USMD Inactive 10-K15 Apr 142013 FY Annual reportFinancial data

Company Profile

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
Document and Entity Information (USD $)	Dec. 31, 2013	Mar. 25, 2014	Jun. 30, 2013
Document Information [Line Items]	'	'	'
Document Type	'10-K	'	'
Amendment Flag	'false	'	'
Document Period End Date	31-Dec-13	'	'
Document Fiscal Year Focus	'2013	'	'
Document Fiscal Period Focus	'FY	'	'
Trading Symbol	'USMD	'	'
Entity Registrant Name	'USMD Holdings, Inc.	'	'
Entity Central Index Key	'0001507881	'	'
Current Fiscal Year End Date	'--12-31	'	'
Entity Well-known Seasoned Issuer	'No	'	'
Entity Current Reporting Status	'Yes	'	'
Entity Voluntary Filers	'No	'	'
Entity Filer Category	'Smaller Reporting Company	'	'
Entity Common Stock, Shares Outstanding	'	10,129,155	'
Entity Public Float	'	'	$36,361,139

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Dec. 31, 2013		Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
Current assets:	'		'
Cash and cash equivalents	$13,137	[1]	$6,878	[1]
Restricted cash	5,000	[1]	5,000	[1]
Accounts receivable, net of allowance for doubtful accounts of $1,758 and $1,127 at December 31, 2013 and 2012, respectively	23,970	[1]	20,615	[1]
Inventories	1,580	[1]	782	[1]
Deferred tax assets	742	[1]	729	[1]
Prepaid expenses and other current assets	3,177	[1]	2,584	[1]
Total current assets	47,606	[1]	36,588	[1]
Property and equipment, net	23,491	[1]	26,203	[1]
Investments in nonconsolidated affiliates	61,822	[1]	35,892	[1]
Goodwill	118,176	[1]	118,261	[1]
Intangible assets, net	27,033	[1]	28,786	[1]
Other assets	324	[1]	386	[1]
Total assets	278,452	[1]	246,116	[1]
Current liabilities:	'		'
Accounts payable	2,500	[2]	3,318	[2]
Accrued payroll	12,599	[2]	9,813	[2]
Other accrued liabilities	10,757	[2]	5,867	[2]
Other current liabilities	1,059	[2]	1,115	[2]
Revolving credit facility	3,000	[2]	0	[2]
Current portion of long-term debt	4,473	[2]	4,639	[2]
Current portion of related party long-term debt	650	[2]	594	[2]
Current portion of capital lease obligations	369	[2]	287	[2]
Total current liabilities	35,407	[2]	25,633	[2]
Other long-term liabilities	1,485	[2]	1,300	[2]
Deferred compensation payable	4,641	[2]	4,898	[2]
Long-term debt, less current portion	33,939	[2]	16,754	[2]
Related party long-term debt, less current portion	3,084	[2]	3,734	[2]
Capital lease obligations, less current portion	683	[2]	561	[2]
Deferred tax liabilities	23,688	[2]	23,789	[2]
Total liabilities	102,927	[2]	76,669	[2]
Commitments and contingencies	'		'
USMD Holdings, Inc. stockholders' equity:	'		'
Preferred stock, $0.01 par value, 1,000,000 shares authorized; none issued	'		'
Common stock, $0.01 par value, 49,000,000 shares authorized; 10,121,462 and 10,033,500 shares issued and outstanding at December 31, 2013 and 2012, respectively	101		100
Additional paid-in capital	158,360		153,444
Retained earnings	13,650		12,671
Accumulated other comprehensive loss	-2		-16
Total USMD Holdings, Inc. stockholders' equity	172,109		166,199
Noncontrolling interests in subsidiaries	3,416		3,248
Total equity	175,525		169,447
Total liabilities and equity	$278,452		$246,116

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.
[2]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parenthetical) (USD $)	Dec. 31, 2013		Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
Allowance for doubtful accounts receivable	$1,758		$1,127
Preferred stock, par value	$0.01		$0.01
Preferred stock, shares authorized	1,000,000		1,000,000
Preferred stock, issued	'		'
Common stock, par value	$0.01		$0.01
Common stock, shares authorized	49,000,000		49,000,000
Common stock, shares issued	10,121,462		10,033,500
Common stock, shares outstanding	10,121,462		10,033,500
Cash and cash equivalents	13,137	[1]	6,878	[1]
Accounts receivable	23,970	[1]	20,615	[1]
Total current assets	47,606	[1]	36,588	[1]
Total assets	278,452	[1]	246,116	[1]
Other accrued liabilities	10,757	[2]	5,867	[2]
Total current liabilities	35,407	[2]	25,633	[2]
Variable Interest Entity, Primary Beneficiary	'		'
Cash and cash equivalents	1,257		'
Accounts receivable	175		'
Total current assets	1,432		'
Deferred tax asset	671		'
Total assets	2,103		'
Other accrued liabilities	2,108		'
Total current liabilities	$2,108		'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.
[2]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Consolidated_Statements_of_Ope

Consolidated Statements of Operations (USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Revenue:	'	'
Patient service revenue	$181,087	$60,309
Provision for doubtful accounts related to patient service revenue	-2,801	-889
Net patient service revenue	178,286	59,420
Capitated revenue	9,524	656
Management and other services revenue	25,536	23,400
Lithotripsy revenue	21,381	22,226
Net operating revenue	234,727	105,702
Operating expenses:	'	'
Salaries, wages and employee benefits	153,999	62,694
Medical supplies and services expense	29,199	7,060
Rent expense	15,034	5,086
Provision for doubtful accounts	70	107
Other operating expenses	27,464	15,711
Electronic Health Record incentive income	-1,643	-474
Depreciation and amortization	7,626	3,302
Total operating expenses	231,749	93,486
Income from operations	2,978	12,216
Other income (expense):	'	'
Interest expense, net	-1,975	-1,013
Equity in income of nonconsolidated affiliates, net	9,769	3,807
Other gain, net	29	230
Total other income, net	7,823	3,024
Income before provision for income taxes	10,801	15,240
Provision for income taxes	71	1,487
Net income	10,730	13,753
Less: net income attributable to noncontrolling interests	-9,751	-11,653
Net income attributable to USMD Holdings, Inc.	$979	$2,100
Earnings per share attributable to USMD Holdings, Inc.	'	'
Basic	$0.10	$0.37
Diluted	$0.10	$0.37
Weighted average common shares outstanding	'	'
Basic	10,080	5,739
Diluted	10,084	5,744

Consolidated_Statements_of_Com

Consolidated Statements of Comprehensive Income (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Net income	$10,730	$13,753
Other comprehensive income, net of tax:	'	'
Foreign currency translation adjustments, net of tax	14	3
Total other comprehensive income	14	3
Comprehensive income	10,744	13,756
Less: comprehensive income attributable to noncontrolling interests	-9,751	-11,653
Comprehensive income attributable to USMD Holdings, Inc. common stockholders	$993	$2,103

Consolidated_Statement_of_Stoc

Consolidated Statement of Stockholders' Equity (USD $)	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings	Treasury Stock	Total USMD Holdings Inc.	Noncontrolling Interests in Subsidiaries
In Thousands, except Share data	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings	Treasury Stock	Total USMD Holdings Inc.	Noncontrolling Interests in Subsidiaries
Beginning balance at Dec. 31, 2011	$21,448	$36	$7,678	($19)	$10,571	($1,184)	$17,082	$4,366
Beginning balance (in shares) at Dec. 31, 2011	'	3,587,000	'	'	'	-154,000	'	'
Net income	13,753	'	'	'	2,100	'	2,100	11,653
Other comprehensive income	3	'	'	3	'	'	3	'
Share-based payment expense	872	'	872	'	'	'	872	'
Consolidation of investee	209	'	'	'	'	'	'	209
Issuance of common stock in in connection with the private placement offering (in shares)	'	42,000	'	'	'	'	'	'
Issuance of common stock in in connection with the private placement offering	980	0	980	'	'	'	980	'
Common stock issued for acquisition of businesses (in shares)	'	6,405,000	'	'	'	154,000	'	'
Common stock issued for acquisition of businesses	144,215	64	143,914	'	'	1,184	145,162	-947
Capital contributions from noncontrolling shareholders	597	'	'	'	'	'	'	597
Distributions to noncontrolling shareholders	-12,630	'	'	'	'	'	'	-12,630
Ending balance at Dec. 31, 2012	169,447	100	153,444	-16	12,671	'	166,199	3,248
Ending balance (in shares) at Dec. 31, 2012	'	10,034,000	'	'	'	'	'	'
Net income	10,730	'	'	'	979	'	979	9,751
Other comprehensive income	14	'	'	14	'	'	14	'
Share-based payment expense-stock options	933	'	933	'	'	'	933	'
Share-based payment expense-common stock (in shares)	'	24,000	'	'	'	'	'	'
Share-based payment expense-common stock	580	'	580	'	'	'	580	'
Common stock issued for share-based payment awards exercised (in shares)	12,074	12,000	'	'	'	'	'	'
Common stock issued for share-based payment awards exercised	200	'	200	'	'	'	200	'
Common stock issued for acquisition of businesses (in shares)	'	4,000	'	'	'	'	'	'
Common stock issued for acquisition of businesses	133	'	133	'	'	'	133	'
Common stock issued for payment of accrued liabilities (in shares)	'	47,000	'	'	'	'	'	'
Common stock issued for payment of accrued liabilities	647	1	646	'	'	'	647	'
Beneficial conversion debt discount on Convertible Subordinated Notes	3,729	'	3,729	'	'	'	3,729	'
Tax effect of beneficial conversion debt discount on Convertible Subordinated Notes	-1,305	'	-1,305	'	'	'	-1,305	'
Capital contributions from noncontrolling shareholders	530	'	'	'	'	'	'	530
Distributions to noncontrolling shareholders	-10,113	'	'	'	'	'	'	-10,113
Ending balance at Dec. 31, 2013	$175,525	$101	$158,360	($2)	$13,650	'	$172,109	$3,416
Ending balance (in shares) at Dec. 31, 2013	'	10,121,000	'	'	'	'	'	'

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
Cash flows from operating activities:	'		'
Net income	$10,730		$13,753
Adjustments to reconcile net income to net cash provided by operating activities:	'		'
Provision for doubtful accounts	2,871		996
Depreciation and amortization of property and equipment	5,835		2,680
Amortization of intangible assets and debt issuance costs	1,986		673
Accretion of debt discount	226		'
(Gain) loss on sale or disposal of assets, net	66		-103
Equity in income of nonconsolidated affiliates, net	-9,769		-3,807
Distributions from nonconsolidated affiliates	8,395		1,737
Share-based payment expense	1,513		872
Recovery of investments in nonconsolidated affiliates	'		-134
Deferred income tax provision (benefit)	-1,163		1,229
Change in operating assets and liabilities, net of effects of business combinations and initial consolidation of investee:	'		'
Accounts receivable	-6,226		-1,973
Inventories	-787		-90
Prepaid expenses and other assets	-593		-614
Current liabilities	7,554		-9,189
Other noncurrent liabilities	283		-38
Net cash provided by operating activities	20,921		5,992
Cash flows from investing activities:	'		'
Cash acquired in business combinations	'		6,967
Capital expenditures	-2,848		-1,311
Investments in nonconsolidated affiliates	-200		-77
Proceeds from sale of life insurance policies	'		3,184
Proceeds from sale of property and equipment	64		106
Increase in cash due to initial consolidation of investee	'		50
Net cash provided by (used in) investing activities	-2,984		8,919
Cash flows from financing activities:	'		'
Borrowings on revolving credit facility	3,000		'
Proceeds from issuance of long-term debt	530		21,124
Payments on long-term debt and capital lease obligations	-5,098		-20,996
Principal payments on related party long-term debt	-594		-2,930
Restricted cash	'		-5,000
Issuance of USMD common stock	'		980
Payment of debt issuance costs	-133		'
Proceeds from exercise of stock options	200		'
Capital contributions from noncontrolling interests	530		597
Distributions to noncontrolling interests	-10,113		-12,630
Net cash used in financing activities	-11,678		-18,855
Net increase (decrease) in cash and cash equivalents	6,259		-3,944
Cash and cash equivalents at beginning of year	6,878	[1]	10,822
Cash and cash equivalents at end of year	13,137	[1]	6,878	[1]
Supplemental non-cash investing and financing information:	'		'
Other liabilities financed	461		1,335
Liabilities paid in common stock	646		'
Equipment acquired through debt financing	491		'
Record convertible debt beneficial conversion discount, net of tax	2,424		'
Investment in nonconsolidated affiliate financed with debt	24,342		'
Fair value of common stock issued in business combinations	133		158,115
Equipment acquired included in other liabilities	'		461
Fair value of assets acquired in the Contribution, excluding cash	'		201,126
Fair value of liabilities assumed in the Contribution	'		49,498
Fair value of stock options issued in the Contribution	'		480
Cash paid for-	'		'
Interest, net of related parties	1,203		367
Interest to related parties	365		561
Income tax	1,559		581
Cash received for- Income tax refund	$909		$13

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Description_of_Business_and_Ba

Description of Business and Basis of Presentation	12 Months Ended
Description of Business and Basis of Presentation	Dec. 31, 2013
Description of Business and Basis of Presentation	'
	Note 1 – Description of Business and Basis of Presentation
	Description of Business:
	USMD Holdings, Inc. (“Holdings” or the “Company”) is a Delaware corporation formed on May 7, 2010 to facilitate the business combination of USMD Inc., a Texas corporation (“USMD”), Urology Associates of North Texas, L.L.P., a Texas limited liability partnership (“UANT”), and UANT Ventures, L.L.P., a Texas limited liability partnership (“Ventures”) (such transaction, the “Contribution”). Holdings described this transaction in its Registration Statement on Form S-4 (as amended, the “Registration Statement”) filed with the Securities and Exchange Commission (the “SEC”). Prior to the consummation of the Contribution, on December 1, 2011, Ventures and Holdings entered into a merger agreement with The Medical Clinic of North Texas, P.A., a Texas professional association (“MCNT”), and on December 15, 2011, Ventures and Holdings entered into a merger agreement with Impel Management Services, L.L.C., a Texas limited liability company (“Impel”), pursuant to which the businesses of MCNT and Impel were merged into subsidiaries of Ventures immediately prior to the Contribution, and these businesses were contributed by Ventures to Holdings as part of the Contribution. Holdings described these transactions in a post-effective amendment to its Registration Statement filed with the SEC on February 10, 2012, which was declared effective on April 30, 2012. Effective August 31, 2012, Holdings and the other parties consummated the Contribution (see Note 3).
	The Company is an innovative early-stage physician-led integrated health system. Through its subsidiaries and affiliates, the Company provides health care services to patients in physician clinics, hospitals and other health care facilities, and the Company also provides management and operational services to hospitals and other healthcare service providers. An integrated health system is considered early-stage when it has not yet established all the components necessary to be considered a fully integrated health system.
	A wholly owned subsidiary of the Company is the sole member of a Texas certified non-profit healthcare organization that owns and operates a multi-specialty physician group practice (“USMD Physician Services”) in the Dallas-Fort Worth, Texas metropolitan area. Through other wholly owned subsidiaries, the Company provides management and operational services to two short-stay hospitals in the Dallas-Fort Worth, Texas metropolitan area and provides management and/or operational services to six cancer treatment centers in five states and 21 lithotripsy service providers primarily located in the South-Central United States. Of these managed entities, the Company has ownership interests in the two hospitals, two cancer treatment centers and 20 lithotripsy service providers. The Company also wholly owns and operates two clinical laboratories, one anatomical pathology laboratory, one cancer treatment center and one lithotripsy service provider in the Dallas-Fort Worth, Texas metropolitan area.
	Basis of Presentation:
	The consolidated financial statements of the Company have been prepared in conformity with accounting principles generally accepted in the United States (“GAAP”). The consolidated financial statements include the accounts of the Company, entities controlled by the Company through its direct or indirect ownership of a majority interest and any other entities in which the Company has a controlling financial interest. The Company consolidates VIEs where the Company is the primary beneficiary. The primary beneficiary of a VIE is the party that has both the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses or the right to receive benefits that could potentially be significant to the VIE. The Company consolidates entities in which it or its wholly owned subsidiary is the general partner or managing member and the limited partners or managing members, respectively, do not have sufficient rights to overcome the presumption of the Company’s control. The Company eliminates all significant intercompany accounts and transactions in consolidation.
	The Company uses the equity method to account for investments in entities it or its wholly owned subsidiaries do not control, but over which it or its wholly owned subsidiaries have the ability to exercise significant influence. The Company does not consolidate equity method investments, but rather measures them at their initial cost and subsequently adjusts their carrying values through income for the Company’s respective share of earnings or losses during the period.
	As a result of the Contribution, the Company’s statements of operations, comprehensive income and cash flows for the year ended December 31, 2012 include eight months of results of operations, comprehensive income and cash flows of pre-Contribution USMD and four months of results of operations, comprehensive income and cash flows of the consolidated post-Contribution Company. The Company’s statements of operations, comprehensive income and cash flows for the year ended December 31, 2013 include a full year of results of operations, comprehensive income and cash flows of the consolidated post-Contribution Company.

Summary_of_Significant_Account

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2013

Summary of Significant Accounting Policies

Note 2 – Summary of Significant Accounting Policies

Revenue Recognition

Patient Service Revenue: The Company records patient service revenue during the period healthcare services are provided based upon estimated amounts due from third-party payers and patients. Amounts the Company receives for patient services paid by patients and third-party payers such as managed care health plans and commercial insurers, governmental programs, such as Medicare and Medicaid, and other payers are generally less than the Company’s customary charges. Patient service revenue is recorded net of these contractual allowances and discounts. The estimation of contractual allowances on charges posted for the period involve payer-specific estimates of net patient services revenue based on the most significant contractual reimbursement methodologies. However, the calculations do not take into consideration all contract provisions that may limit reimbursement, but provide an estimate of net realizable value. Revenue is adjusted when the parties (insurer and patient/guarantor) obligated under the contract have tendered payment on the claim. Historically, these payment adjustments have not been material.

To provide for patients’ accounts receivable that could become uncollectible in the future, the Company establishes an allowance for doubtful accounts to reduce the carrying value of such receivables to their estimated net realizable value. Accordingly, the net patient services revenue and accounts receivable reported in the Company’s accompanying consolidated financial statements are recorded at the net amount expected to be received.

Laws and regulations governing Medicare and Medicaid programs are complex and subject to interpretation. The Company believes that it is in compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of potential wrongdoing that would have a material effect on the Company’s financial statements. Compliance with such laws and regulations can be subject to future government review and interpretation as wel as significant regulatory action including fines, penalties and exclusion from the Medicare and Medicaid programs.

Capitated Revenue: The Company’s consolidated VIE, WNI-DFW, earns capitated revenue (fixed payment per member per month) by contracting with an entity that operates a health services company that contracts directly with a health plan. Capitated revenue is prepaid monthly to WNI-DFW based on the number of Medicare Advantage members of that network electing WNI-DFW primary care physicians as their healthcare provider, regardless of actual medical services utilized. Capitation revenue is reported as revenue in the month in which members are entitled to receive health care. Capitation revenue pertaining to Medicare enrollees is subject to possible retroactive premium risk adjustments based on their individual acuity. Due to lack of sufficient data to project the amount of such retroactive adjustments, the Company records any corresponding retroactive revenues in the year of receipt.

Management Services Revenue: The Company earns management services revenue through the provision of management services to its managed entities. Management fee revenues are generally recognized based on a defined percentage of cash collections or adjusted net revenues of the Company’s managed entities. These terms and percentages are contractually defined and the Company recognizes revenue when the contractual terms are met. The Company may also provide certain managed entities with operational and finance support services. Revenue for these services is included in management and other services revenue and is recognized as the services are provided and contractual terms are met.

Lithotripsy Services Revenue: The Company provides lithotripsy services to hospitals and other medical facilities. Lithotripsy services revenue is comprised of the revenue of consolidated lithotripsy entities that the Company controls. Lithotripsy services revenue is recognized as services are provided and reported based on actual contract price or estimated net realizable amounts.

