R1 RCM 10-K 1 Mar 17 2016 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2016	Feb. 24, 2017	Jun. 30, 2016
Document and Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	FY
Entity Registrant Name	R1 RCM INC.
Entity Central Index Key	1,472,595
Current Fiscal Year End Date	--12-31
Entity Filter Category	Accelerated Filer
Entity Common Stock, Shares Outstanding (in shares)		105,957,743
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Public Float			$ 209,020,006

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 181,176	$ 103,497
Short-term investments	0	1,023
Accounts receivable, net	3,985	10,194
Accounts receivable, net - related party	1,831	0
Prepaid income taxes	3,818	1,102
Prepaid expenses and other current assets	13,804	10,924
Total current assets	204,614	126,740
Property, equipment and software, net	32,789	27,217
Non-current deferred tax asset	169,916	300,825
Restricted cash equivalents	1,500	1,500
Other assets	6,240	4,007
Total assets	415,059	460,289
Current liabilities:
Accounts payable	7,947	5,306
Current portion of customer liabilities	69,713	202,516
Current portion of customer liabilities - related party	14,175	0
Accrued compensation and benefits	24,789	9,062
Other accrued expenses	18,485	15,743
Total current liabilities	135,109	232,627
Non-current portion of customer liabilities	1,000	432,477
Non-current portion of customer liabilities - related party	110,032	0
Other non-current liabilities	9,659	8,498
Total liabilities	255,800	673,602
8.00% Series A convertible preferred stock: par value $0.01 per share, 370,000 authorized, 210,160 shares issued and outstanding as of December 31, 2016; no shares authorized or issued as of December 31, 2015 (aggregate liquidation value of $214,363 as of December 31, 2016)	171,593	0
Stockholders’ equity (deficit):
Common stock, $0.01 par value, 500,000,000 shares authorized, 116,425,524 shares issued and 106,659,542 shares outstanding at December 31, 2016; 113,259,408 shares issued and 107,715,436 shares outstanding at December 31, 2015	1,164	1,133
Additional paid-in capital	349,198	322,492
Accumulated deficit	(304,702)	(481,773)
Accumulated other comprehensive loss	(2,843)	(2,488)
Treasury stock, at cost, 9,765,982 shares as of December 31, 2016; 5,543,972 shares as of December 31, 2015	(55,151)	(52,677)
Total stockholders’ equity (deficit)	(12,334)	(213,313)
Total liabilities and stockholders’ equity (deficit)	$ 415,059	$ 460,289

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 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)	116,425,524	113,259,408
Common stock, shares outstanding (in shares)	106,659,542	107,715,436
Treasury stock, shares (in shares)	9,765,982	5,543,972
Redeemable Convertible Preferred Stock
Preferred stock, dividend rate	8.00%
Preferred stock, par value (in dollars per share)	$ 0.01
Preferred stock, shares issued (in shares)	210,160	0
Preferred stock, shares outstanding (in shares)	210,160	0
Preferred stock, shares authorized (in shares)	370,000	0
Preferred stock, aggregate liquidation value	$ 214,363

Consolidated Statements of Oper

Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Statement [Abstract]
Net services revenue ($461.4 million from related party for the 12 months ended December 31, 2016 and $0 million from related party for the year ended December 31, 2015 and 2014, respectively.)	$ 592,557	$ 117,239	$ 210,140
Operating expenses:
Cost of services	199,697	168,977	182,144
Selling, general and administrative	74,137	74,963	69,883
Other	20,822	9,343	86,766
Total operating expenses	294,656	253,283	338,793
Income (loss) from operations	297,901	(136,044)	(128,653)
Net interest income	297	231	302
Income (loss) before income tax provision	298,198	(135,813)	(128,351)
Income tax provision (benefit)	121,127	(51,557)	(48,731)
Net income (loss)	$ 177,071	$ (84,256)	$ (79,620)
Net income (loss) per common share:
Basic (in dollars per share)	$ 0.65	$ (0.87)	$ (0.83)
Diluted (in dollars per share)	$ 0.65	$ (0.87)	$ (0.83)
Weighted average shares used in calculating net income (loss) per common share:
Basic (in shares)	100,160,206	96,806,885	95,760,762
Diluted (in shares)	100,160,206	96,806,885	95,760,762
Consolidated statements of comprehensive income (loss)
Net income (loss)	$ 177,071	$ (84,256)	$ (79,620)
Other comprehensive loss:
Foreign currency translation adjustments	(355)	(725)	(304)
Comprehensive income (loss)	176,716	(84,981)	(79,924)
Reconciliation of net income (loss) to income (loss) available to common shareholders:
Net income (loss)	177,071	(84,256)	(79,620)
Less dividends on preferred shares	(62,684)	0	0
Less income allocated to preferred shareholders	(48,955)	0	0
Net income (loss) available/allocated to common shareholders - basic	65,432	(84,256)	(79,620)
Less income allocated to preferred shareholders	(48,955)	0	0
Net income (loss) available/allocated to common shareholders - diluted	$ 65,432	$ (84,256)	$ (79,620)

Consolidated Statements of Ope5

Consolidated Statements of Operations and Comprehensive Income (Loss) Parenthetical - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Statement [Abstract]
Revenue from related parties	$ 461,400,000	$ 0	$ 0

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated other comprehensive (loss)
Balance at Dec. 31, 2013	$ (85,612)	$ 1,005	$ (50,700)	$ 283,439	$ (317,897)	$ (1,459)
Balance (in shares) at Dec. 31, 2013		100,525,241	4,514,330
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	27,181			27,181
Deferred tax asset write off net of excess tax benefit and including windfall	(3,521)			(3,521)
Issuance of common stock related to share-based compensation plans	$ 0	$ 24
Issuance of common stock related to share-based compensation plans				(24)
Issuance of common stock related to share-based compensation plans (in shares)		2,365,000
Exercise of vested stock options (in shares)	0
Treasury stock purchases	$ (370)		$ (370)
Treasury stock purchases (in shares)			(263,892)
Foreign currency translation adjustments	(304)					(304)
Net income (loss)	(79,620)				(79,620)
Balance at Dec. 31, 2014	(142,246)	$ 1,029	$ (51,070)	307,075	(397,517)	(1,763)
Balance (in shares) at Dec. 31, 2014		102,890,241	4,778,222
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	29,236			29,236
Deferred tax asset write off net of excess tax benefit and including windfall	(15,262)			(15,262)
Issuance of common stock related to share-based compensation plans	0	$ 90
Issuance of common stock related to share-based compensation plans				(90)
Issuance of common stock related to share-based compensation plans (in shares)		8,994,729
Exercise of vested stock options	$ 1,547	$ 14		1,533
Exercise of vested stock options (in shares)	1,374,438	1,374,438
Treasury stock purchases	$ (1,607)		$ (1,607)
Treasury stock purchases (in shares)			(765,750)
Foreign currency translation adjustments	(725)					(725)
Net income (loss)	(84,256)				(84,256)
Balance at Dec. 31, 2015	(213,313)	$ 1,133	$ (52,677)	322,492	(481,773)	(2,488)
Balance (in shares) at Dec. 31, 2015		113,259,408	5,543,972
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	30,183			30,183
Deferred tax asset write off net of excess tax benefit and including windfall	(10,687)			(10,687)
Issuance of common stock related to share-based compensation plans	0	$ 31
Issuance of common stock related to share-based compensation plans				(31)
Issuance of common stock related to share-based compensation plans (in shares)		3,071,876
Exercise of vested stock options	$ 165	$ 0		165
Exercise of vested stock options (in shares)	94,240	94,240
Beneficial conversion feature	$ 48,320			48,320
Issuance of stock warrants	21,440			21,440
Dividends paid/accrued dividends	(14,364)			(14,364)
Deemed preferred stock dividend	(48,320)			(48,320)
Treasury stock purchases	(2,474)		$ (2,474)
Treasury stock purchases (in shares)			(4,222,010)
Foreign currency translation adjustments	(355)					(355)
Net income (loss)	177,071
Balance at Dec. 31, 2016	$ (12,334)	$ 1,164	$ (55,151)	$ 349,198	$ (304,702)	$ (2,843)
Balance (in shares) at Dec. 31, 2016		116,425,524	9,765,982

Consolidated Statements of Sto7

Consolidated Statements of Stockholders' Equity (Deficit) (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Statement of Stockholders' Equity [Abstract]
Windfall included in deferred tax asset write off		$ 15
Shortfall included in deferred tax asset write-off	$ 3,526		$ 176

Consolidated Statements of Cash

Consolidated Statements of Cash Flows $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Operating activities
Net income (loss)	$ 177,071	$ (84,256)	$ (79,620)
Adjustments to reconcile net income (loss) to net cash used in operations:
Depreciation and amortization	10,198	8,462	6,047
Share-based compensation	29,834	29,236	27,181
Loss on disposal	207	0	1,604
Provision (recovery) for doubtful receivables	5	(46)	(430)
Deferred income taxes	121,834	(52,690)	(49,227)
Excess tax benefit from share-based awards	0	0	(176)
Reimbursed tenant improvements	1,419	0	0
Changes in operating assets and liabilities:
Accounts receivable and related party accounts receivable	4,373	(5,709)	20,548
Restricted cash equivalents	0	(1,500)	0
Prepaid income taxes	(2,770)	5,058	3,794
Prepaid expenses and other assets	(6,920)	(7,465)	(47)
Accounts payable	1,197	(7,162)	8,251
Accrued compensation and benefits	15,747	(5,918)	3,174
Other liabilities	1,018	248	(3,312)
Customer liabilities and customer liabilities - related party	(440,073)	97,930	(15,023)
Net cash used in operating activities	(86,860)	(23,812)	(77,236)
Investing activities
Purchase of short-term investments	0	(1,023)	0
Purchases of property, equipment, and software	(12,635)	(21,275)	(6,034)
Proceeds from maturation of short-term investments	1,023	0	0
Net cash used in investing activities	(11,612)	(22,298)	(6,034)
Financing activities
Series A convertible preferred stock and warrant issuance, net of issuance costs	178,669	0	0
Excess tax benefit from share-based awards	0	0	176
Exercise of vested stock options	165	1,547	0
Purchase of treasury stock	(2,439)	(1,607)	(370)
Restricted cash release from letter of credit	0	5,000	0
Net cash provided by (used in) financing activities	176,395	4,940	(194)
Effect of exchange rate changes in cash	(244)	(500)	(260)
Net increase (decrease) in cash and cash equivalents	77,679	(41,670)	(83,724)
Cash and cash equivalents, at beginning of year	103,497	145,167	228,891
Cash and cash equivalents, at end of year	181,176	103,497	145,167
Supplemental disclosures of cash flow information
Accrued dividends payable to Preferred Stockholders	4,203	0	0
Accrued liabilities related to purchases of property, equipment and software	2,447	411	0
Accounts payable related to purchases of property, equipment and software	2,027	565	863
Income taxes paid	(1,111)	(1,088)	(801)
Income taxes refunded	$ 666	$ 1,441	$ 3,014

