R1 RCM 10-Q 4 Aug 16 2016 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2016	Aug. 01, 2016
Document and Entity Information [Abstract]
Entity Registrant Name	Accretive Health, Inc.
Entity Central Index Key	1,472,595
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Document Type	10-Q
Document Period End Date	Jun. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q2
Amendment Flag	false
Entity Common Stock, Shares Outstanding (in shares)		107,222,530

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 221,673	$ 103,497
Short-term investments	0	1,023
Accounts receivable, net	6,575	10,194
Prepaid income taxes	534	1,102
Other current assets	13,392	10,924
Total current assets	242,174	126,740
Property, equipment and software, net	30,447	27,217
Non-current deferred tax assets	213,908	300,825
Restricted cash equivalents	1,500	1,500
Other assets	4,902	4,007
Total assets	492,931	460,289
Current liabilities:
Accounts payable	3,735	5,306
Current portion of customer liabilities	144,619	202,516
Current portion of customer liabilities - related party	141,089	0
Accrued compensation and benefits	16,273	9,062
Other accrued expenses	20,434	15,743
Total current liabilities	326,150	232,627
Non-current portion of customer liabilities	24,667	432,477
Non-current portion of customer liabilities - related party	26,554
Other non-current liabilities	9,810	8,498
Total liabilities	387,181	673,602
8.00% Series A convertible preferred stock: par value $0.01 per share, 200,000 shares issued and outstanding as of June 30, 2016; no shares authorized or issued as of December 31, 2015 (aggregate liquidation value of $206,040 as of June 30, 2016)	163,269	0
Stockholders' equity (deficit):
Common stock, $0.01 par value, 500,000,000 shares authorized,116,378,064 shares issued and 107,222,530 shares outstanding at June 30, 2016; 113,259,408 shares issued and 107,715,436 shares outstanding at December 31, 2015	1,164	1,133
Additional paid-in capital	353,856	322,492
Accumulated deficit	(355,161)	(481,773)
Accumulative other comprehensive loss	(2,732)	(2,488)
Treasury stock	(54,646)	(52,677)
Total stockholders' equity (deficit)	(57,519)	(213,313)
Total liabilities and stockholders’ equity (deficit)	$ 492,931	$ 460,289

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	116,378,064	113,259,408
Common stock, shares outstanding (in shares)	107,222,530	107,715,436
Preferred Stock
Preferred stock, dividend rate	8.00%
Preferred stock, par value (in dollars per share)	$ 0.01
Preferred stock, shares issued (in shares)	200,000	0
Preferred stock, shares outstanding (in shares)	200,000	0
Preferred stock, shares authorized (in shares)		0
Preferred stock, aggregate liquidation value	$ 206,040

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Income Statement [Abstract]
Net services revenue ($343.4 million and $0 million from related party for the six months ended June 30, 2016 and June 30, 2015, respectively. No related party revenue was recognized for the three months ended June 30, 2016 and 2015, respectively)	$ 8,672	$ 22,085	$ 360,865	$ 33,056
Operating expenses:
Costs of services	45,112	42,762	90,242	84,958
Selling, general and administrative	24,660	20,969	42,196	38,331
Other	8,651	611	19,457	1,886
Total operating expenses	78,423	64,342	151,895	125,175
Income (loss) from operations	(69,751)	(42,257)	208,970	(92,119)
Net interest income	46	69	130	74
Income (loss) before income tax provision	(69,705)	(42,188)	209,100	(92,045)
Income tax provision (benefit)	(28,914)	(15,900)	82,488	(35,312)
Net income (loss)	$ (40,791)	$ (26,288)	$ 126,612	$ (56,733)
Net income (loss) per common share:
Basic (in dollars per share)	$ (0.45)	$ (0.27)	$ 0.45	$ (0.59)
Diluted (in dollars per share)	$ (0.45)	$ (0.27)	$ 0.45	$ (0.59)
Weighted average shares used in calculating net income (loss) per common share:
Basic (in shares)	99,414,066	95,941,077	98,851,934	95,915,255
Diluted (in shares)	99,414,066	95,941,077	99,951,394	95,915,255
Consolidated statements of comprehensive income (loss):
Net income (loss)	$ (40,791)	$ (26,288)	$ 126,612	$ (56,733)
Other comprehensive income (loss):
Foreign currency translation adjustments	(304)	(221)	(244)	(273)
Comprehensive income (loss)	(41,095)	(26,509)	126,368	(57,006)
Reconciliation of net income (loss) to income (loss) available to common shareholders:
Less dividends on preferred shares	(4,062)	0	(54,360)	0
Less income allocated to preferred shareholders - basic	0	0	(27,797)	0
Net income (loss) available/(allocated) to common shareholders - basic	(44,853)	(26,288)	44,455	(56,733)
Less income allocated to preferred shareholders	0	0	(27,608)	0
Net income (loss) available/(allocated) to common shareholders - diluted	$ (44,853)	$ (26,288)	$ 44,644	$ (56,733)

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) (Parenthetical) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Income Statement [Abstract]
Revenue from related parties	$ 0	$ 0	$ 343,400,000	$ 0

Condensed Consolidated Stateme6

Condensed Consolidated Statements of Stockholders' Equity (Deficit) - 6 months ended Jun. 30, 2016 - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated other comprehensive income (loss)
Balance at Beginning of Period at Dec. 31, 2015	$ (213,313)	$ 1,133	$ (52,677)	$ 322,492	$ (481,773)	$ (2,488)
Balance at Beginning of Period (in shares) at Dec. 31, 2015		113,259,408	5,543,972
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	20,413			20,413
Deferred tax asset write off including shortfall of $3,177	$ (4,506)			(4,506)
Issuance of common stock related to share-based compensation plans (in shares)		3,071,876
Issuance of common stock related to share-based compensation plans (in dollars)		$ 31
Issuance of common stock related to share-based compensation plans				(31)
Exercise of vested stock options (in shares)	46,780	46,780
Exercise of vested stock options	$ 88			88
Beneficial conversion feature	48,320			48,320
Issuance of stock warrants	21,440			21,440
Accrued dividends/increase in liquidation value	(6,040)			(6,040)
Deemed preferred stock dividend	(48,320)			(48,320)
Treasury stock purchases (in shares)			(3,611,562)
Treasury stock purchases (in dollars)	(1,969)		$ (1,969)
Foreign currency translation adjustments	(244)					(244)
Net income (loss)	126,612				126,612
Balance at End of Period at Jun. 30, 2016	$ (57,519)	$ 1,164	$ (54,646)	$ 353,856	$ (355,161)	$ (2,732)
Balance at End of Period (in shares) at Jun. 30, 2016		116,378,064	9,155,534

Condensed Consolidated Stateme7

Condensed Consolidated Statements of Stockholders' Equity (Deficit) (Parenthetical) $ in Thousands	6 Months Ended
	Jun. 30, 2016USD ($)
Statement of Stockholders' Equity [Abstract]
Shortfall included in deferred tax asset write-off	$ 3,177

Condensed Consolidated Stateme8

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Operating activities:
Net income (loss)	$ 126,612	$ (56,733)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operations:
Depreciation and amortization	4,632	3,818
Share-based compensation	20,413	12,576
Provision/(Recoveries) for doubtful receivables	(27)	(45)
Deferred income taxes	82,420	(36,369)
Excess tax benefits from share-based awards	0	0
Changes in operating assets and liabilities:
Accounts receivable	3,646	1,101
Prepaid income taxes	503	445
Other assets	(3,394)	(4,472)
Accounts payable	(1,565)	(7,540)
Accrued compensation and benefits	7,213	(2,830)
Other liabilities	5,079	(2,038)
Customer liabilities and customer liabilities - related party	(298,064)	72,904
Net cash provided by (used in) operating activities	(52,532)	(19,183)
Investing activities:
Purchases of property, equipment and software	(7,097)	(8,348)
Proceeds from maturation of short-term investments	1,023	0
Net cash used in investing activities	(6,074)	(8,348)
Financing activities:
Series A convertible preferred stock and warrant issuance, net of issuance costs	178,669	0
Exercise of vested options	88	0
Restricted cash released from letter of credit	0	5,000
Excess tax benefit from share-based awards	0	0
Purchase of treasury stock	(1,969)	(517)
Net cash provided by financing activities	176,788	4,483
Effect of exchange rate changes on cash	(6)	(222)
Net increase (decrease) in cash and cash equivalents	118,176	(23,270)
Cash and cash equivalents at beginning of period	103,497	145,167
Cash and cash equivalents at end of period	221,673	121,897
Supplemental disclosure of non-cash financing activities
Accrued dividends payable to Preferred Stockholders	(4,040)	0
Accrued liabilities related to purchases of property, equipment and software	991	0
Accounts payable related to purchases of property, equipment and software	$ 0	$ 5,250