Physician Recruitment Agreements: In order to meet the hospitals’ needs, hospitals enter into physician recruitment agreements with physicians and/or group practices that employ them under which hospitals agree to contribute to the salary expense of physicians who are recruited to their service area. Several hospitals have entered into such agreements with USMD Physician Services and/or physicians that are employed by that entity or its wholly owned subsidiaries. Under such agreements, the hospital will typically provide the physician with a guaranteed income during an initial guarantee period, generally one year. Amounts paid by a hospital under such agreements are subject to repayment, and repayment is secured by a note payable to the hospital with repayment terms generally beginning in the month following the end of the guarantee period. Principal and interest payments are due monthly over a defined commitment period, generally three years, and the obligation to make monthly installment payments is forgiven on the due date provided no events of default have occurred. Events of default are typically defined as, but not limited to, failure of the physician to maintain a practice in the service area of the hospital as established in the agreement or entering into competing agreements. Upon an event of default, amounts not previously forgiven are due to the hospital in accordance with the terms of the note and, typically, the payment of future installment note payments can be accelerated.

USMD Physician Services records physician recruitment agreement payments received from hospitals for the benefit of employed physicians as deferred revenue and recognizes associated patient service revenue on a straight-line basis over the term of the commitment period. Upon an event of default, amounts due are reclassified to notes payable; however, historically, such amounts have not been material to the Company’s consolidated financial statements. For the years ended December 31, 2013 and 2012, the Company recognized $1.0 million and $0.3 million, respectively, of patient service revenue associated with physician recruitment agreements. At December 31, 2013 and 2012, the Company has on the consolidated balance sheet $0.8 million and $1.0 million, respectively, of deferred revenue associated with physician recruitment agreements included in other current liabilities and $0.4 million and $0.6 million, respectively, of deferred revenue associated with physician recruitment agreements included in other long-term liabilities. The Company had no physician recruitment payments, revenue or balances prior to August 31, 2012.

Concentrations and Credit Risk

Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. The Company places its cash and cash equivalents with high quality financial institutions; however, deposits held with financial institutions often exceed federally insured limits. The Company has not experienced any losses on its deposits of cash and cash equivalents.

Accounts receivable are stated at net realizable value. The Company grants credit without requiring collateral from its non-patient customers, primarily area healthcare facilities. The Company grants credit without requiring collateral from its patients, most of whom are area residents and are insured under third-party payer agreements. The credit risk for non-governmental accounts receivable is limited due to the number of insurance companies and other payers that provide payment and reimbursement for patient services. Collection risks principally relate to self-pay patient accounts, including patient accounts for which the primary insurance payer has paid but patient responsibility amounts (generally deductibles, coinsurance and copayments) remain outstanding. At December 31, 2013 and 2012, the mix of gross patient and customer accounts receivable is as follows:

December 31,

2013

2012

Government-related programs

Managed care and commercial payers

Self-pay

Customer

100

For the years ended December 31, 2013 and 2012, USMD Hospital at Arlington, L.P. accounted for 5% and 11%, respectively, of net operating revenue.

Allowance for Doubtful Accounts

The allowance for doubtful accounts is based on management’s assessment of the collectibility of patient and customer accounts. The Company regularly reviews this allowance by considering factors such as historical experience, credit quality, the age of the accounts receivable balances and current economic conditions that may affect a patient’s or customer’s ability to pay. Uncollectible accounts are written off once collection efforts are exhausted. A summary of the Company’s accounts receivable allowance for doubtful accounts activity is as follows (in thousands):

Balance at

Provision for

Write-

Initial

Balance at

Beginning of

Doubtful

offs

Consolidation of

End of Year

Year

Accounts

Investee (Note 6)

Related to

Patient Service

Revenue

For the years ended December 31,

2013

1,127

2,801

(2,240

)

—

1,758

2012

428

889

107

(368

)

1,127

If actual results are not consistent with the Company’s assumptions and judgments, it may be exposed to gains or losses that could be material. Changes in general economic conditions or payer mix, or trends in federal governmental and private employer healthcare coverage could affect the estimate of the allowance for doubtful accounts, collection of accounts receivable, or financial position, results of operations, and cash flows of the Company.

Cash and Cash Equivalents

Cash equivalents include highly liquid investments with maturities of three months or less when purchased. Cash and cash equivalents consist primarily of bank deposit accounts.

Inventories

Inventories consist primarily of pharmacy supplies and are stated at lower of cost or market on a first-in, first-out basis.

Property and Equipment, Net

Property and equipment are recorded at cost less accumulated depreciation. Expenditures that increase capacities or extend useful lives are capitalized while routine maintenance and repairs are charged to operating expense as incurred. Leased property meeting certain criteria is capitalized and the present value of the related lease payments is recorded as a liability. Depreciation is provided over the estimated useful lives of the assets using the straight-line method. Leasehold improvements and capitalized lease assets are amortized over the respective lease term used in determining the lease classification or the estimated useful life of the asset, whichever is shorter. When property is sold, retired or otherwise disposed of, the cost and related accumulated depreciation are eliminated from the respective accounts and the resulting gain or loss is included in the consolidated statement of operations. Estimated useful lives of assets follow American Hospital Association guidelines where applicable and are as follows at December 31, 2013:

Leasehold improvements

1-15 years

Furniture and equipment

2-15 years

Software

1-5 years

Assets acquired in the Contribution are being depreciated over their estimated remaining useful lives, from one to six years.

Impairment of Long-Lived Assets and Finite-Lived Intangible Assets

Long-lived assets include property and equipment and equity investments in nonconsolidated affiliates. The Company evaluates its long-lived assets and identifiable acquired intangible assets with finite useful lives for possible impairment whenever circumstances indicate that the carrying amount of the asset, or related group of assets, may not be recoverable from estimated future undiscounted cash flows. When evaluating long-lived assets for impairment, the Company compares the carrying value of the asset to the asset’s estimated fair value. An impairment loss is recognized when the carrying amount of the asset or group of assets exceeds the respective fair value. Fair value of assets is estimated based on appraisals, established market values of comparable assets or internal estimates of undiscounted future cash flows. The Company’s estimates of future cash flows are based on assumptions and projections it believes to be reasonable and supportable. No impairment charges were recorded during the years ended December 31, 2013 or 2012. The Company amortizes the cost of intangible assets with finite useful lives over their respective estimated useful lives to their estimated residual value. At December 31, 2013, none of the Company’s finite-lived intangible assets had an estimated residual value.

Goodwill and Other Indefinite-Lived Intangible Assets

Goodwill represents the excess of the purchase price and related costs over the fair value of net tangible and identifiable intangible assets acquired in business combinations. Goodwill and indefinite-lived intangible assets are not subject to amortization but are tested for impairment on an annual basis, or more frequently if circumstances indicate a potential impairment. Such circumstances may include (1) a significant adverse change in legal factors or the business climate, (2) an adverse action or assessment by a regulator, or (3) other adverse changes in the assessment of future operations of a reporting unit.

Goodwill is tested for impairment at a reporting unit level, which for the Company is one level below the operating segment level. The impairment test for goodwill uses a two-step approach. Step one compares the fair value of the reporting unit to which goodwill is assigned to its carrying amount. If the carrying amount of a reporting unit exceeds its estimated fair value, a potential impairment is indicated and step two is performed. Step two compares the carrying amount of the reporting unit’s goodwill to its implied fair value. In calculating the implied fair value of reporting unit goodwill, the fair value of the reporting unit is allocated to all of the other assets and liabilities, including unrecognized intangible assets, of that reporting unit based on their fair values, similar to the allocation that occurs in a business combination. The excess of the fair value of a reporting unit over the amount assigned to its other assets and liabilities is the implied fair value of goodwill. If the carrying value of goodwill exceeds its implied fair value, an impairment charge is recognized in an amount equal to that excess. If the implied fair value of goodwill exceeds the carrying amount, goodwill is not impaired.

To test impairment of acquired indefinite-lived intangible assets (trade names), the fair values are estimated and compared to their carrying amounts. The Company estimates the fair value of these intangible assets based on an income approach – relief from royalty method. This methodology assumes that, in lieu of ownership, a third party would be willing to pay a royalty in order to exploit the related benefits of these types of assets. This approach is dependent on a number of factors, including estimates of future growth and trends, royalty rates in the category of intellectual property, discount rates and other variables. The Company recognizes an impairment loss when the estimated fair value of the intangible asset is less than the carrying amount.

The Company performs its annual impairment tests of goodwill and indefinite-lived intangible assets as of December 31.

Electronic Health Record Incentive Income

The American Recovery and Reinvestment Act of 2009 (“ARRA”) provides for incentive payments under the Medicare program for certain hospitals and physician practices that demonstrate meaningful use of certified electronic health record (“EHR”) technology. These provisions of ARRA are intended to promote the adoption and meaningful use of interoperable health information technology and qualified EHR technology. The Company accounts for Medicare EHR incentive payments in accordance with ASC 450-30, “Gain Contingencies” (“ASC 450-30”). The Company recognizes a gain for EHR incentive payments when its participating physicians have demonstrated meaningful use of certified EHR technology for the applicable period. Once the physicians have demonstrated meaningful use of certified EHR technology for the applicable period, no further contingencies exist as related to the Medicare EHR incentives for physicians. However, individual payment amounts are subject to audit by the administrative contractor and the auditor’s final determination of amounts earned could differ materially from amounts recorded.

Share-Based Payments

Share-based payments to employees, including grants of employee stock options, are recognized in the financial statements based on their estimated grant-date fair value. Share-based payments are generally amortized on a straight-line basis over the requisite service period; however, where the portion of the grant-date value of the award that is vested exceeds straight-line amortization, the vested portion is recognized.

Income Taxes

Income taxes are accounted for using the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which these 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.

Deferred tax assets are reduced by a valuation allowance when based on all available evidence, both positive and negative, and the weight of that evidence to the extent such evidence can be objectively verified, management determines it is more likely than not that all or a portion of the deferred tax assets may not be realized. Primary factors considered include historical earnings, estimates of current and expected future earnings, availability, or lack thereof, of taxable income in prior carryback periods that would limit realization of tax benefits, prudent and feasible tax planning strategies and current and future ownership changes.

Management considers many factors when evaluating the Company’s uncertain tax positions and such judgments are subject to periodic review. Tax benefits associated with uncertain tax positions are recognized in the period in which one of the following conditions is satisfied: (1) the more likely than not recognition threshold is satisfied; (2) the position is ultimately settled through negotiation or litigation; or (3) the statute of limitations for the taxing authority to examine and challenge the position has expired. Tax benefits associated with an uncertain tax position are derecognized in the period in which the more likely than not recognition threshold is no longer satisfied. The Company’s policy is to record interest and penalties related to income tax matters as income tax expense.

The determination and evaluation of the Company’s provision for income taxes and analysis of uncertain tax positions items requires significant judgment and knowledge of federal and state income tax laws, regulations and strategies, including the determination of deferred tax assets and liabilities and, if necessary, any valuation allowances that may be required for deferred tax assets. While the Company believes it has adequately provided for its income tax receivables or liabilities and deferred tax assets or liabilities in accordance with applicable income tax guidance, adverse determinations by taxing authorities or changes in tax laws and regulations could have a material adverse effect on the Company’s consolidated financial condition, results of operations or cash flows.

Fair Value Measurements

Fair value is the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. Preference is given to observable inputs. The basis for these assumptions establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows:

•

Level 1 – Observable inputs such as quoted prices in active markets;

•

Level 2 – Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and

•

Level 3 – Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions.

Assets and liabilities measured at fair value are based on one or more of three valuation techniques. The three valuation techniques are as follows:

•

Market approach – Prices and other market-related information involving identical or comparable assets or liabilities;

•

Cost approach – Amount that would be required to replace the service capacity of an asset (i.e., replacement cost); and

•

Income approach – Techniques to convert future amounts to a single present amount based on market expectations (including present value techniques, option pricing models and lattice models).

Investments in Nonconsolidated Affiliates

Investments in entities the Company does not control but in which the Company has the ability to exercise significant influence over the operating and financial policies of the investee are accounted for under the equity method of accounting. Equity method investments are recorded at original cost and adjusted periodically to recognize the Company’s proportionate share of the investees’ net income or losses after the date of investment, additional contributions made, dividends or distributions received, and impairment losses resulting from adjustments to net realizable value. The Company records equity method losses in excess of the carrying amount of an investment when the Company guarantees obligations or is otherwise committed to provide further financial support to the affiliate.

The Company regularly monitors and evaluates the fair value of its equity method investments. If events and circumstances indicate that a decline in the fair value of these assets has occurred and is other than temporary, the Company will adjust investments in nonconsolidated affiliates in the consolidated balance sheet. The Company’s equity investments do not have a readily determinable fair value as none of them are publicly traded. The fair values of the Company’s private equity investments are primarily determined by discounting the estimated future cash flows of each entity. These cash flow estimates include assumptions on growth rates, discount rates and terminal values (Level 3 fair value measurement).

Noncontrolling Interests in Subsidiaries

The Company’s consolidated financial statements include all assets, liabilities, revenues, expenses and cash flows of less-than-100%-owned affiliates that the Company controls. Accordingly, the Company has recorded noncontrolling interests in the earnings and equity of such entities. The Company records adjustments to controlling interests for the allocable portion of income or loss to which the noncontrolling interests’ holders are entitled based upon the portion of the subsidiaries they own. Contributions from and distributions to holders of noncontrolling interests are adjusted to the respective noncontrolling interests holders’ balance. The Company consolidates the assets, liabilities, revenues, and expenses of 18 less-than-100%-owned lithotripsy entities that it controls and one variable interest entity in which it has a controlling financial interest (see Note 4).

Translation of Foreign Currencies

The financial statements of the Company’s nonconsolidated foreign affiliate in Mexico are measured in local currency and then translated into U.S. dollars. All assets and liabilities have been translated using the current rate of exchange at the balance sheet date. Results of operations have been translated using the average rates prevailing throughout the year. Translation gains or losses resulting from changes in exchange rates are accumulated as a component of accumulated other comprehensive income (loss).

Segment Reporting

GAAP defines operating segments as components of an enterprise about which discrete financial information is available that is evaluated regularly by the chief operating decision maker (“CODM”) in deciding how to allocate resources and in assessing performance. The Company’s CODM is the Chief Executive Officer. The CODM assesses performance and allocates resources at the integrated health system level. Accordingly, the Company has one operating segment for segment reporting purposes.

Advertising Expense

The Company expenses all advertising costs when incurred. The Company incurred $0.3 million in advertising expense for both years ended December 31, 2013 and 2012, which is included in other operating expenses in the accompanying consolidated statements of operations.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities and contingent liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Significant items subject to such estimates and assumptions include patient service revenue, the allowance for doubtful accounts, incurred but not reported medical claims, certain assumptions used in valuations and impairment analyses, depreciable lives of assets, fair value of stock options, the tax provision and contingency and litigation reserves. While management believes current estimates are reasonable and appropriate, the Company cannot predict future events and their effects with certainty; accordingly, the Company’s accounting estimates require the exercise of judgment. The accounting estimates used in the preparation of the Company’s consolidated financial statements will change as new events occur, as better data becomes available, as additional information is obtained, and as facts and circumstances change. The Company evaluates and updates assumptions and estimates on an ongoing basis and may employ outside experts to assist in evaluations, as considered necessary. Actual results could differ materially from estimates.

Out of Period Adjustment:

In calculating the Company’s December 31, 2012 provision for income taxes, certain deferred rent activity that should have been attributed to the opening balance sheet of one of the companies acquired in the Contribution was incorrectly recorded as current period activity. This error resulted in an understatement of the provision for income taxes and an overstatement of goodwill at December 31, 2012 in the amount of $196,000. During the first quarter of 2013, the Company corrected this error by recording additional income tax provision of $196,000 and decreasing goodwill by the same amount. The impact of this out of period adjustment was not material to the consolidated results, financial position or cash flows for the years ended December 31, 2013 or 2012.

Business_Combination

Business Combination	12 Months Ended
Business Combination	Dec. 31, 2013
Business Combination	'

	Note 3 – Business Combination

	The Contribution

	On August 31, 2012, Holdings, USMD, UANT, Ventures, MCNT and Impel consummated the Contribution. The Contribution was accounted for as a reverse acquisition by USMD into Holdings, previously a business combination related shell company. Under reverse acquisition accounting, the financial statements are issued in the name of the legal parent (Holdings), but represent a continuation of the accounting acquirer’s (USMD) financial statements, with an adjustment to retroactively restate USMD’s legal capital to reflect the legal capital of Holdings. The assets and liabilities of USMD continue to be recorded at their pre-combination carrying values. The assets and liabilities of Holdings are recorded at fair value at the acquisition date, which, for Holdings, equaled their carrying values. The assets acquired and liabilities assumed from Ventures, UANT, MCNT and Impel (the “acquired businesses”) are recorded at their respective fair values at the acquisition date.

	In connection with the Contribution, Holdings issued as consideration to the former owners of Ventures, UANT, MCNT and Impel, approximately 6.4 million shares of its common stock with an estimated fair value of $158.1 million and options to purchase an additional 68,982 shares of its common stock with an estimated fair value of $0.5 million. The following table summarizes the estimated fair values of the assets acquired and liabilities assumed of Ventures, UANT, MCNT and Impel at the acquisition date (in thousands):



			August 31, 2012				Measurement			August 31, 2012
			(As initially				Period			(As adjusted)
			reported)				Adjustments
	Current assets		$	25,069			$	36		$	25,105
	Property and equipment			24,020				(171	)		23,849
	Investments in affiliates			36,198				—			36,198
	Other assets			7,240				—			7,240
	Identifiable intangible assets			32,479				(3,377	)		29,102
	Goodwill			83,346				3,057			86,403
	Liabilities assumed, other than long-term debt			(30,925	)			455			(30,470	)
	Long-term debt			(18,832	)			—			(18,832	)

	Net assets acquired and liabilities assumed		$	158,595			$	—		$	158,595


	The Company determined the allocation of assets acquired and liabilities assumed based on management’s estimates of the fair value of assets acquired and liabilities assumed utilizing valuations prepared as of August 31, 2012 and substantially finalized December 18, 2012. The Company determined an estimated net enterprise value of Ventures, UANT, MCNT and Impel using an income approach – discounted cash flow methodology. The analysis included each business unit’s assumptions regarding (1) the development of new businesses and organic growth rates specific to it, (2) managed care reimbursement rates where applicable, (3) discount rates of 16.1% for UANT and Ventures, 15.8% for MCNT and 12.4% for Impel, each developed using a weighted average cost of capital analysis, and (4) capital expenditure requirements associated with any new initiatives developed by such business unit. Significant assumptions utilized in the income approach were based on company specific information and projections, which are not observable in the market and are therefore considered Level 3 fair value measurements.

	As discussed in Note 2, in connection with the Contribution, during the year ended December 31, 2013, the Company reduced goodwill and liabilities assumed by $196,000. In addition, in June 2013, in connection with the valuation of fixed assets acquired, the Company reduced property and equipment acquired and increased goodwill by $171,000. As of August 31, 2013, the Company’s measurement period adjustments are complete.

	The excess of the purchase price over the fair value of assets acquired and liabilities assumed has been recorded to goodwill in the amount of $86.4 million. Goodwill primarily represents the growth opportunities of the Company as an integrated health system and the knowledge and experience of the workforce of the acquired businesses. None of the goodwill recorded as a result of the Contribution is expected to be deductible for tax purposes.

	In connection with the Contribution, the Company acquired additional ownership interests in three lithotripsy partnerships in which it had controlling interests and therefore consolidated. As a result, on the date of acquisition, additional paid-in capital increased and noncontrolling interest in subsidiaries decreased $0.9 million.



	- Intangible Assets Acquired

	Identifiable intangible assets acquired in the Contribution, excluding goodwill, consist of the following (in thousands):



			Fair Value				Weighted-
							Average
							Amortization
							Period
	Noncompete agreements		$	12,488				10.0 years
	Trade names			10,706				Indefinite
	Trade name—Impel			462				5.0 years
	Customer relationships			767				3.0 years
	Management agreement			4,679				30.0 years

			$	29,102


	At the date of acquisition, the weighted-average amortization period of total identifiable intangible assets acquired in the Contribution, excluding goodwill and identifiable indefinite lived intangible assets, was 14.7 years. At December 31, 2012, the weighted average period before renewal or extension of acquired management agreements was 29.7 years.

	Most of the former owners of UANT and MCNT, all of whom are licensed physicians, entered into ten-year employment agreements with USMD Physician Services or its wholly owned subsidiary and these agreements include covenants not to compete. The fair value of the noncompete agreements was estimated using a discounted cash flow model based on estimated reductions in revenue if the former owners of UANT and MCNT were to compete with the Company and discount rates of 16.1% and 15.8%, respectively. The estimated fair values of the trade names of UANT, MCNT and Impel were calculated using an income approach – relief from royalty method, whereby the economic value of the asset is the ability to provide the Company relief from royalty costs. A pre-tax royalty rate of 1% and a discount rate of 17% were used. A subsidiary of Impel provides healthcare consulting services and establishes customer relationships through contract. The estimated fair value of the customer relationships was determined using an income approach – multi-period excess earnings method with a discount rate of 14.5%. Until the acquisition date, Impel had in place a management services agreement with MCNT; in connection with the Contribution, this agreement was terminated and a new management services agreement was entered into between USMD Physician Services and a wholly owned subsidiary of the Company. The estimated fair value of the acquired management agreement intangible asset was determined using an income approach – multi-period excess earnings method with a discount rate of 13.5%, net of contributory charges.