Description of Business

Description of Business	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Description of Business	Description of Business R1 RCM Inc. (the "Company") is a leading provider of revenue cycle management ("RCM") services and physician advisory services ("PAS") to healthcare providers. The Company helps healthcare providers generate sustainable improvements in their operating margins and cash flows while also enhancing patient, physician and staff satisfaction for its customers.The Company achieves these results for its customers by managing healthcare providers’ revenue cycle operations, which encompass processes including patient registration, insurance and benefit verification, medical treatment documentation and coding, bill preparation and collections from patients and payers. The Company does so by deploying a unique operating model that leverages its extensive healthcare site experience, innovative technology and process excellence. The Company's primary service offering consists of end-to-end RCM, which encompasses patient registration, insurance and benefit verification, medical treatment documentation and coding, bill preparation and collections. The Company deploys its RCM services through a co-managed relationship or an operating partner relationship. Under a co-managed relationship, the Company leverages its customers’ existing RCM staff and processes, and supplements them with our infused management, subject matter specialists, proprietary technology and other resources. Under an operating partner relationship, the Company provides comprehensive revenue cycle infrastructure to providers, including all revenue cycle personnel, technology, and process workflow. The Company also offers modular services, allowing customers to engage the Company for only specific components of our end-to-end RCM service offering. The Company's PAS offering complements the Company's RCM offering by strengthening customer’s compliance with certain third-party payer requirements and limiting denials of claims. For example, the Company's PAS offering helps customers determine whether to classify a hospital visit as an in-patient or an out-patient observation case for billing purposes. On February 16, 2016, the Company entered into 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 (the "Transaction"). 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.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The consolidated financial statements include the assets, liabilities and results of operations of the Company and its wholly owned subsidiaries. All material intercompany transactions and balances have been eliminated in consolidation. The preparation of financial statements in conformity with the United States generally accepted accounting principles ("GAAP") requires management to make estimates and assumptions that affect the amounts reported in these consolidated financial statements and accompanying notes. Actual results can differ from those estimates. Segments Reporting segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker, or decision-making group, relating to resource allocation and performance assessments. All of the Company’s 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. The Company views its operations and manages its business as one operating and reporting segment. Revenue Recognition Revenue is generally recognized when all of the following criteria are met: (i) persuasive evidence of an arrangement exists, (ii) services have been rendered, (iii) the fee is fixed or determinable and (iv) collectability is reasonably assured. Net service fees, as reported in the consolidated statement of operations and comprehensive income (loss), consist of: (a) RCM services fees and (b) professional service fees earned on a fixed fee, transactional fee or time and materials basis. The Company’s primary source of revenue is RCM services fees. RCM services fees are primarily contingent, but along with fixed fees are generally viewed as one deliverable. To the extent that certain RCM services fees are fixed and not subject to refund, adjustment or concession, such fees are generally recognized as revenue on a straight-line basis over the term of the contract. On a limited basis, the Company enters into contracts with multiple accounting elements which may include a combination of fixed fee or transactional fee elements. The selling price of each element is determined by using management's best estimate of selling price. Revenues are recognized in accordance with the accounting policies for the separate elements. RCM services fees that are contingent in nature are recognized as revenue once all the criteria for revenue recognition are met, which is generally at the end of a contract or other contractual agreement event. Revenue is recognized for RCM services fees upon the contract reaching the end of its stated term (such that the contractual relationship will not continue in its current form) to the extent that: (i) cash has been received for invoiced fees and (ii) there are no disputes at the conclusion of the term of the contract. If fees or services are disputed by a customer at the end of a contract, a settlement agreement entered into with the customer triggers revenue recognition. An other "contractual agreement event" occurs when a renewal, amendment to an existing contract, or other settlement agreement is executed in which the parties reach agreement on prior fees. Revenue is recognized up to the amount covered by such agreements. RCM services fees consist of the following contingent fees: (i) Net Operating Fees and (ii) Incentive Fees. Net Operating Fees The Company generates net operating fees to the extent the Company is able to assist customers in reducing the cost of revenue cycle operations. The Company’s net operating fees consist of: i) gross base fees invoiced to customers; less ii) corresponding costs of customers’ revenue cycle operations which the Company pays pursuant to its RCM agreements, including salaries and benefits for the customers' RCM personnel, and related third-party vendor costs; less iii) any cost savings the Company shares with customers. Net operating fees are recorded as deferred customer billings until the Company recognizes revenue for a customer contract at the end of a contract or reaches an "other contractual agreement event". The amount of unpaid costs of customers’ revenue cycle operations and shared cost savings are reported as accrued service costs within customer liabilities in the consolidated balance sheets. Incentive Fees The Company generates revenue in the form of performance-based fees when the Company improves the customers’ financial or operational metrics. These performance metrics vary by customer contract. However, certain contracts contain a contract-to-date performance metric that is not resolved until the end of the term of the contract. Incentive fees are reported as deferred customer billings only upon cash receipt and until the Company recognizes revenue for a customer at the end of a contract or other contractual agreement event. In some cases, when a customer agreement is extended under an evergreen provision or other amendment, fees may not be considered finalized until the end of the customer relationship. Incentive fees associated with performance metrics which are not resolved until the end of the term of the contract or an "other contractual agreement event" are recorded in deferred customer billings until the Company recognizes revenue. Incentive fees are considered contingent fees. Customer Liabilities Base fees and fixed fees are billed on a monthly or quarterly basis and incentive fees are billed to customers on a quarterly basis. Generally, base fees are billed in advance of each service period. Customer liabilities include (i) accrued service costs (amounts due and accrued for cost reimbursements net of amounts receivable for base fees from the corresponding customer), (ii) deferred customer billings (net operating fees invoiced or accrued and incentive fees collected that have not met all revenue recognition criteria), (iii) customer deposits (consisting primarily of net operating fees under the Company’s RCM contracts that are paid prior to the service period and amounts due as a refund to our customers on incentive fees) and (iv) deferred revenue (fixed fees amortized to revenue over the service period or fixed or determinable fees that have not met all other revenue recognition criteria). Deferred customer billings are classified as current based on the customer contract end dates or other termination events that fall within twelve months of the balance sheet dates. Accrued service cost, customer deposits and deferred revenue are classified as current or non-current based on the anticipated period in which the liabilities are expected to be settled or the revenue is expected to be recognized. Consulting Fees, Transaction Fees and Contingent Service Fees The Company also generates revenue from fixed-fee arrangements, transactional service contracts and contingent-fee service contracts. Provided all other criteria of revenue recognition are met under Accounting Standards Codification ("ASC") 605, Revenue Recognition, revenue under these arrangements is recognized as services are performed, deliverables are provided and related contingencies are removed. All related direct costs are recorded as period costs when incurred. Such consulting fees, transactional fees and contingent service fees are generated from services such as physician advisory services and other related consulting services. Cost of Services Costs associated with generating the Company’s net services revenue, including the cost of operating its shared services centers, are expensed as incurred. Cost of services consist of (i) infused management, on site revenue cycle employees and technology costs, (ii) shared services costs and (iii) other costs to perform physician advisory services. Infused management and technology costs consist primarily of wages, bonuses, benefits, share-based compensation, travel and other costs associated with deploying the Company’s employees at customer sites to help manage the Company’s customers’ revenue cycle operations. The other significant portion of such expenses is an allocation of the costs associated with maintaining, improving and deploying our integrated proprietary technology suite. Shared services costs relate to the Company’s shared services centers in the U.S. and India that perform patient scheduling and pre-registration, medical transcription, cash posting, reconciliation of payments to billing records, patient follow-up and Medicaid eligibility determination for our customers. The Company incurs expenses related to salaries and benefits for employees in its shared services centers and non-payroll costs associated with operating its shared services centers. Other expenses consist of costs related to managing PAS and other services. These expenses consist primarily of wages, bonuses, benefits, share-based compensation and facilities costs. Comprehensive Income (Loss) Comprehensive income (loss) is the net income (loss) of the Company combined with other changes in stockholders’ equity (deficit) not involving ownership interest changes. For the Company, such changes are foreign currency translation adjustments. Cash and Cash Equivalents The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. Short-term Investments At December 31, 2015 the Company's Indian subsidiaries had invested in $1.0 million of time deposits with an original maturity greater than three months. The Company's time deposits were classified as "held-to-maturity" as the Company had both the intent and ability to hold to maturity. The current value was not materially different than the fair value. Restricted Cash Equivalents In 2015 and 2016 , restricted cash equivalents represent the amount of certificate of deposits ("CDs"), with a maturity of three months or less, that the Company is unable to access for operational purposes as the CDs collateralize the Company's corporate travel program. At December 31, 2015 and December 31, 2016 , the Company had $1.5 million in restricted cash equivalents. Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable is comprised of unpaid balances pertaining to non-RCM services 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. Property, Equipment and Software Property, equipment and software are stated at cost, and related depreciation and amortization are calculated on the straight-line method over the estimated useful lives of the assets. The Company capitalizes qualifying internal and third-party costs and hardware and software costs related to the Company’s software development activities in accordance with GAAP. The Company amortizes the capitalized software development costs over their estimated life on a straight-line basis. The major classifications of property, equipment and software and their expected useful lives are as follows: Computers and other equipment 3 years Leasehold improvements Shorter of 10 years or lease term Office furniture 5 years Software 3 years Impairment of Long-Lived Assets Property, equipment, software and other acquired intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recoverable. If circumstances require a long-lived asset or asset group be reviewed for possible impairment, the Company first compares undiscounted cash flows expected to be generated by each asset or asset group to its carrying value. If the carrying value of the long-lived asset or asset group is not recoverable on an undiscounted cash flow basis, an impairment charge is recognized to the extent that the carrying value exceeds the fair value. There was no impairment of property, equipment, software or other acquired intangible assets for the years ended December 31, 2016 , 2015 and 2014 . Income Taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carry forwards. Deferred tax assets and liabilities are measured using current tax laws and enacted tax rates in effect for the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The Company records a valuation allowance for deferred tax assets if, based upon the weight of all available evidence, both positive and negative, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained upon examination by the tax authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest amount of benefit that has a greater than 50% percent likelihood of being realized upon ultimate settlement. Interest and penalties relating to income taxes are recognized in our income tax provision in the consolidated statements of operations and comprehensive income (loss). Legal and Other Contingencies In the normal course of business, the Company is subject to regulatory investigations or legal proceedings, as well as demands, claims and threatened litigation. The Company records an estimated loss for any claim, lawsuit, investigation or proceeding when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Significant judgment is required in both the determination of the probability and whether the loss can be reasonably estimated. Actual expenses could differ from such estimates. Foreign Currency Translation and Transaction Gains (Losses) Assets and liabilities of non-U.S. subsidiaries that operate in a local currency environment, where such local currency is the functional currency, are translated to U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense accounts are translated at average exchange rates during the year which approximates the rates in effect at the transaction dates. The resulting translation adjustments are recorded as a separate component of accumulated other comprehensive income (loss). The Company’s foreign currency transaction gains and losses are included in selling, general and administrative in the accompanying consolidated statements of operations and comprehensive income (loss). Share-Based Compensation Expense The Company determines the expense for all employee share-based compensation awards by estimating their fair value and recognizing such value as an expense, on a ratable basis, in the consolidated financial statements over the requisite service period in which the employees earn the awards. The fair value of performance and service condition stock options is calculated using the Black-Scholes option pricing model and, for market condition stock options, the fair value is estimated using Monte Carlo simulations. To determine the fair value of a share-based award using the Black-Scholes option pricing model, the Company makes assumptions regarding the risk-free interest rate, expected future volatility, expected life of the award and expected forfeitures of the awards. These inputs are subjective and generally require significant analysis and judgment to develop. The Company aggregates all employees into one pool based on the grant date for valuation purposes. The risk-free rate is based on the U.S. treasury yield curve in effect at the time of grant. The Company estimates the expected volatility of the share price by reviewing the historical volatility levels of its 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 then projecting this information toward its future expected volatility. The Company exercises judgment in selecting these companies, as well as in evaluating the available historical and implied volatility for these companies. The Company calculates the expected term in years for each stock option using a simplified method based on the average of each option’s vesting term and original contractual term. The Company applies an estimated forfeiture rate derived from its historical data and estimates of the likely future actions of option holders when recognizing the share-based compensation expense of the options. To determine the fair value of a share-based award using Monte Carlo simulations, the Company makes assumptions regarding the risk-free interest rate, expected future volatility, expected dividend yield and performance period. The risk-free rate is based on the U.S. treasury yield curve in effect at the time of grant. The Company estimates the expected volatility of the share price by reviewing the historical volatility levels of its 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 then projecting this information toward its future expected volatility. Dividend yield is determined based on the Company’s future plans to pay dividends. The Company had no plans to do so at December 31, 2016. The Company calculates the performance period based on the specific market condition to be achieved and derived from historical data and estimates of future performance. The Company recognizes compensation expense, net of forfeitures, using a straight-line method over the applicable service or performance period. During each quarter, the share-based compensation expense is adjusted to reflect all expense for options that vested during the period; however, compensation expense already recognized is not adjusted if market conditions are not met. The Company accounts for stock options issued to non-employees based on their estimated fair value determined using the Black-Scholes option pricing model. The stock options issued to non-employees vest over the arrangement period. The fair value of the equity awards granted to non-employees is remeasured on each balance sheet date until the awards vest, and the related expense is adjusted based on the resulting changes in fair value, if any. The non-employee share-based compensation expense is recognized over the performance period, which is the vesting period. Upon vesting, the performance of the non-employee is deemed complete and the vested awards are not subsequently remeasured. The fair value of modifications to share-based awards is generally estimated using the Black-Scholes option pricing model. If a share-based compensation award is modified after the grant date, incremental compensation expense, if any, is recognized in an amount equal to the excess of the fair value of the modified award over the fair value of the original award immediately before the modification. Incremental compensation expense for vested awards is recognized immediately. For unvested awards, the sum of the incremental compensation expense and the remaining unrecognized compensation expense for the original award on the modification date is recognized over the modified service period. Treasury Stock The Company records treasury stock at the cost to acquire such shares, including commissions paid to brokers. Treasury stock is included as a component of stockholders’ equity (deficit). Earnings (Loss) 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 (as defined in Note 8) 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.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Recent Accounting Pronouncements	Recent Accounting Pronouncements Recently Issued Accounting Standards and Disclosures 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 two permitted transition methods under the new standard are the full retrospective method, in which case the standard would be applied to each prior reporting period presented and the cumulative effect of applying the standard would be recognized at the earliest period presented, or the modified retrospective method (which we have previously referred to as the cumulative effect method), in which case the cumulative effect of applying the standard would be recognized as of the date of initial application. The Company adopted the standard, effective January 1, 2017, using the modified retrospective method. Under this method, we could elect to apply the cumulative effect method to either all contracts as of the date of initial application or only to contracts that are not complete as of that date. We elected to apply the modified retrospective method to contracts that are not complete as of the date of initial application. As part of adopting the standard, the Company identified two main revenue streams: 1) fees from its end-to-end revenue cycle offering, and 2) fees from its PAS offering. The adoption of the standard is expected to have a material impact on the Company’s consolidated financial statements with the most significant impact being the recognition of revenue at the time services are provided or as the significant uncertainty related to variable fees for incentives is resolved for its end-to-end revenue cycle base and incentive fees. Prior to adopting the standard, the Company recognized these revenues that are contingent in nature when all revenue recognition criteria had been met, which was generally at the end of a contract or other contractual agreement event. Adoption of the standard is not expected to have significant impact on the Company’s PAS revenue stream or its fixed fee arrangements. Additionally, the Company does not anticipate a change in cost capitalization resulting from the application of the fulfillment cost guidance and will continue to capitalize such costs that relate directly to a contract, generate or enhance resources the Company uses to satisfy future performance obligations, and are expected to be recovered, see note 17. The cumulative impact of adopting the standard on January 1, 2017 is an increase in stockholders' equity (deficit), which at December 31, 2016 was $(12.3) million , of between $110 million and $115 million and a decrease to deferred customer billings partially offset by a decrease to deferred tax assets. 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 year ended December 31, 2016, the Company did not enter into any new, material 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 is currently evaluating the impact of the adoption of this prospective guidance on its consolidated financials. 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. Additionally, ASU 2016-09 eliminates additional paid-in capital pools and requires excess tax benefits and tax deficiencies to be recognized as a component of income tax expense rather than equity. Under the new standard, entities can make an accounting policy election to either estimate expected forfeitures or to account for them as they occur. 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 adopted ASU 2016-19 on a prospective basis effective January 1, 2017 and the Company will record forfeitures as they occur rather than estimating expected forfeitures. The Company expects to record the cumulative impact of applying this guidance to retained earnings, which is estimated to increase between $1.0 million and $2.0 million . ASU 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash ("ASU 2016-18"). ASU 2016-18 is intended to reduce diversity in practice in the classification and presentation of changes in restricted cash on the Consolidated Statement of Cash Flows. The ASU requires that the Consolidated Statement of Cash Flows explain the change in total cash and equivalents and amounts generally described as restricted cash or restricted cash equivalents when reconciling the beginning-of-period and end-of-period total amounts. ASU 2016-18 also requires a reconciliation between the total of cash and equivalents and restricted cash presented on the Consolidated Statement of Cash Flows and the cash and equivalents balance presented on the Consolidated Balance Sheet. The guidance is effective for interim and annual periods beginning after December 15, 2017, and early adoption is permitted. The guidance requires application using a retrospective transition method. The Company is currently evaluating the impact of the adoption of this prospective guidance on its consolidated financials.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company records its financial assets and liabilities at fair value. The accounting standard for fair value (i) defines fair value as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the measurement date, (ii) establishes a framework for measuring fair value, (iii) establishes a hierarchy of fair value measurements based upon the ability to observe inputs used to value assets and liabilities, (iv) requires consideration of nonperformance risk and (v) expands disclosures about the methods used to measure fair value. The accounting standard establishes a three-level hierarchy of measurements based upon the reliability of observable and unobservable inputs used to arrive at fair value. Observable inputs are independent market data, while unobservable inputs reflect the Company’s assumptions about valuation. The three levels of the hierarchy are defined as follows: • 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, 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, accrued service costs, accrued compensation and benefits and certain other accrued expenses, approximate their fair values, due to the short-term nature of these instruments. The Company does no t have any financial assets or liabilities that are required to be measured at fair value on a recurring basis.

Accounts Receivable and Allowan

Accounts Receivable and Allowance for Doubtful Accounts	12 Months Ended
	Dec. 31, 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 services 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): For the Year Ended For the Year Ended December 31, December 31, 2016 2015 (unaudited) Beginning balance $ 99 $ 314 (Recoveries) provision 5 (46 ) Write-offs (38 ) (169 ) Ending balance $ 66 $ 99

Property, Equipment, and Softwa

Property, Equipment, and Software	12 Months Ended
	Dec. 31, 2016
Property, Plant and Equipment [Abstract]
Property, Equipment, and Software	Property, Equipment and Software Property, equipment and software consist of the following (in thousands): December 31, 2016 2015 Computer and other equipment $ 23,291 $ 21,348 Leasehold improvements 16,017 17,851 Software 28,131 22,302 Office furniture 4,867 4,888 Property and equipment and software, gross 72,306 66,389 Less accumulated depreciation and amortization (39,517 ) (39,172 ) Property and equipment and software, net $ 32,789 $ 27,217 During the year ended December 31, 2016, the Company wrote-off approximately $9.1 million in fully depreciated assets that were no longer in service. The following table summarizes the allocation of depreciation and amortization expense between cost of services and selling, general and administrative expenses (in thousands): For the Year Ended December 31, 2016 2015 2014 Cost of services $ 9,492 $ 7,536 $ 4,603 Selling, general and administrative 706 926 1,444 Total depreciation and amortization $ 10,198 $ 8,462 $ 6,047

Customer Liabilities

Customer Liabilities	12 Months Ended
	Dec. 31, 2016
Other Liabilities Disclosure [Abstract]
Customer Liabilities	Customer Liabilities Customer liabilities consist of the following (in thousands): December 31, December 31, 2016 2015 Deferred customer billings, current $ 68,173 $ 130,124 Accrued service costs, current (1) 14,768 70,656 Customer deposits, current (1) 947 1,641 Deferred revenue, current — 95 Current portion of customer liabilities 83,888 202,516 Deferred customer billings, non-current (2) $ 110,032 $ 431,944 Customer deposits, non-current — 533 Deferred revenue, non-current $ 1,000 $ — Non current portion of customer liabilities $ 111,032 $ 432,477 Total customer liabilities $ 194,920 $ 634,993 (1) Includes $13.2 million and $1.0 million in current accrued service costs and customer deposits, respectively, for a related party that are included in the current portion of customer liabilities - related party in the accompanying consolidated balance sheets at December 31, 2016 . (2) Includes $110.0 million in deferred customer billings for a related party that are included in the non-current portion of customer liabilities - related party in the accompanying consolidated balance sheets at December 31, 2016 .