Business Description and Basis

Business Description and Basis of Presentation	6 Months Ended
	Jun. 30, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business Description and Basis of Presentation	BUSINESS DESCRIPTION AND BASIS OF PRESENTATION Business Description Accretive Health, Inc., together with its subsidiaries (the "Company"), is a leading provider of services that help healthcare providers generate sustainable improvements in their operating margins and cash flows while also improving patient, physician and staff satisfaction for its customers. The Company achieves these results for its customers through an integrated approach encompassing an end-to-end revenue cycle management service offering and physician advisory services. The Company does so by deploying a unique operating model that leverages its extensive healthcare site experience, innovative technology and process excellence. The Company also offers modular services, allowing clients to engage the Company for only specific components of its end-to-end revenue cycle management service offering. The Company’s primary service offering consists of revenue cycle management ("RCM"), which helps healthcare providers to more efficiently manage their revenue cycles. This encompasses patient registration, insurance and benefit verification, medical treatment documentation and coding, bill preparation and collections from patients and payers. The Company's physician advisory services ("PAS") offering assists hospitals in complying with payer requirements regarding whether to classify a hospital visit as an in-patient or an out-patient observation case for billing purposes and consists of both concurrent review and retrospective chart audits to help its customers achieve compliant and accurate billing. The Company also provides its customers with retrospective appeal management service support for both governmental and commercial payers. In December 2015, the Company announced a long-term strategic partnership with Ascension Health Alliance, the parent of the Company's largest customer and the nation’s largest Catholic and non-profit health system, and TowerBrook Capital Partners ("TowerBrook"), an investment management firm, which transaction (the "Transaction") was completed on February 16, 2016. As part of the Transaction, the Company amended and restated its Master Professional Services Agreement ("A&R MPSA") with Ascension Health ("Ascension") effective February 16, 2016 with a term of ten years. Pursuant to the A&R MPSA and with certain limited exceptions, the Company will become the exclusive provider of RCM services and PAS with respect to acute care services provided by the hospitals affiliated with Ascension that execute supplement agreements with the Company. Basis of Presentation The accompanying unaudited condensed consolidated financial statements reflect the Company's financial position as of June 30, 2016 , the results of operations for the three and six months ended June 30, 2016 and 2015 , and the cash flows of the Company for the six months ended June 30, 2016 and 2015 . These financial statements include the accounts of Accretive Health, Inc. and its wholly owned subsidiaries. All material intercompany amounts have been eliminated in consolidation. These financial statements have been prepared in accordance with United States generally accepted accounting principles ("GAAP") for interim financial reporting and as required by the rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”). Accordingly, certain information and footnote disclosures required for complete financial statements are not included herein. In the opinion of management, all adjustments, consisting of normal recurring adjustments, considered necessary for a fair presentation of the interim financial information, have been included. Operating results for the three and six months ended June 30, 2016 , are not necessarily indicative of the results that may be expected for any other interim period or for the fiscal year ending December 31, 2016 . When preparing financial statements in conformity with GAAP, the Company must make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues, expenses and related disclosures at the date of the financial statements. Actual results could differ from those estimates. For a more complete discussion of the Company’s significant accounting policies and other information, the unaudited condensed consolidated financial statements and notes thereto should be read in conjunction with the audited consolidated financial statements included in the Company's Annual Report on Form 10-K for the year ended December 31, 2015 (the "2015 10-K").

Recent Accounting Pronouncement

Recent Accounting Pronouncements	6 Months Ended
	Jun. 30, 2016
Accounting Changes and Error Corrections [Abstract]
Recent Accounting Pronouncements	RECENT ACCOUNTING PRONOUNCEMENTS From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board ("FASB") and are adopted by the Company as of the specified effective date. Unless otherwise discussed, the Company's management believes that recently issued accounting pronouncements do not have a material impact on the Company's consolidated financial position, results of operations, or cash flows, or do not apply to the Company's operations. In May 2014, the FASB issued Accounting Standards Update ("ASU") No. 2014-09, Revenue from Contracts with Customers (Topic 606) ("ASU 2014-09") , which supersedes the revenue recognition requirements in Accounting Standard Codification 605, Revenue Recognition ("ASC 605"). ASU 2014-09 is based on the principle that revenue is recognized to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. ASU 2014-09 also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments. ASU 2014-09 is effective for annual reporting periods beginning after December 15, 2017, including interim periods within such reporting period, with early application permitted. The Company plans to early adopt the standard, effective January 1, 2017, and to apply the standard using the cumulative effect method to contracts for which all or substantially all of the revenue has not been recognized under GAAP as of the adoption date. The Company's ability to early adopt ASU 2014-09 is dependent on the completion of its analysis of the information necessary to calculate the cumulative effect. The Company anticipates this standard will have a material impact on it consolidated financial statements. While it is continuing to assess all potential impacts of the standard, the Company believes the most significant impact will be the recognition of revenue at the time services are provided or incentive measurements are finalized, as opposed to at the time of a contractual agreement event, which is when the Company now recognizes revenue for its end-to-end revenue cycle contracts for its base and incentive fee revenues. The Company has not yet finalized all the potential effects of the new standard on its consolidated financial statements. In April 2015, the FASB issued ASU No. 2015-05, Customers Accounting for Fees Paid in a Cloud Computing Arrangement ("ASU 2015-05"). The Company adopted ASU 2015-05 on the required date of January 1, 2016 using the prospective method. For the six months ended June 30, 2016, the Company did not enter into any new arrangements covered by this standard. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) ("ASU 2016-02"), which supersedes existing guidance on accounting for leases in Topic 840, Leases. ASU 2016-02 generally requires all leases to be recognized in the statement of financial position. The provisions of ASU 2016-02 are effective for reporting periods beginning after December 15, 2018; early adoption is permitted. The provisions of ASU 2016-02 are to be applied using a modified retrospective approach. The Company has not yet determined the potential effects of this new standard on its consolidated financial statements, if any. In March 2016, the FASB issued ASU No. 2016-09, Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting ("ASU 2016-09"). ASU 2016-09 simplifies the accounting for employee share-based payment transactions, including the accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. The provisions of ASU 2016-09 are effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. Early adoption is permitted for any entity in any interim or annual period. The Company is currently evaluating the impact of the adoption of this prospective guidance on its consolidated financial statements.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2016
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	FAIR VALUE OF FINANCIAL INSTRUMENTS The Company has adopted the provisions of FASB Accounting Standards Codification ("ASC") Topic 820, Fair Value Measurements ("ASC 820"), which defines fair value, establishes a framework for measuring fair value in GAAP, and expands disclosures about fair value measurements. ASC 820 does not require any new fair value measurements, but provides guidance on how to measure fair value by providing a fair value hierarchy used to classify the source of the information. The fair value hierarchy distinguishes between assumptions based on market data (observable inputs) and an entity’s own assumptions (unobservable inputs). The hierarchy consists of three levels: • Level 1: Observable inputs such as quoted prices in active markets for identical assets and liabilities; • Level 2: Inputs other than quoted prices that are observable for the asset or liability, either directly or indirectly. These include quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active, and model-derived valuations in which all significant inputs and significant value drivers are observable in active markets; and • Level 3: Valuations derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable. The carrying amounts of the Company’s financial instruments, which include financial assets such as cash and cash equivalents, restricted cash equivalents, accounts receivable, amounts due from related party, short-term investments and certain other current assets, as well as financial liabilities such as accounts payable, customer liabilities, customer liabilities-related party, accrued compensation and benefits and certain other accrued expenses, approximate their fair values, due to the short-term nature of these instruments. The Company’s financial assets which are required to be measured at fair value on a recurring basis consist of cash equivalents, which are short-term investments with maturity dates of less than three months and accordingly are classified as Level 1 assets in the fair value hierarchy. The Company’s certificates of deposit are valued at face value, plus accrued interest, which approximates fair value, and are reported as Level 2 assets in the fair value hierarchy. The Company does no t have any financial liabilities that are required to be measured at fair value on a recurring basis. The Company’s 8.00% Series A Convertible Preferred Stock, $0.01 par value per share (the “Preferred Stock”), and the Warrant (as defined in Note 10) are Level 3 financial instruments and were valued using a combination of binomial lattice and Black-Scholes models to determine the fair value allocation. The primary assumptions used in such models were expected length of time prior to conversion, and exercise of warrants, of the Preferred Stock and Warrant ( 5 - 10 years), the exercise price of the Warrant ( $3.50 per share), the risk free rate over the expected time horizon ( 1.35% to 1.66% ), the Company’s common stock price as of February 16, 2016 ( $2.65 per share), the expected annual volatility of the Company stock price ( 40% ) and the market rate of preferred stock for comparable companies ( 9.50% ).