	Amortizable intangible assets are being amortized on a straight-line basis because this methodology most accurately reflects the estimated usage pattern of the assets.

	- Supplemental Pro Forma Disclosures

The results of operations and cash flows of the acquired businesses are included in Holdings’ consolidated financial statements beginning September 1, 2012. For the years ended December 31, 2013 and 2012, the acquired businesses contributed net operating revenues of $182.7 million and $60.6 million, respectively. It is impracticable for the Company to determine the amount of earnings of the acquired businesses included in the Company’s consolidated statements of operations for the years ended December 31, 2013 or 2012 due to the significant transfers of personnel, fixed assets and departments into and between newly created or historical departments and business units that have occurred subsequent to the Contribution.

The following table presents unaudited pro forma results as if the entities had been combined on January 1, 2011. The pro forma financial information includes adjustments to give effect to activity that is directly attributable to the Contribution, factually supportable and expected to have a continuing impact on the combined results of operations. The pro forma financial information also includes adjustments to give effect to direct, incremental costs of the Contribution as nonrecurring charges directly related to the Contribution. The pro forma combined financial information has been prepared for illustrative purposes only and is not necessarily indicative of the results of operations in future periods or the results of operations that would have been realized had Holdings, USMD, Ventures, UANT, MCNT and Impel been a combined company during the specified periods (in thousands, except per share data).



		Years Ended December 31,
		2013				2012
		(unaudited, pro forma)
Net operating revenue		$	234,727			$	223,881
Net income		$	10,798			$	14,160
Net income attributable to USMD Holdings, Inc.		$	1,047			$	4,048
Earnings per share attributable to USMD Holdings, Inc.
Basic		$	0.1			$	0.4
Diluted		$	0.1			$	0.4

For the year ended December 31, 2012, pro forma adjustments include reductions to other operating expenses totaling $1.0 million for nonrecurring transaction costs directly attributable to the Contribution, primarily legal, accounting and other professional fees as well as document printing expenses associated with filings of Holdings’ Registration Statement on Form S-4 and related amendments.



Acquisitions of Physician Practices

In July and November 2013, the Company acquired two physician practices in exchange for an aggregate 4,502 shares of the Company’s common stock with a fair value of $133,000.

Variable_Interest_Entity

Variable Interest Entity	12 Months Ended
Variable Interest Entity	Dec. 31, 2013
Variable Interest Entity	'
	Note 4 – Variable Interest Entity
	In April 2013, the Company became an equal co-member of a Texas non-profit corporation (WNI-DFW) that has been approved by the Texas Medical Board as a certified non-profit healthcare organization. WNI-DFW has a contractual arrangement to manage patient care by providing or arranging for the provision of all the necessary healthcare services for a health plan’s given Medicare Advantage patient population in the North Texas area served by WNI-DFW. Pursuant to the arrangement, WNI-DFW receives a fixed fee per patient under what is typically known as a “risk contract.” Risk contracting, or full risk capitation, refers to a model in which an entity receives from the third party payer a fixed payment per member per month for a defined patient population, and the entity is then responsible for arranging and/or providing all of the healthcare services required by that patient population. The entity accomplishes this by managing patient care and by contracting with downstream healthcare providers to provide needed healthcare services for the patient population. In such a model, the contracting entity is then responsible for incurring or paying for the cost of healthcare services required by that patient population. The entity generates a net surplus if the cost of all healthcare services provided to the patient population is less than the payments received from the third party payer, and it generates a net deficit if the cost of such services is higher than the payments received. In early May 2013, the Company and its equal co-member both made a $100,000 capital contribution to WNI-DFW. On June 1, 2013, WNI-DFW commenced operations.
	The Company evaluated whether it has a variable interest in WNI-DFW, whether WNI-DFW is a VIE and whether the Company has a controlling financial interest in WNI-DFW. The Company concluded that it has variable interests in WNI-DFW on the basis of its capital contribution to WNI-DFW and because WNI-DFW has entered into a Primary Care Physician Agreement (“PCP Agreement”) with USMD Physician Services. WNI-DFW’s equity at risk, as defined by GAAP, is considered to be insufficient to finance its activities without additional support, and, therefore, WNI-DFW is considered a VIE.
	In order to determine whether the Company has a controlling financial interest in the VIE and, thus, is the VIE’s primary beneficiary, the Company considered whether it has i) the power to direct the activities of WNI-DFW that most significantly impact its economic performance and ii) the obligation to absorb losses of WNI-DFW that could potentially be significant to it or the right to receive benefits from WNI-DFW that could potentially be significant to it. The Company concluded that the members, the board of directors and the executive management team of WNI-DFW are structured in a way that neither member nor its designee has the individual power to direct the activities of WNI-DFW that most significantly impact its economic performance. Management considered whether the various service and support agreements between WNI-DFW and its members (or their affiliates) provide either variable interest party with this power and concluded that the PCP Agreement between USMD Physician Services and WNI-DFW does provide the power to direct such activities to USMD Physician Services. Under the PCP Agreement, USMD Physician Services is responsible for providing many services related to the growth of the patient population WNI-DFW will manage, the management of that population’s healthcare needs, and the provision of required healthcare services to those patients. The Company has concluded that the success or failure of USMD Physician Services in conducting these activities will most significantly impact the economic performance of WNI-DFW. In addition, the Company’s variable interests in WNI-DFW obligate the Company to absorb deficits and provide it with the right to receive benefits that could potentially be significant to WNI-DFW. As a result of this analysis, the Company concluded that it is the primary beneficiary of WNI-DFW and therefore consolidates the balance sheets, results of operations and cash flows of WNI-DFW. We perform a qualitative assessment of WNI-DFW on an ongoing basis to determine if we continue to be the primary beneficiary.
	The following table summarizes the carrying amount of the assets and liabilities of WNI-DFW included in the Company’s consolidated balance sheet at December 31, 2013 (after elimination of intercompany transactions and balances) (in thousands):


		December 31,
		2013
	Current assets:
	Cash and cash equivalents	$	1,257
	Accounts receivable		175

	Total current assets		1,432
	Deferred tax asset		671

	Total assets	$	2,103

	Current liabilities:
	Other accrued liabilities	$	2,108

	Total current liabilities	$	2,108

	The assets of WNI-DFW can only be used to settle obligations of WNI-DFW. The creditors of WNI-DFW have no recourse to the general credit of the Company. The Company is contractually obligated to make additional contributions of capital to WNI-DFW under certain circumstances, particularly in the event of deficits incurred by WNI-DFW. In January 2014, as a result of a deficit at WNI-DFW, the Company made an additional contribution of capital of $0.7 million.
	The results of operations and cash flows of WNI-DFW are included in the Company’s consolidated financial statements beginning June 1, 2013. For the year ended December 31, 2013, WNI-DFW contributed net operating revenues of $7.4 million and income before provision for income taxes of $0.5 million (after elimination of intercompany transactions).
	Estimated Medical Claims Liability
	In connection with the operations of WNI-DFW, the Company makes estimates related to incurred but not reported medical claims (“IBNR”) of WNI-DFW.

	The patient population to which WNI-DFW provides health services has limited medical claims activity from which claims-based actuarial judgments can be made. In addition, the full population is relatively small for precise actuarial determinations. Therefore, in addition to calculating IBNR using an actuarial estimate based on historical medical claims activity, management includes an adjustment factor based on broader patient populations deemed to be similar in risk profile to the WNI-DFW managed patient population. If actual results are not consistent with the Company’s estimate, the Company may be exposed to variances in medical supplies and services expense that may be material.

Investments_in_Nonconsolidated

Investments in Nonconsolidated Affiliates	12 Months Ended
Investments in Nonconsolidated Affiliates	Dec. 31, 2013
Investments in Nonconsolidated Affiliates	'

	Note 5 – Investments in Nonconsolidated Affiliates

	The net carrying values and ownership percentages of nonconsolidated affiliates accounted for under the equity method are as follows (dollars in thousands):



			December 31, 2013							December 31, 2012
			Carrying			Ownership				Carrying			Ownership
			Value			Percentage				Value			Percentage
	USMD Hospital at Arlington, L.P.		$	50,055			46.4	%		$	24,997			28.44	%
	USMD Hospital at Fort Worth, L.P.			11,246			30.88	%			10,779			30.88	%
	Other			521			4%-34	%			116			4%-34	%

			$	61,822						$	35,892


	2013 Activity

	Effective September 1, 2013, the Company issued convertible subordinated notes payable (see Note 10) to certain limited partners of USMD Hospital at Arlington, L.P. (“USMD Arlington”) to acquire additional ownership interests in USMD Arlington. As a result of this transaction, the Company’s investment in USMD Arlington increased by $24.3 million and its ownership percentage in USMD Arlington increased to 46.4%.

	In February 2013, the Company invested $200,000 in a new cancer treatment center in Anchorage, Alaska. The Company has an existing agreement to provide management services to this center. Because the Company has the ability to exercise significant influence over the management and operations of the center, the Company accounts for the investment under the equity method of accounting.

	2012 Activity

	In connection with the Contribution, the Company acquired additional ownership interests in USMD Arlington and USMD Hospital at Fort Worth, L.P. (“USMD Fort Worth”).

	In 2011, the Company invested $0.3 million in a radiation oncology center in Monterrey, Mexico. Because the Company has the ability to exercise significant influence over the management and operations of the investee, the Company accounts for the investment under the equity method of accounting. Due to losses at the investee, the Company’s carrying value of the investment was reduced to zero in 2012 and, as a result, the Company’s financial results are not negatively affected by the investee’s ongoing operations. The Company has no obligation to fund future capital requirements of the investee.

	Other

	At December 31, 2013, the carrying value of the investments in USMD Arlington and USMD Fort Worth is greater than the Company’s equity in the underlying net assets of the hospitals by $41.1 million due primarily to recording ownership interests at fair value in connection with the Contribution in 2012, the acquisition of Class P partnership interests in September 2013 and deconsolidation of the hospitals in 2010, net of impairment.

	Summarized combined financial information for the Company’s nonconsolidated affiliates accounted for under the equity method is as follows (in thousands):



			December 31,
			2013			2012
	Current assets		$	43,558		$	38,146
	Noncurrent assets		$	83,895		$	85,090
	Current liabilities		$	19,148		$	27,175
	Noncurrent liabilities		$	55,455		$	49,675


			Years Ended December 31,
			2013			2012
	Revenue		$	141,363		$	129,030
	Income from operations		$	35,925		$	28,701
	Income from continuing operations		$	33,502		$	25,362
	Net income		$	33,502		$	25,362



	At December 31, 2013, USMD Arlington and USMD Forth Worth were significant equity investees, as that term is defined by SEC Regulation S-X Rule 3-09. Financial information for USMD Arlington and USMD Forth Worth is included in the summarized information above and is as follows individually (in thousands):



			USMD Arlington							USMD Fort Worth
			December 31,
			2013			2012				2013			2012
	Current assets		$	26,055		$	24,986			$	13,445		$	11,859
	Noncurrent assets		$	54,205		$	55,767			$	17,439		$	18,365
Current liabilities		$	9,987		$	8,975			$	5,593		$	15,888
Noncurrent liabilities		$	36,361		$	40,144			$	10,758		$	1,567

		Years Ended December 31,
		2013			2012				2013			2012
Revenue		$	90,619		$	84,936			$	39,172		$	37,092
Income from operations		$	21,317		$	17,836			$	9,336		$	7,843
Income from continuing operations		$	20,429		$	15,264			$	8,386		$	7,097
Net income		$	20,429		$	15,264			$	8,386		$	7,097

Patient_Service_Revenue

Patient Service Revenue	12 Months Ended
Patient Service Revenue	Dec. 31, 2013
Patient Service Revenue	'

	Note 6 – Patient Service Revenue

	The Company’s patient service revenue by payer is summarized in the table that follows (dollars in thousands). The Company had no patient service revenue prior to September 1, 2012.



		Years Ended December 31,
		2013						2012
		Amount			Ratio of Net			Amount			Ratio of Net
					Patient Service						Patient Service
					Revenue						Revenue
	Medicare	$	52,003			29.2	%	$	16,820			28.3	%
	Medicaid		1,460			0.8			388			0.7
	Managed care and commercial payers		123,336			69.2			41,689			70.2
	Self-pay		4,288			2.4			1,412			2.4

	Patient service revenue before provision for doubtful accounts		181,087			101.6			60,309			101.5
	Patient service revenue provision for doubtful accounts		(2,801	)		(1.6	)		(889	)		(1.5	)

	Net patient service revenue	$	178,286			100	%	$	59,420			100	%

Property_and_Equipment

Property and Equipment	12 Months Ended
Property and Equipment	Dec. 31, 2013
Property and Equipment	'
	Note 7 – Property and Equipment
	Property and equipment consist of the following (in thousands):


		December 31,
		2013			2012
	Leasehold improvements	$	12,565		$	11,723
	Furniture and equipment		21,691			20,587
	Software		3,043			2,857

	Gross property and equipment		37,299			35,167
	Less: accumulated depreciation and amortization		(13,808	)		(8,964	)

	Property and equipment, net	$	23,491		$	26,203

	Property and equipment depreciation and amortization expense for the years ended December 31, 2013 and 2012 was $5.8 million and $2.7 million, respectively.

	Assets recorded under capital lease arrangements included in property and equipment consist of the following (in thousands):


		December 31,
		2013			2012
	Furniture and equipment	$	1,990		$	1,499

	Gross assets recorded under capital leases		1,990			1,499
	Less: accumulated amortization		(854	)		(595	)

	Net assets recorded under capital leases	$	1,136		$	904

	Amortization expense pertaining to property and equipment under capital lease arrangements is included with depreciation and amortization expense in the consolidated statements of operations.

Goodwill_and_Other_Intangible_

Goodwill and Other Intangible Assets	12 Months Ended
Goodwill and Other Intangible Assets	Dec. 31, 2013
Goodwill and Other Intangible Assets	'
	Note 8 – Goodwill and Other Intangible Assets
	The following table sets forth the goodwill activity for each of the Company’s reporting units during the years ended December 31, 2013 and 2012 (in thousands):


		Physician and			Cancer			Lithotripsy			Total
		Ancillary Services			Treatment			Services
					Services
	Balance at January 1, 2012:
	Goodwill	$	4,907		$	—		$	6,837		$	11,744
	Accumulated impairment		—			—			(3,409	)		(3,409	)

			4,907			—			3,428			8,335
	Increase due to business combination		55,707			54,219			—			109,926
	Balance at December 31, 2012:
	Goodwill		60,614			54,219			6,837			121,670
	Accumulated impairment		—			—			(3,409	)		(3,409	)

			60,614			54,219			3,428			118,261
	Adjustments related to business combination		(196	)		111			—			(85	)
	Balance at December 31, 2013:
	Goodwill		60,418			54,330			6,837			121,585
	Accumulated impairment		—			—			(3,409	)		(3,409	)

		$	60,418		$	54,330		$	3,428		$	118,176

	In June 2013, the Company reduced fixed assets acquired in the Contribution by $171,000. This resulted in an increase to goodwill of $111,000, net of tax.
	In addition to $86.4 million of goodwill recorded as a direct result of the allocation of assets acquired and liabilities assumed in the Contribution in 2012, the Company recorded $23.5 million of goodwill associated with deferred tax liabilities recorded in connection with investments and amortizable intangible assets acquired in the Contribution.
	For the years ended December 31, 2013 and 2012, as a result of the Company’s annual goodwill impairment testing, the Company determined all remaining goodwill to be recoverable. In estimating the fair value of the Company’s reporting units in connection with the impairment testing, management makes estimates and judgments about future cash flows and market valuations using a combination of income and market approaches, respectively, defined as Level 3 inputs under the fair value measurement hierarchy. In performing its impairment analyses, the Company relied primarily on an income approach, specifically a discounted cash flow analysis, which includes assumptions for, among other factors, discount rates, cash flow projections, growth rates and terminal value rates, all of which require significant judgment. The Company updates specific assumptions at the date of each impairment test to incorporate current industry and Company-specific risk factors from the perspective of a market participant.
	The components of amortizable intangible assets consist of the following (in thousands):


		December 31, 2013									December 31, 2012
		Gross			Accumulated			Net Carrying			Gross			Accumulated			Net Carrying
		Carrying			Amortization			Amount			Carrying			Amortization			Amount
		Amount									Amount
	Management agreements	$	5,246		$	(544	)	$	4,702		$	5,246		$	(351	)	$	4,895
	Trade name		462			(123	)		339			462			(31	)		431
	Customer relationships		767			(341	)		426			767			(85	)		682
	Noncompete agreements		12,527			(1,667	)		10,860			12,488			(416	)		12,072

		$	19,002		$	(2,675	)	$	16,327		$	18,963		$	(883	)	$	18,080


	Aggregate amortization expense for the years ended December 31, 2013 and 2012, totaled $1.8 million and $0.6 million, respectively. The weighted average period before the next renewal period for management agreements is 27.6 years. The carrying value of indefinite-lived trade names, which are not subject to amortization, is $10.7 million at December 31, 2013 and 2012. For the years ended December 31, 2013 and 2012, as a result of the Company’s annual indefinite-lived asset impairment testing, the Company determined trade name amounts to be recoverable.
	Total estimated amortization expense for the Company’s intangible assets during the next five years is as follows (in thousands):


	2014	$	1,800
	2015		1,800
	2016		1,500
	2017		1,500
	2018		1,500

	Total	$	8,100

Other_Accrued_Liabilities

Other Accrued Liabilities	12 Months Ended
Other Accrued Liabilities	Dec. 31, 2013
Other Accrued Liabilities	'
	Note 9 – Other Accrued Liabilities
	Other accrued liabilities consist of the following (in thousands):


		December 31,
		2013		2012
	Accrued expenses	$	3,002	$	3,108
	Accrued bonus		1,860		1,469
	Accrued payables		3,582		822
	IBNR payable		1,918		—
	Income taxes payable		395		468

		$	10,757	$	5,867

LongTerm_Debt_Capital_Lease_Ob

Long-Term Debt, Capital Lease Obligations and Other Long-Term Liabilities	12 Months Ended
	Dec. 31, 2013
Long-Term Debt, Capital Lease Obligations and Other Long-Term Liabilities	'

	Note 10 – Long-Term Debt, Capital Lease Obligations and Other Long-Term Liabilities

	Long-term debt and capital lease obligations consist of the following (in thousands):



			December 31,
			2013			2012
	Holdings:
	Credit Agreement:
	Term debt		$	15,687		$	19,938
	Revolving credit facility			3,000			—
	Convertible subordinated notes, net of unamortized discount of $3,503			20,839			—
	Subordinated related party notes payable			3,734			4,328
	Other note payable			120			185

				43,380			24,451
	Consolidated lithotripsy entities:
	Notes payable			1,766			1,270
	Capital lease obligations			1,052			848

				2,818			2,118

	Total long-term debt and capital lease obligations			46,198			26,569
	Less: current portion			(8,492	)		(5,520	)

	Long-term debt and capital lease obligations, less current portion		$	37,706		$	21,049


	Holdings

	Credit Agreement

	On August 31, 2012, in connection with the Contribution, Holdings and its wholly owned subsidiaries (collectively “Borrower”) entered into a credit agreement with JPMorgan Chase Bank, N.A., as Administrative Agent, and additional lenders (the “Credit Agreement”). The Credit Agreement provides for a Term Loan Credit Facility (“Term Loans”) in an aggregate principal amount of $21.0 million and a Revolving Credit Facility (“Revolver”) in an aggregate principal amount of $10.0 million. Proceeds from borrowings under the Term Loans were used to repay existing debt of the acquired businesses and to repay in whole or in part certain of the Company’s related party debt. Proceeds from borrowings under the Revolver are available solely to finance working capital of the Company. An unused commitment fee is payable on the undrawn portion of the Revolver at a rate of 0.25% per annum.