Stockholders' Equity (Deficit)

Stockholders' Equity (Deficit)	12 Months Ended
	Dec. 31, 2016
Equity [Abstract]
Stockholders' Equity (Deficit)	Stockholders’ Equity (Deficit) Preferred Stock and Warrant The Company has 5,000,000 shares of authorized preferred stock, each with a par value of $0.01 . The preferred stock may be issued from time to time in one or more series. The board of directors of the Company ("Board") is authorized to determine the rights, preferences, privileges and restrictions of the Company’s authorized but unissued shares of preferred stock. On February 16, 2016, at the close of the Transaction, the Company issued to TCP-ASC ACHI Series LLLP, a limited liability limited partnership jointly owned by Ascension Health Alliance and investment funds affiliated with TowerBrook (the "Investor"): (i) 200,000 shares of its 8.00% Series A Convertible Preferred Stock, par value $0.01 per share (the "Series A Preferred Stock" or "Preferred Stock"), for an aggregate price of $200 million and (ii) an exercisable warrant to acquire up to 60 million shares of its common stock with an exercise price of $3.50 per common share and a term of ten years. The Series A Preferred Stock is immediately convertible into shares of common stock. As of December 31, 2015 and 2014 , the Company did no t have any shares of preferred stock outstanding. See Note 13, 8% Series A Convertible Preferred Stock, for additional information. Common Stock Each outstanding share of the Company's common stock, par value $0.01 per share ("common stock"), is entitled to one vote per share on all matters submitted to a vote by shareholders. Subject to the rights of any preferred stock which may from time to time be outstanding, the holders of outstanding shares of common stock are entitled to receive dividends and, upon liquidation or dissolution, are entitled to receive pro rata all assets legally available for distribution to stockholders. No dividends were declared or paid on the common stock during 2016 , 2015 and 2014 . Treasury Stock On November 13, 2013, the Board authorized a repurchase of up to $50.0 million of the Company’s common stock in the open market or in privately negotiated transactions. The timing and amount of any shares repurchased will be determined by the Company based on its evaluation of market conditions and other factors. The repurchase program may be suspended or discontinued at any time at the sole discretion of the Board. Any repurchased shares will be available for use in connection with the Company’s stock plans and for other corporate purposes. The Company funds the repurchases from cash on hand. As of December 31, 2015, no shares of common stock had been repurchased under this plan. During the fourth quarter of 2016, the Company repurchased 158,557 shares of the Company stock for $0.4 million . No shares have been retired. As of December 31, 2016, the Company held in treasury 4,465,919 shares of repurchased stock. Treasury stock also includes repurchases of Company stock related to employees’ tax withholding upon vesting of restricted shares. See Note 9, Share-Based Compensation.

Share-Based Compensation

Share-Based Compensation	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-Based Compensation	Share-Based Compensation The Company maintains two stock incentive plans: the Amended and Restated Stock Option Plan (the "2006 Plan") and the Second Amended and Restated Stock 2010 Incentive Plan (the "2010 Amended Plan", together with the 2006 Plan, the "Plans"). In December 2016, the Company's stockholders approved the Second Amended and Restated 2010 Stock Incentive Plan, which authorized the issuance of an additional seventeen million shares of the Company's common stock pursuant to awards. Under the Plans, the Company could issue (up to a maximum of 46,374,756 shares) any shares that remained available for issuance under the 2006 Plan as of the date of the IPO and any shares subject to awards that were outstanding under the 2006 Plan as of the date of the IPO that expire, terminate or are otherwise surrendered, canceled, forfeited or repurchased by the Company without the issuance of shares thereunder. The Company will not make any further grants under the 2006 Plan. The 2010 Amended Plan provides for the grant of incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock awards ("RSAs"), restricted stock units ("RSUs") and other share-based awards. As of December 31, 2016 , 15,581,377 shares were available for future grants of awards under the 2010 Amended Plan. To the extent that previously granted awards under the 2006 Plan or 2010 Amended Plan expire, terminate or are otherwise surrendered, canceled or forfeited, the number of shares available for future awards under the 2010 Amended Plan will increase. Under the terms of the Plans, all stock options will expire if they are not exercised within ten years of their grant date. Generally all employee options, RSAs and RSUs vest ratably between one and four years. In 2014 and 2013, the Company granted service-based, non-qualified options to purchase 3,400,000 and 4,703,801 shares of common stock and awarded 1,000,000 and 400,000 shares of restricted stock, respectively, to key employees pursuant to inducement grant rules of the New York Stock Exchange ("NYSE"), of which 3,703,801 and 7,103,801 of the stock options were outstanding as of December 31, 2016 and 2015 , respectively, and 41,630 and 1,399,980 of the shares of restricted stock were outstanding as of December 31, 2016 and 2015 , respectively. Also in 2014, pursuant to inducement grant rules of the NYSE, the Company granted a market-based award of 500,000 shares of restricted stock to the Chief Executive Officer. This RSA vests only when the average closing price of the Company’s stock price equals or exceeds twice the amount of the grant date stock price. As of December 31, 2016 , this RSA was no longer outstanding. The Company uses the Black-Scholes option pricing model to estimate the fair value of its service-based options as of its grant date. The Company uses the 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 during 2016 , 2015 and 2014 : Year Ended December 31, 2016 2015 2014 Expected dividend yield — — — Risk-free interest rate 1.2% to 2.06% 1.5% to 2.0% 1.9% to 2.2% Expected volatility 45% - 50% 50% 50% Expected term (in years) 5.96 to 6.30 6.25 6.25 to 7.50 Forfeitures 5.68% annually 5.68% annually 5.68% annually Total share-based compensation costs that have been included in the Company’s consolidated statements of operations were as follows (in thousands): Year Ended December 31, 2016 2015 2014 Share-Based Compensation Expense Allocation Details: Cost of services $ 6,137 $ 7,208 $ 6,668 Selling, general and administrative 21,965 24,463 13,503 Other costs 1,828 — 8,761 Total share-based compensation expense (1) $ 29,930 $ 31,671 $ 28,932 (1) Includes $0.1 million , $2.4 million and $1.8 million in share-based compensation expense paid in cash during the years ended December 31, 2016 , 2015 and 2014 , respectively. There was $23.2 million , $47.2 million and $ 42.8 million of total, unrecognized share-based compensation expense related to stock options, RSAs and RSUs granted under the Plans, which the Company expects to recognize over a weighted-average period of 2.8 years , 2.9 years and 3.2 years as of December 31, 2016 , 2015 and 2014 , respectively. Refer to the consolidated statements of stockholders’ equity (deficit) for the tax benefits realized for the tax deductions from stock option exercises. Stock options The following table sets forth a summary of all employee and non-employee option activity under all plans and inducement grants for the years ended December 31, 2016 , 2015 and 2014 : Shares Weighted- Average Exercise Price Weighted- Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (in thousands) Outstanding at January 1, 2014 20,540,273 $ 11.77 7.4 $ 15,673 Granted 4,406,856 8.78 Exercised — — Canceled/forfeited (5,022,724 ) 13.17 Outstanding at December 31, 2014 19,924,405 10.91 6.9 9,444 Granted 2,231,504 5.60 Exercised (1,374,438 ) 1.13 Canceled/forfeited (5,521,205 ) 13.17 Outstanding at December 31, 2015 15,260,266 10.23 7.0 261 Granted 11,186,107 2.39 Exercised (94,240 ) 1.93 Canceled/forfeited (5,933,526 ) 9.22 Outstanding at December 31, 2016 20,418,607 6.26 7.9 256 Outstanding, vested and exercisable at December 31, 2014 9,605,505 $ 11.89 5.9 $ 15,096 Outstanding, vested and exercisable at December 31, 2015 11,879,209 $ 11.73 5.6 $ 9,444 Outstanding, vested and exercisable at December 31, 2016 7,993,168 $ 11.34 5.3 $ 15 The weighted-average grant date fair value of options granted during the years ended December 31, 2016 , 2015 and 2014 was $ 1.07 , $ 2.78 and $ 4.40 per share, respectively. The total intrinsic value of the options exercised in the years ended December 31, 2016 and 2015 was $0.1 million and $ 4.9 million, respectively. No options were exercised in the year ended December 31, 2014 . The total fair value of options vested during the years ended December 31, 2016 , 2015 and 2014 was $ 15.0 million, $ 14.9 million and $ 22.9 million, respectively. Restricted stock awards In the third quarter of 2011, the Company began to grant RSAs to its employees. A summary of the activity during the years ended December 31, 2016 , 2015 and 2014 is shown below: Shares Weighted- Average Grant Date Fair Value Outstanding and unvested at January 1, 2014 458,299 $ 11.45 Granted 2,365,000 8.39 Vested (127,084 ) 11.46 Forfeited (218,750 ) 9.40 Outstanding and unvested at December 31, 2014 2,477,465 $ 8.71 Granted 8,994,729 3.34 Vested (1,892,049 ) 5.24 Forfeited (324,213 ) 7.61 Outstanding and unvested at December 31, 2015 9,255,932 $ 4.24 Granted 3,071,876 2.58 Vested (3,361,336 ) 4.37 Forfeited (3,103,760 ) 4.69 Outstanding and unvested at December 31, 2016 5,862,712 $ 3.01 The total fair value of RSAs vested during the years ended December 31, 2016 , 2015 and 2014 was $ 14.7 million , $ 9.9 million and $ 1.5 million , respectively. The Company’s RSA agreements allow employees to deliver to the Company shares of 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 years ended December 31, 2016 , 2015 and 2014 , employees delivered to the Company 996,510 , 441,537 and 45,142 shares of stock, respectively, which the Company recorded at a cost of approximately $2.2 million , $1.6 million and $0.4 million , respectively. As of December 31, 2016 , the Company held 1,529,937 shares of surrendered common stock in treasury related to the vesting of RSAs. Forfeited and canceled RSAs are added to treasury stock. For the years ended December 31, 2016 , 2015 and 2014 , 3,103,760 , 324,213 and 218,750 shares were respectively added to treasury stock due to canceled RSAs. Restricted stock units In the fourth quarter of 2016, the Company began to grant RSUs to its employees. A summary of the activity during the years ended December 31, 2016 is shown below: Shares Weighted- Average Grant Date Fair Value Outstanding and unvested at December 31, 2015 — $ — Granted 1,361,794 2.35 Vested — — Forfeited (15,020 ) 2.35 Outstanding and unvested at December 31, 2016 1,346,774 $ 2.35 The Company’s RSU agreements allow employees to receive shares of stock upon vesting of their RSUs. As of December 31, 2016 , no RSUs had vested. Modifications of share-based awards During the second quarter of 2014, the Company modified the terms of awards granted to 39 employees (including the 13 who were affected in 2013) who were terminated under the 2013 restructuring plan to allow for the extension of the exercise period for vested options until such time as the Company's registration statement on Form S-8 had been effective for 60 consecutive days. Such modifications resulted in a net increase in share-based compensation expense of $2.3 million for the year ended December 31, 2014. During the first quarter of 2014, in connection with the resignation of a senior executive from the Company, the Company modified the terms of awards previously granted to such executive. Such modification extended the term to exercise vested options from 60 days following his effective resignation date to such time as the Company's registration statement on Form S-8 had been effective for 60 consecutive days. Such modification resulted in a net increase of share-based compensation expense for the year ended December 31, 2014 of $5.6 million . During the second quarter of 2013, the Company modified the terms of an award granted to Mary Tolan, the Company's former chief executive officer, in connection with her transition to the role of the Chairman of the Board of the Company. This modification allowed for the extension of the exercise period for options vested as of the date of the modification from 60 days following the termination of employment to the expiration of the original award ( ten years from the grant date). This modification resulted in a net increase in share-based compensation expense of $1.5 million for the year ended December 31, 2014. During the second quarter of 2014, the Company granted to the Chief Operating Officer (the "COO") retention equity awards subject to the approval of our stockholders of an amendment to our Amended 2010 Plan. In the event that the stockholders did not approve the amendment prior to December 31, 2014, then in lieu of the incentive equity awards, the COO would be entitled to receive cash payments following each date that any portion of such equity grant would have otherwise vested equal to: (i) for stock options, the difference between the exercise price and the closing price of the common stock on the vesting date and (ii) for restricted stock, the closing price of the common stock on the vesting date. The Company determined that stockholder approval to amend the 2010 Plan would not occur by December 31, 2014 and accrued for these grants at the value as explained above. For the years ended December 31, 2016 , 2015 and 2014 , the Company incurred $0.1 million , $0.6 million and $ 0.9 million of share-based compensation expense related to this grant, respectively. Additionally, as part of the COO's retention agreement, the Company modified the terms of a stock option granted to the COO at the commencement of his employment. This modification would be triggered upon termination of employment by the Company without cause or by the COO for good reason and if triggered, the vested portion of the stock option would remain exercisable for a period of time equal to 60 days plus the number of days of service with the Company, but not longer than two years, or until the stock option otherwise expires, if earlier. This modification resulted in a net increase in share-based compensation expense of $ 0.2 million for year ended December 31, 2014. During the year ended December 31, 2014, the Company settled share-based awards in cash with three employees who had options that expired during the year as all employees were restricted from exercising vested options during the year. This modification resulted in an increase in share-based compensation expense of $ 0.9 million for the year ended December 31, 2014. During the second quarter of 2015, in connection with the resignation of a member of the Board who was also the former Chief Executive Officer of the Company, 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. Such modification resulted in a net increase of share-based compensation expense for the year ended December 31, 2015 of $3.1 million . During the third quarter of 2015, the Compensation Committee of the Board approved the grant of cash bonuses to the participants in the Company's 2014 annual cash incentive bonus plan who received all or a portion of their 2014 annual cash incentive award in the form of restricted shares of the Company's common stock (the "2014 Bonus Plan RSA Grantees"). Such bonuses were paid to 2014 Bonus Plan RSA Grantees on the second regularly scheduled payroll date following the Company’s scheduled second quarter earnings release on August 5, 2015 and were equal to the product of (i) $2.66 (which amount represents the difference of $5.38 , the trading price per share of the Company’s common stock as of the close of trading on the date that the Company determined the number of restricted shares to be granted to 2014 Bonus Plan RSA Grantees, minus $2.72 , the trading price per share of the Company’s common stock as of the close of trading on the second business day following the earnings release), multiplied by (ii) the number of restricted shares granted to the applicable 2014 Bonus Plan RSA Grantee. The aggregate number of restricted shares granted to 2014 Bonus Plan RSA Grantees was 683,401 . This modification resulted in a net increase of share-based compensation expense for the year ended December 31, 2015 of $1.8 million . During the second quarter of 2016, in connection with the resignation of the Company's Chief Executive Officer, Chief Financial Officer and the Restructuring Plan as further described in Note 11, the vesting of certain options and RSAs was accelerated pursuant to the agreements previously entered into by the former employees and resulted in an increase of share-based compensation expense for the year ended December 31, 2016 of $7.0 million .

Retirement Plan

Retirement Plan	12 Months Ended
	Dec. 31, 2016
Compensation and Retirement Disclosure [Abstract]
Retirement Plan	Retirement Plan The Company maintains a 401(k) retirement plan (the "401(k) plan") that is intended to be a tax-qualified defined contribution plan under Section 401(k) of the Internal Revenue Code. In general, all employees are eligible to participate. The 401(k) plan includes a salary deferral arrangement pursuant to which participants may elect to reduce their current compensation by up to the statutorily prescribed limit, equal to $18,000 , $18,000 and $17,500 in 2016 , 2015 and 2014 , respectively, and have the amount of the reduction contributed to the 401(k) plan. The Company currently matches employee contributions up to 50% of the first 3% of base compensation that a participant contributes to the 401(k) plan. In 2016 , 2015 and 2014 , director-level and above employees were excluded from the matching contribution feature of the plan. For the years ended December 31, 2016 , 2015 and 2014 , total Company contributions to the plan were $0.7 million , $0.4 million and $0.5 million , respectively.