Accounts Receivable and Allowan

Accounts Receivable and Allowance for Doubtful Accounts	6 Months Ended
	Jun. 30, 2016
Receivables [Abstract]
Accounts Receivable and Allowance for Doubtful Accounts	ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS Accounts receivable is comprised of unpaid balances pertaining to non-RCM service fees and net receivable balances for RCM customers after considering cost reimbursements owed to such customers, including related accrued balances. The Company maintains an estimated allowance for doubtful accounts to reduce its accounts receivable to the amount that it believes will be collected. This allowance is based on the Company’s historical experience, its assessment of each customer’s ability to pay, the length of time a balance has been outstanding, input from key customer resources assigned to each customer, and the status of any ongoing operations with each applicable customer. Movements in the allowance for doubtful accounts are as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Beginning balance $ 82 $ 239 $ 99 $ 314 (Recoveries) provision (10 ) (54 ) (27 ) (45 ) Write-offs (31 ) (73 ) (31 ) (157 ) Ending balance $ 41 $ 112 $ 41 $ 112

Property, Equipment, and Softwa

Property, Equipment, and Software	6 Months Ended
	Jun. 30, 2016
Property, Plant and Equipment [Abstract]
Property, Equipment, and Software	PROPERTY, EQUIPMENT AND SOFTWARE Property, equipment and software consist of the following (in thousands): June 30, 2016 December 31, 2015 (unaudited) Computer and other equipment $ 20,647 $ 21,348 Leasehold improvements 15,053 17,851 Software 24,445 22,302 Office furniture 4,522 4,888 Property, equipment and software, gross 64,667 66,389 Less: Accumulated depreciation and amortization (34,220 ) (39,172 ) Property, equipment and software, net $ 30,447 $ 27,217 The following table summarizes the allocation of depreciation and amortization expense between cost of services and selling, general and administrative expenses (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Cost of services $ 2,229 $ 1,826 $ 4,327 $ 3,308 Selling, general and administrative 132 275 305 510 Total depreciation and amortization $ 2,361 $ 2,101 $ 4,632 $ 3,818

Customer Liabilities

Customer Liabilities	6 Months Ended
	Jun. 30, 2016
Other Liabilities Disclosure [Abstract]
Customer Liabilities	CUSTOMER LIABILITIES Customer liabilities consist of the following (in thousands): June 30, December 31, 2016 2015 (unaudited) Deferred customer billings, current (1) $ 229,110 $ 130,124 Accrued service costs, current (1) 48,550 70,656 Customer deposits, current (1) 8,034 1,641 Deferred revenue, current 14 95 Current portion of customer liabilities 285,708 202,516 Deferred customer billings, non-current $ 51,221 $ 431,944 Customer deposits, non-current (1) — 533 Non current portion of customer liabilities $ 51,221 $ 432,477 Total customer liabilities $ 336,929 $ 634,993 (1) Includes $107.4 million , $25.7 million and $8.0 million in current deferred customer billings, accrued service costs and customer deposits, respectively, for a related party that is included in the current portion of customer liabilities - related party in the accompanying Condensed Consolidated Balance Sheets at June 30, 2016. In addition, at June 30, 2016, the Company had $26.6 million in non-current portion of customer liabilities due to such related party.

Share-Based Compensation

Share-Based Compensation	6 Months Ended
	Jun. 30, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-Based Compensation	SHARE-BASED COMPENSATION The share-based compensation expense relating to the Company’s stock options and restricted stock awards ("RSAs") for the three months ended June 30, 2016 and 2015 was $13.6 million and $7.8 million , respectively, with related tax benefits of approximately $5.4 million and $2.9 million , respectively. The share-based compensation expense relating to the Company’s stock options and RSAs for the six months ended June 30, 2016 and 2015 was $20.5 million and $13.0 million , respectively, with related tax benefits of approximately $8.1 million and $5.0 million , respectively. Total share-based compensation expense that has been included in the Company's consolidated statements of operations was as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Share-based compensation expense allocation details: Cost of services $ 1,520 $ 1,204 $ 3,523 $ 2,604 Selling, general and administrative 10,265 6,603 15,160 10,399 Other 1,828 — 1,828 — Total share-based compensation expense (1) $ 13,613 $ 7,807 $ 20,511 $ 13,003 (1) Includes $0.1 million in share-based compensation expense paid in cash during the three and six months ended June 30, 2016, and $0.2 million and $0.4 million in share-based compensation expense paid in cash during the three and six months ended June 30, 2015, respectively. The Company uses the Black-Scholes option pricing model to determine the estimated fair value of each option as of its grant date. These inputs are subjective and generally require significant analysis and judgment to develop. The Company used Monte Carlo simulations to estimate the fair value of its RSAs with vesting based on market-based performance conditions as of their respective grant dates. Expected life is based on the market condition to which the vesting is tied. The following table sets forth the significant assumptions used in the Black-Scholes option pricing model and the Monte Carlo simulations and the calculation of share-based compensation expense for the six months ended June 30, 2016 and 2015 : Six Months Ended June 30, 2016 2015 Future dividends — — Risk-free interest rate 1.4% to 1.9% 1.5% to 1.8% Expected volatility 50% 50% Expected life 6.25 6.25 Forfeitures 5.68% annually 5.68% annually The risk-free interest rate input is based on U.S. Treasury instruments, and expected volatility of the share price based upon review of the historical volatility levels of the Company’s common stock in conjunction with that of public companies that operate in similar industries or are similar in terms of stage of development or size and a projection of this information toward its future expected volatility. The Company used the simplified method to estimate the expected option life for 2016 and 2015 option grants. The simplified method was used due to the lack of sufficient historical data available to provide a reasonable basis upon which to estimate the expected term of each stock option. Stock Options A summary of the options activity during the six months ended June 30, 2016 is shown below: Shares Weighted-Average Exercise Price Outstanding at January 1, 2016 15,260,266 $ 10.23 Granted 456,661 2.64 Exercised (46,780 ) 1.87 Canceled (600,939 ) 12.60 Forfeited (2,042,344 ) 7.74 Outstanding at June 30, 2016 13,026,864 $ 9.61 Outstanding and vested and exercisable at June 30, 2016 10,364,780 $ 10.15 Outstanding and vested and exercisable at December 31, 2015 8,876,517 $ 11.63 Restricted Stock Awards A summary of the restricted stock activity during the six months ended June 30, 2016 is shown below: Weighted-Average Grant Date Fair Value Shares Outstanding at January 1, 2016 9,255,932 $ 4.24 Granted 3,071,876 2.58 Vested (3,046,332 ) 3.73 Forfeited (2,723,902 ) 4.79 Outstanding at June 30, 2016 6,557,574 $ 3.11 In most cases, RSA vesting is based on the passage of time. The amount of share-based compensation expense is based on the fair value of the Company's common stock on the respective grant dates and is recognized ratably over the vesting period. The Company's RSA agreements allow employees to surrender to the Company shares of common stock upon vesting of their RSAs in lieu of their payment of the required personal employment-related taxes. The Company does not withhold taxes in excess of minimum required statutory requirements. During the six months ended June 30, 2016 and 2015, employees delivered to the Company 887,660 and 85,086 shares of stock, respectively, which the Company recorded at a cost of approximately $2.0 million and $0.5 million , respectively. Shares surrendered for payment of personal employment-related taxes are held in treasury. Other Matters During the second quarter of 2016, in connection with the resignation of the Company's Chief Executive Officer, Chief Financial Officer and restructuring plan described in Note 8 below, the vesting of certain options and RSAs was accelerated as described in the agreements previously entered into by the former employees and resulted in an increase of share-based compensation expense for both the three and six months ended June 30, 2016 of $7.0 million , respectively, and is recorded in selling, general and administrative expenses. During the second quarter of 2015, in connection with the resignation of a former Chief Executive Officer of the Company from the Company's board of directors (the "Board"), the Company modified the terms of awards previously granted to such Board member. This modification allowed for the continuation of vesting of options despite his resignation from the Board, and resulted in a net increase of share-based compensation expense for both the three and six months ended June 30, 2015 of $3.1 million , respectively, and is recorded in other operating expenses.