	The Term Loans consist of the Tranche A Term Loan with an aggregate principal amount of $12.5 million, the Tranche B Term Loan with an aggregate principal amount of $3.5 million, and the Tranche C Term Loan with an aggregate principal amount of $5.0 million. Interest on the Term Loans is due monthly. The Tranche A Term Loan accrues interest at the 30-Day London Interbank Offered Rate (“LIBOR”) plus a margin of 3.00% (3.19 % at December 31, 2013) and matures on August 31, 2017. Principal payments of $625,000 are due quarterly. The Tranche B Term Loan accrues interest at the 30-Day LIBOR plus a margin of 3.50% (3.69% at December 31, 2013) and matures on August 31, 2014. Principal payments of $437,500 are due quarterly. The Tranche C Term Loan accrues interest at the 30-Day LIBOR plus a margin of 1.25% (1.44% at December 31, 2013) and matures on August 31, 2017. The outstanding principal balance and any unpaid interest will be due upon the Tranche C Term Loan maturity date. Borrowings under the Revolver accrue interest at the 30-Day LIBOR plus a margin of 3.00% (3.19% at December 31, 2013) with interest payments due monthly.

	The obligations under the Credit Agreement are secured by substantially all the tangible and intangible assets of the Borrower to the extent permitted by applicable law and subject to certain exceptions. Pursuant to the Credit Agreement, the Company is required to maintain a compensating balance of $5.0 million as collateral related to its borrowings under the Credit Agreement. The Credit Agreement provides that the balance be held in an account at the Company’s Administrative Agent bank.

	The Credit Agreement contains a number of covenants that, among other things, limit or restrict the ability of the Borrower to dispose of assets, incur additional indebtedness, make dividends and other restricted payments, create liens securing other indebtedness and enter into restrictive agreements. At December 31, 2013, the Company was subject to a financial covenant that requires it to maintain a fixed charge coverage ratio greater than or equal to 1.50:1.00 for the period of four consecutive fiscal quarters from and including December 31, 2012 through December 31, 2013 and of 1.25:1.00 for any period of four consecutive fiscal quarters beginning March 31, 2014 through August 31, 2017. In addition, the Company was subject to a financial covenant that requires it to maintain a senior leverage ratio less than or equal to 1.50:1.00 for any period of four consecutive fiscal quarters from and including December 31, 2013 through September 30, 2014 and of 1.25:1.00 for any period of four consecutive fiscal quarters beginning December 31, 2014 through August 31, 2017.

	On February 25, 2014, the Company entered into Amendment No. 3 to the Credit Agreement (the “Amendment No. 3”). Among other things, Amendment No. 3 extended the maturity date of the Revolver from February 28, 2014 to June 30, 2015. In addition, Amendment No. 3 reduced the minimum fixed charge coverage ratio and established the senior leverage ratio requirement.

	In early 2014, the Company determined that it had not been in compliance with its fixed charge coverage ratio or senior leverage ratio covenants. Effective April 14, 2014, the Company obtained from the Credit Agreement lenders a permanent waiver of the existing covenant violations. In addition, the lenders amended the Credit Agreement resulting in modifications to the fixed charge coverage ratio, the senior leverage ratio covenant requirements, the Revolver commitment amount and the Tranche C Term Loan maturity date (collectively, “Amendment No. 4”).

	Amendment No. 4 reduced the fixed charge coverage ratio to greater than or equal to 1.00:1.00 for the period of four consecutive fiscal quarters ending December 31, 2013 and 0.35:1.00 for the period of four consecutive fiscal quarters ending March 31, 2014. Subsequent to those dates, the Company is subject to the fixed charge coverage ratio covenant as described above and in Amendment No. 3. Amendment No. 4 waived the senior leverage ratio requirement at December 31, 2013, increased the senior leverage ratio to less than or equal to 3.10:1.00 for the period of four consecutive fiscal quarters ending March 31, 2014, decreased the senior leverage ratio to less than or equal to 1.25:1.00 for the period of four consecutive fiscal quarters ending June 30, 2014 and decreased the ratio to less than or equal to 1.00:1.00 for any period of four consecutive fiscal quarters from and including September 30, 2014 through August 31, 2017. Amendment No. 4 reduced the Revolver commitment amount to $3.0 million from $10.0 million and amended the Tranche C Term Loan maturity date to April 2014.

	In connection with the borrowings under the Credit Agreement, the Company incurred debt issuance costs of $500,000, of which $190,000 was amortized during the year ended December 31, 2013; the remaining balance of $259,000 will be amortized through August 2017 using the effective interest method. In connection with the Amendment, the Company incurred debt issuance costs of $61,000, which will be amortized through June 30, 2015 using the effective interest method. In connection with Amendment No. 4, the Company incurred debt issuance costs of $50,000, which will be amortized through August 2017 using the effective interest method.

	Convertible Subordinated Notes

	Effective September 1, 2013, the Company issued convertible subordinated notes in the aggregate principal amount of $24.3 million (the “Convertible Subordinated Notes”) to certain limited partners of USMD Arlington to acquire their limited partnership interests in USMD Arlington. The Convertible Subordinated Notes bear interest at a fixed rate of 5.00% per annum and mature on March 1, 2019. Interest payments are due and payable on the last day of each month and the principal is due upon maturity. The Company may prepay the Convertible Subordinated Notes, in whole or in part, at any time after September 1, 2014 without penalty.

	Each noteholder will have the right at any time after September 1, 2014 to convert all or any part of the unpaid principal balance of their respective Convertible Subordinated Note into shares of common stock of Holdings at the rate of one share of common stock for each $23.37 of principal. The conversion price will be appropriately adjusted for stock splits, mergers or other fundamental corporate transactions. The conversion option has no cash settlement provisions. The Company evaluated the embedded conversion option and concluded that it does not meet the criteria for bifurcation and separate accounting as a derivative as it is indexed to the Company’s own stock and, if freestanding, would be classified in stockholders’ equity. Specifically, the variables affecting any adjustment to the conversion price would be inputs to the fair value of a fixed-for-fixed option on equity shares, or are otherwise designed to maintain the economic position of both parties before and after the event that precipitates an adjustment of the conversion price (i.e. merger).

	At the date of execution of the Convertible Subordinated Notes, the commitment date, the conversion price was less than the fair value of shares of Holdings’ common stock. The Company recognized the intrinsic value of the conversion option’s in-the-money portion as a $3.7 million beneficial conversion discount to the debt with an offsetting entry to additional paid-in capital. The beneficial conversion discount will be accreted to the Convertible Subordinated Notes using the effective interest method over 66 months until they mature on March 1, 2019. Recognition of the beneficial conversion discount results in a temporary book-tax basis difference in the debt instrument. Accordingly, the Company recorded a $1.3 million deferred tax liability with an offsetting entry to additional paid-in capital.

	The aggregate Convertible Subordinated Notes are convertible into 1,041,581 common shares of Holdings at a conversion price of $23.37 per share. The Convertible Subordinated Notes have an effective interest rate of 8.50%. For the year ended December 31, 2013, the Company recognized interest expense related to the Convertible Subordinated Notes of $0.6 million, comprised of $0.4 million related to the contractual interest rate and $0.2 million related to discount accretion.

	In connection with the borrowings under the Convertible Subordinated Notes, the Company incurred debt issuance costs of $70,000, of which $4,000 was amortized during the year ended December 31, 2013; the remaining balance will be amortized through March 2019 using the effective interest method.

The indebtedness represented by the Convertible Subordinated Notes is expressly subordinate to all senior indebtedness of Holdings currently outstanding or incurred in the future, which includes without limitation its indebtedness to banks.

Subordinated Related Party Notes Payable

Effective January 1, 2007, the Company acquired the remaining 59.4% of partnership interests in U.S. Lithotripsy L.P. it did not own in exchange for cash of $1.2 million and notes payable totaling $9.7 million. Two of the notes were paid in full on August 31, 2012. At December 31, 2013, the subordinated notes payable are due to two individuals who are current members of the Company’s Board of Directors. Borrowings under the notes are secured by substantially all present and future assets of U.S. Lithotripsy L.P. and the partnership interests redeemed as part of the transaction. The indebtedness represented by the Subordinated Related Party Notes Payable is expressly subordinate to all senior indebtedness of Holdings currently outstanding or incurred in the future, which includes without limitation its indebtedness to banks.



Monthly principal and interest payments of $80,000 are due on the notes through maturity on October 31, 2018. Interest accrues at a fixed rate of 9.00%, subject to a premium of 1.00% under certain payment options available to the Company.

Consolidated Lithotripsy Entities

Notes Payable

During the third quarter of 2013, one of the Company’s consolidated lithotripsy partnerships acquired equipment totaling $0.4 million from another consolidated entity and executed a note payable with a third party to finance the full amount of the purchased equipment. The note bears a fixed interest rate of 4.2%, and principal and interest payments are due monthly in 60 equal installments of $6,488 until maturity in July, 2018. The note is secured by the financed equipment. The associated asset disposal and acquisition transactions have been eliminated in consolidation from the Company’s results of operations and cash flows.

During the second quarter of 2013, one of the Company’s consolidated lithotripsy partnerships acquired equipment totaling $0.2 million from another consolidated lithotripsy partnership and executed a note payable with a third party to finance the full amount of the purchased equipment. The note bears a fixed interest rate of 4.2% and principal and interest payments are due monthly in 36 equal installments of $5,336 until maturity in May, 2016. The note is secured by the financed equipment. The associated asset disposal and acquisition transactions have been eliminated in consolidation from the Company’s results of operations and cash flows.

During the third quarter of 2012, one of the Company’s consolidated lithotripsy partnerships acquired equipment totaling $0.5 million. Financing agreements were not finalized at December 31, 2012; however, the entity executed a note payable agreement in the first quarter of 2013 to finance the full amount of the purchased equipment. The note bears a fixed interest rate of 3.87% and principal and interest payments are due monthly in 48 equal installments of $10,390 until maturity in January, 2017. The note is secured by the financed equipment. At December 31, 2012, $0.1 million and $0.4 million of the balance were recorded in other current liabilities and other long-term liabilities, respectively.

Effective late December 2011, three consolidated lithotripsy service providers purchased equipment totaling $1.3 million. Financing agreements were not finalized at December 31, 2011; however, the entities executed agreements in the first quarter of 2012 to finance the full amount of the purchased equipment and an additional $0.1 million of purchased equipment. The notes payable bear fixed interest rates ranging from 3.97% to 4.75%. One of the notes requires 36 equal monthly payments and matures in March 2015. One of the notes requires 60 equal monthly payments and matures in March 2017. The remaining note was amended and matures in January 2018. The amendment requires interest payments until the first quarter of 2013 and then requires 59 equal monthly payments. The individual notes are generally secured by the assets of the individual entity and are guaranteed by the respective entity owners.

Capital Lease Obligations

During the fourth quarter of 2013, one of the Company’s consolidated lithotripsy partnerships entered into a capital lease for equipment totaling $0.5 million. Payments are due monthly in 60 equal installments of $9,440 until maturity in December, 2018.

During the first quarter of 2011, one of the Company’s consolidated lithotripsy partnerships entered into a capital lease for equipment totaling $0.5 million. Payments are due monthly in 60 equal installments of $8,600 until maturity in January 2016.

During the third quarter of 2010, one of the Company’s consolidated lithotripsy partnerships entered into a capital lease for equipment totaling $0.9 million. Payments are due monthly in 60 equal installments of $17,900 until maturity in October 2015.

Long-Term Debt Maturities

Maturities of the Company’s long-term debt are as follows as of December 31, 2013 (in thousands):



Year Ending December 31,
2014		$	8,123
2015			3,753
2016			3,711
2017			7,937
2018			785
Thereafter			20,837

Total		$	45,146




Capital Lease Obligations

The future minimum lease payments required under the capital leases and the present value of the net minimum lease payments as of December 31, 2013 are as follows:



Year Ending December 31,
2014		$	431
2015			395
2016			122
2017			114
2018			113

Total minimum lease payments			1,175
Less: amounts representing estimated taxes, maintenance and insurance amounts included in the total above			—

Net minimum capital lease payments			1,175
Less: amount representing interest			(123	)

Present value of minimum lease payments			1,052
Less: current portion of capital lease obligations			(369	)

Capital lease obligations, less current portion		$	683

Fair_Value_of_Financial_Instru

Fair Value of Financial Instruments	12 Months Ended
Fair Value of Financial Instruments	Dec. 31, 2013
Fair Value of Financial Instruments	'
	Note 11 – Fair Value of Financial Instruments
	Financial instruments consist mainly of cash and cash equivalents, accounts receivable, accounts payable, short-term borrowings and long-term debt. The carrying value of financial instruments with a short-term or variable-rate nature approximate fair value and are not presented in the table below. The carrying value and estimated fair value of the Company’s financial instruments that do not approximate fair value are set forth in the table below (in thousands):


		December 31, 2013				December 31, 2012
		Carrying		Fair		Carrying		Fair
		Value		Value		Value		Value
	Convertible Subordinated Notes	$	20,839	$	25,985	$	—	$	—
	Subordinated related party notes payable	$	3,734	$	3,481	$	4,328	$	5,078
	Consolidated lithotripsy entity notes payable	$	1,766	$	1,767	$	1,270	$	1,273
	Other long-term liabilities	$	—	$	—	$	461	$	461
	Other note payable	$	120	$	124	$	185	$	194
	The Company estimates the fair value of the Convertible Subordinated Notes as the sum of the independently estimated fair values of the debt host instrument and embedded conversion option. The Company calculates the present value of future principal and interest payments of the debt host using borrowing rates currently available to it for similar subordinated debt or debt for which the Company could use to retire the existing debt. The fair value of the embedded conversion option is valued using a Black-Scholes option pricing model and is added to the value of the debt host. Quoted market prices are not available for the Convertible Subordinated Notes. Estimation of the fair value of the Convertible Subordinated Notes is a Level 3 fair value measurement.
	The Company estimates the fair value of its subordinated related party notes payable using discounted cash flows based primarily on borrowing rates currently available to it for similar debt or debt for which the Company could use the proceeds to retire existing debt (Level 3 fair value measurement). The Company’s consolidated lithotripsy entities enter into term notes for equipment; borrowing rates are based on individual entity creditworthiness. The Company estimates current borrowing rates for the lithotripsy entity notes payable by adjusting the discount factor of the obligations at the balance sheet date by the variance in borrowing rates between the inception dates and balance sheet date (Level 2 fair value measurement). Management noted no significant events that would otherwise affect the borrowers’ creditworthiness. At December 31, 2012, the carrying value of other long-term liabilities approximated fair value due to recent inception. Quoted market prices are not available for the Company’s notes payable.

Deferred_Compensation_Plans

Deferred Compensation Plans	12 Months Ended
Deferred Compensation Plans	Dec. 31, 2013
Deferred Compensation Plans	'
	Note 12 – Deferred Compensation Plans
	Deferred Compensation – Nonqualified Savings Plan
	Upon consummation of the Contribution, the Company adopted a nonqualified deferred compensation savings plan (the “Savings Plan”) previously managed and held by MCNT. The Savings Plan is unfunded and was maintained primarily for the purpose of providing deferred compensation benefits to participating employees. The Savings Plan is intended to comply with the requirements of Section 409A of the Internal Revenue Code and applicable provisions of the Employee Retirement Income Security Act (“ERISA”). Once the Contribution occurred, the plan participant accounts were effectively frozen; no additional contributions can be made. When a participant terminates employment for any reason, he or she is entitled to begin receiving their accrued benefit. Distributions are made in five equal annual installments beginning in the January following the participant’s termination. The Savings Plan accounts are not held in a trust for the exclusive benefit of the participants and, therefore, remain subject to the claims of the Company’s creditors. Savings Plan account balances may be used to guarantee the Company’s Revolver or as otherwise deemed necessary by the Company’s management. At December 31, 2013, the Company’s deferred compensation obligation under the Savings Plan totaled $4.8 million with $0.2 million classified as a current liability and $4.6 million classified as a long-term liability in the accompanying consolidated balance sheet.

	Deferred Compensation – Nonqualified Income Plan
	Upon consummation of the Contribution, the Company acquired a nonqualified deferred compensation plan (the “Income Plan”) previously managed and held by MCNT and Impel. In order to partially fund the Income Plan, MCNT historically purchased corporate-owned life insurance policies on the Income Plan participants; these life insurance policies were also acquired in the Contribution. Upon consummation of the Contribution, a change of control occurred as defined by the Income Plan document, requiring the Income Plan’s account balances be distributed to its participants within 90 days of the change in control, or sooner if required by Internal Revenue Service Regulations. During September 2012, the Company surrendered the life insurance policies to the issuer for their cash surrender value in the aggregate amount of $3.2 million. Effective September 20, 2012, the Company distributed all amounts due to participants in the aggregate amount of $3.7 million. Effective October 1, 2012, the Income Plan was dissolved and terminated.

Income_Taxes

Income Taxes	12 Months Ended
Income Taxes	Dec. 31, 2013
Income Taxes	'
	Note 13 – Income Taxes
	Significant components of the provision (benefit) for income taxes are as follows (in thousands):


			Years Ended December 31,
			2013				2012
	Current:
	Federal		$	1,067			$	80
	State			228				178

	Total current			1,295				258

	Deferred:
	Federal			(1,224	)			1,229
	State			—				—

	Total deferred			(1,224	)			1,229

	Provision for income taxes		$	71			$	1,487

	A reconciliation of the actual tax rate to the statutory U.S. tax rate is as follows:


			Years Ended December 31,
			2013				2012
	Federal statutory rate			35	%			35	%
	State income taxes, net of federal tax benefit			1.3				0.8
	Net income attributable to noncontrolling interests			(30.7	)			(26.8	)
	Prior year corrections			(2.4	)			—
	Other			(1.6	)			0.7

	Effective tax rate for income from operations			1.6	%			9.7	%


	Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts reported for income tax purposes at the enacted tax rates in effect when the differences reverse. The components of deferred tax assets and liabilities are as follows (in thousands):


			December 31,
			2013				2012
	Deferred tax assets:
	Net operating losses		$	290			$	867
	Deferred revenue			150				207
	Share-based payment expense			850				791
	Deferred and other compensation			2,101				2,310
	Allowance for doubtful accounts			578				452
	IBNR liability			671				—
	Facilitative acquisition costs			385				385
	Intangible assets			572				907
	Other			538				206

	Total deferred tax assets			6,135				6,125

	Deferred tax liabilities:
	Partnership investments			(13,922	)			(13,593	)
	Property and equipment			(4,321	)			(5,358	)
	Tax impact of beneficial conversion feature of debt			(1,226	)			—
	Intangible assets			(9,301	)			(9,915	)
	Other			(311	)			(319	)

	Total deferred tax liabilities			(29,081	)			(29,185	)

	Net deferred tax liabilities		$	(22,946	)		$	(23,060	)


		Years Ended
		December 31,
		2013				2012
Current deferred tax assets		$	1,054			$	1,048
Current deferred tax liabilities			(312	)			(319	)

Net current deferred tax assets			742				729

Noncurrent deferred tax assets			5,081				5,077
Noncurrent deferred tax liabilities			(28,769	)			(28,866	)

Net noncurrent deferred tax liabilities			(23,688	)			(23,789	)

Net deferred tax liabilities		$	(22,946	)		$	(23,060	)

The Company has performed an evaluation and concluded that there are no significant uncertain tax positions requiring recognition in the Company’s consolidated financial statements for any year presented, nor have any changes occurred in uncertain tax positions in any year presented. The evaluation was performed for the tax years that remain subject to examination by major tax jurisdictions as of December 31, 2013, which includes the tax years 2010 through 2013.
At December 31, 2013, the Company had available unused net operating loss carryforwards of $827,000 that may be available to reduce future income tax liabilities. These loss carryforwards expire in 2031.

ShareBased_Payment

Share-Based Payment	12 Months Ended
Share-Based Payment	Dec. 31, 2013
Share-Based Payment	'
	Note 14 – Share-Based Payment
	Pursuant to its 2010 Equity Compensation Plan (the “Plan”), the Company may grant equity awards to employees, nonemployee directors and nonemployee service providers in the form of stock options, restricted stock and stock appreciation rights. The terms of the Plan provide for the reservation of up to 1,000,000 shares of common stock for issuance under the Plan, including a maximum of 900,000 shares issued pursuant to stock options and 100,000 shares issued pursuant to restricted stock and stock appreciation rights. Stock options may be granted with a contractual life of up to ten years. At December 31, 2013, the Company had 332,843 shares available for grant under the Plan.