Other

Other	12 Months Ended
	Dec. 31, 2016
Restructuring and Related Activities [Abstract]
Other	Other Other costs are comprised of reorganization-related and certain other costs. For the years ended December 31, 2016 and 2015 , the Company incurred $ 20.8 million and 9.3 million in other costs, respectively. Other costs consist of the following (in millions): Year Ended December 31, 2016 2015 2014 Severance and employee benefits $ 3.5 $ 0.6 $ 9.2 Facility charges 1.1 2.6 5.0 Non-cash share based compensation 1.8 — 7.9 Reorganization-related 6.4 3.2 22.1 Restatement costs 1.2 2.5 57.3 Transaction fees (1) 12.7 — — Defined Contribution plan contributions (2) 0.5 — — Strategic Alternative Exploration — 3.8 — Prior year employment tax expense — (0.2 ) 0.9 Office Transformation — — 6.5 Other 14.4 6.1 64.7 Total other $ 20.8 $ 9.3 $ 86.8 (1) Costs related to retention payments and legal fees paid in connection with the closing of the Transaction (see Note 8). (2) Additional contributions to the Company's defined contribution plan for the year ended December 31, 2016. Reorganization-related In 2013, the Company initiated a restructuring plan (the "Restructuring Plan") consisting of reductions in workforce in order to align its organizational structure and resources to better serve its customers. In January 2014, the Company revised the Restructuring Plan to include additional reductions to its workforce in certain corporate, administrative and management functions. During the second and fourth quarter of 2016, the Company initiated a restructuring 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 Company's reorganization activity was as follows (in thousands): Severance and Employee Benefits Facilities and Other Costs Total Reorganization liability at January 1, 2014 $ 1,143 $ — $ 1,143 Restructuring charges 17,108 5,010 22,118 Cash payments (7,050 ) (3,482 ) (10,532 ) Non-cash charges (7,905 ) (1,370 ) (9,275 ) Reorganization liability at December 31, 2014 $ 3,296 $ 158 $ 3,454 Restructuring charges 596 2,564 3,160 Cash payments (3,575 ) (546 ) (4,121 ) Non-cash charges — — — Reorganization liability at December 31, 2015 $ 317 $ 2,176 $ 2,493 Restructuring charges 5,369 1,080 6,449 Cash payments (2,272 ) (2,731 ) (5,003 ) Non-cash charges (1,800 ) $ — (1,800 ) Reorganization liability at December 31, 2016 $ 1,614 $ 525 $ 2,139

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The domestic and foreign components of income (loss) before income taxes consist of the following (in thousands): Year Ended December 31, 2016 2015 2014 Domestic $ 292,400 $ (139,058 ) $ (130,945 ) Foreign 5,798 3,245 2,594 Total income (loss) before income taxes $ 298,198 $ (135,813 ) $ (128,351 ) For the years ended December 31, 2016 , 2015 and 2014 , the Company’s current and deferred income tax expense (benefit) attributable to income (loss) from operations are as follows (in thousands): Current Deferred Total Year Ended December 31, 2014 U.S. Federal $ (627 ) $ (42,240 ) $ (42,867 ) State & Local 46 (6,363 ) (6,317 ) Foreign 1,025 (572 ) 453 $ 444 $ (49,175 ) (48,731 ) Year Ended December 31, 2015 U.S. Federal $ 68 $ (43,199 ) $ (43,131 ) State & Local (176 ) (8,468 ) (8,644 ) Foreign 530 (312 ) 218 $ 422 $ (51,979 ) $ (51,557 ) Year Ended December 31, 2016 U.S. Federal $ (210 ) $ 95,613 $ 95,403 State & Local (25 ) 24,977 24,952 Foreign 1,176 (404 ) 772 $ 941 $ 120,186 $ 121,127 Reconciliation of the difference between the actual tax rate and the statutory U.S. federal income tax rate is as follows: Year Ended December 31, 2016 2015 2014 Federal statutory tax rate 35 % 35 % 35 % Increase in income tax rate resulting from: State and local income taxes, net of federal tax benefits 5 % 4 % 3 % Other 1 % (1 )% Actual tax rate 41 % 38 % 38 % In the three month period ended March 31, 2014, the Company corrected the statutory rate used in one of its state deferred calculations for the year ended December 31, 2013. The Company discovered this error in the process of preparing its annual and quarterly financial statements for the year ended December 31, 2014, and recorded the amount in the first quarter of 2014. The correction of this error increased tax expense for the year ended December 31, 2014 by approximately $2.4 million . The Company has determined the amount is immaterial for the year ended December 31, 2014. The following table sets forth the Company’s net deferred tax assets as of December 31, 2016 and 2015 (in thousands): As of December 31, 2016 2015 Deferred Tax assets: Deferred customer billings 67,935 220,075 Net operating loss carryforwards 70,953 48,201 Share-based compensation 22,905 24,995 Accrued bonus 4,786 2,008 Other reserves 699 606 Alternative minimum tax 1,857 1,537 Other 919 2,446 Fixed assets 238 435 R&D credit 289 189 Charitable contributions 539 534 Stock warrants 72 101 Total gross deferred tax assets 171,192 301,127 Less valuation allowance (1,276 ) (302 ) Net deferred tax asset $ 169,916 $ 300,825 At December 31, 2016 , the Company had cumulative U.S. federal net operating loss carryforwards of approximately $181.2 million which are available to offset U.S. federal taxable income in future periods through 2036. At December 31, 2016 , the Company has cumulative state net operating loss ("NOL") carryforwards of approximately $185.8 million which are available to offset state taxable income in future periods through 2036. A valuation allowance is required to be established when, based on currently available information, it is more likely than not that all or a portion of a deferred tax asset will not be realized. The guidance on accounting for income taxes provides important factors in determining whether a deferred tax asset will be realized, including whether there has been sufficient taxable income in recent years and whether sufficient income can reasonably be expected in future years in order to utilize the deferred tax asset. The valuation allowance recorded relates to state NOL carryforwards where the Company no longer has business activities in that state, or where the activity level has decreased to such a level where it is not more likely than not the NOL will be realized. Consideration is given to the weight of all available evidence, both positive and negative. Generally, a cumulative loss in recent years is negative evidence in determining the need for a deferred tax asset valuation allowance. However, the recent cumulative losses in book income are primarily the result of a delay in revenue recognition on contracts that have been in place for a number of years. Revenue is being deferred by the Company until a future event occurs and the revenue becomes fixed, per the terms of each contract. The Company notes that the majority of the remaining deferred revenue from contracts that the Company has previously entered are recognized in the cumulative effect transition adjustment that was recognized with the adoption of the new revenue recognition standard on January 1, 2017 as discussed in Note 3. The majority of the deferred revenue amounts have already been reported on income tax returns filed in accordance with a previously established and approved method of accounting for federal and state income tax reporting. The significant positive evidence related to the projected realization of the deferred customer billings from existing contracts and projected taxable income outweighs the negative evidence from the cumulative losses incurred in recent years. The Company estimates its already contracted business growth associated with the Ascension A&R MPSA will be profitable and allow the Company to utilize its NOL carryforwards and other deferred tax assets. Accordingly, the Company believes that it is more likely than not that the remaining deferred tax assets will be realized. Should the Company not operationally execute as expected, and the growth in the Ascension business not be as profitable as expected, such realizability assessment may change. The Company has recorded valuation allowances at December 31, 2016 and 2015 of $1.3 million and $0.3 million , respectively, based on our assessment that it is more likely than not that a portion of the Company’s separate state income tax net operating loss will not be realized. The Company has not recognized a deferred tax liability for the undistributed earnings of its foreign subsidiaries that arose in 2016 or 2015 because the Company considers such earnings to be indefinitely reinvested outside of the United States. As of December 31, 2016 and 2015 , the undistributed earnings of such subsidiaries were $11.9 million and $9.0 million , respectively. It is not practicable to estimate the amount of recognized deferred tax liabilities, if any, for these undistributed foreign earnings. The 2016 , 2015 and 2014 current tax provision includes $1.2 million , $0.5 million and $1.0 million , respectively, for income taxes arising from the pre-tax income of the Company’s India subsidiaries. The tax provisions are net of the impact of a tax holiday in India. The Company’s benefits from this tax holiday were $ 0.9 million for the year ended December 31, 2016 , $0.7 million for the year ended December 31, 2015 and $0.5 million for the year ended December 31, 2014 . The tax holiday is set to expire on March 31, 2021. The Company recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained upon examination by taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial statements are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. The Company’s unrecognized tax benefits as of December 31, 2016 , 2015 and 2014 totaled $0.3 million , $1.2 million and $1.1 million , respectively. The following table summarizes the activity related to the unrecognized tax benefits (in thousands): Tax Benefit Unrecognized tax benefits at December 31, 2013 $ 1,302 Increases in positions taken in a current period 66 Increases in positions taken in prior period 94 Decreases in positions taken in a prior period (51 ) Decreases due to lapse of statute of limitations (313 ) Decreases due to settlement — Unrecognized tax benefits at December 31, 2014 $ 1,098 Increases in positions taken in a current period 134 Increases in positions taken in prior period 597 Decreases in positions taken in a prior period — Decreases due to lapse of statute of limitations (587 ) Decreases due to settlement — Unrecognized tax benefits at December 31, 2015 $ 1,242 Increases in positions taken in prior period — Increases in positions taken in a current period 504 Decreases in position taken in prior period (465 ) Decreases due to lapse of statute of limitations — Decreases due to settlement (940 ) Unrecognized tax benefits at December 31, 2016 $ 341 As of December 31, 2016 , approximately $0.3 million of the total gross unrecognized tax benefits represented the amount that, if recognized, would result in an adjustment to the effective income tax rate in future periods. The Company recognizes interest and penalties related to income tax matters as part of income tax expense. The Company recorded adjustments to interest and potential penalties related to these unrecognized tax benefits during 2016 , and in total, as of December 31, 2016 , the Company has recorded a liability for interest and potential penalties of $0.0 million . The Company anticipates changes to the reserves within the next 12 months to be primarily related to interest. The Company believes it has sufficient accruals for contingent tax liabilities. In connection with tax return examinations, contingencies can arise that generally result from different interpretations of tax laws and regulations as they pertain to the amount, timing or inclusion of revenues and expenses in taxable income, or the ability to utilize tax credits to reduce income taxes payable. While it is probable, based on the potential outcome of the Company’s federal and state tax examinations or the expiration of the statute of limitations for specific jurisdictions, that the liability for unrecognized tax benefits may increase or decrease within the next 12 months, the Company does not expect any such change would have a material effect on our financial condition, results of operations or cash flow. The Company and its subsidiaries are subject to U.S. federal income tax as well as income tax of multiple state and foreign jurisdictions. U.S. federal income tax returns since 2011 are currently open for examination. State jurisdictions vary for open tax years. The statute of limitations for most states ranges from three to six years. Local tax authorities have completed their income tax examinations of the Company’s subsidiary in India for fiscal years 2009 and 2010. The proposed adjustments in India have been appealed, and the Company believes the ultimate outcome of these appeals will not result in a material adjustment to its tax liability. Pursuant to the acquisition of a business in May 2006, the sellers, certain of which were former employees of the Company, are obligated to indemnify the Company for federal and state income taxes, including 50% of any interest and penalties incurred, related to periods up to and including the date of the acquisition. The potential amount due to the Company related to this indemnity was $1.3 million as of December 31, 2014 and 2013. As of December 31, 2015, the Company released $1.3 million due to the lapse of the statute of limitations (of which $0.7 million related to interest and penalties). The amount due from the related party was secured by the fair value of shares and cost held by the Company in escrow. The escrow agreement expired on June 15, 2015. The cost and fair value of the shares were $0.8 million and $1.0 million at December 31, 2014 and 2013, respectively. Given that the fair value of the shares was less than the amount due from the related party in 2014 and 2013, the Company recorded a reserve of $0.5 million and $0.3 million , respectively, to reflect the difference between the fair value of the shares and the receivable they securitized. Subsequent to the expiration of the escrow agreement in 2015, the shares held as security by the Company were released to the former sellers.

8.00% Series A Convertible Pref

8.00% Series A Convertible Preferred Stock	12 Months Ended
	Dec. 31, 2016
Temporary Equity Disclosure [Abstract]
8.00% Series A Convertible Preferred Stock	8.00% Series A Convertible Preferred Stock At the close of the Transaction on February 16, 2016 (as described in Note 1), the Company issued to 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. As of December 31, 2016 , the Company had accrued dividends of $4.2 million associated with the Preferred Stock, of which $4.2 million was paid in additional shares of Preferred Stock and $0.0002 million was paid in cash in January 2017. For the year ended December 31, 2016 , the dividends that were paid, or accrued, in additional shares of Preferred Stock totaled $14.4 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. In the event the Company believes that redemption of the Preferred Stock is probable, the Company would be required to accrete changes in the carrying value to the redemption value over the period until the expected redemption date. 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 year ended December 31, 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 Dividends paid/accrued dividends 10,160 14,364 Balance at December 31, 2016 210,160 $ 171,593

Earnings (Loss) Per Share

Earnings (Loss) Per Share	12 Months Ended
	Dec. 31, 2016
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) 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 year ended December 31, 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, RSUs and Preferred Stock. Basic and diluted net income (loss) per common share are calculated as follows (in thousands, except share and per share data): 2016 2015 2014 Basic EPS: Net income (loss) $ 177,071 $ (84,256 ) $ (79,620 ) Less dividends on preferred shares (62,684 ) — — Less income allocated to preferred shareholders (48,955 ) — — Net income (loss) available/(allocated) to common shareholders - basic $ 65,432 $ (84,256 ) $ (79,620 ) Diluted EPS: Net income (loss) 177,071 (84,256 ) (79,620 ) Less dividends on preferred shares (62,684 ) — — Less income allocated to preferred shareholders (48,955 ) — — Net income (loss) available/(allocated) to common shareholders - diluted $ 65,432 $ (84,256 ) $ (79,620 ) Basic weighted-average common shares 100,160,206 96,806,885 95,760,762 Add: Effect of dilutive securities — — — Diluted weighted average common shares 100,160,206 96,806,885 95,760,762 Net income (loss) per common share (basic) $ 0.65 $ (0.87 ) $ (0.83 ) Net income (loss) per common share (diluted) $ 0.65 $ (0.87 ) $ (0.83 ) Because of their anti-dilutive effect, 27,628,093 common share equivalents comprised of stock options, RSAs and RSUs have been excluded from the diluted earnings per share calculation for the year ended December 31, 2016 . Due to the net loss, stock options and RSAs totaling 24,516,198 and 22,401,870 were not included in the computation of diluted income (loss) per share for the years ended December 31, 2015 and 2014 , respectively.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Operating Leases The Company rents office space and equipment under operating leases, primarily for its Chicago corporate office, U.S. shared services centers and India operations. Office space lease terms range from one to 10 years, whereas equipment lease terms range from one to three years. The Company’s leases contain various rent holidays and rent escalation clauses and entitlements for tenant improvement allowances. Lease payments are amortized to expense on a straight-line basis over the lease term. Total rent expense under all operating leases was $ 5.6 million , $ 6.2 million and $ 4.9 million for the years ended December 31, 2016 , 2015 and 2014 , respectively. The aggregate future minimum rental commitments under all noncancelable operating leases having remaining terms in excess of one year as of December 31, 2016 are as follows (in thousands): 2017 5,962 2018 6,365 2019 5,957 2020 5,393 2021 4,198 Thereafter 10,511 Total $ 38,386 Legal Proceedings 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 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 Fair Debt Collection Practices Act 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. On February 23, 2017, the parties reached a settlement in principle and are preparing a motion for pre-approval and class settlement. 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 and other defendants filed motions to dismiss the Third Amended Complaint on March 21, 2016. Those motions were granted with respect to the retaliation claims, but denied with respect to the False Claims Act claims by the federal district court in January 2017. The parties are currently engaged in an initial discovery phase. There is a scheduling conference with the court scheudled for April 5, 2017. The Company believes that it has meritorious defenses to all of the claims in the federal qui tam case, and intends to vigorously defend itself against these claims. The outcomes are not presently determinable. In May 2016, the Company was served with a False Claims Act case brought by 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 ( USA ex rel. Graziosi vs. Accretive Health, Inc. et. al.) . The Second Amended Complaint, which seeks monetary damages, 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. Those motions are now fully briefed and awaiting decision by the federal district court. 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	12 Months Ended
	Dec. 31, 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 13, 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 $437.4 million in connection with these services for the year ended December 31, 2016 . In addition to the revenue recorded related to the execution of the A&R MPSA, the Company recorded revenue from services provided to Ascension of $24.0 million for the year ended December 31, 2016 . At December 31, 2016 , the Company had $14.2 million in current portion of customer liabilities for a related party, consisting of $13.2 million in current accrued service costs and $1.0 million in current customer deposits. The Company had $110.0 million in non-current portion of customer liabilities for a related party related to deferred customer billings as of December 31, 2016 . At December 31, 2016, the Company had $1.8 million in accounts receivable with Ascension. As part of the transition of Ascension personnel to the Company in conjunction with the A&R MPSA, the Company has agreed to reimburse Ascension for certain severance and retention costs related to certain Ascension employees who will not be transitioned to the Company. The Company has accrued $1.7 million in accrued compensation and benefits at December 31, 2016 related to these costs. 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	12 Months Ended
	Dec. 31, 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 December 31, 2016 , the Company had $4.8 million in deferred eligible costs and had no eligible costs deferred at December 31, 2015 . These deferred costs are included in other assets in the accompanying condensed consolidated balance sheets.

Segments and Customer Concentra

Segments and Customer Concentrations	12 Months Ended
	Dec. 31, 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. For the years ended December 31, 2016 , 2015 and 2014 , net services revenue from hospitals affiliated with Ascension accounted for 78% , 45% and 12% of the Company's total net services revenue, respectively. For the year ended December 31, 2016 , Intermountain Healthcare accounted for 15% of the Company's total net services revenue. For the year ended December 31, 2015 , one customer, unaffiliated with Ascension, accounted for 17% of the Company's total net services revenue. For the year ended December 31, 2014 , three different customers, unaffiliated with Ascension, accounted for 71% of the Company's total net services revenue. The Ascension system, through its individual customer contracts with the Company, accounted for 62% , 75% and 76% of the Company’s total deferred customer billings at December 31, 2016 , 2015 and 2014 , respectively. The loss of customers within the Ascension health system would have a material adverse impact on the Company’s operations. The Company did not have a concentration of credit risk within accounts receivable as reported in the consolidated balance sheets with any one large customer at December 31, 2015 or December 31, 2016 .

