Ended		12 Months Ended	2 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2013	Feb. 26, 2014
	Hospitalist	Hospitalist	Hospitalist	Subsequent Events [Member]
				Hospitalist
Subsequent Event [Line Items]	'	'	'	'
Number of hospitalist physician practices acquired	8	6	19	1

Schedule_II_Valuation_and_Qual1

Schedule II - Valuation and Qualifying Accounts (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Valuation And Qualifying Accounts [Abstract]	'	'	'
Balance at beginning of year	$4,837	$4,831	$2,904
Amount charged against operating revenue	15,274	14,611	13,539
Accounts receivable write-offs (net of recovery)	-13,601	-14,605	-11,612
Balance at end of year	$6,510	$4,837	$4,831