	The fair value of stock option awards on the date of grant is estimated using the Black-Scholes option pricing model, which requires the Company to make certain predictive assumptions. The risk-free interest rate is based on the implied yield of U.S. Treasury zero-coupon securities that correspond to the expected life of the award. As a recently formed public entity with a small public float and limited trading of its common shares on the NASDAQ stock market, it was not practicable for the Company to estimate the volatility of its common shares; therefore, management estimated volatility based on the historical volatilities of a small group of companies considered as close to comparable to the Company as available and an industry index, all equally weighted, over the expected life of the option. Management concluded that this group is more characteristic of the Company’s business than a broad industry index. The expected life of awards granted represents the period of time that the awards are expected to be outstanding based on the “simplified” method, which is allowed for companies that cannot reasonably estimate the expected life of options based on its historical award exercise experience. The Company does not expect to pay dividends on its common stock. Due to the nature of the grants, the company estimated zero option forfeitures. Share-based payment expense is recorded only for those awards that are expected to vest. Weighted-average assumptions used in the Black-Scholes option pricing model for stock options granted were as follows:


		Years Ended December 31,
		2013			2012
	Risk-free interest rate		1.78	%		0.64	%
	Expected volatility of common stock		45.2	%		51.3	%
	Expected life of options		6.2 years			5.0 years
	Dividend yield		0	%		0	%
	The Black-Scholes option pricing model was developed for estimating the fair value of traded options that have no vesting restrictions and are fully transferable. Because option valuation models require the use of subjective assumptions, changes in these assumptions can materially affect the fair value of the options. The Company’s options do not have the characteristics of exchange traded options and, therefore, the option valuation models do not necessarily provide a reliable measure of the fair value of stock options. A summary of stock option activity for the year ended December 31, 2013 is as follows:


	Options	Number of			Weighted-			Weighted-Average		Aggregate
		Shares			Average			Remaining		Intrinsic Value
					Exercise			Contractual Term
					Price			(in years)
	Outstanding as of December 31, 2012		321,807		$	24.26				$	—
	Granted		287,845			26.24
	Exercised		(12,074	)		16.56				$	168,372
	Forfeited		(13,881	)		17.24

	Outstanding as of December 31, 2013		583,697		$	25.39			6.74	$	34,772

	Vested and expected to vest at December 31, 2013		251,395		$	24.85			5.94	$	34,772
	Exercisable at December 31, 2013		149,137		$	24.3			5.22	$	34,772
	The weighted-average grant-date fair value of stock options granted during the years ended December 31, 2013 and 2012 was $10.94 and $7.18 per option, respectively. The fair value of stock options vested and share-based payment expense recognized for the year ended December 31, 2013 and 2012 was $933,000 and $515,000, respectively, and is included in salaries, wages and employee benefits. At December 31, 2013, the total unrecognized compensation cost related to nonvested share-based payment awards was $3,025,000, which is expected to be recognized over a remaining weighted-average period of 3.6 years.
	Activity Related to the Contribution
	As additional consideration in the Contribution, on August 31, 2012, Holdings issued to Ventures nonemployee options to purchase 68,982 shares of Holdings’ common stock (“Ventures Options”). The Ventures Options vested immediately and expire five years from the grant date. The weighted-average grant-date fair value of the Ventures Options was $6.96 calculated using the Black-Scholes model with a risk-free interest rate of 0.26%, expected volatility of 46.6% and a simplified expected life of 2.5 years. The $480,000 estimated fair value of the Ventures Options was recorded to goodwill and additional paid-in capital.
	In connection with the Contribution, historical stock options of USMD (the accounting acquirer) were replaced with options to purchase shares of Holdings’ common stock. The Company recognized $149,000 of incremental value related to these stock options, which was recognized ratably over a term of three months following the Contribution, the implicit service period of the options.
	On August 31, 2012, 33,500 shares of Holdings’ restricted common stock held by nonemployees became unrestricted shares. On that date, the Company recorded $357,000 of share-based payment expense, the fair value of the total unrecognized cost of the shares, which is included in other operating expenses.
	Payments in Common Stock
	Pursuant to the Plan, on March 11, 2013, the Company granted 47,011 shares of its common stock with a fair value of $646,000 to certain executives and members of senior management in payment of all or a portion of their bonuses accrued at December 31, 2012.
	In August 2013, the Company granted 706 shares of its common stock with a fair value of $12,000 to a consultant in payment of amounts due.
	Effective September 30, 2013, one of the Company’s executives entered into a severance agreement with the Company. In connection with the severance agreement, the former executive was granted 14,583 shares of Holdings’ common stock with a fair value of $387,000, which is included in salaries, wages and employee benefits on the Company’s statement of operations.

	Effective December 31, 2013, the Company issued 9,086 shares of its common stock with a fair value of $183,000 to two members of senior management in payment of certain accrued compensation.
	The common shares described above have not been registered under the Securities Act of 1933, as amended (the “1933 Act”), and may not be transferred without an effective registration statement or pursuant to an appropriate exemption from the registration requirement of the 1933 Act.

Earnings_per_Share

Earnings per Share	12 Months Ended
Earnings per Share	Dec. 31, 2013
Earnings per Share	'
	Note 15 – Earnings per Share
	Basic earnings per share is computed by dividing net income attributable to the Company’s stockholders by the weighted-average number of common shares outstanding during the period. Diluted earnings per share is based on the weighted-average number of common shares outstanding plus the number of additional shares that would have been outstanding had the potentially dilutive common shares been issued. Securities that are potentially dilutive to common shares include outstanding stock options and the Convertible Subordinated Notes. Potential common shares are excluded from the computation of diluted earnings per common share when the effect would be antidilutive.
	Dilutive potential common shares related to stock options are calculated in accordance with the treasury stock method, which assumes that proceeds from the exercise of stock options are used to purchase common shares at the average market price during the period. Proceeds from the exercise of stock options include the amount the employee must pay for exercising stock options, the amount of compensation cost for future services that the Company has not yet recognized and the amount of tax benefits that would be recorded in additional paid-in capital when the award becomes deductible. The number of shares remaining represents the potentially dilutive effect of the securities. Stock options are only dilutive to the extent that the average market price of common stock during the period exceeds the exercise price of the options.
	Dilutive common shares related to the Convertible Subordinated Notes are calculated in accordance with the if-converted method. Under the if-converted method, if dilutive, net income attributable to the Company’s stockholders is adjusted to add back the amount of after-tax interest charges recognized in the period, including any deemed interest from the beneficial conversion feature, and the Convertible Subordinated Notes are assumed to have been converted with the resulting common shares added to weighted average shares outstanding. These securities are only dilutive to the extent that the after-tax interest charges per common share exceed basic earnings per share.
	In accordance with reverse acquisition accounting, the Company’s 2012 weighted-average number of common shares outstanding and potentially dilutive common shares have been retroactively adjusted to reflect the legal capital of the Company after the Contribution. The following table presents a reconciliation of the numerators and denominators of basic and diluted earnings per share and the computation of basic and diluted earnings per share (in thousands, except per share data):


		Years Ended December 31,
		2013		2012
	Numerator :
	Net earnings attributable to USMD Holdings, Inc.—basic	$	979	$	2,100
	Effect of potentially dilutive securities:
	Interest on Convertible Subordinated Notes, net of tax		—		—

	Net earnings attributable to USMD Holdings, Inc.—diluted	$	979	$	2,100

	Denominator :
	Weighted-average common shares outstanding		10,080		5,739
	Effect of potentially dilutive securities:
	Stock options		4		5
	Convertible Subordinated Notes		—		—

	Weighted-average common shares outstanding assuming dilution		10,084		5,744

	Earnings per share attributable to USMD Holdings, Inc.:
	Basic	$	0.1	$	0.37
	Diluted	$	0.1	$	0.37
	The following table presents the potential shares excluded from the diluted earnings per share calculation because the effect of including these potential shares would be antidilutive (in thousands):


		Years Ended December 31,
		2013		2012
	Stock options		643		183
	Convertible Subordinated Notes		1,042		—

			1,685		183

Commitments_and_Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2013
Commitments and Contingencies	'
	Note 16 – Commitments and Contingencies
	Financial Guarantees
	As of December 31, 2013, the Company had issued guarantees to third parties of the indebtedness and other obligations of certain of its nonconsolidated investees. Should the investees fail to pay the obligations due, the Company could be required to make payments totaling an aggregate of $20.8 million. The guarantees provide for recourse against the investee; however, if the Company were required to perform under the guarantees, recovery of any amount from investees would be unlikely. The remaining terms of these guarantees range from 13 to 75 months. The Company records a liability for performance under financial guarantees when, upon review of available financial information of the nonconsolidated affiliate and in consideration of pertinent factors, management determines that it is probable it will have to perform under the guarantee and the liability is reasonably estimable. The Company has not recorded a liability for these guarantees, as it believes it is not probable that it will have to perform under these agreements.
	Litigation
	The Company is from time to time subject to litigation and related claims and arbitration matters arising in the ordinary course of business, including claims relating to contracts and financial obligations, partnership or joint venture entity disputes and, with respect to USMD Physician Services, claims arising from the provision of professional medical services to patients. In some cases, plaintiffs may seek damages, including punitive damages, that may not be covered by insurance. In other cases, claims may not be covered by insurance at all. The Company maintains professional and general liability insurance through commercial insurance carriers for claims and in amounts that the Company believes to be sufficient for its operations, although, potentially, some claims may exceed the scope and amount of coverage in effect. The Company expenses as incurred legal costs associated with litigation or other loss contingencies.
	The Company accrues for a contingent loss when it is both probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Judgment is required in both the determination of the probability of a loss and the determination as to whether a loss is reasonably estimable. These determinations are updated at least quarterly and are adjusted to reflect the effects of negotiations, settlements, rulings, advice of legal counsel and technical experts and other information and events pertaining to a particular matter. To the extent there is a reasonable possibility that probable losses could exceed amounts already accrued, if any, and the additional loss or range of loss is estimable, management discloses the additional loss or range of loss. For matters where the Company has evaluated that a loss is not probable, but is reasonably possible, the Company will disclose an estimate of the possible loss or range of loss or make a statement that such an estimate cannot be made.
	Certain subsidiaries of the Company in the ordinary course of business are party to various medical negligence lawsuits and wrongful termination lawsuits. In addition, subsidiaries of the Company have received notices of potential claims. For medical negligence lawsuits where the Company can reasonably estimate a range of loss, the Company estimates a reasonably possible range of loss of $-0- to $0.5 million. In the remaining lawsuits and the potential claims, the parties are in the early stages of discovery and/or the plaintiffs have not made specific demands for damages. Due to these circumstances, the Company is unable to estimate a reasonably possible range of loss related to these lawsuits and claims. The Company is insured against the claims described above and believes based on the facts known to date that any damage award related to such claims would be recoverable from its insurer.
	The Company is subject to various additional claims and legal proceedings that have arisen in the ordinary course of its business activities. Management believes that any liability that may ultimately result from the resolution of these matters will not have a material adverse effect on the financial condition or results of operations of the Company.
	Gain Contingency
	On October 26, 2012, a subsidiary of the Company entered into a settlement agreement with an entity to which the subsidiary had provided management services under a long term contract. The entity agreed to pay the Company the sum of $650,000 to settle certain claims between the Company and the entity arising from the entity’s early termination of the contract. The settlement agreement required the entity to pay the Company $100,000 in November 2012 and to make fifty-five monthly payments of $10,000 on the first day of each month beginning December 2012. The Company concluded that collection of the settlement amount is not reasonably assured and has recorded the gain as amounts are collected. The Company has received total payments of $130,000 and $110,000 for the years ended December 31, 2013 and 2012, respectively, and the payments are recorded in management and other services revenue on the Company’s statements of operations.
	Operating Lease Commitments
	The Company leases certain medical and corporate office space and medical and office equipment under non-cancelable operating lease agreements expiring at various dates through 2028. The facility leases generally include renewal options with terms to be negotiated at the time of renewal and also generally require the lessee to pay all executory costs such as maintenance and insurance. Facility leases may or may not contain provisions for future rent increases, rent free periods or periods in which rent payments are reduced (abated). Total rental payments due over the lease term are charged to rent expense using the straight-line method over the term of the lease. The difference between rent expense recorded and the amount paid is credited or charged to deferred rent in the accompanying consolidated balance sheet. In addition, facility leases may or may not include a provision for a tenant allowance to be used for build out of the leased space; the build out is managed and controlled by the lessor. Tenant allowances are credited to deferred rent and amortized as reductions to rent expense over the lease term, and the related leasehold improvements are recorded and amortized over the shorter of their economic lives or the lease term.

	Future minimum rental commitments under non-cancelable operating leases are as follows (in thousands):


		Minimum Lease
		Commitments
	Years Ending December 31,
	2014	$	11,761
	2015		10,902
	2016		8,913
	2017		7,612
	2018		6,706
	Thereafter		33,785

	Total	$	79,679

	Aggregate future minimum rentals to be received under non-cancelable subleases as of December 31, 2013 were $1.4 million.

Related_Party_Transactions

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2013
Related Party Transactions	'
	Note 17 – Related Party Transactions
	The Company provides management, clinical and support services to various nonconsolidated affiliates in which it has limited partnership or ownership interests. Management services revenue and accounts receivable from these entities are as follows:


		Management Services Revenue				Accounts Receivable
		Years Ended December 31,				As of December 31,
		2013		2012		2013		2012
		(in thousands)
	USMD Arlington	$	10,423	$	9,945	$	2,625	$	2,480
	USMD Fort Worth		4,434		4,275		1,221		1,153
	Other equity method investees		1,379		336		435		82

		$	16,236	$	14,556	$	4,281	$	3,715

	One consolidated lithotripsy entity provides lithotripsy services to USMD Arlington and USMD Fort Worth. For the years ended December 31, 2013 and 2012, the Company recognized lithotripsy revenues from USMD Arlington and USMD Fort Worth totaling $2.2 million and $2.1 million, respectively.
	The Company leases space from USMD Arlington for certain of its physicians and its Arlington-based cancer treatment center. The Company recorded rent expense related to USMD Arlington totaling $1.7 million for both years ended December 31, 2013 and 2012.

Employee_Benefit_Plans

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2013
Employee Benefit Plans	'
	Note 18 – Employee Benefit Plans
	The Company provides a 401(k) defined contribution plan for all eligible employees. Through December 31, 2013, the Company provided a matching contribution of up to 6.0% of participants’ eligible compensation. The Company’s contributions to the plan totaled $3.1 million and $0.9 million in 2013 and 2012, respectively. Beginning January 1, 2014, the Company replaced the matching contribution with a safe harbor non-elective contribution. The non-elective contribution is 3% of annual compensation and is provided to all eligible employees. The non-elective contributions have a two-year vesting period.

Subsequent_Events

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2013
Subsequent Events	'
	Note 19 – Subsequent Events
	Stock Options
	Pursuant to its 2010 Equity Compensation Plan, during the first quarter of 2014, the Company granted to new executives of the Company options to purchase 150,000 shares of the Company’s common stock with an aggregate fair value of $1.0 million. The awards vest at the rate of 20% at the grant date and 20% per year on the first day of each year through January 1, 2018.

Summary_of_Significant_Account1

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2013

Patient Service Revenue

Capitated Revenue

Management Services Revenue

Lithotripsy Services Revenue

Physician Recruitment Agreements

Concentrations and Credit Risk

Accounts Receivable

December 31,

2013

2012

Government-related programs

Managed care and commercial payers

Self-pay

Customer

100

For the years ended December 31, 2013 and 2012, USMD Hospital at Arlington, L.P. accounted for 5% and 11%, respectively, of net operating revenue.

Allowance for Doubtful Accounts

Balance at

Provision for

Write-

Initial

Balance at

Beginning of

Doubtful

offs

Consolidation of

End of Year

Year

Accounts

Investee (Note 6)

Related to

Patient Service

Revenue

For the years ended December 31,

2013

1,127

2,801

(2,240

)

—

1,758

2012

428

889

107

(368

)

1,127

Cash and Cash Equivalents

Cash equivalents include highly liquid investments with maturities of three months or less when purchased. Cash and cash equivalents consist primarily of bank deposit accounts.

Inventories

Inventories consist primarily of pharmacy supplies and are stated at lower of cost or market on a first-in, first-out basis.

Property and Equipment, Net

Leasehold improvements

1-15 years

Furniture and equipment

2-15 years

Software

1-5 years

Assets acquired in the Contribution are being depreciated over their estimated remaining useful lives, from one to six years.

Impairment of Long-Lived Assets and Finite-Lived Intangible Assets

Goodwill and Other Indefinite-Lived Intangible Assets

The Company performs its annual impairment tests of goodwill and indefinite-lived intangible assets as of December 31.

Electronic Health Record Incentive Income

Share-Based Payments

Income Taxes

Fair Value Measurements

•

Level 1 – Observable inputs such as quoted prices in active markets;

•

Level 2 – Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and

•

Level 3 – Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions.

Assets and liabilities measured at fair value are based on one or more of three valuation techniques. The three valuation techniques are as follows:

•

Market approach – Prices and other market-related information involving identical or comparable assets or liabilities;

•

Cost approach – Amount that would be required to replace the service capacity of an asset (i.e., replacement cost); and

•

Income approach – Techniques to convert future amounts to a single present amount based on market expectations (including present value techniques, option pricing models and lattice models).

Investments in Nonconsolidated Affiliates

Noncontrolling Interests in Subsidiaries

Translation of Foreign Currencies

Segment Reporting

Advertising Expense

Use of Estimates

Out of Period Adjustment:

Summary_of_Significant_Account2

Summary of Significant Accounting Policies (Tables)	12 Months Ended
Summary of Significant Accounting Policies (Tables)	Dec. 31, 2013
Percentage of Patient and Customer Accounts Receivable	'
	At December 31, 2013 and 2012, the mix of gross patient and customer accounts receivable is as follows:


		December 31,
		2013			2012
	Government-related programs		29	%		37	%
	Managed care and commercial payers		58	%		53	%
	Self-pay		3	%		2	%
	Customer		10	%		8	%

			100	%		100	%

Summary of Accounts Receivable Allowance	'
	A summary of the Company’s accounts receivable allowance for doubtful accounts activity is as follows (in thousands):


		Balance at			Provision for			Provision for		Write-			Initial		Balance at
		Beginning of			Doubtful			Doubtful		offs			Consolidation of		End of Year
		Year			Accounts			Accounts					Investee (Note 6)
					Related to
					Patient Service
					Revenue
	For the years ended December 31,
	2013	$	1,127			2,801			70		(2,240	)		—	$	1,758
	2012	$	428			889			107		(368	)		71	$	1,127
Estimated Useful Lives of Assets	'
	Estimated useful lives of assets follow American Hospital Association guidelines where applicable and are as follows at December 31, 2013:


	Leasehold improvements		1-15 years
	Furniture and equipment		2-15 years
	Software		1-5 years

Business_Combination_Tables

Business Combination (Tables)	12 Months Ended
Business Combination (Tables)	Dec. 31, 2013
Summary of Estimated Fair Values of Assets Acquired and Liabilities Assumed of Ventures	'
	The following table summarizes the estimated fair values of the assets acquired and liabilities assumed of Ventures, UANT, MCNT and Impel at the acquisition date (in thousands):


		August 31, 2012			Measurement			August 31, 2012
		(As initially			Period			(As adjusted)
		reported)			Adjustments
	Current assets	$	25,069		$	36		$	25,105
	Property and equipment		24,020			(171	)		23,849
	Investments in affiliates		36,198			—			36,198
	Other assets		7,240			—			7,240
	Identifiable intangible assets		32,479			(3,377	)		29,102
	Goodwill		83,346			3,057			86,403
	Liabilities assumed, other than long-term debt		(30,925	)		455			(30,470	)
	Long-term debt		(18,832	)		—			(18,832	)

	Net assets acquired and liabilities assumed	$	158,595		$	—		$	158,595

Schedule of Identifiable Intangible Assets Acquired in Contribution, Excluding Goodwill	'
	Identifiable intangible assets acquired in the Contribution, excluding goodwill, consist of the following (in thousands):


		Fair Value			Weighted-
					Average
					Amortization
					Period
	Noncompete agreements	$	12,488			10.0 years
	Trade names		10,706			Indefinite
	Trade name—Impel		462			5.0 years
	Customer relationships		767			3.0 years
	Management agreement		4,679			30.0 years

		$	29,102

Pro Forma Combined Financial Information	'

	The pro forma combined financial information has been prepared for illustrative purposes only and is not necessarily indicative of the results of operations in future periods or the results of operations that would have been realized had Holdings, USMD, Ventures, UANT, MCNT and Impel been a combined company during the specified periods (in thousands, except per share data).