Quarterly Financial Information

Quarterly Financial Information (Unaudited)	12 Months Ended
	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Information (Unaudited)	Quarterly Financial Information (Unaudited) The following tables provide our Quarterly Condensed Consolidated Statements of Operations (in thousands, except per share data): 1st Quarter Ended March 31, 2nd Quarter Ended June 30, 3rd Quarter Ended September, 30 4th Quarter Ended December 31, 2016 2015 2016 2015 2016 2015 2016 2015 Net services revenue $ 352,193 $ 10,971 $ 8,672 $ 22,085 $ 125,535 $ 15,842 $ 106,157 $ 68,341 Total operating expenses 73,472 60,833 78,423 64,342 64,113 70,685 78,648 57,423 Income (loss) from operations 278,721 (49,862 ) (69,751 ) (42,257 ) 61,422 (54,843 ) 27,509 10,918 Net income (loss) $ 167,403 $ (30,445 ) $ (40,791 ) $ (26,288 ) $ 37,333 $ (32,970 ) $ 13,126 $ 5,447 Net income (loss) per common share Basic $ 0.85 $ (0.32 ) $ (0.45 ) $ (0.27 ) $ 0.18 $ (0.34 ) $ 0.05 $ 0.06 Diluted $ 0.85 $ (0.32 ) $ (0.45 ) $ (0.27 ) $ 0.18 $ (0.34 ) $ 0.05 $ 0.06

Summary of Significant Accoun28

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The consolidated financial statements include the assets, liabilities and results of operations of the Company and its wholly owned subsidiaries. All material intercompany transactions and balances have been eliminated in consolidation. The preparation of financial statements in conformity with the United States generally accepted accounting principles ("GAAP") requires management to make estimates and assumptions that affect the amounts reported in these consolidated financial statements and accompanying notes. Actual results can differ from those estimates.
Segments	Segments Reporting segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker, or decision-making group, relating to resource allocation and performance assessments. All of the Company’s 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. The Company views its operations and manages its business as one operating and reporting segment.
Revenue Recognition	Revenue Recognition Revenue is generally recognized when all of the following criteria are met: (i) persuasive evidence of an arrangement exists, (ii) services have been rendered, (iii) the fee is fixed or determinable and (iv) collectability is reasonably assured. Net service fees, as reported in the consolidated statement of operations and comprehensive income (loss), consist of: (a) RCM services fees and (b) professional service fees earned on a fixed fee, transactional fee or time and materials basis. The Company’s primary source of revenue is RCM services fees. RCM services fees are primarily contingent, but along with fixed fees are generally viewed as one deliverable. To the extent that certain RCM services fees are fixed and not subject to refund, adjustment or concession, such fees are generally recognized as revenue on a straight-line basis over the term of the contract. On a limited basis, the Company enters into contracts with multiple accounting elements which may include a combination of fixed fee or transactional fee elements. The selling price of each element is determined by using management's best estimate of selling price. Revenues are recognized in accordance with the accounting policies for the separate elements. RCM services fees that are contingent in nature are recognized as revenue once all the criteria for revenue recognition are met, which is generally at the end of a contract or other contractual agreement event. Revenue is recognized for RCM services fees upon the contract reaching the end of its stated term (such that the contractual relationship will not continue in its current form) to the extent that: (i) cash has been received for invoiced fees and (ii) there are no disputes at the conclusion of the term of the contract. If fees or services are disputed by a customer at the end of a contract, a settlement agreement entered into with the customer triggers revenue recognition. An other "contractual agreement event" occurs when a renewal, amendment to an existing contract, or other settlement agreement is executed in which the parties reach agreement on prior fees. Revenue is recognized up to the amount covered by such agreements. RCM services fees consist of the following contingent fees: (i) Net Operating Fees and (ii) Incentive Fees. Net Operating Fees The Company generates net operating fees to the extent the Company is able to assist customers in reducing the cost of revenue cycle operations. The Company’s net operating fees consist of: i) gross base fees invoiced to customers; less ii) corresponding costs of customers’ revenue cycle operations which the Company pays pursuant to its RCM agreements, including salaries and benefits for the customers' RCM personnel, and related third-party vendor costs; less iii) any cost savings the Company shares with customers. Net operating fees are recorded as deferred customer billings until the Company recognizes revenue for a customer contract at the end of a contract or reaches an "other contractual agreement event". The amount of unpaid costs of customers’ revenue cycle operations and shared cost savings are reported as accrued service costs within customer liabilities in the consolidated balance sheets. Incentive Fees The Company generates revenue in the form of performance-based fees when the Company improves the customers’ financial or operational metrics. These performance metrics vary by customer contract. However, certain contracts contain a contract-to-date performance metric that is not resolved until the end of the term of the contract. Incentive fees are reported as deferred customer billings only upon cash receipt and until the Company recognizes revenue for a customer at the end of a contract or other contractual agreement event. In some cases, when a customer agreement is extended under an evergreen provision or other amendment, fees may not be considered finalized until the end of the customer relationship. Incentive fees associated with performance metrics which are not resolved until the end of the term of the contract or an "other contractual agreement event" are recorded in deferred customer billings until the Company recognizes revenue. Incentive fees are considered contingent fees.
Customer Liabilities	Customer Liabilities Base fees and fixed fees are billed on a monthly or quarterly basis and incentive fees are billed to customers on a quarterly basis. Generally, base fees are billed in advance of each service period. Customer liabilities include (i) accrued service costs (amounts due and accrued for cost reimbursements net of amounts receivable for base fees from the corresponding customer), (ii) deferred customer billings (net operating fees invoiced or accrued and incentive fees collected that have not met all revenue recognition criteria), (iii) customer deposits (consisting primarily of net operating fees under the Company’s RCM contracts that are paid prior to the service period and amounts due as a refund to our customers on incentive fees) and (iv) deferred revenue (fixed fees amortized to revenue over the service period or fixed or determinable fees that have not met all other revenue recognition criteria). Deferred customer billings are classified as current based on the customer contract end dates or other termination events that fall within twelve months of the balance sheet dates. Accrued service cost, customer deposits and deferred revenue are classified as current or non-current based on the anticipated period in which the liabilities are expected to be settled or the revenue is expected to be recognized.
Consulting Fees, Transaction Fees and Contingent Service Fees	Consulting Fees, Transaction Fees and Contingent Service Fees The Company also generates revenue from fixed-fee arrangements, transactional service contracts and contingent-fee service contracts. Provided all other criteria of revenue recognition are met under Accounting Standards Codification ("ASC") 605, Revenue Recognition, revenue under these arrangements is recognized as services are performed, deliverables are provided and related contingencies are removed. All related direct costs are recorded as period costs when incurred. Such consulting fees, transactional fees and contingent service fees are generated from services such as physician advisory services and other related consulting services.
Cost of Services	Cost of Services Costs associated with generating the Company’s net services revenue, including the cost of operating its shared services centers, are expensed as incurred. Cost of services consist of (i) infused management, on site revenue cycle employees and technology costs, (ii) shared services costs and (iii) other costs to perform physician advisory services. Infused management and technology costs consist primarily of wages, bonuses, benefits, share-based compensation, travel and other costs associated with deploying the Company’s employees at customer sites to help manage the Company’s customers’ revenue cycle operations. The other significant portion of such expenses is an allocation of the costs associated with maintaining, improving and deploying our integrated proprietary technology suite. Shared services costs relate to the Company’s shared services centers in the U.S. and India that perform patient scheduling and pre-registration, medical transcription, cash posting, reconciliation of payments to billing records, patient follow-up and Medicaid eligibility determination for our customers. The Company incurs expenses related to salaries and benefits for employees in its shared services centers and non-payroll costs associated with operating its shared services centers. Other expenses consist of costs related to managing PAS and other services. These expenses consist primarily of wages, bonuses, benefits, share-based compensation and facilities costs.
Comprehensive Income (Loss)	Comprehensive Income (Loss) Comprehensive income (loss) is the net income (loss) of the Company combined with other changes in stockholders’ equity (deficit) not involving ownership interest changes. For the Company, such changes are foreign currency translation adjustments.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents.
Short-term Investments	Short-term Investments At December 31, 2015 the Company's Indian subsidiaries had invested in $1.0 million of time deposits with an original maturity greater than three months. The Company's time deposits were classified as "held-to-maturity" as the Company had both the intent and ability to hold to maturity. The current value was not materially different than the fair value.
Restricted Cash Equivalents	Restricted Cash Equivalents In 2015 and 2016 , restricted cash equivalents represent the amount of certificate of deposits ("CDs"), with a maturity of three months or less, that the Company is unable to access for operational purposes as the CDs collateralize the Company's corporate travel program.
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 services 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.
Property, Equipment and Software	Property, Equipment and Software Property, equipment and software are stated at cost, and related depreciation and amortization are calculated on the straight-line method over the estimated useful lives of the assets. The Company capitalizes qualifying internal and third-party costs and hardware and software costs related to the Company’s software development activities in accordance with GAAP. The Company amortizes the capitalized software development costs over their estimated life on a straight-line basis. The major classifications of property, equipment and software and their expected useful lives are as follows: Computers and other equipment 3 years Leasehold improvements Shorter of 10 years or lease term Office furniture 5 years Software 3 years
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets Property, equipment, software and other acquired intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recoverable. If circumstances require a long-lived asset or asset group be reviewed for possible impairment, the Company first compares undiscounted cash flows expected to be generated by each asset or asset group to its carrying value. If the carrying value of the long-lived asset or asset group is not recoverable on an undiscounted cash flow basis, an impairment charge is recognized to the extent that the carrying value exceeds the fair value.
Income Taxes	Income Taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carry forwards. Deferred tax assets and liabilities are measured using current tax laws and enacted tax rates in effect for the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The Company records a valuation allowance for deferred tax assets if, based upon the weight of all available evidence, both positive and negative, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained upon examination by the tax authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest amount of benefit that has a greater than 50% percent likelihood of being realized upon ultimate settlement. Interest and penalties relating to income taxes are recognized in our income tax provision in the consolidated statements of operations and comprehensive income (loss).
Legal and Other Contingencies	Legal and Other Contingencies In the normal course of business, the Company is subject to regulatory investigations or legal proceedings, as well as demands, claims and threatened litigation. The Company records an estimated loss for any claim, lawsuit, investigation or proceeding when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Significant judgment is required in both the determination of the probability and whether the loss can be reasonably estimated. Actual expenses could differ from such estimates.
Foreign Currency Translation and Transaction Gains (Losses)	Foreign Currency Translation and Transaction Gains (Losses) Assets and liabilities of non-U.S. subsidiaries that operate in a local currency environment, where such local currency is the functional currency, are translated to U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense accounts are translated at average exchange rates during the year which approximates the rates in effect at the transaction dates. The resulting translation adjustments are recorded as a separate component of accumulated other comprehensive income (loss). The Company’s foreign currency transaction gains and losses are included in selling, general and administrative in the accompanying consolidated statements of operations and comprehensive income (loss).
Share-Based Compensation Expense	Share-Based Compensation Expense The Company determines the expense for all employee share-based compensation awards by estimating their fair value and recognizing such value as an expense, on a ratable basis, in the consolidated financial statements over the requisite service period in which the employees earn the awards. The fair value of performance and service condition stock options is calculated using the Black-Scholes option pricing model and, for market condition stock options, the fair value is estimated using Monte Carlo simulations. To determine the fair value of a share-based award using the Black-Scholes option pricing model, the Company makes assumptions regarding the risk-free interest rate, expected future volatility, expected life of the award and expected forfeitures of the awards. These inputs are subjective and generally require significant analysis and judgment to develop. The Company aggregates all employees into one pool based on the grant date for valuation purposes. The risk-free rate is based on the U.S. treasury yield curve in effect at the time of grant. The Company estimates the expected volatility of the share price by reviewing the historical volatility levels of its 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 then projecting this information toward its future expected volatility. The Company exercises judgment in selecting these companies, as well as in evaluating the available historical and implied volatility for these companies. The Company calculates the expected term in years for each stock option using a simplified method based on the average of each option’s vesting term and original contractual term. The Company applies an estimated forfeiture rate derived from its historical data and estimates of the likely future actions of option holders when recognizing the share-based compensation expense of the options. To determine the fair value of a share-based award using Monte Carlo simulations, the Company makes assumptions regarding the risk-free interest rate, expected future volatility, expected dividend yield and performance period. The risk-free rate is based on the U.S. treasury yield curve in effect at the time of grant. The Company estimates the expected volatility of the share price by reviewing the historical volatility levels of its 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 then projecting this information toward its future expected volatility. Dividend yield is determined based on the Company’s future plans to pay dividends. The Company had no plans to do so at December 31, 2016. The Company calculates the performance period based on the specific market condition to be achieved and derived from historical data and estimates of future performance. The Company recognizes compensation expense, net of forfeitures, using a straight-line method over the applicable service or performance period. During each quarter, the share-based compensation expense is adjusted to reflect all expense for options that vested during the period; however, compensation expense already recognized is not adjusted if market conditions are not met. The Company accounts for stock options issued to non-employees based on their estimated fair value determined using the Black-Scholes option pricing model. The stock options issued to non-employees vest over the arrangement period. The fair value of the equity awards granted to non-employees is remeasured on each balance sheet date until the awards vest, and the related expense is adjusted based on the resulting changes in fair value, if any. The non-employee share-based compensation expense is recognized over the performance period, which is the vesting period. Upon vesting, the performance of the non-employee is deemed complete and the vested awards are not subsequently remeasured. The fair value of modifications to share-based awards is generally estimated using the Black-Scholes option pricing model. If a share-based compensation award is modified after the grant date, incremental compensation expense, if any, is recognized in an amount equal to the excess of the fair value of the modified award over the fair value of the original award immediately before the modification. Incremental compensation expense for vested awards is recognized immediately. For unvested awards, the sum of the incremental compensation expense and the remaining unrecognized compensation expense for the original award on the modification date is recognized over the modified service period.
Treasury Stock	Treasury Stock The Company records treasury stock at the cost to acquire such shares, including commissions paid to brokers. Treasury stock is included as a component of stockholders’ equity (deficit).
Earnings (Loss) Per Share	Earnings (Loss) 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 (as defined in Note 8) 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.
Recently Issued Accounting Standards and Disclosures	Recently Issued Accounting Standards and Disclosures 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 two permitted transition methods under the new standard are the full retrospective method, in which case the standard would be applied to each prior reporting period presented and the cumulative effect of applying the standard would be recognized at the earliest period presented, or the modified retrospective method (which we have previously referred to as the cumulative effect method), in which case the cumulative effect of applying the standard would be recognized as of the date of initial application. The Company adopted the standard, effective January 1, 2017, using the modified retrospective method. Under this method, we could elect to apply the cumulative effect method to either all contracts as of the date of initial application or only to contracts that are not complete as of that date. We elected to apply the modified retrospective method to contracts that are not complete as of the date of initial application. As part of adopting the standard, the Company identified two main revenue streams: 1) fees from its end-to-end revenue cycle offering, and 2) fees from its PAS offering. The adoption of the standard is expected to have a material impact on the Company’s consolidated financial statements with the most significant impact being the recognition of revenue at the time services are provided or as the significant uncertainty related to variable fees for incentives is resolved for its end-to-end revenue cycle base and incentive fees. Prior to adopting the standard, the Company recognized these revenues that are contingent in nature when all revenue recognition criteria had been met, which was generally at the end of a contract or other contractual agreement event. Adoption of the standard is not expected to have significant impact on the Company’s PAS revenue stream or its fixed fee arrangements. Additionally, the Company does not anticipate a change in cost capitalization resulting from the application of the fulfillment cost guidance and will continue to capitalize such costs that relate directly to a contract, generate or enhance resources the Company uses to satisfy future performance obligations, and are expected to be recovered, see note 17. The cumulative impact of adopting the standard on January 1, 2017 is an increase in stockholders' equity (deficit), which at December 31, 2016 was $(12.3) million , of between $110 million and $115 million and a decrease to deferred customer billings partially offset by a decrease to deferred tax assets. 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 year ended December 31, 2016, the Company did not enter into any new, material 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 is currently evaluating the impact of the adoption of this prospective guidance on its consolidated financials. 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. Additionally, ASU 2016-09 eliminates additional paid-in capital pools and requires excess tax benefits and tax deficiencies to be recognized as a component of income tax expense rather than equity. Under the new standard, entities can make an accounting policy election to either estimate expected forfeitures or to account for them as they occur. 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 adopted ASU 2016-19 on a prospective basis effective January 1, 2017 and the Company will record forfeitures as they occur rather than estimating expected forfeitures. The Company expects to record the cumulative impact of applying this guidance to retained earnings, which is estimated to increase between $1.0 million and $2.0 million . ASU 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash ("ASU 2016-18"). ASU 2016-18 is intended to reduce diversity in practice in the classification and presentation of changes in restricted cash on the Consolidated Statement of Cash Flows. The ASU requires that the Consolidated Statement of Cash Flows explain the change in total cash and equivalents and amounts generally described as restricted cash or restricted cash equivalents when reconciling the beginning-of-period and end-of-period total amounts. ASU 2016-18 also requires a reconciliation between the total of cash and equivalents and restricted cash presented on the Consolidated Statement of Cash Flows and the cash and equivalents balance presented on the Consolidated Balance Sheet. The guidance is effective for interim and annual periods beginning after December 15, 2017, and early adoption is permitted. The guidance requires application using a retrospective transition method. The Company is currently evaluating the impact of the adoption of this prospective guidance on its consolidated financials.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company records its financial assets and liabilities at fair value. The accounting standard for fair value (i) defines fair value as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the measurement date, (ii) establishes a framework for measuring fair value, (iii) establishes a hierarchy of fair value measurements based upon the ability to observe inputs used to value assets and liabilities, (iv) requires consideration of nonperformance risk and (v) expands disclosures about the methods used to measure fair value. The accounting standard establishes a three-level hierarchy of measurements based upon the reliability of observable and unobservable inputs used to arrive at fair value. Observable inputs are independent market data, while unobservable inputs reflect the Company’s assumptions about valuation. The three levels of the hierarchy are defined as follows: • 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, 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, accrued service costs, accrued compensation and benefits and certain other accrued expenses, approximate their fair values, due to the short-term nature of these instruments. The Company does no t have any financial assets or liabilities that are required to be measured at fair value on a recurring basis.
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 services 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.