Other

Other	6 Months Ended
	Jun. 30, 2016
Restructuring and Related Activities [Abstract]
Other	OTHER Other costs are comprised of reorganization-related and certain other costs. For the three and six months ended June 30, 2016, the Company incurred $8.7 million and $19.5 million in other costs, respectively. For the three and six months ended June 30, 2015, the Company incurred $0.6 million and $1.9 million in other costs, respectively. Reorganization-related During the second quarter of 2016, the Company initiated a restructuring plan (the "Plan") consisting of reductions in its workforce in order to align the size and composition of its workforce to its current client base, better position itself for already committed future growth, and enable the Company to more efficiently serve contracted demand . The Plan affected 40 employees. The majority of the reductions occurred in June 2016, and the Company expects the Plan to be completed by the end of the third quarter of 2016. In connection with the Plan, the Company incurred pretax restructuring charges of $4.6 million for the three months ended June 30, 2016. Restructuring charges for the six months ended June 30, 2016 also include $0.7 million related to facility charges recognized in the first quarter. Restructuring charges for the three months ended June 30, 2016 primarily consisted of $2.8 million in severance and employee benefits and related expenses and $1.8 million of non-cash expense related to share based compensation expense for the acceleration of existing RSAs for affected employees. The Company did no t incur restructuring charges for the three and six months ended June 30, 2015. The Company’s reorganization liability activity is included in accrued compensation and benefits and other accrued expenses in the accompanying condensed consolidated balance sheets. The Company’s reorganization liability activity was as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Reorganization liability, beginning balance $ 2,878 $ 1,532 $ 2,493 $ 3,454 Restructuring charges 4,595 — 5,282 — Cash payments (152 ) (688 ) (454 ) (2,610 ) Non-cash payments $ (1,828 ) $ (1,828 ) Reorganization liability, ending balance $ 5,493 $ 844 $ 5,493 $ 844 Other During the three and six months ended June 30, 2016, the Company incurred other costs of $3.2 million and $13.3 million , respectively, primarily related to incentive payments and legal fees paid in connection with the closing of the transaction with Ascension Health Alliance and TowerBrook that was completed on February 16, 2016 (see Note 10). In addition, the Company recorded an accrual of $0.9 million to account for expected additional contributions to the Company's defined contribution plan for the three and six months ended June 30, 2016. For the three and six months ended June 30, 2015, the Company incurred other costs of $0.6 million and $1.9 million , respectively, primarily related to the restatement of its previously issued consolidated financial statements (the "restatement'). These costs were primarily legal, accounting and consulting costs incurred related to the restatement.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2016
Income Tax Disclosure [Abstract]
Income Taxes	INCOME TAXES Income tax provisions for interim periods are based on estimated annual income tax rates, adjusted to reflect the effects of any significant infrequent or unusual items which are required to be discretely recognized within the current interim period. The Company’s intention is to permanently reinvest its foreign earnings outside the United States. As a result, the effective tax rates in the periods presented are largely based upon the projected annual pre-tax earnings by jurisdiction and the allocation of certain expenses in various taxing jurisdictions where the Company conducts its business. These taxing jurisdictions apply a broad range of statutory income tax rates. The income tax expense and benefit for the six months ended June 30, 2016 and 2015 were higher than the amount derived by applying the federal statutory tax rate of 35% primarily due to the impact of state taxes. The tax rate is also impacted by discrete items that may occur in any given period. The Company and its subsidiaries are subject to U.S. federal income taxes as well as income taxes in multiple state and foreign jurisdictions. The Company's 2013, 2012, and 2011 U.S. federal income tax returns are currently under examination. State jurisdictions have various open tax years. The statutes of limitations for most states range from three to six years. During the six months ended June 30, 2016 and 2015, respectively, the Company wrote-off approximately $4.5 million and $2.2 million of deferred tax assets due to the expiration and exercise of shared-based awards. The additional paid-in capital was reduced by the corresponding amount. The decrease in the Company’s deferred tax assets in the six month period ended June 30, 2016 is due primarily to the contractual revenue recognition event related to Ascension. This event reduced the deferred customer billings deferred tax asset by approximately $111.2 million during the reporting period, offset by additions to deferred customer billings during the quarter. At December 31, 2015, the Company had deferred tax assets of $300.8 million , of which $48.2 million related to net operating loss carryforwards. The majority of these carryforwards were generated in 2013, 2014 and 2015 when the Company incurred substantial expenses related to the restatement. On February 16, 2016, the Company entered into the A&R MPSA with Ascension, effective February 16, 2016 with a term of 10 years. Pursuant to the A&R MPSA and with certain limited exceptions, the Company will become the exclusive provider of RCM services and PAS with respect to acute care services provided by the hospitals affiliated with Ascension that execute supplement agreements with the Company. At June 30, 2016, the Company believes its deferred tax assets will be realizable. Should the additional business with Ascension that the Company anticipates receiving in connection with the A&R MPSA not be as profitable as expected, such realizability assessment may change.

8% Series A Convertible Preferr

8% Series A Convertible Preferred Stock	6 Months Ended
	Jun. 30, 2016
Temporary Equity [Abstract]
8% Series A Convertible Preferred Stock	8% SERIES A CONVERTIBLE PREFERRED STOCK At the close of the Transaction on February 16, 2016 (as described in Note 1), the Company issued to TCP-ASC ACHI Series LLLP, a limited liability limited partnership jointly owned by Ascension Health Alliance and TowerBrook (the “Investor”): (i) 200,000 shares of Preferred Stock, for an aggregate price of $200 million , and (ii) a warrant with a term of ten years to acquire up to 60 million shares of common stock, par value $0.01 per share (“common stock”), at an exercise price of $3.50 per share, on the terms and subject to the conditions set forth in the Warrant Agreement (“Warrant”). The Preferred Stock is immediately convertible into shares of common stock. The Company incurred direct and incremental expenses of $21.3 million (including $14.0 million in closing fees paid to the Investor) relating to financial advisory fees, closing costs, legal expenses and other offering-related expenses in connection with the Transaction. These direct and incremental expenses reduced the carrying amount of the Preferred Stock. In connection with the issuance of the Preferred Stock, a beneficial conversion feature of $48.3 million was recognized. Since the Preferred Stock is presently convertible into common stock, this amount was subsequently accreted to the carrying amount of the Preferred Stock, and treated as a deemed preferred stock dividend in the calculation of earnings per share. Dividend Rights The holders of the Preferred Stock are entitled to receive cumulative dividends January 1, April 1, July 1 and October 1 of each year (dividend payment dates), commencing on April 1, 2016, at a rate equal to 8% per annum (preferred dividend) multiplied by the liquidation preference per share, initially $1,000 per share adjusted for any unpaid cumulative preferred dividends. For the first seven years after issuance, the dividends on the Preferred Stock will be paid-in-kind. In lieu of the dividend payment for the three months ended March 31, 2016, the aggregate liquidation preference on the then outstanding Preferred Stock as of March 31, 2016 was increased by $2.0 million . For the quarter ended June 30, 2016, the Company had accrued dividends of $4.0 million associated with the Preferred Stock which were paid in additional shares of Preferred Stock with an aggregate liquidation preference of $4.0 million in July. There were no cash dividends declared in the three and six months ended June 30, 2016. For the six months ended June 30, 2016, the accrued dividends that were paid in additional shares of Preferred Stock and the increase in liquidation preference of the Preferred Stock totaled $6.0 million . Conversion Features Each share of the Preferred Stock may be converted to common stock on any date at the option of the holder into the per share amount (as defined in the Certificate of Designations of the 8.00% Series A Convertible Preferred Stock (the "Series A COD")). Fractional shares will be rounded to the nearest whole share. Redemption Rights Since the redemption of the Preferred Stock is contingently or optionally redeemable and therefore not certain to occur, the Preferred Stock is not required to be classified as a liability under ASC 480, Distinguishing Liabilities from Equity . As the Preferred Stock is redeemable at the option of the holders upon a fundamental change (as defined in the Series A COD) and is redeemable in certain circumstances upon the occurrence of an event that is not solely within the Company's control, the Company has classified the Preferred Stock in mezzanine equity on the Condensed Consolidated Balance Sheets. Voting Rights Each holder of the Preferred Stock is entitled to vote with the common stock on an as-converted basis, and has full voting rights and powers equal to the voting rights and powers of the holders of common stock. The following summarizes the Preferred Stock activity for the six months ended June 30, 2016: Preferred Stock Shares Issued and Outstanding Carrying Value Balance at December 31, 2015 — $ — Issuance of preferred stock 200,000 108,909 Beneficial conversion feature deemed dividend — 48,320 Accrued dividends/increase in liquidation value — 6,040 Balance at June 30, 2016 200,000 $ 163,269