		Years Ended December 31,
		2013			2012
		(unaudited, pro forma)
	Net operating revenue	$	234,727		$	223,881
	Net income	$	10,798		$	14,160
	Net income attributable to USMD Holdings, Inc.	$	1,047		$	4,048
	Earnings per share attributable to USMD Holdings, Inc.
	Basic	$	0.1		$	0.4
	Diluted	$	0.1		$	0.4

Variable_Interest_Entity_Table

Variable Interest Entity (Tables)	12 Months Ended
Variable Interest Entity (Tables)	Dec. 31, 2013
Carrying Amount of Assets and Liabilities of WNI-DFW	'
	The following table summarizes the carrying amount of the assets and liabilities of WNI-DFW included in the Company’s consolidated balance sheet at December 31, 2013 (after elimination of intercompany transactions and balances) (in thousands):


		December 31,
		2013
	Current assets:
	Cash and cash equivalents	$	1,257
	Accounts receivable		175

	Total current assets		1,432
	Deferred tax asset		671

	Total assets	$	2,103

	Current liabilities:
	Other accrued liabilities	$	2,108

	Total current liabilities	$	2,108

Investments_in_Nonconsolidated1

Investments in Nonconsolidated Affiliates (Tables)	12 Months Ended
Investments in Nonconsolidated Affiliates (Tables)	Dec. 31, 2013
Financial Information of Nonconsolidated Affiliates Accounted for Under Equity Method	'
	The net carrying values and ownership percentages of nonconsolidated affiliates accounted for under the equity method are as follows (dollars in thousands):


		December 31, 2013					December 31, 2012
		Carrying		Ownership			Carrying		Ownership
		Value		Percentage			Value		Percentage
	USMD Hospital at Arlington, L.P.	$	50,055		46.4	%	$	24,997		28.44	%
	USMD Hospital at Fort Worth, L.P.		11,246		30.88	%		10,779		30.88	%
	Other		521		4%-34	%		116		4%-34	%

		$	61,822				$	35,892

Individually Summarized Financial Information	'
	Summarized combined financial information for the Company’s nonconsolidated affiliates accounted for under the equity method is as follows (in thousands):


		December 31,
		2013		2012
	Current assets	$	43,558	$	38,146
	Noncurrent assets	$	83,895	$	85,090
	Current liabilities	$	19,148	$	27,175
	Noncurrent liabilities	$	55,455	$	49,675

		Years Ended December 31,
		2013		2012
	Revenue	$	141,363	$	129,030
	Income from operations	$	35,925	$	28,701
	Income from continuing operations	$	33,502	$	25,362
	Net income	$	33,502	$	25,362
Individual	'
Individually Summarized Financial Information	'

	Financial information for USMD Arlington and USMD Forth Worth is included in the summarized information above and is as follows individually (in thousands):



		USMD Arlington					USMD Fort Worth
		December 31,
		2013		2012			2013		2012
	Current assets	$	26,055	$	24,986		$	13,445	$	11,859
	Noncurrent assets	$	54,205	$	55,767		$	17,439	$	18,365
	Current liabilities	$	9,987	$	8,975		$	5,593	$	15,888
	Noncurrent liabilities	$	36,361	$	40,144		$	10,758	$	1,567

		Years Ended December 31,
		2013		2012			2013		2012
	Revenue	$	90,619	$	84,936		$	39,172	$	37,092
	Income from operations	$	21,317	$	17,836		$	9,336	$	7,843
	Income from continuing operations	$	20,429	$	15,264		$	8,386	$	7,097
	Net income	$	20,429	$	15,264		$	8,386	$	7,097

Patient_Service_Revenue_Tables

Patient Service Revenue (Tables)	12 Months Ended
Patient Service Revenue (Tables)	Dec. 31, 2013
Patient Service Revenue	'

	The Company’s patient service revenue by payer is summarized in the table that follows (dollars in thousands). The Company had no patient service revenue prior to September 1, 2012.



		Years Ended December 31,
		2013						2012
		Amount			Ratio of Net			Amount			Ratio of Net
					Patient Service						Patient Service
					Revenue						Revenue
	Medicare	$	52,003			29.2	%	$	16,820			28.3	%
	Medicaid		1,460			0.8			388			0.7
	Managed care and commercial payers		123,336			69.2			41,689			70.2
	Self-pay		4,288			2.4			1,412			2.4

	Patient service revenue before provision for doubtful accounts		181,087			101.6			60,309			101.5
	Patient service revenue provision for doubtful accounts		(2,801	)		(1.6	)		(889	)		(1.5	)

	Net patient service revenue	$	178,286			100	%	$	59,420			100	%

Property_and_Equipment_Tables

Property and Equipment (Tables)	12 Months Ended
Property and Equipment (Tables)	Dec. 31, 2013
Summary of Property and Equipment	'
	Property and equipment consist of the following (in thousands):


		December 31,
		2013			2012
	Leasehold improvements	$	12,565		$	11,723
	Furniture and equipment		21,691			20,587
	Software		3,043			2,857

	Gross property and equipment		37,299			35,167
	Less: accumulated depreciation and amortization		(13,808	)		(8,964	)

	Property and equipment, net	$	23,491		$	26,203

Assets Recorded under Capital Lease Arrangements Included in Property and Equipment	'
	Assets recorded under capital lease arrangements included in property and equipment consist of the following (in thousands):


		December 31,
		2013			2012
	Furniture and equipment	$	1,990		$	1,499

	Gross assets recorded under capital leases		1,990			1,499
	Less: accumulated amortization		(854	)		(595	)

	Net assets recorded under capital leases	$	1,136		$	904

Goodwill_and_Other_Intangible_1

Goodwill and Other Intangible Assets (Tables)	12 Months Ended
Goodwill and Other Intangible Assets (Tables)	Dec. 31, 2013
Changes in Carrying Amount of Goodwill	'
	The following table sets forth the goodwill activity for each of the Company’s reporting units during the years ended December 31, 2013 and 2012 (in thousands):


		Physician and			Cancer			Lithotripsy			Total
		Ancillary Services			Treatment			Services
					Services
	Balance at January 1, 2012:
	Goodwill	$	4,907		$	—		$	6,837		$	11,744
	Accumulated impairment		—			—			(3,409	)		(3,409	)

			4,907			—			3,428			8,335
	Increase due to business combination		55,707			54,219			—			109,926
	Balance at December 31, 2012:
	Goodwill		60,614			54,219			6,837			121,670
	Accumulated impairment		—			—			(3,409	)		(3,409	)

			60,614			54,219			3,428			118,261
	Adjustments related to business combination		(196	)		111			—			(85	)
	Balance at December 31, 2013:
	Goodwill		60,418			54,330			6,837			121,585
	Accumulated impairment		—			—			(3,409	)		(3,409	)

		$	60,418		$	54,330		$	3,428		$	118,176

Components of Amortizable Intangible Assets	'
	The components of amortizable intangible assets consist of the following (in thousands):


		December 31, 2013									December 31, 2012
		Gross			Accumulated			Net Carrying			Gross			Accumulated			Net Carrying
		Carrying			Amortization			Amount			Carrying			Amortization			Amount
		Amount									Amount
	Management agreements	$	5,246		$	(544	)	$	4,702		$	5,246		$	(351	)	$	4,895
	Trade name		462			(123	)		339			462			(31	)		431
	Customer relationships		767			(341	)		426			767			(85	)		682
	Noncompete agreements		12,527			(1,667	)		10,860			12,488			(416	)		12,072

		$	19,002		$	(2,675	)	$	16,327		$	18,963		$	(883	)	$	18,080

Estimated Amortization Expense for Intangible Assets during Next Five Years	'
	Total estimated amortization expense for the Company’s intangible assets during the next five years is as follows (in thousands):


	2014	$	1,800
	2015		1,800
	2016		1,500
	2017		1,500
	2018		1,500

	Total	$	8,100

Other_Accrued_Liabilities_Tabl

Other Accrued Liabilities (Tables)	12 Months Ended
Other Accrued Liabilities (Tables)	Dec. 31, 2013
Summary of Other Accrued Liabilities	'
	Other accrued liabilities consist of the following (in thousands):


		December 31,
		2013		2012
	Accrued expenses	$	3,002	$	3,108
	Accrued bonus		1,860		1,469
	Accrued payables		3,582		822
	IBNR payable		1,918		—
	Income taxes payable		395		468

		$	10,757	$	5,867

LongTerm_Debt_Capital_Lease_Ob1

Long-Term Debt, Capital Lease Obligations and Other Long-Term Liabilities (Tables)	12 Months Ended
	Dec. 31, 2013
Schedule of Long-term Debt Instruments	'
	Long-term debt and capital lease obligations consist of the following (in thousands):


		December 31,
		2013			2012
	Holdings:
	Credit Agreement:
	Term debt	$	15,687		$	19,938
	Revolving credit facility		3,000			—
	Convertible subordinated notes, net of unamortized discount of $3,503		20,839			—
	Subordinated related party notes payable		3,734			4,328
	Other note payable		120			185

			43,380			24,451
	Consolidated lithotripsy entities:
	Notes payable		1,766			1,270
	Capital lease obligations		1,052			848

			2,818			2,118

	Total long-term debt and capital lease obligations		46,198			26,569
	Less: current portion		(8,492	)		(5,520	)

	Long-term debt and capital lease obligations, less current portion	$	37,706		$	21,049

Maturities of Long-Term Debt	'
	Maturities of the Company’s long-term debt are as follows as of December 31, 2013 (in thousands):


	Year Ending December 31,
	2014	$	8,123
	2015		3,753
	2016		3,711
	2017		7,937
	2018		785
	Thereafter		20,837

	Total	$	45,146

Future Minimum Lease Payments under Capital Leases and Present Value of Net Minimum Lease Payments	'
	The future minimum lease payments required under the capital leases and the present value of the net minimum lease payments as of December 31, 2013 are as follows:


	Year Ending December 31,
	2014	$	431
	2015		395
	2016		122
	2017		114
	2018		113

	Total minimum lease payments		1,175
	Less: amounts representing estimated taxes, maintenance and insurance amounts included in the total above		—

	Net minimum capital lease payments		1,175
	Less: amount representing interest		(123	)

	Present value of minimum lease payments		1,052
	Less: current portion of capital lease obligations		(369	)

	Capital lease obligations, less current portion	$	683

Fair_Value_of_Financial_Instru1

Fair Value of Financial Instruments (Tables)	12 Months Ended
Fair Value of Financial Instruments (Tables)	Dec. 31, 2013
Carrying Value and Estimated Fair Value of Financial Instruments	'
	The carrying value and estimated fair value of the Company’s financial instruments that do not approximate fair value are set forth in the table below (in thousands):


		December 31, 2013				December 31, 2012
		Carrying		Fair		Carrying		Fair
		Value		Value		Value		Value
	Convertible Subordinated Notes	$	20,839	$	25,985	$	—	$	—
	Subordinated related party notes payable	$	3,734	$	3,481	$	4,328	$	5,078
	Consolidated lithotripsy entity notes payable	$	1,766	$	1,767	$	1,270	$	1,273
	Other long-term liabilities	$	—	$	—	$	461	$	461
	Other note payable	$	120	$	124	$	185	$	194

Income_Taxes_Tables

Income Taxes (Tables)	12 Months Ended
Income Taxes (Tables)	Dec. 31, 2013
Schedule of Significant Components of Provision (Benefit) for Income Taxes	'
	Significant components of the provision (benefit) for income taxes are as follows (in thousands):


		Years Ended December 31,
		2013			2012
	Current:
	Federal	$	1,067		$	80
	State		228			178

	Total current		1,295			258

	Deferred:
	Federal		(1,224	)		1,229
	State		—			—

	Total deferred		(1,224	)		1,229

	Provision for income taxes	$	71		$	1,487

Reconciliation of Actual Tax Rate	'
	A reconciliation of the actual tax rate to the statutory U.S. tax rate is as follows:


		Years Ended December 31,
		2013			2012
	Federal statutory rate		35	%		35	%
	State income taxes, net of federal tax benefit		1.3			0.8
	Net income attributable to noncontrolling interests		(30.7	)		(26.8	)
	Prior year corrections		(2.4	)		—
	Other		(1.6	)		0.7

	Effective tax rate for income from operations		1.6	%		9.7	%

Schedule of Components of Deferred Tax Assets and Liabilities	'
	The components of deferred tax assets and liabilities are as follows (in thousands):


		December 31,
		2013			2012
	Deferred tax assets:
	Net operating losses	$	290		$	867
	Deferred revenue		150			207
	Share-based payment expense		850			791
	Deferred and other compensation		2,101			2,310
	Allowance for doubtful accounts		578			452
	IBNR liability		671			—
	Facilitative acquisition costs		385			385
	Intangible assets		572			907
	Other		538			206

	Total deferred tax assets		6,135			6,125

	Deferred tax liabilities:
	Partnership investments		(13,922	)		(13,593	)
	Property and equipment		(4,321	)		(5,358	)
	Tax impact of beneficial conversion feature of debt		(1,226	)		—
	Intangible assets		(9,301	)		(9,915	)
	Other		(311	)		(319	)

	Total deferred tax liabilities		(29,081	)		(29,185	)

	Net deferred tax liabilities	$	(22,946	)	$	(23,060	)


		Years Ended
		December 31,
		2013			2012
	Current deferred tax assets	$	1,054		$	1,048
	Current deferred tax liabilities		(312	)		(319	)

	Net current deferred tax assets		742			729

	Noncurrent deferred tax assets		5,081			5,077
	Noncurrent deferred tax liabilities		(28,769	)		(28,866	)

	Net noncurrent deferred tax liabilities		(23,688	)		(23,789	)

	Net deferred tax liabilities	$	(22,946	)	$	(23,060	)

ShareBased_Payment_Tables

Share-Based Payment (Tables)	12 Months Ended
Share-Based Payment (Tables)	Dec. 31, 2013
Weighted Average Assumptions Used in Black-Scholes Model for Stock Options	'
	Weighted-average assumptions used in the Black-Scholes option pricing model for stock options granted were as follows:


		Years Ended December 31,
		2013			2012
	Risk-free interest rate		1.78	%		0.64	%
	Expected volatility of common stock		45.2	%		51.3	%
	Expected life of options		6.2 years			5.0 years
	Dividend yield		0	%		0	%
Summary of Stock Option Activity	'
	A summary of stock option activity for the year ended December 31, 2013 is as follows:


	Options	Number of			Weighted-			Weighted-Average		Aggregate
		Shares			Average			Remaining		Intrinsic Value
					Exercise			Contractual Term
					Price			(in years)
	Outstanding as of December 31, 2012		321,807		$	24.26				$	—
	Granted		287,845			26.24
	Exercised		(12,074	)		16.56				$	168,372
	Forfeited		(13,881	)		17.24

	Outstanding as of December 31, 2013		583,697		$	25.39			6.74	$	34,772

	Vested and expected to vest at December 31, 2013		251,395		$	24.85			5.94	$	34,772
	Exercisable at December 31, 2013		149,137		$	24.3			5.22	$	34,772

Earnings_per_Share_Tables

Earnings per Share (Tables)	12 Months Ended
Earnings per Share (Tables)	Dec. 31, 2013
Reconciliation of Numerators and Denominators of Basic and Diluted Earnings (Loss) Per Share and Computation of Basic and Diluted Earnings (Loss) Per Share	'
	The following table presents a reconciliation of the numerators and denominators of basic and diluted earnings per share and the computation of basic and diluted earnings per share (in thousands, except per share data):


		Years Ended December 31,
		2013		2012
	Numerator :
	Net earnings attributable to USMD Holdings, Inc.—basic	$	979	$	2,100
	Effect of potentially dilutive securities:
	Interest on Convertible Subordinated Notes, net of tax		—		—

	Net earnings attributable to USMD Holdings, Inc.—diluted	$	979	$	2,100

	Denominator :
	Weighted-average common shares outstanding		10,080		5,739
	Effect of potentially dilutive securities:
	Stock options		4		5
	Convertible Subordinated Notes		—		—

	Weighted-average common shares outstanding assuming dilution		10,084		5,744

	Earnings per share attributable to USMD Holdings, Inc.:
	Basic	$	0.1	$	0.37
	Diluted	$	0.1	$	0.37
Potential Shares Excluded from Diluted Earnings (loss) per share Calculation	'
	The following table presents the potential shares excluded from the diluted earnings per share calculation because the effect of including these potential shares would be antidilutive (in thousands):


		Years Ended December 31,
		2013		2012
	Stock options		643		183
	Convertible Subordinated Notes		1,042		—

			1,685		183

Commitments_and_Contingencies_

Commitments and Contingencies (Tables)	12 Months Ended
Commitments and Contingencies (Tables)	Dec. 31, 2013
Schedule of Future Minimum Lease Commitments under Operating Leases	'
	Future minimum rental commitments under non-cancelable operating leases are as follows (in thousands):


		Minimum Lease
		Commitments
	Years Ending December 31,
	2014	$	11,761
	2015		10,902
	2016		8,913
	2017		7,612
	2018		6,706
	Thereafter		33,785

	Total	$	79,679

Related_Party_Transactions_Tab

Related Party Transactions (Tables)	12 Months Ended
Related Party Transactions (Tables)	Dec. 31, 2013
Management Services Revenue and Accounts Receivable	'
	Management services revenue and accounts receivable from these entities are as follows:


		Management Services Revenue				Accounts Receivable
		Years Ended December 31,				As of December 31,
		2013		2012		2013		2012
		(in thousands)
	USMD Arlington	$	10,423	$	9,945	$	2,625	$	2,480
	USMD Fort Worth		4,434		4,275		1,221		1,153
	Other equity method investees		1,379		336		435		82

		$	16,236	$	14,556	$	4,281	$	3,715

Description_of_Business_and_Ba1

Description of Business and Basis of Presentation - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013
	TreatmentCenter
	Hospital
	Lab
Description Of Company And Significant Accounting Policies [Line Items]	'
Providing Management and operational services to care hospitals	2
Number of cancer treatment center	6
Number of lithotripsy service providers	21
Numbers of managed hospitals in which the Company has ownership interests.	2
Number of cancer treatment centers in which Company has ownership interests	2
Number of managed lithotripsy service centers in which Company has ownership interests	20
Number of wholly owned and operated Clinical Labs	2
Numbers of wholly owned and operated anatomical pathology laboratories	1
Number of wholly owned and operated cancer treatment centers	1
Number of wholly owned and operated lithotripsy service centers	1

Summary_of_Significant_Account3

Summary of Significant Accounting Policies - Additional Information (Detail) (USD $)	3 Months Ended	12 Months Ended
	Mar. 31, 2013	Dec. 31, 2013	Dec. 31, 2012
		Segment
		Entity
Significant Accounting Policies [Line Items]	'	'	'
Other operating revenue	'	$181,087,000	$60,309,000
Impairment charges of long-lived assets and other intangible assets	'	0	0
Consolidated lithotripsy entities that are less than 100% owned	'	18	'
Consolidated variable interest entity that is less than 100% owned	'	1	'
Number of operating segments	'	1	'
Misstatement resulting in decrease in goodwill in December 2012 and increase in income tax provision in 2013	196,000	'	196,000
Physician Recruitment Agreements	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Other operating revenue	'	1,000,000	300,000
Other Operating Expenses	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Advertising Expense	'	300,000	300,000
Minimum \| Acquired Assets	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Estimated useful lives of assets	'	'1 year	'
Maximum \| Acquired Assets	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Estimated useful lives of assets	'	'6 years	'
USMD Hospital at Arlington, L.P. \| Net operating Revenue	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Net operating revenue	'	5.00%	11.00%
Other Current Liabilities \| Physician Recruitment Agreements	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Deferred revenue associated with physician recruitment agreements	'	800,000	1,000,000
Other Long Term Liabilities \| Physician Recruitment Agreements	'	'	'
Significant Accounting Policies [Line Items]	'	'	'
Deferred revenue associated with physician recruitment agreements	'	$400,000	$600,000

Percentage_of_Patient_and_Cust

Percentage of Patient and Customer Accounts Receivable (Detail) (Accounts Receivable)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Concentration Risk [Line Items]	'	'
Percentage of accounts receivable	100.00%	100.00%
Government-related programs	'	'
Concentration Risk [Line Items]	'	'
Percentage of accounts receivable	29.00%	37.00%
Managed care and commercial payers	'	'
Concentration Risk [Line Items]	'	'
Percentage of accounts receivable	58.00%	53.00%
Self-pay	'	'
Concentration Risk [Line Items]	'	'
Percentage of accounts receivable	3.00%	2.00%
Customer	'	'
Concentration Risk [Line Items]	'	'
Percentage of accounts receivable	10.00%	8.00%

Summary_of_Accounts_Receivable

Summary of Accounts Receivable Allowance (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Allowance for Doubtful Accounts [Line Items]	'	'
Beginning balance	$1,127	$428
Provision for Doubtful Accounts Related to Patient Service Revenue	2,801	889
Provision for doubtful accounts	70	107
Write-offs, net of Recoveries	-2,240	-368
Initial Consolidation of Investee	'	71
Ending balance	$1,758	$1,127

Estimated_Useful_Lives_of_Asse

Estimated Useful Lives of Assets (Detail)	12 Months Ended
Estimated Useful Lives of Assets (Detail)	Dec. 31, 2013
Leasehold Improvement \| Minimum	'
Property, Plant and Equipment [Line Items]	'
Estimated useful lives of assets	'1 year
Leasehold Improvement \| Maximum	'
Property, Plant and Equipment [Line Items]	'
Estimated useful lives of assets	'15 years
Furniture and Equipment \| Minimum	'
Property, Plant and Equipment [Line Items]	'
Estimated useful lives of assets	'2 years
Furniture and Equipment \| Maximum	'
Property, Plant and Equipment [Line Items]	'
Estimated useful lives of assets	'15 years
Software \| Minimum	'
Property, Plant and Equipment [Line Items]	'
Estimated useful lives of assets	'1 year
Software \| Maximum	'
Property, Plant and Equipment [Line Items]	'
Estimated useful lives of assets	'5 years

Business_Combination_Additiona

Business Combination - Additional Information (Detail) (USD $)

0 Months Ended

1 Months Ended

12 Months Ended

0 Months Ended

5 Months Ended

0 Months Ended

12 Months Ended

Aug. 31, 2012

Jun. 30, 2013

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Aug. 31, 2012

Nov. 30, 2013

Aug. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

TreatmentCenter

Noncompete agreements

Trade names

Management agreement

Customer relationships

Physician Practice

Call Option

Common Stock

Uant and Venture

Mcnt

Impel

Ventures, UANT, MCNT, and Impel

Entity

Business Acquisition [Line Items]

Number of equity instruments paid as consideration in the business combination

4,502

68,982

6,400,000

Fair Value of equity instruments paid as consideration in the business combination

$133,000

$480,000

$158,100,000

Discount rates

17.00%

13.50%

14.50%

16.10%

15.80%

12.40%

Increase/decrease in goodwill

171,000

-196,000

Liabilities assumed

-196,000

Goodwill

86,403,000

118,176,000

[1]

118,261,000

[1]

8,335,000

Goodwill expected to be deductible for tax purposes

Number of additional ownership interests acquired in lithotripsy partnerships

Noncontrolling interest in subsidiaries

900,000

Total weighted-average amortization period

'14 years 8 months 12 days

'10 years

'30 years

'3 years

Weighted average period before the renewal period of management agreements

'29 years 8 months 12 days

Pre-tax royalty rate

1.00%

Net operating revenue

182,700,000

60,600,000

Business Combination, Pro Forma Information, Disclosure Impracticable

'It is impracticable for the Company to determine the amount of earnings of the acquired businesses included in the Company's consolidated statements of operations for the years ended December 31, 2013 or 2012 due to the significant transfers of personnel, fixed assets and departments into and between newly created or historical departments and business units that have occurred subsequent to the Contribution.