Summary of Significant Accoun29

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Property, Equipment and Software, Schedule of Useful Lives	The major classifications of property, equipment and software and their expected useful lives are as follows: Computers and other equipment 3 years Leasehold improvements Shorter of 10 years or lease term Office furniture 5 years Software 3 years

Accounts Receivable and Allow30

Accounts Receivable and Allowance for Doubtful Accounts (Tables)	12 Months Ended
	Dec. 31, 2016
Receivables [Abstract]
Schedule of Allowance for Doubtful Accounts	Movements in the allowance for doubtful accounts are as follows (in thousands): For the Year Ended For the Year Ended December 31, December 31, 2016 2015 (unaudited) Beginning balance $ 99 $ 314 (Recoveries) provision 5 (46 ) Write-offs (38 ) (169 ) Ending balance $ 66 $ 99

Property, Equipment, and Soft31

Property, Equipment, and Software (Tables)	12 Months Ended
	Dec. 31, 2016
Property, Plant and Equipment [Abstract]
Schedule of Property, Equipment, and Software	Property, equipment and software consist of the following (in thousands): December 31, 2016 2015 Computer and other equipment $ 23,291 $ 21,348 Leasehold improvements 16,017 17,851 Software 28,131 22,302 Office furniture 4,867 4,888 Property and equipment and software, gross 72,306 66,389 Less accumulated depreciation and amortization (39,517 ) (39,172 ) Property and equipment and software, net $ 32,789 $ 27,217
Summary of the Allocation of Depreciation and Amortization Expense between Cost of Services and Selling, General and Administrative Expenses	The following table summarizes the allocation of depreciation and amortization expense between cost of services and selling, general and administrative expenses (in thousands): For the Year Ended December 31, 2016 2015 2014 Cost of services $ 9,492 $ 7,536 $ 4,603 Selling, general and administrative 706 926 1,444 Total depreciation and amortization $ 10,198 $ 8,462 $ 6,047

Customer Liabilities (Tables)

Customer Liabilities (Tables)	12 Months Ended
	Dec. 31, 2016
Other Liabilities Disclosure [Abstract]
Schedule of Customer Liabilities	Customer liabilities consist of the following (in thousands): December 31, December 31, 2016 2015 Deferred customer billings, current $ 68,173 $ 130,124 Accrued service costs, current (1) 14,768 70,656 Customer deposits, current (1) 947 1,641 Deferred revenue, current — 95 Current portion of customer liabilities 83,888 202,516 Deferred customer billings, non-current (2) $ 110,032 $ 431,944 Customer deposits, non-current — 533 Deferred revenue, non-current $ 1,000 $ — Non current portion of customer liabilities $ 111,032 $ 432,477 Total customer liabilities $ 194,920 $ 634,993 (1) Includes $13.2 million and $1.0 million in current accrued service costs and customer deposits, respectively, for a related party that are included in the current portion of customer liabilities - related party in the accompanying consolidated balance sheets at December 31, 2016 . (2) Includes $110.0 million in deferred customer billings for a related party that are included in the non-current portion of customer liabilities - related party in the accompanying consolidated balance sheets at December 31, 2016 .

Share-Based Compensation (Table

Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
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 during 2016 , 2015 and 2014 : Year Ended December 31, 2016 2015 2014 Expected dividend yield — — — Risk-free interest rate 1.2% to 2.06% 1.5% to 2.0% 1.9% to 2.2% Expected volatility 45% - 50% 50% 50% Expected term (in years) 5.96 to 6.30 6.25 6.25 to 7.50 Forfeitures 5.68% annually 5.68% annually 5.68% annually
Schedule of Share-based Compensation Expense	Total share-based compensation costs that have been included in the Company’s consolidated statements of operations were as follows (in thousands): Year Ended December 31, 2016 2015 2014 Share-Based Compensation Expense Allocation Details: Cost of services $ 6,137 $ 7,208 $ 6,668 Selling, general and administrative 21,965 24,463 13,503 Other costs 1,828 — 8,761 Total share-based compensation expense (1) $ 29,930 $ 31,671 $ 28,932 (1) Includes $0.1 million , $2.4 million and $1.8 million in share-based compensation expense paid in cash during the years ended December 31, 2016 , 2015 and 2014 , respectively.
Schedule of Stock Option Activity	The following table sets forth a summary of all employee and non-employee option activity under all plans and inducement grants for the years ended December 31, 2016 , 2015 and 2014 : Shares Weighted- Average Exercise Price Weighted- Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (in thousands) Outstanding at January 1, 2014 20,540,273 $ 11.77 7.4 $ 15,673 Granted 4,406,856 8.78 Exercised — — Canceled/forfeited (5,022,724 ) 13.17 Outstanding at December 31, 2014 19,924,405 10.91 6.9 9,444 Granted 2,231,504 5.60 Exercised (1,374,438 ) 1.13 Canceled/forfeited (5,521,205 ) 13.17 Outstanding at December 31, 2015 15,260,266 10.23 7.0 261 Granted 11,186,107 2.39 Exercised (94,240 ) 1.93 Canceled/forfeited (5,933,526 ) 9.22 Outstanding at December 31, 2016 20,418,607 6.26 7.9 256 Outstanding, vested and exercisable at December 31, 2014 9,605,505 $ 11.89 5.9 $ 15,096 Outstanding, vested and exercisable at December 31, 2015 11,879,209 $ 11.73 5.6 $ 9,444 Outstanding, vested and exercisable at December 31, 2016 7,993,168 $ 11.34 5.3 $ 15
Schedule of Restricted Stock Awards Activity	In the third quarter of 2011, the Company began to grant RSAs to its employees. A summary of the activity during the years ended December 31, 2016 , 2015 and 2014 is shown below: Shares Weighted- Average Grant Date Fair Value Outstanding and unvested at January 1, 2014 458,299 $ 11.45 Granted 2,365,000 8.39 Vested (127,084 ) 11.46 Forfeited (218,750 ) 9.40 Outstanding and unvested at December 31, 2014 2,477,465 $ 8.71 Granted 8,994,729 3.34 Vested (1,892,049 ) 5.24 Forfeited (324,213 ) 7.61 Outstanding and unvested at December 31, 2015 9,255,932 $ 4.24 Granted 3,071,876 2.58 Vested (3,361,336 ) 4.37 Forfeited (3,103,760 ) 4.69 Outstanding and unvested at December 31, 2016 5,862,712 $ 3.01
Schedule of Share-based Compensation, Restricted Stock Units Award Activity	In the fourth quarter of 2016, the Company began to grant RSUs to its employees. A summary of the activity during the years ended December 31, 2016 is shown below: Shares Weighted- Average Grant Date Fair Value Outstanding and unvested at December 31, 2015 — $ — Granted 1,361,794 2.35 Vested — — Forfeited (15,020 ) 2.35 Outstanding and unvested at December 31, 2016 1,346,774 $ 2.35

Other (Tables)

Other (Tables)	12 Months Ended
	Dec. 31, 2016
Restructuring and Related Activities [Abstract]
Other Restructuring and Related Costs	Other costs consist of the following (in millions): Year Ended December 31, 2016 2015 2014 Severance and employee benefits $ 3.5 $ 0.6 $ 9.2 Facility charges 1.1 2.6 5.0 Non-cash share based compensation 1.8 — 7.9 Reorganization-related 6.4 3.2 22.1 Restatement costs 1.2 2.5 57.3 Transaction fees (1) 12.7 — — Defined Contribution plan contributions (2) 0.5 — — Strategic Alternative Exploration — 3.8 — Prior year employment tax expense — (0.2 ) 0.9 Office Transformation — — 6.5 Other 14.4 6.1 64.7 Total other $ 20.8 $ 9.3 $ 86.8 (1) Costs related to retention payments and legal fees paid in connection with the closing of the Transaction (see Note 8). (2) Additional contributions to the Company's defined contribution plan for the year ended December 31, 2016.
Reorganization Activity	The Company's reorganization activity was as follows (in thousands): Severance and Employee Benefits Facilities and Other Costs Total Reorganization liability at January 1, 2014 $ 1,143 $ — $ 1,143 Restructuring charges 17,108 5,010 22,118 Cash payments (7,050 ) (3,482 ) (10,532 ) Non-cash charges (7,905 ) (1,370 ) (9,275 ) Reorganization liability at December 31, 2014 $ 3,296 $ 158 $ 3,454 Restructuring charges 596 2,564 3,160 Cash payments (3,575 ) (546 ) (4,121 ) Non-cash charges — — — Reorganization liability at December 31, 2015 $ 317 $ 2,176 $ 2,493 Restructuring charges 5,369 1,080 6,449 Cash payments (2,272 ) (2,731 ) (5,003 ) Non-cash charges (1,800 ) $ — (1,800 ) Reorganization liability at December 31, 2016 $ 1,614 $ 525 $ 2,139

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Domestic and Foreign Components of Income (Loss) Before Income Taxes	The domestic and foreign components of income (loss) before income taxes consist of the following (in thousands): Year Ended December 31, 2016 2015 2014 Domestic $ 292,400 $ (139,058 ) $ (130,945 ) Foreign 5,798 3,245 2,594 Total income (loss) before income taxes $ 298,198 $ (135,813 ) $ (128,351 )
Schedule of Components of Income Tax Expenses (Benefit)	For the years ended December 31, 2016 , 2015 and 2014 , the Company’s current and deferred income tax expense (benefit) attributable to income (loss) from operations are as follows (in thousands): Current Deferred Total Year Ended December 31, 2014 U.S. Federal $ (627 ) $ (42,240 ) $ (42,867 ) State & Local 46 (6,363 ) (6,317 ) Foreign 1,025 (572 ) 453 $ 444 $ (49,175 ) (48,731 ) Year Ended December 31, 2015 U.S. Federal $ 68 $ (43,199 ) $ (43,131 ) State & Local (176 ) (8,468 ) (8,644 ) Foreign 530 (312 ) 218 $ 422 $ (51,979 ) $ (51,557 ) Year Ended December 31, 2016 U.S. Federal $ (210 ) $ 95,613 $ 95,403 State & Local (25 ) 24,977 24,952 Foreign 1,176 (404 ) 772 $ 941 $ 120,186 $ 121,127
Schedule of Effective Income Tax Rate Reconciliation	Reconciliation of the difference between the actual tax rate and the statutory U.S. federal income tax rate is as follows: Year Ended December 31, 2016 2015 2014 Federal statutory tax rate 35 % 35 % 35 % Increase in income tax rate resulting from: State and local income taxes, net of federal tax benefits 5 % 4 % 3 % Other 1 % (1 )% Actual tax rate 41 % 38 % 38 %
Schedule of Net Deferred Tax Assets	The following table sets forth the Company’s net deferred tax assets as of December 31, 2016 and 2015 (in thousands): As of December 31, 2016 2015 Deferred Tax assets: Deferred customer billings 67,935 220,075 Net operating loss carryforwards 70,953 48,201 Share-based compensation 22,905 24,995 Accrued bonus 4,786 2,008 Other reserves 699 606 Alternative minimum tax 1,857 1,537 Other 919 2,446 Fixed assets 238 435 R&D credit 289 189 Charitable contributions 539 534 Stock warrants 72 101 Total gross deferred tax assets 171,192 301,127 Less valuation allowance (1,276 ) (302 ) Net deferred tax asset $ 169,916 $ 300,825
Summary of Activity Related to Unrecognized Tax Benefits	The following table summarizes the activity related to the unrecognized tax benefits (in thousands): Tax Benefit Unrecognized tax benefits at December 31, 2013 $ 1,302 Increases in positions taken in a current period 66 Increases in positions taken in prior period 94 Decreases in positions taken in a prior period (51 ) Decreases due to lapse of statute of limitations (313 ) Decreases due to settlement — Unrecognized tax benefits at December 31, 2014 $ 1,098 Increases in positions taken in a current period 134 Increases in positions taken in prior period 597 Decreases in positions taken in a prior period — Decreases due to lapse of statute of limitations (587 ) Decreases due to settlement — Unrecognized tax benefits at December 31, 2015 $ 1,242 Increases in positions taken in prior period — Increases in positions taken in a current period 504 Decreases in position taken in prior period (465 ) Decreases due to lapse of statute of limitations — Decreases due to settlement (940 ) Unrecognized tax benefits at December 31, 2016 $ 341

8.00% Series A Convertible Pr36

8.00% Series A Convertible Preferred Stock (Tables)	12 Months Ended
	Dec. 31, 2016
Temporary Equity Disclosure [Abstract]
Summary of Preferred Stock Activity	The following summarizes the Preferred Stock activity for the year ended December 31, 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 Dividends paid/accrued dividends 10,160 14,364 Balance at December 31, 2016 210,160 $ 171,593

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	12 Months Ended
	Dec. 31, 2016
Earnings Per Share [Abstract]
Schedule of Earnings (Loss) Per Share, Basic and Diluted	Basic and diluted net income (loss) per common share are calculated as follows (in thousands, except share and per share data): 2016 2015 2014 Basic EPS: Net income (loss) $ 177,071 $ (84,256 ) $ (79,620 ) Less dividends on preferred shares (62,684 ) — — Less income allocated to preferred shareholders (48,955 ) — — Net income (loss) available/(allocated) to common shareholders - basic $ 65,432 $ (84,256 ) $ (79,620 ) Diluted EPS: Net income (loss) 177,071 (84,256 ) (79,620 ) Less dividends on preferred shares (62,684 ) — — Less income allocated to preferred shareholders (48,955 ) — — Net income (loss) available/(allocated) to common shareholders - diluted $ 65,432 $ (84,256 ) $ (79,620 ) Basic weighted-average common shares 100,160,206 96,806,885 95,760,762 Add: Effect of dilutive securities — — — Diluted weighted average common shares 100,160,206 96,806,885 95,760,762 Net income (loss) per common share (basic) $ 0.65 $ (0.87 ) $ (0.83 ) Net income (loss) per common share (diluted) $ 0.65 $ (0.87 ) $ (0.83 )

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Rental Payment for Operating Leases	The aggregate future minimum rental commitments under all noncancelable operating leases having remaining terms in excess of one year as of December 31, 2016 are as follows (in thousands): 2017 5,962 2018 6,365 2019 5,957 2020 5,393 2021 4,198 Thereafter 10,511 Total $ 38,386