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 2016
Earnings Per Share [Abstract]
Earnings Per Share	EARNINGS PER SHARE Basic net income per share is computed by dividing net income, less any dividends, accretion or decretion, redemption or induced conversion on the Preferred Stock, by the weighted average number of common shares outstanding during the period. As the Preferred Stock participates in dividends alongside the Company’s common stock (per their participating dividends), the Preferred Stock would constitute participating securities under ASC 260-10 and are applied to earnings per share using the two-class method. Under this method, all earnings (distributed and undistributed) are allocated to common shares and participating securities based on their respective rights to receive dividends. Diluted net income per share is calculated using the more dilutive of the if-converted or the two-class method. For the three and six months ended June 30, 2016, the two-class method was more dilutive and was computed by adjusting the denominator used in the basic net income per share computation by the weighted average number of common shares outstanding and potentially dilutive securities outstanding during the period plus, when their effect is dilutive, incremental shares consisting of shares subject to stock options, shares issuable upon vesting of RSAs and Preferred Stock. The following table sets forth the computation of basic and diluted earnings per share available to common shareholders for the three and six months ended June 30, 2016 and 2015, respectively (in thousands, except share and per share data). Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Basic EPS: Net income (loss) $ (40,791 ) $ (26,288 ) $ 126,612 $ (56,733 ) Less dividends on preferred shares (4,062 ) — (54,360 ) — Less income allocated to preferred shareholders — — (27,797 ) — Net income (loss) available/(allocated) to common shareholders - basic $ (44,853 ) $ (26,288 ) $ 44,455 $ (56,733 ) Diluted EPS: Net income (loss) (40,791 ) (26,288 ) 126,612 (56,733 ) Less dividends on preferred shares (4,062 ) — (54,360 ) — Less income allocated to preferred shareholders — — (27,608 ) — Net income (loss) available/(allocated) to common shareholders - diluted $ (44,853 ) $ (26,288 ) $ 44,644 $ (56,733 ) Basic weighted-average common shares 99,414,066 95,941,077 98,851,934 95,915,255 Add: Effect of dilutive securities — — 1,099,460 — Diluted weighted average common shares 99,414,066 95,941,077 99,951,394 95,915,255 Net income (loss) per common share (basic) $ (0.45 ) $ (0.27 ) $ 0.45 $ (0.59 ) Net income (loss) per common share (diluted) $ (0.45 ) $ (0.27 ) $ 0.45 $ (0.59 ) Because of their anti-dilutive effect, 19,584,438 and 22,883,463 common share equivalents comprised of stock options and RSAs have been excluded from the diluted earnings per share calculation for the three months ended June 30, 2016 and 2015 , respectively. Stock options and RSAs totaling 15,418,216 and 22,883,463 were not included in the computation of diluted income per share for the six months ended June 30, 2016 and 2015, respectively, as these options and awards were anti-dilutive.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIES Legal Proceedings The Company is subject to various claims, other pending and possible legal actions for product liability and other damages, and other matters arising out of the conduct of the Company’s business. On a quarterly basis, the Company reviews material legal claims against the Company. The Company accrues for the costs of such claims as appropriate and in the exercise of its judgment and experience. However, due to a lack of factual information available to the Company about a claim, or the procedural stage of a claim, it may not be possible for the Company to reasonably assess either the probability of a favorable or unfavorable outcome of the claim or to reasonably estimate the amount of loss should there be an unfavorable outcome. Therefore, for many of the claims, the Company cannot estimate a range of loss. The Company believes, based on current knowledge and after consultation with counsel, that the outcome of such claims and actions will not have a material adverse effect on the Company’s results of operations or financial position. However, in the event of unexpected future developments, it is possible that the ultimate resolution of such matters, if unfavorable, could have a material adverse effect on the Company’s results of operations or financial position. Other than as described below, the Company is not presently a party to any material litigation or regulatory proceeding and is not aware of any pending or threatened litigation or regulatory proceeding against the Company which, individually or in the aggregate, could have a material adverse effect on its business, operating results, financial condition or cash flows. On May 17, 2013, the Company, along with certain of its former directors and former officers, was named as a defendant in a putative securities class action lawsuit filed in the U.S. District Court for the Northern District of Illinois ( Hughes v. Accretive Health, Inc. et al.). The primary allegations, relating to its March 8, 2013 announcement that the Company would be restating its prior period financial statements, are that its public statements, including filings with the SEC, were false and/or misleading with respect to its revenue recognition and earnings prospects. On November 27, 2013, plaintiffs voluntarily dismissed the Company’s directors and former directors, other than Mary Tolan. On January 31, 2014, the Company filed a motion to dismiss the complaint. On September 25, 2014, the Court granted the Company motion to dismiss without prejudice, however, the plaintiffs filed a second amended complaint on October 23, 2014. On November 10, 2014, the Company filed a motion to dismiss the second amended complaint. While that motion was still pending, on January 8, 2015, plaintiffs filed a motion to amend the second amended complaint, seeking to add allegations regarding the recently issued restatement. On April 22, 2015, the court granted plaintiffs’ motion to amend, and a third amended complaint was filed on May 13, 2015. The Company moved to dismiss the third amended complaint on June 3, 2015. On December 7, 2015, the parties executed a memorandum of understanding to resolve the suit for $3.9 million and filed a notice of settlement with the district court. On March 8, 2016, the district court granted preliminary approval to the settlement, and on June 28, 2016, the district court granted final approval. The settlement payment of $3.9 million was covered by insurance. On February 11, 2014, the Company was named as a defendant in a putative class action lawsuit filed in the U.S. District Court for the Southern District of Alabama ( Church v. Accretive Health, Inc .). The primary allegation is that the Company attempted to collect debts without providing the notice required by the Fair Debt Collection Practices Act ("FDCPA"). On November 24, 2015, the district court granted the Company's motion for summary judgment and dismissed the case with prejudice. Plaintiff filed a notice of appeal on December 21, 2015. The appeal was decided July 6, 2016, and the Eleventh Circuit Court of Appeals affirmed the dismissal of the case with prejudice, finding that the Company is not a debt collector as defined in the FDCPA. On July 22, 2014, the Company was named as a defendant in a putative class action lawsuit filed in the U.S. District Court for the Eastern District of Michigan ( Anger v. Accretive Health, Inc .). The primary allegations are that the Company attempted to collect debts without providing the notice required by the FDCPA and Michigan Fair Debt Collection Practices Act and failed to abide by the terms of an agreed payment plan in violation of those same statutes. On August 27, 2015, the Court granted in part and denied in part the Company’s motion to dismiss. An amended complaint was filed on November 30, 2015. Discovery is underway, but on July 15, 2016, the court postponed all deadlines in the case as the parties attempt to finalize a confidential agreement in principle to settle the case. The Company believes that it has meritorious defenses and intends to vigorously defend itself against these claims, if the settlement in principle is not finalized. In April 2015, the Company was named among other defendants in an employment action brought by a former employee before the Maine Human Rights Commission ("MHRC"), alleging that she was improperly terminated in retaliation for uncovering alleged Medicare fraud. The Company filed its response with the MHRC on May 19, 2015 seeking that the Company be dismissed entirely from the action. On June 23, 2015, the MHRC issued its Notice of Right to Sue and decision to terminate its process with respect to all charges asserted by the former employee. The Plaintiff has filed a parallel qui tam action in the District of Maine ( Worthy v. Eastern Maine Healthcare Systems ) in which she makes the same allegations. The U.S. Department of Justice declined to intervene in the federal court action, and the case was unsealed in April 2015. The Company filed a motion to dismiss the Third Amended Complaint on March 21, 2016. The Company believes that it has meritorious defenses to both the employment law-related retaliation claim for which the MHRC has granted the Notice of Right to Sue letter and the federal qui tam case, and intends to vigorously defend itself against these claims. The outcomes are not presently determinable. On June 17, 2015, the Company filed a confidential arbitration demand with the American Arbitration Association against Salem Hospital for unpaid fees due under the parties’ Accretive Health Services Agreement in an aggregate amount of $9.3 million . On July 31, 2015, Salem Hospital filed its answer, in which it denied the Company’s claims and asserted counterclaims against the Company in the amount of $2.7 million . The outcome is not presently determinable. In May 2016, the Company was served with a False Claims Act case brought by Cherry Graziosi, a former emergency department service associate who worked at a hospital of one of the Company’s customers, MedStar Inc.’s Washington Hospital Center (“WHC”), along with WHC and three other hospitals that were PAS clients and a place holder, John Doe hospital, representing all PAS clients. The Second Amended Complaint alleges that the Company’s PAS business violates the federal False Claims Act. The case was originally filed under seal in 2013 in the Federal District Court in Chicago, was presented to the U.S. Attorney in Chicago twice, and the U.S. Attorneys declined to intervene. The Company filed a motion to dismiss the Second Amended Complaint on July 29, 2016. The Company believes that it has meritorious defenses to all claims in the case, and intends to vigorously defend itself against these claims. The outcome is not presently determinable.

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2016
Related Party Transactions [Abstract]
Related Party Transactions	RELATED PARTY TRANSACTIONS As a result of the closing of the Transaction on February 16, 2016 and Ascension's ownership interest in the Investor, Ascension became a related party to the Company. See Note 10, 8% Series A Convertible Preferred Stock, for additional information. The Company provides RCM services to Ascension. The execution of the A&R MPSA, as discussed in Note 1, was a contractual settlement agreement of the prior Master Professional Services Agreement between the Company and Ascension. Therefore, the Company recorded revenue of $343.4 million in connection with these services for both the three and six months ended June 30, 2016. At June 30, 2016, the Company had $141.1 million in current portion of customer liabilities for a related party, consisting of $25.7 million in current accrued service costs, $8.0 million in current customer deposits and $107.4 million in current deferred customer billings. In addition, at June 30, 2016, the Company had $26.6 million in non-current portion of customer liabilities due to such related party. As Ascension is the Company's largest customer, a significant percentage of the Company's cost of services is associated with providing services to Ascension. However, due to the nature of the Company's shared services and information technology operations, it is impractical to assign the dollar amount associated with services provided to Ascension.

Deferred Contract Costs

Deferred Contract Costs	6 Months Ended
	Jun. 30, 2016
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Deferred Contract Costs	DEFERRED CONTRACT COSTS Eligible, one-time, nonrecurring costs associated with the initial phases of the Ascension A&R MPSA and with the transition of additional Ascension hospitals are deferred and subsequently amortized. The costs related to transition or setup activities for personnel, process, and systems are amortized on a straight-line basis over the expected period of benefit. At June 30, 2016, the Company had $0.9 million in deferred eligible costs and did no t have any eligible costs deferred at December 31, 2015. These deferred costs are included in other assets in the accompanying condensed consolidated balance sheets. Any contracts entered into by the Company having similar characteristics will be accounted for in a similar manner.

Segments and Customer Concentra

Segments and Customer Concentrations	6 Months Ended
	Jun. 30, 2016
Segment Reporting [Abstract]
Segments and Customer Concentrations	SEGMENTS AND CUSTOMER CONCENTRATIONS The Company has determined that it has a single operating segment in accordance with how its business activities are managed and evaluated. All of the Company’s significant operations are organized around the single business of providing end-to-end management services of revenue cycle operations for U.S.-based hospitals and other medical providers. Accordingly, for purposes of segment disclosures, the Company has only one reporting segment. All of the Company’s net services revenue and trade accounts receivable are derived from healthcare providers domiciled in the United States. Hospital systems affiliated with Ascension have accounted for a significant portion of the Company’s net services revenue each year since the Company’s formation. The Company did no t have any revenue associated with Ascension for the three months ended June 30, 2016. For the three months ended June 30, 2016, two different customers, unaffiliated with Ascension, accounted for 35% of the Company's total net services revenue. For the six months ended June 30, 2016, net services revenue from hospitals affiliated with Ascension accounted for 95% of the Company's total net services revenue. The Company did no t have any revenue associated with Ascension for the three and six months ended June 30, 2015. For the three months and six months ended June, 30, 2015, four different customers, unaffiliated with Ascension, accounted for 74% and 62% of the Company's total net services revenue, respectively. The Ascension system, through its individual customer contracts with the Company, accounted for 48% and 75% of the Company’s total deferred customer billings at June 30, 2016 and December 31, 2015, respectively. The loss of customers within the Ascension health system would have a material adverse impact on the Company’s operations. The Company does not have a concentration of credit risk within accounts receivable as reported in the consolidated balance sheets with any one large customer at June 30, 2016 and December 31, 2015 .