Other operating expenses

$1,000,000

Number of businesses acquired

[1]

Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Summary_of_Estimated_Fair_Valu

Summary of Estimated Fair Values of Assets Acquired and Liabilities Assumed of Ventures (Detail) (USD $)	Dec. 31, 2013		Dec. 31, 2012		Aug. 31, 2012	Dec. 31, 2011	Aug. 31, 2012	Aug. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012		Aug. 31, 2012	Dec. 31, 2011	As initially reported	Measurement Period Adjustments
Business Acquisition [Line Items]	'		'		'	'	'	'
Current assets	'		'		$25,105	'	$25,069	$36
Property and equipment	'		'		23,849	'	24,020	-171
Investments in affiliates	'		'		36,198	'	36,198	'
Other assets	'		'		7,240	'	7,240	'
Identifiable intangible assets	'		'		29,102	'	32,479	-3,377
Goodwill	118,176	[1]	118,261	[1]	86,403	8,335	83,346	3,057
Liabilities assumed, other than long-term debt	'		'		-30,470	'	-30,925	455
Long-term debt	'		'		-18,832	'	-18,832	'
Net assets acquired and liabilities assumed	'		'		$158,595	'	$158,595	'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Schedule_of_Identifiable_Intan

Schedule of Identifiable Intangible Assets Acquired in Contribution, Excluding Goodwill (Detail) (USD $)	0 Months Ended
In Thousands, unless otherwise specified	Aug. 31, 2012
Business Acquisition [Line Items]	'
Identifiable intangible assets	$29,102
Identifiable intangible assets, Weighted Average Amortization Period	'14 years 8 months 12 days
Noncompete agreements	'
Business Acquisition [Line Items]	'
Identifiable intangible assets, Fair Value	12,488
Identifiable intangible assets, Weighted Average Amortization Period	'10 years
Trade name - Impel	'
Business Acquisition [Line Items]	'
Identifiable intangible assets, Fair Value	462
Identifiable intangible assets, Weighted Average Amortization Period	'5 years
Customer relationships	'
Business Acquisition [Line Items]	'
Identifiable intangible assets, Fair Value	767
Identifiable intangible assets, Weighted Average Amortization Period	'3 years
Management agreement	'
Business Acquisition [Line Items]	'
Identifiable intangible assets, Fair Value	4,679
Identifiable intangible assets, Weighted Average Amortization Period	'30 years
Trade names	'
Business Acquisition [Line Items]	'
Identifiable intangible assets, Fair Value, Indefinite lived	$10,706
Identifiable intangible assets, Weighted Average Amortization Period, Indefinite lived	'Indefinite

Financial_Information_Prepared

Financial Information Prepared for Illustrative Purposes Indicative of Results of Operations in Future Periods or Results of Operations Have Been Realized Had Holdings (Detail) (USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Business Combination, Pro Forma Information [Line Items]	'	'
Net operating revenue	$234,727	$223,881
Net income	10,798	14,160
Net income attributable to USMD Holdings, Inc.	$1,047	$4,048
Earnings per share attributable to USMD Holdings, Inc.	'	'
Basic	$0.10	$0.40
Diluted	$0.10	$0.40

Variable_Interest_Entity_Addit

Variable Interest Entity - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2013	31-May-13	Jan. 31, 2014
			Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary	Variable Interest Entity, Primary Beneficiary
					Subsequent Event
Variable Interest Entity [Line Items]	'	'	'	'	'
Investment in WNI DFW	'	'	'	$100,000	$700,000
Net operating revenue	234,727,000	105,702,000	7,400,000	'	'
Income before provision for income taxes	$10,801,000	$15,240,000	$500,000	'	'

Carrying_Amount_of_Assets_and_

Carrying Amount of Assets and Liabilities of WNI-DFW (Detail) (USD $)	Dec. 31, 2013		Dec. 31, 2012		Dec. 31, 2011
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012		Dec. 31, 2011
Current assets:	'		'		'
Cash and cash equivalents	$13,137	[1]	$6,878	[1]	$10,822
Accounts receivable	23,970	[1]	20,615	[1]	'
Total current assets	47,606	[1]	36,588	[1]	'
Total assets	278,452	[1]	246,116	[1]	'
Current liabilities:	'		'		'
Other accrued liabilities	10,757	[2]	5,867	[2]	'
Total current liabilities	35,407	[2]	25,633	[2]	'
Variable Interest Entity, Primary Beneficiary	'		'		'
Current assets:	'		'		'
Cash and cash equivalents	1,257		'		'
Accounts receivable	175		'		'
Total current assets	1,432		'		'
Deferred tax asset	671		'		'
Total assets	2,103		'		'
Current liabilities:	'		'		'
Other accrued liabilities	2,108		'		'
Total current liabilities	$2,108		'		'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.
[2]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Net_Carrying_Values_and_Owners

Net Carrying Values and Ownership Percentages of Nonconsolidated Affiliates Accounted for Under Equity Method (Detail) (USD $)	Dec. 31, 2013		Sep. 02, 2013	Dec. 31, 2012
Schedule of Equity Method Investments [Line Items]	'		'	'
Equity method investments	$61,822,000	[1]	'	$35,892,000	[1]
USMD Hospital at Arlington, L.P.	'		'	'
Schedule of Equity Method Investments [Line Items]	'		'	'
Equity method investments	50,055,000		'	24,997,000
Percentage of wholly-owned subsidiary	46.40%		46.40%	28.44%
USMD Hospital at Fort Worth, L.P.	'		'	'
Schedule of Equity Method Investments [Line Items]	'		'	'
Equity method investments	11,246,000		'	10,779,000
Percentage of wholly-owned subsidiary	30.88%		'	30.88%
Other	'		'	'
Schedule of Equity Method Investments [Line Items]	'		'	'
Equity method investments	$521,000		'	$116,000
Other \| Minimum	'		'	'
Schedule of Equity Method Investments [Line Items]	'		'	'
Percentage of wholly-owned subsidiary	4.00%		'	4.00%
Other \| Maximum	'		'	'
Schedule of Equity Method Investments [Line Items]	'		'	'
Percentage of wholly-owned subsidiary	34.00%		'	34.00%

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Investments_in_Nonconsolidated2

Investments in Nonconsolidated Affiliates - Additional Information (Detail) (USD $)	12 Months Ended				0 Months Ended			12 Months Ended		1 Months Ended
	Dec. 31, 2013		Dec. 31, 2012		Sep. 02, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2012	Feb. 28, 2013
	Dec. 31, 2013		Dec. 31, 2012		USMD Hospital at Arlington, L.P.	USMD Hospital at Arlington, L.P.	USMD Hospital at Arlington, L.P.	Oncology	Oncology	Cancer Treatment Services
Schedule of Equity Method Investments [Line Items]	'		'		'	'	'	'	'	'
Investments in Equity Method Investees	$200,000		$77,000		$24,300,000	'	'	$300,000	'	$200,000
Acquired ownership interest, percentage	'		'		46.40%	46.40%	28.44%	'	'	'
Equity method investments	61,822,000	[1]	35,892,000	[1]	'	50,055,000	24,997,000	'	0	'
Difference between carrying amount of investments and company's equity in underlying net assets	$41,100,000		'		'	'	'	'	'	'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Summarized_Combined_Financial_

Summarized Combined Financial Information for Nonconsolidated Affiliates Accounted for under Equity Method (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Schedule of Equity Method Investments [Line Items]	'	'
Current assets	$43,558	$38,146
Noncurrent assets	83,895	85,090
Current liabilities	19,148	27,175
Noncurrent liabilities	55,455	49,675
Revenue	141,363	129,030
Income from operations	35,925	28,701
Income from continuing operations	33,502	25,362
Net income	$33,502	$25,362

Summarized_Financial_Informati

Summarized Financial Information for Individually Significant Equity Method Investees (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Schedule of Equity Method Investments [Line Items]	'	'
Current assets	$43,558	$38,146
Noncurrent assets	83,895	85,090
Current liabilities	19,148	27,175
Noncurrent liabilities	55,455	49,675
Revenue	141,363	129,030
Income from operations	35,925	28,701
Income from continuing operations	33,502	25,362
Net income	33,502	25,362
USMD Hospital at Arlington, L.P.	'	'
Schedule of Equity Method Investments [Line Items]	'	'
Current assets	26,055	24,986
Noncurrent assets	54,205	55,767
Current liabilities	9,987	8,975
Noncurrent liabilities	36,361	40,144
Revenue	90,619	84,936
Income from operations	21,317	17,836
Income from continuing operations	20,429	15,264
Net income	20,429	15,264
USMD Hospital at Fort Worth, L.P.	'	'
Schedule of Equity Method Investments [Line Items]	'	'
Current assets	13,445	11,859
Noncurrent assets	17,439	18,365
Current liabilities	5,593	15,888
Noncurrent liabilities	10,758	1,567
Revenue	39,172	37,092
Income from operations	9,336	7,843
Income from continuing operations	8,386	7,097
Net income	$8,386	$7,097

Patient_Service_Revenue_Detail

Patient Service Revenue (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'
Health care organization patient service revenue one	$181,087	$60,309
Patient service revenue provision for doubtful accounts, Amount	-2,801	-889
Net patient service revenue, Amount	178,286	59,420
Health care organization patient service revenue percentage for consolidation	101.60%	101.50%
Patient service revenue provision for doubtful accounts, percentage	-1.60%	-1.50%
Net patient service revenue, Percentage	100.00%	100.00%
Medicare	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'
Health care organization patient service revenue one	52,003	16,820
Health care organization patient service revenue percentage for consolidation	29.20%	28.30%
Medicaid	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'
Health care organization patient service revenue one	1,460	388
Health care organization patient service revenue percentage for consolidation	0.80%	0.70%
Managed care and commercial payers	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'
Health care organization patient service revenue one	123,336	41,689
Health care organization patient service revenue percentage for consolidation	69.20%	70.20%
Self-pay	'	'
Health Care Organization, Receivable and Revenue Disclosures [Line Items]	'	'
Health care organization patient service revenue one	$4,288	$1,412
Health care organization patient service revenue percentage for consolidation	2.40%	2.40%

Summary_of_Property_and_Equipm

Summary of Property and Equipment (Detail) (USD $)	Dec. 31, 2013		Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
Property and Equipment	'		'
Gross property and equipment	$37,299		$35,167
Less: accumulated depreciation and amortization	-13,808		-8,964
Property and equipment, net	23,491	[1]	26,203	[1]
Leasehold Improvements	'		'
Property and Equipment	'		'
Gross property and equipment	12,565		11,723
Furniture and Equipment	'		'
Property and Equipment	'		'
Gross property and equipment	21,691		20,587
Software	'		'
Property and Equipment	'		'
Gross property and equipment	$3,043		$2,857

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Property_and_Equipment_Additio

Property and Equipment - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Property, Plant and Equipment [Line Items]	'	'
Property and equipment depreciation	$5.80	$2.70

Assets_Recorded_under_Capital_

Assets Recorded under Capital Lease Arrangements Included in Property and Equipment (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Capital Leased Assets [Line Items]	'	'
Gross assets recorded under capital leases	$1,990	$1,499
Less: accumulated amortization	-854	-595
Net assets recorded under capital leases	1,136	904
Furniture and Equipment	'	'
Capital Leased Assets [Line Items]	'	'
Gross assets recorded under capital leases	$1,990	$1,499

Changes_in_Carrying_Amount_of_

Changes in Carrying Amount of Goodwill (Detail) (USD $)	1 Months Ended	12 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2013	Dec. 31, 2013		Dec. 31, 2012		Aug. 31, 2012	Dec. 31, 2011
Goodwill [Line Items]	'	'		'		'	'
Adjustments related to business combination	$111	($85)		'		'	'
Increase due to business combination	'	'		109,926		'	'
Goodwill	'	121,585		121,670		'	11,744
Accumulated impairment	'	-3,409		-3,409		'	-3,409
Goodwill, net	'	118,176	[1]	118,261	[1]	86,403	8,335
Physician and Ancillary Services	'	'		'		'	'
Goodwill [Line Items]	'	'		'		'	'
Adjustments related to business combination	'	-196		'		'	'
Increase due to business combination	'	'		55,707		'	'
Goodwill	'	60,418		60,614		'	4,907
Goodwill, net	'	60,418		60,614		'	4,907
Cancer Treatment Services	'	'		'		'	'
Goodwill [Line Items]	'	'		'		'	'
Adjustments related to business combination	'	111		'		'	'
Increase due to business combination	'	'		54,219		'	'
Goodwill	'	54,330		54,219		'	'
Goodwill, net	'	54,330		54,219		'	'
Lithotripsy Entity	'	'		'		'	'
Goodwill [Line Items]	'	'		'		'	'
Goodwill	'	6,837		6,837		'	6,837
Accumulated impairment	'	-3,409		-3,409		'	-3,409
Goodwill, net	'	$3,428		$3,428		'	$3,428

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Goodwill_and_Other_Intangible_2

Goodwill and Other Intangible Assets - Additional Information (Detail) (USD $)	1 Months Ended	12 Months Ended
	Jun. 30, 2013	Dec. 31, 2013		Dec. 31, 2012		Aug. 31, 2012	Dec. 31, 2011
Goodwill [Line Items]	'	'		'		'	'
Business acquisition fixed assets adjustment	$171,000	($196,000)		'		'	'
Increase/decrease in goodwill	111,000	-85,000		'		'	'
Goodwill	'	118,176,000	[1]	118,261,000	[1]	86,403,000	8,335,000
Goodwill associated with deferred tax liabilities	'	'		23,500,000		'	'
Aggregate intangible asset amortization expense	'	1,800,000		600,000		'	'
Indefinite lived intangible assets	'	$10,700,000		$10,700,000		'	'
Weighted average period for management agreements	'	'27 years 7 months 6 days		'		'	'

[1]	Assets of consolidated variable interest entity ("VIE") included in total assets above (after elimination of intercompany transactions and balances): Cash and cash equivalents $ 1,257 Accounts receivable 175 Total current assets 1,432 Deferred tax asset 671 Total assets $ 2,103 The assets of the consolidated VIE can only be used to settle the obligations of the VIE.

Components_of_Amortizable_Inta

Components of Amortizable Intangible Assets (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Amount	$19,002	$18,963
Accumulated Amortization	-2,675	-883
Net Carrying Amount	16,327	18,080
Management agreement	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Amount	5,246	5,246
Accumulated Amortization	-544	-351
Net Carrying Amount	4,702	4,895
Trade Name	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Amount	462	462
Accumulated Amortization	-123	-31
Net Carrying Amount	339	431
Customer relationships	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Amount	767	767
Accumulated Amortization	-341	-85
Net Carrying Amount	426	682
Noncompete agreements	'	'
Finite-Lived Intangible Assets [Line Items]	'	'
Gross Carrying Amount	12,527	12,488
Accumulated Amortization	-1,667	-416
Net Carrying Amount	$10,860	$12,072

Estimated_Amortization_Expense

Estimated Amortization Expense for Intangible Assets during Next Five Years (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013
Finite-Lived Intangible Assets [Line Items]	'
2014	$1,800
2015	1,800
2016	1,500
2017	1,500
2018	1,500
Total	$8,100

Summary_of_Other_Accrued_Liabi

Summary of Other Accrued Liabilities (Detail) (USD $)	Dec. 31, 2013		Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
Other Accrued Liabilities	'		'
Accrued expenses	$3,002		$3,108
Accrued bonus	1,860		1,469
Accrued payables	3,582		822
IBNR payable	1,918		'
Income taxes payable	395		468
Other accrued liabilities	$10,757	[1]	$5,867	[1]

[1]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Long_Term_Debt_and_Capital_Lea

Long Term Debt and Capital Lease Obligations (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Schedule of Long-term Debt Instruments	'	'
Term debt	$45,146	'
Total long-term debt and capital lease obligations	46,198	26,569
Less: current portion	-8,492	-5,520
Long-term debt and capital lease obligations, less current portion	37,706	21,049
Usmd Holdings	'	'
Schedule of Long-term Debt Instruments	'	'
Term debt	15,687	19,938
Revolving credit facility	3,000	'
Convertible subordinated notes	20,839	'
Subordinated related party notes payable	3,734	4,328
Other note payable	120	185
Total long-term debt and capital lease obligations	43,380	24,451
Lithotripsy Entity	'	'
Schedule of Long-term Debt Instruments	'	'
Notes payable	1,766	1,270
Capital lease obligations	1,052	848
Total long-term debt and capital lease obligations	$2,818	$2,118

Long_Term_Debt_and_Capital_Lea1

Long Term Debt and Capital Lease Obligations (Parenthetical) (Detail) (Usmd Holdings, USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013
Usmd Holdings	'
Debt Instrument [Line Items]	'
Convertible subordinated notes, unamortized discount	$3,503

LongTerm_Debt_Capital_Lease_Ob2

Long-Term Debt, Capital Lease Obligations and Other Long-Term Liabilities - Additional Information (Detail) (USD $)

0 Months Ended

12 Months Ended

0 Months Ended

12 Months Ended

0 Months Ended

12 Months Ended

0 Months Ended

12 Months Ended

0 Months Ended

3 Months Ended

0 Months Ended

1 Months Ended

3 Months Ended

Feb. 28, 2013

Jan. 01, 2007

Dec. 31, 2013

Dec. 31, 2012

Sep. 30, 2013

Dec. 31, 2013

Sep. 13, 2013

Aug. 31, 2013

Aug. 31, 2012

Dec. 31, 2012

Dec. 31, 2013

Aug. 31, 2012

Dec. 31, 2013

Aug. 31, 2012

Dec. 31, 2013

Aug. 31, 2012

Dec. 31, 2013

Aug. 31, 2013

Dec. 31, 2013

Feb. 25, 2014

Mar. 31, 2014

Sep. 30, 2014

Jun. 30, 2014

Jan. 01, 2007

Dec. 31, 2011

Sep. 30, 2013

Jun. 30, 2013

Sep. 30, 2012

Mar. 31, 2012

Dec. 31, 2012

Dec. 31, 2013

Mar. 31, 2011

Sep. 30, 2010

Sep. 30, 2013

Jun. 30, 2013

Mar. 31, 2013

Mar. 31, 2012

PartnershipUnit

Convertible Subordinated Notes due 2019 (the "Notes")

Term Loans

Revolving Credit Facility

Notes Payable Maturity On December Thirty First Twenty Twenty One

Usmd Lithotripsy Division

Lithotripsy Entity

Tranche A

Tranche B

Tranche C

December 31, 2012 through December 31, 2013

March 31, 2014 through August 31, 2017

December 31, 2013 through September 30, 2014

December 31, 2014 through August 31, 2017.