Quarterly Financial Informati39

Quarterly Financial Information (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Schedule of Quarterly Financial Information	The following tables provide our Quarterly Condensed Consolidated Statements of Operations (in thousands, except per share data): 1st Quarter Ended March 31, 2nd Quarter Ended June 30, 3rd Quarter Ended September, 30 4th Quarter Ended December 31, 2016 2015 2016 2015 2016 2015 2016 2015 Net services revenue $ 352,193 $ 10,971 $ 8,672 $ 22,085 $ 125,535 $ 15,842 $ 106,157 $ 68,341 Total operating expenses 73,472 60,833 78,423 64,342 64,113 70,685 78,648 57,423 Income (loss) from operations 278,721 (49,862 ) (69,751 ) (42,257 ) 61,422 (54,843 ) 27,509 10,918 Net income (loss) $ 167,403 $ (30,445 ) $ (40,791 ) $ (26,288 ) $ 37,333 $ (32,970 ) $ 13,126 $ 5,447 Net income (loss) per common share Basic $ 0.85 $ (0.32 ) $ (0.45 ) $ (0.27 ) $ 0.18 $ (0.34 ) $ 0.05 $ 0.06 Diluted $ 0.85 $ (0.32 ) $ (0.45 ) $ (0.27 ) $ 0.18 $ (0.34 ) $ 0.05 $ 0.06

Description of Business (Narrat

Description of Business (Narrative) (Details)	Feb. 16, 2016
Accounting Policies [Abstract]
Long term strategic partnership, term	10 years

Summary of Significant Accoun41

Summary of Significant Accounting Policies - Additional Information (Details)	12 Months Ended
	Dec. 31, 2016USD ($)segment	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Accounting Policies [Abstract]
Number of operating segments | segment	1
Number of reportable segments | segment	1
Held-to-maturity securities, current	$ 1,000,000
Restricted cash	1,500,000	$ 1,500,000
Asset impairment	$ 0	$ 0	$ 0

Summary of Significant Accoun42

Summary of Significant Accounting Policies - Property, Equipment and Software (Details)	12 Months Ended
	Dec. 31, 2016
Computers and other equipment
Property, Plant and Equipment [Line Items]
Useful lives	3 years
Leasehold Improvements
Property, Plant and Equipment [Line Items]
Estimated useful lives	Shorter of 10 years or lease term
Leasehold Improvements | Maximum
Property, Plant and Equipment [Line Items]
Useful lives	10 years
Office furniture
Property, Plant and Equipment [Line Items]
Useful lives	5 years
Software
Property, Plant and Equipment [Line Items]
Useful lives	3 years

Recent Accounting Pronounceme43

Recent Accounting Pronouncements (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings (deficit)		$ (304,702)	$ (481,773)
New Accounting Pronouncement, Early Adoption, Effect
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings (deficit)		$ (12,300)
Minimum | Accounting Standards Update 2016-09 | Scenario, Forecast
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings (deficit)	$ 1,000
Minimum | New Accounting Pronouncement, Early Adoption, Effect | Accounting Standards Update 2014-09 | Scenario, Forecast
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings (deficit)	110,000
Decrease to deferred customer billings partially offset by a decrease to deferred tax assets	110,000
Maximum | Accounting Standards Update 2016-09 | Scenario, Forecast
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings (deficit)	2,000
Maximum | New Accounting Pronouncement, Early Adoption, Effect | Accounting Standards Update 2014-09 | Scenario, Forecast
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings (deficit)	115,000
Decrease to deferred customer billings partially offset by a decrease to deferred tax assets	$ 115,000

Fair Value of Financial Instr44

Fair Value of Financial Instruments - Additional Information (Details)	Dec. 31, 2016USD ($)
Fair Value, Measurements, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial liabilities required to be measured at fair value	$ 0

Accounts Receivable and Allow45

Accounts Receivable and Allowance for Doubtful Accounts - Schedule of Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Allowance for Doubtful Accounts Receivable [Roll Forward]
Beginning balance	$ 99	$ 314
(Recoveries) provision	5	(46)	$ (430)
Write-offs	(38)	(169)
Ending balance	$ 66	$ 99	$ 314

Property, Equipment, and Soft46

Property, Equipment, and Software (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property and equipment and software, gross	$ 72,306	$ 66,389
Less accumulated depreciation and amortization	(39,517)	(39,172)
Property and equipment and software, net	32,789	27,217
Write-off fully-depreciated assets no longer in service	9,100
Computer and other equipment
Property, Plant and Equipment [Line Items]
Property and equipment and software, gross	23,291	21,348
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment and software, gross	16,017	17,851
Software
Property, Plant and Equipment [Line Items]
Property and equipment and software, gross	28,131	22,302
Office furniture
Property, Plant and Equipment [Line Items]
Property and equipment and software, gross	$ 4,867	$ 4,888

Allocation of Depreciation and

Allocation of Depreciation and Amortization Expense between Cost of Services and Selling, General and Administrative Expenses (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Total depreciation and amortization	$ 10,198	$ 8,462	$ 6,047
Cost of services
Property, Plant and Equipment [Line Items]
Total depreciation and amortization	9,492	7,536	4,603
Selling, general and administrative
Property, Plant and Equipment [Line Items]
Total depreciation and amortization	$ 706	$ 926	$ 1,444

Customer Liabilities - Schedule

Customer Liabilities - Schedule of Customer Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Related Party Transaction [Line Items]
Deferred customer billings, current	$ 68,173	$ 130,124
Accrued service costs, current	14,768	70,656
Customer deposits, current	947	1,641
Deferred revenue, current	0	95
Current portion of customer liabilities	83,888	202,516
Deferred customer billings, non-current	110,032	431,944
Customer deposits, non-current	0	533
Deferred revenue, non-current	1,000	0
Non current portion of customer liabilities	111,032	432,477
Total customer liabilities	194,920	$ 634,993
Investor
Related Party Transaction [Line Items]
Accrued service costs, current	13,200
Customer deposits, current	1,000
Deferred customer billings, non-current	$ 110,000

Stockholders' Equity (Deficit)

Stockholders' Equity (Deficit) - Additional Information (Details)	Feb. 16, 2016USD ($)$ / sharesshares	Dec. 31, 2016USD ($)Vote$ / sharesshares	Sep. 30, 2016	Dec. 31, 2016USD ($)Vote$ / sharesshares	Dec. 31, 2015USD ($)$ / sharesshares	Dec. 31, 2014USD ($)shares	Nov. 13, 2013USD ($)
Class of Stock [Line Items]
Preferred stock, shares authorized (in shares)		5,000,000		5,000,000
Preferred stock, par or stated value per share (in USD per share) | $ / shares		$ 0.01		$ 0.01
Investment warrants, exercise price (in dollars per share) | $ / shares	$ 3.50
Preferred stock, shares outstanding					0	0
Common stock, par value (in dollars per share) | $ / shares	0.01	$ 0.01		$ 0.01	$ 0.01
Common stock, vote per share | Vote		1		1
Common stock, voting rights				Each outstanding share of common stock is entitled to one vote per share on all matters submitted to a vote by shareholders.
Dividends, common stock | $				$ 0	$ 0	$ 0
Stock repurchase program, authorized amount | $							$ 50,000,000
Stock repurchased during period, shares (in shares)		158,557			0
Stock repurchased during period, value | $		$ 400,000
Treasury stock, shares retired (in shares)				0
Treasury stock, shares (in shares)		4,465,919		4,465,919
Redeemable Convertible Preferred Stock
Class of Stock [Line Items]
Preferred stock, shares issued (in shares)		210,160		210,160	0
Preferred stock, dividend rate			8.00%	8.00%
Preferred stock, par value (in dollars per share) | $ / shares	$ 0.01	$ 0.01		$ 0.01
Preferred stock, issued, value | $				$ 108,909,000
TCP-ASC ACHI Series LLLP | Redeemable Convertible Preferred Stock
Class of Stock [Line Items]
Preferred stock, shares issued (in shares)	200,000
Preferred stock, dividend rate	8.00%			8.00%
Preferred stock, issued, value | $	$ 200,000,000
Long-term purchase commitment, period	10 years
TCP-ASC ACHI Series LLLP | Common Stock
Class of Stock [Line Items]
Class of warrant or right, number of securities called by warrants or rights (in shares) (up to)	60,000,000
Investment warrants, exercise price (in dollars per share) | $ / shares	$ 3.50
Long-term purchase commitment, period	10 years

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details)	1 Months Ended	3 Months Ended					12 Months Ended
	Dec. 31, 2016USD ($)planshares	Jun. 30, 2016USD ($)	Sep. 30, 2015$ / sharesshares	Jun. 30, 2014employee	Mar. 31, 2014	Jun. 30, 2013	Dec. 31, 2016USD ($)plan$ / sharesshares	Dec. 31, 2015USD ($)$ / sharesshares	Dec. 31, 2014USD ($)employee$ / sharesshares	Dec. 31, 2013employeeshares	Aug. 07, 2015$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock incentive plans | plan	2						2
Maximum number of shares issuable under plan (in shares) (up to)	46,374,756						46,374,756
Exercise of vested stock options (in shares)							94,240	1,374,438	0
Restricted stock awarded (in shares)			683,401
Outstanding options (in shares)	20,418,607						20,418,607	15,260,266	19,924,405	20,540,273
Unrecognized share-based compensation expense | $	$ 23,200,000						$ 23,200,000	$ 47,200,000	$ 42,800,000
Unrecognized stock-based compensation expense, weighted-average recognition period							2 years 9 months 18 days	2 years 10 months 24 days	3 years 2 months 12 days
Weighted-average grant date fair value of options granted (in dollars per share) | $ / shares							$ 1.07	$ 2.78	$ 4.40
Total intrinsic value of options exercised | $							$ 100,000	$ 4,900,000	$ 0
Total fair value of options vested | $							$ 15,000,000	$ 14,900,000	$ 22,900,000
Options granted (in shares)							11,186,107	2,231,504	4,406,856
Weighted-average exercise price, granted (in dollars per share) | $ / shares							$ 2.39	$ 5.60	$ 8.78
Treasury stock due to canceled RSA (in shares)	4,465,919						4,465,919
Net increase in share-based compensation as a result of stock awards modification | $		$ 7,000,000						$ 3,100,000
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period							1 year
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period							4 years
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award expiration period (or less)							10 years
Exercise of vested stock options (in shares)								0	0
Employee Stock Option | Key Employees
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding options (in shares)	3,703,801						3,703,801	7,103,801
Non-Qualified Options | Key Employees
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock granted (in shares)									3,400,000	4,703,801
Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock awarded (in shares)							3,071,876	8,994,729	2,365,000
Fair value of restricted stock vested in period | $							$ 14,700,000	$ 9,900,000	$ 1,500,000
Shares paid for tax withholding for share-based compensation (in shares)							996,510	441,537	45,142
Shares paid for tax withholding for share-based compensation, cost | $							$ 2,200,000	$ 1,600,000	$ 400,000
Treasury stock purchases (in shares)							1,529,937
Treasury stock due to canceled RSA (in shares)	3,103,760						3,103,760	324,213	218,750
Vesting triggering event, percent of average share price to grant date stock price							200.00%
Restricted Stock Awards | Key Employees
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restricted stock awarded (in shares)									1,000,000	400,000
Restricted stock, outstanding (in shares)	41,630						41,630	1,399,980
Restricted Stock Awards | Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted (in shares)									500,000
Amended and Restated 2010 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Additional shares authorized (in shares)	17,000,000
2010 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for future grants under the 2010 plan (in shares)	15,581,377						15,581,377
Plan Modification Due to Restructuring Plans | Senior Executive
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Extension of the exercise period for vested options before plan modification					60 days
Net increase in share-based compensation as a result of stock awards modification | $									$ 5,600,000
Extension of the exercise period for vested options, after the effective period of registration statement					60 days
Plan Modification Due to Restructuring Plans | Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Net increase in share-based compensation as a result of stock awards modification | $									2,300,000
Number of employees affected | employee				39						13
Extension of the exercise period for vested options, after the effective period of registration statement				60 days
Plan Modification Due to Transition of CEO Role
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Net increase in share-based compensation as a result of stock awards modification | $									1,500,000
Plan Modification Due to Transition of CEO Role | Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Extension of the exercise period for vested options before plan modification						60 days
Extension of the exercise period for vested options after plan modification						10 years
Plan Modification Due to Retention Equity Awards Granted to COO
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Net increase in share-based compensation as a result of stock awards modification | $							$ 100,000	$ 600,000	900,000
Plan Modification Due to Modification of Award Terms Granted to COO
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Net increase in share-based compensation as a result of stock awards modification | $									$ 200,000
Plan Modification Due to Modification of Award Terms Granted to COO | Employee Stock Option | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Extension of the exercise period for vested options after plan modification									60 days
Plan Modification Due to Modification of Award Terms Granted to COO | Employee Stock Option | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Extension of the exercise period for vested options after plan modification									2 years
Plan Modification Due to Cash Settlement of Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Net increase in share-based compensation as a result of stock awards modification | $									$ 900,000
Number of employees affected | employee									3
2014 Bonus Plan RSA
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Net increase in share-based compensation as a result of stock awards modification | $								$ 1,800,000
2014 Bonus Plan RSA | Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Distributions paid (in dollars per share) | $ / shares			$ 2.66
Trading price per share (in dollars per share) | $ / shares			$ 5.38								$ 2.72

Share-Based Compensation - Blac

Share-Based Compensation - Black Scholes Assumptions (Details)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	45.00%
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividend yield	0.00%	0.00%	0.00%
Risk-free interest rate, minimum	1.20%	1.50%	1.90%
Risk-free interest rate, maximum	2.06%	2.00%	2.20%
Expected volatility		50.00%	50.00%
Expected term		6 years 3 months
Forfeitures	5.68%	5.68%	5.68%
Employee Stock Option | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term	5 years 11 months 16 days		6 years 3 months
Employee Stock Option | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	50.00%
Expected term	6 years 3 months 18 days		7 years 6 months

Share-Based Compensation - Comp

Share-Based Compensation - Compensation Expense Allocation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 29,930	$ 31,671	$ 28,932
Share-based compensation expense paid in cash	100	2,400	1,800
Cost of services
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	6,137	7,208	6,668
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	21,965	24,463	13,503
Other costs
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 1,828	$ 0	$ 8,761

Share-Based Compensation - Stoc

Share-Based Compensation - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Shares
Outstanding at beginning of period (in shares)	15,260,266	19,924,405	20,540,273
Granted (in shares)	11,186,107	2,231,504	4,406,856
Exercised (in shares)	(94,240)	(1,374,438)	0
Canceled/forfeited (in shares)	(5,933,526)	(5,521,205)	(5,022,724)
Outstanding at end of period (in shares)	20,418,607	15,260,266	19,924,405	20,540,273
Outstanding, vested and exercisable at end of period (in shares)	7,993,168	11,879,209	9,605,505
Weighted- Average Exercise Price
Outstanding at beginning of period (in dollars per share)	$ 10.23	$ 10.91	$ 11.77
Granted (in dollars per share)	2.39	5.60	8.78
Exercised (in dollars per share)	1.93	1.13	0
Canceled/forfeited (in dollars per share)	9.22	13.17	13.17
Outstanding at end of period (in dollars per share)	6.26	10.23	10.91	$ 11.77
Outstanding, vested and exercisable at end of period (in dollars per share)	$ 11.34	$ 11.73	$ 11.89
Weighted- Average Remaining Contractual Term (in years)
Outstanding at end of period	7 years 10 months 24 days	7 years	6 years 10 months 24 days	7 years 4 months 24 days
Outstanding, vested and exercisable at end of period	5 years 3 months 18 days	5 years 7 months 6 days	5 years 10 months 24 days
Aggregate Intrinsic Value
Outstanding at end of period	$ 256	$ 261	$ 9,444	$ 15,673
Outstanding, vested and exercisable at end of period	$ 15	$ 9,444	$ 15,096

Share-Based Compensation - Rest

Share-Based Compensation - Restricted Stock Award Activity (Details) - $ / shares	3 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Shares
Granted (in shares)	683,401
Restricted Stock Awards
Shares
Outstanding at beginning of period (in shares)		9,255,932	2,477,465	458,299
Granted (in shares)		3,071,876	8,994,729	2,365,000
Vested (in shares)		(3,361,336)	(1,892,049)	(127,084)
Forfeited (in shares)		(3,103,760)	(324,213)	(218,750)
Outstanding at end of period (in shares)		5,862,712	9,255,932	2,477,465
Weighted- Average Grant Date Fair Value
Outstanding at beginning of period (in dollars per share)		$ 4.24	$ 8.71	$ 11.45
Granted (in dollars per share)		2.58	3.34	8.39
Vested (in dollars per share)		4.37	5.24	11.46
Forfeited (in dollars per share)		4.69	7.61	9.40
Outstanding at end of period (in dollars per share)		$ 3.01	$ 4.24	$ 8.71