Business Description and Basi24

Business Description and Basis of Presentation (Policies)	6 Months Ended
	Jun. 30, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements reflect the Company's financial position as of June 30, 2016 , the results of operations for the three and six months ended June 30, 2016 and 2015 , and the cash flows of the Company for the six months ended June 30, 2016 and 2015 . These financial statements include the accounts of Accretive Health, Inc. and its wholly owned subsidiaries. All material intercompany amounts have been eliminated in consolidation. These financial statements have been prepared in accordance with United States generally accepted accounting principles ("GAAP") for interim financial reporting and as required by the rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”). Accordingly, certain information and footnote disclosures required for complete financial statements are not included herein. In the opinion of management, all adjustments, consisting of normal recurring adjustments, considered necessary for a fair presentation of the interim financial information, have been included. Operating results for the three and six months ended June 30, 2016 , are not necessarily indicative of the results that may be expected for any other interim period or for the fiscal year ending December 31, 2016 .
Use of Estimates	When preparing financial statements in conformity with GAAP, the Company must make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues, expenses and related disclosures at the date of the financial statements. Actual results could differ from those estimates.
New Accounting Pronouncements	RECENT ACCOUNTING PRONOUNCEMENTS From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board ("FASB") and are adopted by the Company as of the specified effective date. Unless otherwise discussed, the Company's management believes that recently issued accounting pronouncements do not have a material impact on the Company's consolidated financial position, results of operations, or cash flows, or do not apply to the Company's operations. In May 2014, the FASB issued Accounting Standards Update ("ASU") No. 2014-09, Revenue from Contracts with Customers (Topic 606) ("ASU 2014-09") , which supersedes the revenue recognition requirements in Accounting Standard Codification 605, Revenue Recognition ("ASC 605"). ASU 2014-09 is based on the principle that revenue is recognized to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. ASU 2014-09 also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments. ASU 2014-09 is effective for annual reporting periods beginning after December 15, 2017, including interim periods within such reporting period, with early application permitted. The Company plans to early adopt the standard, effective January 1, 2017, and to apply the standard using the cumulative effect method to contracts for which all or substantially all of the revenue has not been recognized under GAAP as of the adoption date. The Company's ability to early adopt ASU 2014-09 is dependent on the completion of its analysis of the information necessary to calculate the cumulative effect. The Company anticipates this standard will have a material impact on it consolidated financial statements. While it is continuing to assess all potential impacts of the standard, the Company believes the most significant impact will be the recognition of revenue at the time services are provided or incentive measurements are finalized, as opposed to at the time of a contractual agreement event, which is when the Company now recognizes revenue for its end-to-end revenue cycle contracts for its base and incentive fee revenues. The Company has not yet finalized all the potential effects of the new standard on its consolidated financial statements. In April 2015, the FASB issued ASU No. 2015-05, Customers Accounting for Fees Paid in a Cloud Computing Arrangement ("ASU 2015-05"). The Company adopted ASU 2015-05 on the required date of January 1, 2016 using the prospective method. For the six months ended June 30, 2016, the Company did not enter into any new arrangements covered by this standard. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) ("ASU 2016-02"), which supersedes existing guidance on accounting for leases in Topic 840, Leases. ASU 2016-02 generally requires all leases to be recognized in the statement of financial position. The provisions of ASU 2016-02 are effective for reporting periods beginning after December 15, 2018; early adoption is permitted. The provisions of ASU 2016-02 are to be applied using a modified retrospective approach. The Company has not yet determined the potential effects of this new standard on its consolidated financial statements, if any. In March 2016, the FASB issued ASU No. 2016-09, Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting ("ASU 2016-09"). ASU 2016-09 simplifies the accounting for employee share-based payment transactions, including the accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. The provisions of ASU 2016-09 are effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. Early adoption is permitted for any entity in any interim or annual period. The Company is currently evaluating the impact of the adoption of this prospective guidance on its consolidated financial statements.

Accounts Receivable and Allow25

Accounts Receivable and Allowance for Doubtful Accounts (Tables)	6 Months Ended
	Jun. 30, 2016
Receivables [Abstract]
Activity in Allowance for Doubtful Accounts	Movements in the allowance for doubtful accounts are as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Beginning balance $ 82 $ 239 $ 99 $ 314 (Recoveries) provision (10 ) (54 ) (27 ) (45 ) Write-offs (31 ) (73 ) (31 ) (157 ) Ending balance $ 41 $ 112 $ 41 $ 112

Property, Equipment, and Soft26

Property, Equipment, and Software (Tables)	6 Months Ended
	Jun. 30, 2016
Property, Plant and Equipment [Abstract]
Property, Equipment, and Software	Property, equipment and software consist of the following (in thousands): June 30, 2016 December 31, 2015 (unaudited) Computer and other equipment $ 20,647 $ 21,348 Leasehold improvements 15,053 17,851 Software 24,445 22,302 Office furniture 4,522 4,888 Property, equipment and software, gross 64,667 66,389 Less: Accumulated depreciation and amortization (34,220 ) (39,172 ) Property, equipment and software, net $ 30,447 $ 27,217 The following table summarizes the allocation of depreciation and amortization expense between cost of services and selling, general and administrative expenses (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Cost of services $ 2,229 $ 1,826 $ 4,327 $ 3,308 Selling, general and administrative 132 275 305 510 Total depreciation and amortization $ 2,361 $ 2,101 $ 4,632 $ 3,818

Customer Liabilities (Tables)

Customer Liabilities (Tables)	6 Months Ended
	Jun. 30, 2016
Other Liabilities Disclosure [Abstract]
Schedule of Customer Liabilities	Customer liabilities consist of the following (in thousands): June 30, December 31, 2016 2015 (unaudited) Deferred customer billings, current (1) $ 229,110 $ 130,124 Accrued service costs, current (1) 48,550 70,656 Customer deposits, current (1) 8,034 1,641 Deferred revenue, current 14 95 Current portion of customer liabilities 285,708 202,516 Deferred customer billings, non-current $ 51,221 $ 431,944 Customer deposits, non-current (1) — 533 Non current portion of customer liabilities $ 51,221 $ 432,477 Total customer liabilities $ 336,929 $ 634,993 (1) Includes $107.4 million , $25.7 million and $8.0 million in current deferred customer billings, accrued service costs and customer deposits, respectively, for a related party that is included in the current portion of customer liabilities - related party in the accompanying Condensed Consolidated Balance Sheets at June 30, 2016. In addition, at June 30, 2016, the Company had $26.6 million in non-current portion of customer liabilities due to such related party.

Share-Based Compensation (Table

Share-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule Share-Based Compensation Expense	Total share-based compensation expense that has been included in the Company's consolidated statements of operations was as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Share-based compensation expense allocation details: Cost of services $ 1,520 $ 1,204 $ 3,523 $ 2,604 Selling, general and administrative 10,265 6,603 15,160 10,399 Other 1,828 — 1,828 — Total share-based compensation expense (1) $ 13,613 $ 7,807 $ 20,511 $ 13,003 (1) Includes $0.1 million in share-based compensation expense paid in cash during the three and six months ended June 30, 2016, and $0.2 million and $0.4 million in share-based compensation expense paid in cash during the three and six months ended June 30, 2015, respectively.
Summary of Valuation Assumptions	The following table sets forth the significant assumptions used in the Black-Scholes option pricing model and the Monte Carlo simulations and the calculation of share-based compensation expense for the six months ended June 30, 2016 and 2015 : Six Months Ended June 30, 2016 2015 Future dividends — — Risk-free interest rate 1.4% to 1.9% 1.5% to 1.8% Expected volatility 50% 50% Expected life 6.25 6.25 Forfeitures 5.68% annually 5.68% annually
Schedule of Stock Option Activity	A summary of the options activity during the six months ended June 30, 2016 is shown below: Shares Weighted-Average Exercise Price Outstanding at January 1, 2016 15,260,266 $ 10.23 Granted 456,661 2.64 Exercised (46,780 ) 1.87 Canceled (600,939 ) 12.60 Forfeited (2,042,344 ) 7.74 Outstanding at June 30, 2016 13,026,864 $ 9.61 Outstanding and vested and exercisable at June 30, 2016 10,364,780 $ 10.15 Outstanding and vested and exercisable at December 31, 2015 8,876,517 $ 11.63
Schedule of Restricted Stock Awards Activity	A summary of the restricted stock activity during the six months ended June 30, 2016 is shown below: Weighted-Average Grant Date Fair Value Shares Outstanding at January 1, 2016 9,255,932 $ 4.24 Granted 3,071,876 2.58 Vested (3,046,332 ) 3.73 Forfeited (2,723,902 ) 4.79 Outstanding at June 30, 2016 6,557,574 $ 3.11

Other (Tables)