After Amendment

Amendment No. 4

Subsequent Event

Scenario, Forecast

Capital Lease Obligations

Notes Payable

Note Payable One

Note Payable Two

Amended

Quarter

Minimum

Tranche C

Amendment No. 4

Quarter

Minimum

Quarter

Debt Instrument [Line Items]

Aggregate principal amount

$24,300,000

$21,000,000

$12,500,000

$3,500,000

$5,000,000

$10,000,000

$3,000,000

Unused commitment fee percentage payable on undrawn portion of Revolver

0.25%

Interest rate description

'30-Day London Interbank Offered Rate ("LIBOR") plus a margin of 3.00%

'30-Day LIBOR plus a margin of 3.50%

'30-Day LIBOR plus a margin of 1.25%

'30-Day LIBOR plus a margin of 3.00%

Margin in addition to LIBOR

3.00%

3.50%

1.25%

3.00%

Term loan interest rate at end of period

3.19%

3.69%

1.44%

3.19%

Debt instrument, maturity date

1-Mar-19

31-Aug-17

31-Aug-14

31-Aug-17

31-Oct-18

Principal payment

625,000

437,500

Credit agreement compensation balance

5,000,000

Debt Instrument Covenant Compliance for maintaining fixed charge coverage ratio

'Financial covenant that requires it to maintain a fixed charge coverage ratio greater than or equal to 1.501.00 for the period of four consecutive fiscal quarters from and including December 31, 2012 through December 31, 2013

'Financial covenant that requires it to maintain a fixed charge coverage ratio of 1.251.00 for any period of four consecutive fiscal quarters beginning March 31, 2014 through August 31, 2017

'Financial covenant that requires it to maintain a senior leverage ratio less than or equal to 1.501.00 for any period of four consecutive fiscal quarters from and including December 31, 2013 through September 30, 2014

'Financial covenant that requires it to maintain a senior leverage ratio of 1.251.00 for any period of four consecutive fiscal quarters beginning December 31, 2014 through August 31, 2017.

Debt instrument fixed charge coverage ratio

150.00%

125.00%

100.00%

35.00%

Debt instrument senior leverage ratio

150.00%

125.00%

310.00%

100.00%

125.00%

Credit agreement contains descriptions

'The Credit Agreement contains a number of covenants that, among other things, limit or restrict the ability of the Borrower to dispose of assets, incur additional indebtedness, make dividends and other restricted payments, create liens securing other indebtedness and enter into restrictive agreements. The Company is subject to a financial covenant that requires it to maintain a fixed charge coverage ratio greater than or equal to 1.501.00 for the period of four consecutive fiscal quarters from and including December 31, 2012 through December 31, 2013 and of 1.251.00 for any period of four consecutive fiscal quarters beginning March 31, 2014 through August 31, 2017. The Company is subject to a financial covenant that requires it to maintain a senior leverage ratio less than or equal to 1.501.00 for any period of four consecutive fiscal quarters from and including December 31, 2013 through September 30, 2014 and of 1.251.00 for any period of four consecutive fiscal quarters beginning December 31, 2014 through A gust 31, 2017.

Revolver termination date

15-Jun-15

Number of quarters for debt instrument fixed charge coverage ratios

Number of quarters for debt instrument senior leverage ratio

Term loan, maturity date

'2014-04

Debt issuance cost

70,000

500,000

61,000

50,000

Debt issue cost amortization for the period

4,000

190,000

Unamortized debt issue cost

259,000

Debt issuance cost amortization date

'2017-08

Debt instrument interest rate

5.00%

4.20%

3.87%

Conversion price of common stock, per share

$23.37

Intrinsic value of the conversion option

3,729,000

3,700,000

Number of installments of principal and interest payments due

'66 months

'60 months

'36 months

'48 months

'36 months

'60 months

'59 months

Tax effect of beneficial conversion debt discount on Convertible Subordinated Notes

-1,305,000

-1,300,000

Convertible subordinated notes convertible in to common share

1,041,581

Convertible subordinated notes, effective interest rate

8.50%

Convertible subordinated notes interest expenses

600,000

Convertible subordinated notes interest expenses, contractual interest rate

400,000

Convertible subordinated notes interest expenses, discount accretion

200,000

Partnership interests acquired

59.40%

Cash paid to predecessor owners

1,200,000

Notes payable issued to predecessor owners

9,700,000

Number of individuals to which notes payable are due

Monthly principal and interest payments

80,000

9,440

8,600

17,900

6,488

5,336

10,390

Accrued Interest fixed rate

9.00%

Debt instrument premium rate

1.00%

Purchased equipment

1,300,000

400,000

200,000

500,000

100,000

500,000

900,000

Note issued to finance purchase of equipment

400,000

200,000

Notes maturity date

'2018-12

'2016-01

'2015-10

'2018-07

'2016-05

'2017-01

'2015-03

'2017-03

'2018-01

Current liabilities

1,059,000

[1]

1,115,000

[1]

100,000

Other long term liabilities

$1,485,000

[1]

$1,300,000

[1]

$400,000

Fixed interest rates of notes payable, minimum

3.97%

Fixed interest rates of notes payable, maximum

4.75%

[1]

Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Maturities_of_LongTerm_Debt_De

Maturities of Long-Term Debt (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013
Long Term Debt Maturities Repayments Of Principal [Line Items]	'
2014	$8,123
2015	3,753
2016	3,711
2017	7,937
2018	785
Thereafter	20,837
Total	$45,146

Future_Minimum_Lease_Payments_

Future Minimum Lease Payments under Capital Leases and Present Value of Net Minimum Lease Payments (Detail) (USD $)	Dec. 31, 2013		Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
2014	$431		'
2015	395		'
2016	122		'
2017	114		'
2018	113		'
Total minimum lease payments	1,175		'
Less: amounts representing estimated taxes, maintenance and insurance amounts included in the total above	'		'
Net minimum capital lease payments	1,175		'
Less: amount representing interest	-123		'
Present value of minimum lease payments	1,052		'
Less: current portion of capital lease obligations	-369	[1]	-287	[1]
Capital lease obligations, less current portion	$683	[1]	$561	[1]

[1]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Carrying_Value_and_Estimated_F

Carrying Value and Estimated Fair Value of Financial Instruments (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Carrying Value	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	$3,734	$4,328
Other long-term liabilities	'	461
Carrying Value \| Convertible subordinated notes Payable	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	20,839	'
Carrying Value \| Lithotripsy Entity	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	1,766	1,270
Carrying Value \| Notes Payable, Other Payables	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	120	185
Fair Value	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	3,481	5,078
Other long-term liabilities	'	461
Fair Value \| Convertible subordinated notes Payable	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	25,985	'
Fair Value \| Lithotripsy Entity	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	1,767	1,273
Fair Value \| Notes Payable, Other Payables	'	'
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]	'	'
Notes payable	$124	$194

Deferred_Compensation_Plans_Ad

Deferred Compensation Plans - Additional Information (Detail) (USD $)	1 Months Ended	12 Months Ended
	Sep. 30, 2012	Dec. 31, 2013		Dec. 31, 2012
	Sep. 30, 2012	Installment		Dec. 31, 2012
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]	'	'		'
Number of installments of distribution	'	5		'
Deferred compensation obligation	'	$4,800,000		'
Deferred compensation obligation, long-term	'	4,641,000	[1]	4,898,000	[1]
Deferred compensation obligation, current	'	200,000		'
Duration of the distribution of Income plan's account balances	'	'90 days		'
Cash surrender value of life insurance policies	3,184,000	'		3,184,000
Amount of distribution due to participants	$3,700,000	'		'

[1]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Schedule_of_Significant_Compon

Schedule of Significant Components of Provision (Benefit) for Income Taxes (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Current:	'	'
Federal	$1,067	$80
State	228	178
Total current	1,295	258
Deferred:	'	'
Federal	-1,224	1,229
State	'	'
Total deferred	-1,224	1,229
Provision for income taxes	$71	$1,487

Reconciliation_of_Actual_Tax_R

Reconciliation of Actual Tax Rate (Detail)	12 Months Ended
Reconciliation of Actual Tax Rate (Detail)	Dec. 31, 2013	Dec. 31, 2012
Reconciliation of the actual tax rate to the statutory U.S. tax rate	'	'
Federal statutory rate	35.00%	35.00%
State income taxes, net of federal tax benefit	1.30%	0.80%
Net income attributable to noncontrolling interests	-30.70%	-26.80%
Prior year corrections	-2.40%	'
Other	-1.60%	0.70%
Effective tax rate for income from operations	1.60%	9.70%

Schedule_of_Components_of_Defe

Schedule of Components of Deferred Tax Assets and Liabilities (Detail) (USD $)	Dec. 31, 2013		Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2013		Dec. 31, 2012
Deferred tax assets:	'		'
Net operating losses	$290		$867
Deferred revenue	150		207
Share-based payment expense	850		791
Deferred and other compensation	2,101		2,310
Allowance for doubtful accounts	578		452
IBNR liability	671		'
Facilitative acquisition costs	385		385
Intangible assets	572		907
Other	538		206
Total deferred tax assets	6,135		6,125
Deferred tax liabilities:	'		'
Partnership investments	-13,922		-13,593
Property and equipment	-4,321		-5,358
Tax impact of beneficial conversion feature of debt	-1,226		'
Intangible assets	-9,301		-9,915
Other	-311		-319
Total deferred tax liabilities	-29,081		-29,185
Net deferred tax liabilities	-22,946		-23,060
Current deferred tax assets	1,054		1,048
Current deferred tax liabilities	-312		-319
Net current deferred tax assets	742		729
Noncurrent deferred tax assets	5,081		5,077
Noncurrent deferred tax liabilities	-28,769		-28,866
Net noncurrent deferred tax liabilities	-23,688	[1]	-23,789	[1]
Net deferred tax liabilities	($22,946)		($23,060)

[1]	Liabilities of consolidated VIE included in total liabilities above (after elimination of intercompany transactions and balances): Other accrued liabilities $ 2,108 Total current liabilities $ 2,108

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	12 Months Ended
Income Taxes - Additional Information (Detail) (USD $)	Dec. 31, 2013
Income Taxes [Line Items]	'
Unused net operating loss carryforwards	$827,000
Unused net operating loss carryforwards, expiration year	'2031

ShareBased_Payment_Additional_

Share-Based Payment - Additional Information (Detail) (USD $)

0 Months Ended

12 Months Ended

0 Months Ended

12 Months Ended

0 Months Ended

12 Months Ended

0 Months Ended

Aug. 31, 2012

Dec. 31, 2013

Dec. 31, 2012

Mar. 11, 2013

Aug. 31, 2012

Dec. 31, 2013

Sep. 30, 2013

Dec. 31, 2013

Dec. 31, 2012

Aug. 31, 2012

USMD Holdings

Stock Option

Restricted Stock And Stock Appreciation Rights

Stock Options

Unrestricted Shares

Company's executive

Senior Management

USMD Holdings

Non Employees

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Common stock for issuance

1,000,000

900,000

100,000

Holdings reserved shares for grant

332,843

Stock option granted weighted average fair value

$6.96

$10.94

$7.18

Salaries, wages and employee benefits

$357,000

$933,000

$515,000

Unrecognized compensation cost related to unvested share-based compensation awards

3,025,000

Share-based payment remaining weighted-average period

'3 years 7 months 6 days

Venture option to purchase company's common stock

68,982

Expiration period of ventures options

'5 years

Risk-free interest rate

1.78%

0.64%

0.26%

Expected volatility of common stock

45.20%

51.30%

46.60%

Expected life of options

'6 years 2 months 12 days

'5 years

'2 years 6 months

Estimated fair value of Ventures Options recorded to goodwill and additional paid-in capital

480,000

Incremental value related to these stock options

149,000

Service Period of Venture Option

'3 months

Restricted common stock held by nonemployees that became unrestricted shares

33,500

Number of Shares, Granted

287,845

47,011

706

14,583

9,086

Common stock fair value

$646,000

$12,000

$387,000

$183,000

Weighted_Average_Assumptions_U

Weighted Average Assumptions Used in Black-Scholes Model for Stock Options (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Schedule Of Weighted Average Assumptions [Line Items]	'	'
Risk-free interest rate	1.78%	0.64%
Expected volatility of common stock	45.20%	51.30%
Expected life of options	'6 years 2 months 12 days	'5 years
Dividend yield	0.00%	0.00%

Summary_of_Stock_Option_Activi

Summary of Stock Option Activity (Detail) (USD $)	12 Months Ended
Summary of Stock Option Activity (Detail) (USD $)	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'
Opening balance of Number of Shares Outstanding	321,807
Number of Shares, Granted	287,845
Number of Shares, Exercised	-12,074
Number of Shares, Forfeited	-13,881
Ending balance of Number of Shares Outstanding	583,697
Ending balance of Number of Shares, Vested and expected to vest	251,395
Ending balance of Number of Shares, Exercisable	149,137
Opening balance of Weighted-Average Exercise Price Outstanding	$24.26
Weighted-Average Exercise Price, Granted	$26.24
Weighted-Average Exercise Price, Exercised	$16.56
Weighted-Average Exercise Price, Forfeited	$17.24
Ending balance of Weighted-Average Exercise Price, Outstanding	$25.39
Ending balance of Weighted-Average Exercise Price, Vested and expected to vest	$24.85
Ending balance of Weighted-Average Exercise Price, Exercisable	$24.30
Ending balance of Weighted-Average Remaining Contractual Terms, Outstanding	'6 years 8 months 27 days
Ending balance of Weighted-Average Remaining Contractual Terms, Vested and expected to vest	'5 years 11 months 9 days
Ending balance of Weighted-Average Remaining Contractual Terms, Exercisable	'5 years 2 months 19 days
Exercised, Aggregate Intrinsic Value	$168,372
Ending balance of Aggregate Intrinsic Value, Outstanding	34,772
Ending balance of Aggregate Intrinsic Value, Vested and expected to vest	34,772
Ending balance of Aggregate Intrinsic Value, Exercisable	$34,772

Reconciliation_of_Numerators_a

Reconciliation of Numerators and Denominators of Basic and Diluted Earnings (Loss) Per Share and Computation of Basic and Diluted Earnings (Loss) Per Share (Detail) (USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Numerator :	'	'
Net earnings attributable to USMD Holdings, Inc.-basic	$979	$2,100
Interest on Convertible Subordinated Notes, net of tax	'	'
Net earnings attributable to USMD Holdings, Inc.-diluted	$979	$2,100
Denominator :	'	'
Weighted-average common shares outstanding	10,080	5,739
Stock options	4	5
Convertible Subordinated Notes	'	'
Weighted-average common shares outstanding assuming dilution	10,084	5,744
Earnings per share attributable to USMD Holdings, Inc.:	'	'
Basic	$0.10	$0.37
Diluted	$0.10	$0.37

Potential_Shares_Excluded_from

Potential Shares Excluded from Diluted Earnings (loss) per share Calculation (Detail)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Schedule Of Calculation Of Numerator And Denominator In Earnings Per Share [Line Items]	'	'
Antidilutive Securities Excluded From Computation of Earnings Per Share	1,685	183
Stock Option	'	'
Schedule Of Calculation Of Numerator And Denominator In Earnings Per Share [Line Items]	'	'
Antidilutive Securities Excluded From Computation of Earnings Per Share	643	183
Convertible Subordinated Notes	'	'
Schedule Of Calculation Of Numerator And Denominator In Earnings Per Share [Line Items]	'	'
Antidilutive Securities Excluded From Computation of Earnings Per Share	1,042	'

Commitments_and_Contingencies_1

Commitments and Contingencies - Additional Information (Detail) (USD $)	1 Months Ended	12 Months Ended
	Nov. 30, 2012	Dec. 31, 2013	Dec. 31, 2012
	Nov. 30, 2012	Installment	Dec. 31, 2012
Commitments and Contingencies Disclosure [Line Items]	'	'	'
Maximum aggregate payments to pay the obligations due	'	$20,800,000	'
Claim settlement amount	'	650,000	'
Number of installments to pay settlement amount	'	55	'
Installments on the first day of each of month	'	10,000	'
Cash received associated with the settlement	100,000	130,000	110,000
Non-cancelable operating lease agreements expiration year	'	'2028	'
Future minimum rentals to be received under non-cancelable subleases	'	1,400,000	'
Medical Negligence Lawsuits	'	'	'
Commitments and Contingencies Disclosure [Line Items]	'	'	'
Estimate range of loss, minimum	'	0	'
Estimate range of loss, maximum	'	$500,000	'
Minimum	'	'	'
Commitments and Contingencies Disclosure [Line Items]	'	'	'
Remaining terms of guarantees	'	'13 months	'
Maximum	'	'	'
Commitments and Contingencies Disclosure [Line Items]	'	'	'
Remaining terms of guarantees	'	'75 months	'

Future_Minimum_Lease_Commitmen

Future Minimum Lease Commitments Under Operating Leases (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2013
Commitments and Contingencies Disclosure [Line Items]	'
Minimum Lease Commitments 2014	$11,761
Minimum Lease Commitments 2015	10,902
Minimum Lease Commitments 2016	8,913
Minimum Lease Commitments 2017	7,612
Minimum Lease Commitments 2018	6,706
Minimum Lease Commitments Thereafter	33,785
Minimum Lease Commitments Total	$79,679

Management_Services_Revenue_an

Management Services Revenue and Accounts Receivable (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Related Party Transaction [Line Items]	'	'
Management Services Revenue	$16,236	$14,556
Accounts Receivable	4,281	3,715
USMD Hospital at Arlington, L.P.	'	'
Related Party Transaction [Line Items]	'	'
Management Services Revenue	10,423	9,945
Accounts Receivable	2,625	2,480
USMD Hospital at Fort Worth, L.P.	'	'
Related Party Transaction [Line Items]	'	'
Management Services Revenue	4,434	4,275
Accounts Receivable	1,221	1,153
Other	'	'
Related Party Transaction [Line Items]	'	'
Management Services Revenue	1,379	336
Accounts Receivable	$435	$82

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Related Party Transaction [Line Items]	'	'
Lithotripsy revenue	$21,381	$22,226
Leased space rent expense	15,034	5,086
USMD Arlington and USMD Fort Worth	'	'
Related Party Transaction [Line Items]	'	'
Lithotripsy revenue	2,200	2,100
USMD Hospital at Arlington, L.P.	'	'
Related Party Transaction [Line Items]	'	'
Leased space rent expense	$1,700	$1,700

Employee_Benefit_Plans_Additio

Employee Benefit Plans - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Company's contributions to 401(k) plan	$3.10	$0.90
Non-elective contribution percentage on employees compensation	3.00%	'
Non-elective contribution vesting period	'2 years	'
Maximum	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Defined contribution plan, maximum employer's contribution percentage	6.00%	'

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (USD $)	12 Months Ended		3 Months Ended
	Dec. 31, 2013	Dec. 31, 2013	Mar. 31, 2014	Mar. 31, 2014	Mar. 31, 2014	Mar. 31, 2014
		Company's executive	Subsequent Event	Subsequent Event	Subsequent Event	Subsequent Event
		Stock Options	Company's executive	Company's executive	Company's executive	Company's executive
				Stock Options	Stock Options	Stock Options
					Scenario 1	Scenario 2
Subsequent Event [Line Items]	'	'	'	'	'	'
Number of shares granted	287,845	'	150,000	'	'	'
Number of shares granted, fair value	'	'	'	$1,000,000	'	'
Share based compensation award vesting percentage	'	'	'	'	20.00%	20.00%
Shares granted, expiration date	'	1-Jan-18	'	'	'	'