Share-Based Compensation - Re55

Share-Based Compensation - Restricted Stock Unit Activity (Details) - $ / shares	3 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2016
Shares
Granted (in shares)	683,401
Restricted Stock Units (RSUs)
Shares
Outstanding at beginning of period (in shares)		0
Granted (in shares)		1,361,794
Vested (in shares)		0
Forfeited (in shares)		(15,020)
Outstanding at end of period (in shares)		1,346,774
Weighted- Average Grant Date Fair Value
Outstanding at beginning of period (in dollars per share)		$ 0
Granted (in dollars per share)		2.35
Vested (in dollars per share)		0
Forfeited (in dollars per share)		2.35
Outstanding at end of period (in dollars per share)		$ 2.35
Vested (in shares)		0

Retirement Plan - Additional In

Retirement Plan - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Compensation and Retirement Disclosure [Abstract]
Maximum employee contributions to the plan, per annum	$ 18,000	$ 18,000	$ 17,500
Company match to 401K contributions made by employee, percent	50.00%
Base compensation that a participant contributes to the plan the company currently matches	3.00%
Company contributions to the plan	$ 700,000	$ 400,000	$ 500,000

Other - Additional Information

Other - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring and Related Activities [Abstract]
Reorganization, restatement, and other non-recurring cost	$ 20.8	$ 9.3	$ 86.8

Other - Other Costs (Details)

Other - Other Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring Cost and Reserve [Line Items]
Severance and employee benefits	$ 3,500	$ 600	$ 9,200
Restructuring charges	6,449	3,160	22,118
Non-cash share based compensation	1,800	0	7,900
Restatement costs	1,200	2,500	57,300
Transaction fees	12,700	0	0
Defined Contribution plan contributions	500	0	0
Strategic Alternative Exploration	0	3,800	0
Prior year employment tax expense	0	(200)	900
Office Transformation	0	0	6,500
Other	14,400	6,100	64,700
Total other	20,800	9,300	86,800
Facility charges
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 1,100	$ 2,600	$ 5,000

Other - Reorganization Liabilit

Other - Reorganization Liability Activity (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring Reserve [Roll Forward]
Reorganization liability, beginning of period	$ 2,493	$ 3,454	$ 1,143
Restructuring charges	6,449	3,160	22,118
Cash payments	(5,003)	(4,121)	(10,532)
Non-cash charges	(1,800)	0	(9,275)
Reorganization liability, end of period	2,139	2,493	3,454
Severance and Employee Benefits
Restructuring Reserve [Roll Forward]
Reorganization liability, beginning of period	317	3,296	1,143
Restructuring charges	5,369	596	17,108
Cash payments	(2,272)	(3,575)	(7,050)
Non-cash charges	(1,800)	0	(7,905)
Reorganization liability, end of period	1,614	317	3,296
Facilities and Other Costs
Restructuring Reserve [Roll Forward]
Reorganization liability, beginning of period	2,176	158	0
Restructuring charges	1,080	2,564	5,010
Cash payments	(2,731)	(546)	(3,482)
Non-cash charges	0	0	(1,370)
Reorganization liability, end of period	$ 525	$ 2,176	$ 158

Income Taxes - Domestic and For

Income Taxes - Domestic and Foreign Components of Income (Loss) Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Domestic	$ 292,400	$ (139,058)	$ (130,945)
Foreign	5,798	3,245	2,594
Income (loss) before income tax provision	$ 298,198	$ (135,813)	$ (128,351)

Income Taxes - Current and Defe

Income Taxes - Current and Deferred Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Current
Current U.S. Federal Tax Expense (Benefit)	$ (210)	$ 68	$ (627)
Current State and Local Tax Expense (Benefit)	(25)	(176)	46
Current Foreign Tax Expense (Benefit)	1,176	530	1,025
Current Income Tax Expense (Benefit)	941	422	444
Deferred
Deferred Federal Income Tax Expense (Benefit)	95,613	(43,199)	(42,240)
Deferred State and Local Income Tax Expense (Benefit)	24,977	(8,468)	(6,363)
Deferred Foreign Income Tax Expense (Benefit)	(404)	(312)	(572)
Deferred Income Tax Expense (Benefit)	120,186	(51,979)	(49,175)
Total
Federal Income Tax Expense (Benefit), Continuing Operations	95,403	(43,131)	(42,867)
State and Local Income Tax Expense (Benefit), Continuing Operations	24,952	(8,644)	(6,317)
Foreign Income Tax Expense (Benefit), Continuing Operations	772	218	453
Income Tax Expense (Benefit), Continuing Operations	$ 121,127	$ (51,557)	$ (48,731)

Income Taxes - Effective Income

Income Taxes - Effective Income Tax Rate Reconciliation (Details)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Federal statutory tax rate	35.00%	35.00%	35.00%
Increase in income tax rate resulting from:
State and local income taxes, net of federal tax benefits	5.00%	4.00%	3.00%
Other	1.00%	(1.00%)
Actual tax rate	41.00%	38.00%	38.00%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Taxes Disclosure [Line Items]
Income tax expense	$ 121,127	$ (51,557)	$ (48,731)
Valuation allowances	1,276	302
Undistributed earnings of foreign subsidiary	11,900	9,000
Current tax provision	941	422	444
Unrecognized tax benefits	341	1,242	1,098	$ 1,302
Unrecognized tax benefits that would impact effective tax rate	300
Unrecognized tax benefits, interest and potential penalties liabilities	$ 0
Statute of limitations minimum	3 years
Statute of limitations maximum	6 years
Decreases due to lapse of statute of limitations	$ 0	587	313
Fair value of shares held in escrow			800	1,000
Acquisition of a business in May 2006
Income Taxes Disclosure [Line Items]
Reserve recorded			500	300
Affiliated Entity
Income Taxes Disclosure [Line Items]
Percentage of interest and penalties indemnified	50.00%
Due from related parties			1,300	$ 1,300
Decreases due to lapse of statute of limitations		1,300
Corrected State Statutory Rate | Restatement Adjustment
Income Taxes Disclosure [Line Items]
Income tax expense			2,400
U.S. federal
Income Taxes Disclosure [Line Items]
Net operating carryforwards	$ 181,200
State and Local Jurisdiction
Income Taxes Disclosure [Line Items]
Net operating carryforwards	185,800
INDIA
Income Taxes Disclosure [Line Items]
Current tax provision	1,200	500	1,000
Benefit from tax holiday	$ 900	$ 700	$ 500

Income Taxes - Net Deferred Tax

Income Taxes - Net Deferred Tax Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred Tax assets:
Deferred customer billings	$ 67,935	$ 220,075
Net operating loss carryforwards	70,953	48,201
Share-based compensation	22,905	24,995
Accrued bonus	4,786	2,008
Other reserves	699	606
Alternative minimum tax	1,857	1,537
Other	919	2,446
Fixed assets	238	435
R&D credit	289	189
Charitable contributions	539	534
Stock warrants	72	101
Total gross deferred tax assets	171,192	301,127
Less valuation allowance	(1,276)	(302)
Net deferred tax asset	$ 169,916	$ 300,825

Income Taxes - Uncertain Tax Po

Income Taxes - Uncertain Tax Positions (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, beginning balance	$ 1,242	$ 1,098	$ 1,302
Increases in positions taken in a current period	504	134	66
Increases in positions taken in prior period	0	597	94
Decreases in positions taken in a prior period	(465)	0	(51)
Decreases due to lapse of statute of limitations	0	(587)	(313)
Decreases due to settlement	(940)	0	0
Unrecognized tax benefits, ending balance	$ 341	$ 1,242	$ 1,098

8.00% Series A Convertible Pr66

8.00% Series A Convertible Preferred Stock - Additional Information (Details) - USD ($)	Feb. 16, 2016	Jan. 31, 2017	Sep. 30, 2016	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Temporary Equity [Line Items]
Common stock, par value (in dollars per share)	$ 0.01			$ 0.01	$ 0.01
Investment warrants, exercise price (in dollars per share)	$ 3.50
Closing fees paid to investor				$ 1,200,000	$ 2,500,000	$ 57,300,000
Accrued dividends payable to Preferred Stockholders				4,203,000	$ 0	$ 0
Dividends paid to preferred shareholders paid in stock				$ 48,320,000
Subsequent Event
Temporary Equity [Line Items]
Dividends paid to preferred shareholders paid in stock		$ 4,200,000
Dividends paid to preferred shareholders paid in cash		$ 200
Redeemable Convertible Preferred Stock
Temporary Equity [Line Items]
Preferred stock, shares issued (in shares)				210,160	0
Preferred stock, issued, value				$ 108,909,000
Beneficial conversion feature	$ 48,300,000
Preferred stock, dividend rate			8.00%	8.00%
Liquidation preference per share (in dollars per share)				$ 1,000
Dividends, paid-in-kind, period				7 years
Accrued dividends payable to Preferred Stockholders				$ 4,200,000
Liquidation preference and dividends accrued				$ 14,400,000
Redeemable Convertible Preferred Stock | TCP-ASC ACHI Series LLLP
Temporary Equity [Line Items]
Preferred stock, shares issued (in shares)	200,000
Preferred stock, issued, value	$ 200,000,000
Long-term purchase commitment, period	10 years
Direct and incremental fees	$ 21,300,000
Closing fees paid to investor	$ 14,000,000
Preferred stock, dividend rate	8.00%			8.00%
Common Stock | TCP-ASC ACHI Series LLLP
Temporary Equity [Line Items]
Long-term purchase commitment, period	10 years
Class of warrant or right, number of securities called by warrants or rights (in shares) (up to)	60,000,000
Investment warrants, exercise price (in dollars per share)	$ 3.50

8.00% Series A Convertible Pr67

8.00% Series A Convertible Preferred Stock - Schedule of Preferred Stock Activity (Details) - Redeemable Convertible Preferred Stock $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)shares
Shares Issued and Outstanding
Beginning Balance (in shares) | shares	0
Issuance of preferred stock (in shares) | shares	200,000
Dividends paid/accrued dividends (in shares) | shares	10,160
Ending Balance (in shares) | shares	210,160
Carrying Value
Beginning Balance, Carrying Value	$ 0
Issuance of preferred stock	108,909
Beneficial conversion feature deemed dividend	48,320
Dividends paid/accrued dividends	14,364
Ending Balance, Carrying Value	$ 171,593

Earnings (Loss) Per Share - Com

Earnings (Loss) Per Share - Computation of Basic Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Earnings Per Share Reconciliation [Abstract]
Net income (loss)	$ 13,126	$ 37,333	$ (40,791)	$ 167,403	$ 5,447	$ (32,970)	$ (26,288)	$ (30,445)	$ 177,071	$ (84,256)	$ (79,620)
Less dividends on preferred shares									(62,684)	0	0
Less income allocated to preferred shareholders									(48,955)	0	0
Net income (loss) available/(allocated) to common shareholders - basic									65,432	(84,256)	(79,620)
Less income allocated to preferred shareholders									(48,955)	0	0
Net income (loss) available/(allocated) to common shareholders - diluted									$ 65,432	$ (84,256)	$ (79,620)
Basic weighted-average common shares (in shares)									100,160,206	96,806,885	95,760,762
Add: Effect of dilutive securities (in shares)									0	0	0
Diluted weighted-average common shares (in shares)									100,160,206	96,806,885	95,760,762
Net income (loss) per common share (basic) (in dollars per share)	$ 0.05	$ 0.18	$ (0.45)	$ 0.85	$ 0.06	$ (0.34)	$ (0.27)	$ (0.32)	$ 0.65	$ (0.87)	$ (0.83)
Net income (loss) per common share (diluted) (in dollars per share)	$ 0.05	$ 0.18	$ (0.45)	$ 0.85	$ 0.06	$ (0.34)	$ (0.27)	$ (0.32)	$ 0.65	$ (0.87)	$ (0.83)

Earnings (Loss) Per Share - Add

Earnings (Loss) Per Share - Additional Information (Details) - shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share (in share)	27,628,093	24,516,198	22,401,870

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Commitments and Contingencies [Line Items]
Total rent expense under operating leases	$ 5.6	$ 6.2	$ 4.9
Minimum | Office space
Commitments and Contingencies [Line Items]
Lease term	1 year
Minimum | Other equipment
Commitments and Contingencies [Line Items]
Lease term	1 year
Maximum | Office space
Commitments and Contingencies [Line Items]
Lease term	10 years
Maximum | Other equipment
Commitments and Contingencies [Line Items]
Lease term	3 years

Commitments and Contingencies71

Commitments and Contingencies - Operating Leases (Details) $ in Thousands	Dec. 31, 2016USD ($)
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]
2,017	$ 5,962
2,018	6,365
2,019	5,957
2,020	5,393
2,021	4,198
Thereafter	10,511
Total	$ 38,386

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details) - USD ($)	Feb. 16, 2016	Sep. 30, 2016	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Related Party Transaction [Line Items]
Revenue from related parties			$ 461,400,000	$ 0	$ 0
Current customer deposits			947,000	1,641,000
Accounts receivable with Ascension			1,831,000	$ 0
A&R MPSA Services
Related Party Transaction [Line Items]
Revenue from related parties			437,400,000
Accrued compensation and benefits			1,700,000
Sales Revenue, Net
Related Party Transaction [Line Items]
Revenue from related parties			24,000,000
Investor
Related Party Transaction [Line Items]
Current portion of customer liabilities			14,200,000
Current accrued service costs			13,200,000
Current customer deposits			1,000,000
Deferred customer billings, non-current			$ 110,000,000
Redeemable Convertible Preferred Stock
Related Party Transaction [Line Items]
Preferred stock, dividend rate, percentage		8.00%	8.00%
Redeemable Convertible Preferred Stock | TCP-ASC ACHI Series LLLP
Related Party Transaction [Line Items]
Preferred stock, dividend rate, percentage	8.00%		8.00%
Redeemable Convertible Preferred Stock | TCP-ASC ACHI Series LLLP | Investor
Related Party Transaction [Line Items]
Preferred stock, dividend rate, percentage			8.00%

Deferred Contract Costs - Addit

Deferred Contract Costs - Additional Information (Details) - USD ($)	Dec. 31, 2016	Dec. 31, 2015
Other Assets
Guarantor Obligations [Line Items]
Deferred Costs	$ 4,800,000	$ 0

Segments and Customer Concent74

Segments and Customer Concentrations - Additional Information (Details)	12 Months Ended
	Dec. 31, 2016segment	Dec. 31, 2015customer	Dec. 31, 2014customer
Segment Reporting Information [Line Items]
Number of reportable segments | segment	1
Sales Revenue, Services, Net | Customer Concentration Risk | Intermountain Healthcare
Segment Reporting Information [Line Items]
Concentration percentage	15.00%
Sales Revenue, Services, Net | Customer Concentration Risk | One Customer Note Affiliated with Ascension Health
Segment Reporting Information [Line Items]
Concentration percentage		17.00%
Number of individual customers		1
Sales Revenue, Services, Net | Customer Concentration Risk | Three Customers Unaffiliated with Ascension Health
Segment Reporting Information [Line Items]
Concentration percentage			71.00%
Number of individual customers		3	3
Sales Revenue, Services, Net | Customer Concentration Risk | Ascension
Segment Reporting Information [Line Items]
Concentration percentage	78.00%	45.00%	12.00%
Deferred customer billings | Customer Concentration Risk | The large health system
Segment Reporting Information [Line Items]
Concentration percentage	62.00%	75.00%	76.00%

Quarterly Financial Informati75

Quarterly Financial Information (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Quarterly Financial Information Disclosure [Abstract]
Net services revenue	$ 106,157	$ 125,535	$ 8,672	$ 352,193	$ 68,341	$ 15,842	$ 22,085	$ 10,971	$ 592,557	$ 117,239	$ 210,140
Total operating expenses	78,648	64,113	78,423	73,472	57,423	70,685	64,342	60,833	294,656	253,283	338,793
Income (loss) from operations	27,509	61,422	(69,751)	278,721	10,918	(54,843)	(42,257)	(49,862)	297,901	(136,044)	(128,653)
Net income (loss)	$ 13,126	$ 37,333	$ (40,791)	$ 167,403	$ 5,447	$ (32,970)	$ (26,288)	$ (30,445)	$ 177,071	$ (84,256)	$ (79,620)
Net income (loss) per common share:
Basic (in dollars per share)	$ 0.05	$ 0.18	$ (0.45)	$ 0.85	$ 0.06	$ (0.34)	$ (0.27)	$ (0.32)	$ 0.65	$ (0.87)	$ (0.83)
Diluted (in dollars per share)	$ 0.05	$ 0.18	$ (0.45)	$ 0.85	$ 0.06	$ (0.34)	$ (0.27)	$ (0.32)	$ 0.65	$ (0.87)	$ (0.83)