Other (Tables)	6 Months Ended
	Jun. 30, 2016
Restructuring and Related Activities [Abstract]
Reorganization Activity	The Company’s reorganization liability activity was as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Reorganization liability, beginning balance $ 2,878 $ 1,532 $ 2,493 $ 3,454 Restructuring charges 4,595 — 5,282 — Cash payments (152 ) (688 ) (454 ) (2,610 ) Non-cash payments $ (1,828 ) $ (1,828 ) Reorganization liability, ending balance $ 5,493 $ 844 $ 5,493 $ 844

8% Series A Convertible Prefe30

8% Series A Convertible Preferred Stock (Tables)	6 Months Ended
	Jun. 30, 2016
Temporary Equity [Abstract]
Temporary Equity	The following summarizes the Preferred Stock activity for the six months ended June 30, 2016: Preferred Stock Shares Issued and Outstanding Carrying Value Balance at December 31, 2015 — $ — Issuance of preferred stock 200,000 108,909 Beneficial conversion feature deemed dividend — 48,320 Accrued dividends/increase in liquidation value — 6,040 Balance at June 30, 2016 200,000 $ 163,269

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2016
Earnings Per Share [Abstract]
Schedule of Earnings (Loss) Per Share, Basic and Diluted	The following table sets forth the computation of basic and diluted earnings per share available to common shareholders for the three and six months ended June 30, 2016 and 2015, respectively (in thousands, except share and per share data). Three Months Ended Six Months Ended June 30, June 30, 2016 2015 2016 2015 (unaudited) (unaudited) Basic EPS: Net income (loss) $ (40,791 ) $ (26,288 ) $ 126,612 $ (56,733 ) Less dividends on preferred shares (4,062 ) — (54,360 ) — Less income allocated to preferred shareholders — — (27,797 ) — Net income (loss) available/(allocated) to common shareholders - basic $ (44,853 ) $ (26,288 ) $ 44,455 $ (56,733 ) Diluted EPS: Net income (loss) (40,791 ) (26,288 ) 126,612 (56,733 ) Less dividends on preferred shares (4,062 ) — (54,360 ) — Less income allocated to preferred shareholders — — (27,608 ) — Net income (loss) available/(allocated) to common shareholders - diluted $ (44,853 ) $ (26,288 ) $ 44,644 $ (56,733 ) Basic weighted-average common shares 99,414,066 95,941,077 98,851,934 95,915,255 Add: Effect of dilutive securities — — 1,099,460 — Diluted weighted average common shares 99,414,066 95,941,077 99,951,394 95,915,255 Net income (loss) per common share (basic) $ (0.45 ) $ (0.27 ) $ 0.45 $ (0.59 ) Net income (loss) per common share (diluted) $ (0.45 ) $ (0.27 ) $ 0.45 $ (0.59 )

Business Description and Basi32

Business Description and Basis of Presentation (Details)	Feb. 16, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Long-term purchase commitment, period	10 years

Fair Value of Financial Instr33

Fair Value of Financial Instruments (Details) - USD ($)	6 Months Ended
	Jun. 30, 2016	Feb. 16, 2016
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Class of warrant or right, exercise price of warrants or rights (in dollars per share)	$ 3.50
Share price (in dollars per share)		$ 2.65
Fair value assumptions, expected volatility rate	40.00%
Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial liabilities fair value disclosure	$ 0
Preferred Stock
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Preferred Stock, dividend rate, percentage	8.00%
Temporary equity, par or stated value per share (in dollars per share)	$ 0.01
Fair value assumptions, market rate comparable companies	9.50%
TCP-ASC ACHI Series LLLP | Preferred Stock
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Preferred Stock, dividend rate, percentage	8.00%
Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Preferred stock, period prior to conversion	5 years
Fair value assumptions, risk free interest rate	1.35%
Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Preferred stock, period prior to conversion	10 years
Fair value assumptions, risk free interest rate	1.66%

Accounts Receivable and Allow34

Accounts Receivable and Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Allowance for Doubtful Accounts Receivable [Roll Forward]
Beginning balance	$ 82	$ 239	$ 99	$ 314
(Recoveries) provision	(10)	(54)	(27)	(45)
Write-offs	(31)	(73)	(31)	(157)
Ending balance	$ 41	$ 112	$ 41	$ 112

Property, Equipment, and Soft35

Property, Equipment, and Software (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property, equipment and software, gross	$ 64,667	$ 66,389
Less: Accumulated depreciation and amortization	(34,220)	(39,172)
Property, equipment and software, net	30,447	27,217
Computer and other equipment
Property, Plant and Equipment [Line Items]
Property, equipment and software, gross	20,647	21,348
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property, equipment and software, gross	15,053	17,851
Software
Property, Plant and Equipment [Line Items]
Property, equipment and software, gross	24,445	22,302
Office furniture
Property, Plant and Equipment [Line Items]
Property, equipment and software, gross	$ 4,522	$ 4,888

Property, Plant and Equipment -

Property, Plant and Equipment - Allocation of Depreciation and Amortization (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Property, Plant and Equipment [Line Items]
Total depreciation and amortization	$ 2,361	$ 2,101	$ 4,632	$ 3,818
Cost of services
Property, Plant and Equipment [Line Items]
Total depreciation and amortization	2,229	1,826	4,327	3,308
Selling, general and administrative
Property, Plant and Equipment [Line Items]
Total depreciation and amortization	$ 132	$ 275	$ 305	$ 510

Customer Liabilities (Details)

Customer Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Related Party Transaction [Line Items]
Deferred customer billings, current	$ 229,110	$ 130,124
Accrued service costs, current	48,550	70,656
Customer deposits, current	8,034	1,641
Deferred revenue, current	14	95
Current portion of customer liabilities	285,708	202,516
Deferred customer billings, non-current	51,221	431,944
Customer deposits, non-current	0	533
Non current portion of customer liabilities	51,221	432,477
Total customer liabilities	336,929	$ 634,993
Investor
Related Party Transaction [Line Items]
Deferred customer billings, current	107,400
Accrued service costs, current	25,700
Customer deposits, current	8,000
Customer deposits, non-current	$ 26,600

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 13,613	$ 7,807	$ 20,511	$ 13,003
Stock-based compensation expense, related tax benefits	5,400	2,900	$ 8,100	$ 5,000
Shares paid for tax withholding for share-based compensation (in shares)			887,660	85,086
Shares paid for tax withholding for share-based compensation, cost			$ 2,000	$ 500
Selling, General and Administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	10,265	6,603	15,160	10,399
Share-based compensation arrangement by share-based payment award, plan modification, incremental compensation cost	$ 7,000		$ 7,000
Other Expense
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share-based payment award, plan modification, incremental compensation cost		$ 3,100		$ 3,100

Share-Based Compensation - Allo

Share-Based Compensation - Allocation of Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Share-based compensation expense allocation details:
Share-based compensation expense	$ 13,613	$ 7,807	$ 20,511	$ 13,003
Share-based compensation expense, paid in cash	100	200	100	400
Cost of services
Share-based compensation expense allocation details:
Share-based compensation expense	1,520	1,204	3,523	2,604
Selling, general and administrative
Share-based compensation expense allocation details:
Share-based compensation expense	10,265	6,603	15,160	10,399
Other
Share-based compensation expense allocation details:
Share-based compensation expense	$ 1,828	$ 0	$ 1,828	$ 0

Share-Based Compensation - Blac

Share-Based Compensation - Black Scholes Assumptions (Details)	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Future dividends	0.00%	0.00%
Risk-Free interest rate, min	1.40%	1.50%
Risk-Free interest rate, max	1.90%	1.80%
Expected volatility	50.00%	50.00%
Expected life	6 years 3 months	6 years 3 months
Forfeitures	5.68%	5.68%

Share-Based Compensation - Stoc

Share-Based Compensation - Stock Option Activity (Details) - $ / shares	6 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Shares
Outstanding at Januray 1, 2016 (in shares)	15,260,266
Granted (in shares)	456,661
Exercised (in shares)	(46,780)
Canceled (in shares)	(600,939)
Forfeited (in shares)	(2,042,344)
Outstanding at June 30, 2016 (in shares)	13,026,864
Outstanding and vested at end of period (in shares)	10,364,780	8,876,517
Weighted- Average Exercise Price
Outstanding at January 1, 2016 (in dollars per share)	$ 10.23
Granted (in dollars per share)	2.64
Exercised (in dollars per share)	1.87
Canceled (in dollars per share)	12.60
Forfeited (in dollars per share)	7.74
Outstanding at June 30, 2016 (in dollars per share)	9.61
Outstanding and vested at end of period (in dollars per share)	$ 10.15	$ 11.63

Share-Based Compensation - Rest

Share-Based Compensation - Restricted Stock Award Activity (Details) - Restricted Stock Awards	6 Months Ended
	Jun. 30, 2016$ / sharesshares
Shares
Outstanding at January 1, 2016 (in shares) | shares	9,255,932
Granted (in shares) | shares	3,071,876
Vested (in shares) | shares	(3,046,332)
Forfeited (in shares) | shares	(2,723,902)
Outstanding at June 30, 2016 (in shares) | shares	6,557,574
Weighted- Average Grant Date Fair Value
Outstanding at January 1, 2016 (in dollars per share) | $ / shares	$ 4.24
Granted (in dollars per share) | $ / shares	2.58
Vested (in dollars per share) | $ / shares	3.73
Forfeited (in dollars per share) | $ / shares	4.79
Outstanding at June 30, 2016 (in dollars per share) | $ / shares	$ 3.11

Other - Reorganization-related,

Other - Reorganization-related, Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Restructuring Cost and Reserve [Line Items]
Reorganization, restatement, and other non-recurring cost	$ 8,651,000	$ 611,000	$ 19,457,000	$ 1,886,000
Restructuring charges	4,595,000	$ 0	5,282,000	$ 0
Severance costs	2,800,000		2,800,000
Restricted Stock Awards
Restructuring Cost and Reserve [Line Items]
Non-cash share-based compensation expense, RSA modification	$ 1,828,000		$ 1,828,000

Other - Reorganization Liabilit

Other - Reorganization Liability Activity (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Restructuring Reserve [Roll Forward]
Reorganization liability, beginning balance	$ 2,878,000	$ 1,532,000	$ 2,493,000	$ 3,454,000
Restructuring charges	4,595,000	0	5,282,000	0
Cash payments	(152,000)	(688,000)	(454,000)	(2,610,000)
Reorganization liability, ending balance	5,493,000	$ 844,000	5,493,000	$ 844,000
Restricted Stock Awards
Restructuring Reserve [Roll Forward]
Non-cash payments	$ (1,828,000)		(1,828,000)
Facility Closing
Restructuring Reserve [Roll Forward]
Restructuring charges			$ 700,000

Other - Restatement and Other (

Other - Restatement and Other (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Restructuring and Related Activities [Abstract]
Other costs related to exploration of potential strategic alternatives	$ 3.2		$ 13.3
Defined Contribution Plan, Employer Discretionary Contribution Amount	$ 0.9		$ 0.9
Restatement-related costs		$ 0.6		$ 1.9

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	Feb. 16, 2016	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Federal statutory tax rate		35.00%	35.00%
Write off of deferred tax asset due to the expiration and exercise of share-based awards		$ 4.5	$ 2.2
Deferred tax asset, deferred customer billings		$ 111.2
Deferred tax assets, net				$ 300.8
Deferred tax assets, operating loss carryforwards				$ 48.2
Long-term purchase commitment, period	10 years

8% Series A Convertible Prefe47

8% Series A Convertible Preferred Stock (Details) - USD ($)	Feb. 16, 2016	Jun. 30, 2016	Jun. 30, 2016	Jul. 31, 2016	Mar. 31, 2016	Dec. 31, 2015	Jun. 30, 2015
Temporary Equity [Line Items]
Long-term purchase commitment, period	10 years
Common stock, par or stated value per share (in dollars per share)		$ 0.01	$ 0.01			$ 0.01
Investment warrants, exercise price (in dollars per share)			$ 3.50
Stock dividend payable to Preferred Stockholders		$ 4,040,000	$ 4,040,000				$ 0
Preferred Stock
Temporary Equity [Line Items]
Preferred stock, shares issued (in shares)		200,000	200,000			0
Temporary equity, stock issued during period, value, new issues			$ 108,909,000
Beneficial conversion feature deemed dividend	$ 48,300,000
Preferred stock, dividend rate			8.00%
Temporary equity, liquidation preference per share (in dollars per share)		$ 1,000	$ 1,000
Dividends, paid-in-kind, period			7 years
Preferred stock, liquidation preference		$ 206,040,000	$ 206,040,000		$ 2,000,000
Stock dividend payable to Preferred Stockholders		4,000,000	4,000,000
Liquidation preference and dividends accrued			6,000,000
Preferred Stock | Dividend Declared
Temporary Equity [Line Items]
Dividends		$ 0	$ 0
TCP-ASC ACHI Series LLLP | Preferred Stock
Temporary Equity [Line Items]
Preferred stock, shares issued (in shares)	200,000
Temporary equity, stock issued during period, value, new issues	$ 200,000,000
Long-term purchase commitment, period		10 years
Temporary equity, direct and incremental expenses	21,300,000
Professional fees	$ 14,000,000
Preferred stock, dividend rate			8.00%
TCP-ASC ACHI Series LLLP | Common Stock
Temporary Equity [Line Items]
Class of warrant or right, number of securities called by warrants or rights (in shares)	60,000,000
Subsequent Event | Preferred Stock
Temporary Equity [Line Items]
Preferred stock, liquidation preference				$ 4,000,000

8% Series A Convertible Prefe48

8% Series A Convertible Preferred Stock - Activity (Details) - Preferred Stock $ in Thousands	6 Months Ended
	Jun. 30, 2016USD ($)shares
Increase (Decrease) in Temporary Equity [Roll Forward]
Balance at December 31, 2015 (in shares) | shares	0
Issuance of preferred stock (in shares) | shares	200,000
Balance at June 30, 2016 (in shares) | shares	200,000
Balance at December 31, 2015	$ 0
Issuance of preferred stock	108,909
Beneficial conversion feature deemed dividend	48,320
Accrued dividends/increase in liquidation value	6,040
Balance at June 30, 2016	$ 163,269

Earnings Per Share - Computatio

Earnings Per Share - Computation of Basic Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Earnings Per Share [Abstract]
Net income (loss)	$ (40,791)	$ (26,288)	$ 126,612	$ (56,733)
Less dividends on preferred shares	(4,062)	0	(54,360)	0
Less income allocated to preferred shareholders	0	0	(27,797)	0
Net income (loss) available/(allocated) to common shareholders - basic	(44,853)	(26,288)	44,455	(56,733)
Less income allocated to preferred shareholders	0	0	(27,608)	0
Net income (loss) available/(allocated) to common shareholders - diluted	$ (44,853)	$ (26,288)	$ 44,644	$ (56,733)
Basic weighted-average common shares (in shares)	99,414,066	95,941,077	98,851,934	95,915,255
Add: Effect of dilutive securities (in shares)	0	0	1,099,460	0
Diluted weighted average common shares (in shares)	99,414,066	95,941,077	99,951,394	95,915,255
Net income (loss) per common share (basic) (in dollars per share)	$ (0.45)	$ (0.27)	$ 0.45	$ (0.59)
Net income (loss) per common share (diluted) (in dollars per share)	$ (0.45)	$ (0.27)	$ 0.45	$ (0.59)

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share (in shares)	19,584,438	22,883,463	15,418,216	22,883,463

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	Mar. 08, 2016	Dec. 07, 2015	Jun. 17, 2015	Jul. 31, 2015
Against Salem Hospital
Loss Contingencies [Line Items]
Confidential arbitration demand in an aggregate amount			$ 9.3
Asserted counterclaim value				$ 2.7
Settled Litigation | Hughes Litigation Case
Loss Contingencies [Line Items]
Litigation settlement sum		$ 3.9
Litigation settlement, amount to be paid by insurance	$ 3.9

Related Party Transactions (Det

Related Party Transactions (Details) - USD ($)	Feb. 16, 2016	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Related Party Transaction [Line Items]
Net services revenue - related party		$ 0	$ 0	$ 343,400,000	$ 0
Customer deposits, current		8,034,000		8,034,000		$ 1,641,000
Customer deposits, noncurrent		0		0		$ 533,000
Investor
Related Party Transaction [Line Items]
Net services revenue - related party		343,400,000		343,400,000
Related party, customer liabilities, current		141,100,000		141,100,000
Accrued service costs, related party, current		25,700,000		25,700,000
Customer deposits, current		8,000,000		8,000,000
Deferred customer billings, related party, current		107,400,000		107,400,000
Customer deposits, noncurrent		$ 26,600,000		$ 26,600,000
Preferred Stock
Related Party Transaction [Line Items]
Preferred stock, dividend rate				8.00%
TCP-ASC ACHI Series LLLP | Preferred Stock
Related Party Transaction [Line Items]
Preferred stock, dividend rate				8.00%
TCP-ASC ACHI Series LLLP | Preferred Stock | Investor
Related Party Transaction [Line Items]
Preferred stock, dividend rate	8.00%

Deferred Costs (Details)

Deferred Costs (Details) - USD ($)	Jun. 30, 2016	Dec. 31, 2015
Other Assets
Guarantor Obligations [Line Items]
Deferred costs	$ 900,000	$ 0

Segments and Customer Concent54

Segments and Customer Concentrations - Additional Information (Details)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2016USD ($)customer	Jun. 30, 2015USD ($)customer	Jun. 30, 2016USD ($)segment	Jun. 30, 2015USD ($)customer	Dec. 31, 2015
Segment Reporting Information [Line Items]
Number of reportable segments | segment			1
Sales revenue, services, net	$ 8,672,000	$ 22,085,000	$ 360,865,000	$ 33,056,000
Sales Revenue, Services, Net | Ascension Health
Segment Reporting Information [Line Items]
Sales revenue, services, net	$ 0			$ 0
Sales | Ascension Health
Segment Reporting Information [Line Items]
Sales revenue, services, net		$ 0
Sales | Customer Concentration Risk | Two Customers Unaffiliated with Ascension Health
Segment Reporting Information [Line Items]
Number of customers | customer	2
Concentration percentage	35.00%
Sales | Customer Concentration Risk | Three Customers Unaffiliated with Ascension Health
Segment Reporting Information [Line Items]
Number of customers | customer		4		4
Concentration percentage		74.00%		62.00%
Deferred customer billings | Customer Concentration Risk | Ascension Health
Segment Reporting Information [Line Items]
Concentration percentage			48.00%		75.00%
Ascension Health | Sales | Customer Concentration Risk
Segment Reporting Information [Line Items]
Concentration percentage			95.00%