USMD 10-K 15 Apr 15 2014 FY Annual report Financial data

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
	Dec. 31, 2014	Mar. 15, 2015	Jun. 30, 2014
Document Information [Line Items]
Document Type	10-K
Amendment Flag	FALSE
Document Period End Date	31-Dec-14
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	FY
Trading Symbol	USMD
Entity Registrant Name	USMD Holdings, Inc.
Entity Central Index Key	1507881
Current Fiscal Year End Date	-19
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		10,267,993
Entity Public Float			$15,722,599

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Dec. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$15,940	[1]	$13,137	[1]
Restricted cash			5,000	[1]
Accounts receivable, net of allowance for doubtful accounts of $2,100 and $1,758 at December 31, 2014 and 2013, respectively	24,673	[1]	23,970	[1]
Inventories	2,512	[1]	1,580	[1]
Deferred tax assets, net	5,873	[1]	1,413	[1]
Prepaid expenses and other current assets	4,466	[1]	3,177	[1]
Total current assets	53,464	[1]	48,277	[1]
Property and equipment, net	20,796	[1]	23,491	[1]
Investments in nonconsolidated affiliates	59,780	[1]	61,822	[1]
Goodwill	97,836	[1]	118,176	[1]
Intangible assets, net	16,613	[1]	27,033	[1]
Other assets	159	[1]	324	[1]
Total assets	248,648	[1]	279,123	[1]
Current liabilities:
Accounts payable	7,708	[2]	2,500	[2]
Accrued payroll	13,816	[2]	12,599	[2]
Other accrued liabilities	18,373	[2]	10,757	[2]
Other current liabilities	606	[2]	1,059	[2]
Current portion of long-term debt	2,040	[2]	7,473	[2]
Current portion of related party long-term debt	746	[2]	650	[2]
Current portion of capital lease obligations	537	[2]	369	[2]
Total current liabilities	43,826	[2]	35,407	[2]
Other long-term liabilities	1,888	[2]	1,485	[2]
Deferred compensation payable	4,491	[2]	4,641	[2]
Long-term debt, less current portion	28,264	[2]	33,939	[2]
Related party long-term debt, less current portion	3,085	[2]	3,084	[2]
Capital lease obligations, less current portion	1,789	[2]	683	[2]
Deferred tax liabilities, net	20,127	[2]	24,359	[2]
Total liabilities	103,470	[2]	103,598	[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; 10,181,258 and 10,121,462 shares issued and outstanding at December 31, 2014 and 2013, respectively	102		101
Additional paid-in capital	160,458		158,360
Retained earnings (accumulated deficit)	-18,750		13,650
Accumulated other comprehensive loss	-2		-2
Total USMD Holdings, Inc. stockholders' equity	141,808		172,109
Noncontrolling interests in subsidiaries	3,370		3,416
Total equity	145,178		175,525
Total liabilities and equity	$248,648		$279,123
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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 the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parenthetical) (USD $)	Dec. 31, 2014		Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified
Allowance for doubtful accounts receivable	$2,100		$1,758
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	10,181,258		10,121,462
Common stock, shares outstanding	10,181,258		10,121,462
Cash and cash equivalents	15,940	[1]	13,137	[1]
Accounts receivable	24,673	[1]	23,970	[1]
Total current assets	53,464	[1]	48,277	[1]
Accounts payable	7,708	[2]	2,500	[2]
Other accrued liabilities	18,373	[2]	10,757	[2]
Total current liabilities	43,826	[2]	35,407	[2]
Variable Interest Entity, Primary Beneficiary
Cash and cash equivalents	10,169		1,257
Accounts receivable	1,150		175
Prepaid expenses	61
Deferred tax asset	3,850		671
Total current assets	15,230		2,103
Accounts payable	3,517
Other accrued liabilities	11,506		2,108
Total current liabilities	$15,023		$2,108
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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 the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Consolidated_Statements_of_Ope

Consolidated Statements of Operations (USD $)	12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Revenue:
Patient service revenue	$187,424	$181,087
Provision for doubtful accounts related to patient service revenue	-3,492	-2,801
Net patient service revenue	183,932	178,286
Capitated revenue	66,544	9,524
Management and other services revenue	22,721	25,536
Lithotripsy revenue	21,568	21,381
Net operating revenue	294,765	234,727
Operating expenses:
Salaries, wages and employee benefits	166,401	153,999
Medical services and supplies expense	79,990	29,199
Rent expense	15,869	15,034
Provision for doubtful accounts	183	70
Other operating expenses	33,849	27,530
Electronic Health Record incentive income	-1,164	-1,643
Impairment of goodwill	20,340	0
Depreciation and amortization	16,192	7,626
Total operating expenses	331,660	231,815
Income (loss) from operations	-36,895	2,912
Other income (expense):
Interest expense, net	-2,885	-1,975
Equity in income of nonconsolidated affiliates, net	11,521	9,769
Other gain (loss), net	-171	95
Total other income, net	8,465	7,889
Income (loss) before income taxes	-28,430	10,801
Provision (benefit) for income taxes	-5,544	71
Net income (loss)	-22,886	10,730
Less: net income attributable to noncontrolling interests	-9,514	-9,751
Net income (loss) attributable to USMD Holdings, Inc.	($32,400)	$979
Loss per share attributable to USMD Holdings, Inc.
Basic	($3.19)	$0.10
Diluted	($3.19)	$0.10
Weighted average common shares outstanding
Basic	10,168	10,080
Diluted	10,168	10,084

Consolidated_Statements_of_Com

Consolidated Statements of Comprehensive Income (Loss) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Net income (loss)	($22,886)	$10,730
Other comprehensive income, net of tax:
Foreign currency translation adjustments, net of tax		14
Total other comprehensive income		14
Comprehensive income (loss)	-22,886	10,744
Less: comprehensive income attributable to noncontrolling interests	-9,514	-9,751
Comprehensive income (loss) attributable to USMD Holdings, Inc. common stockholders	($32,400)	$993

Consolidated_Statement_of_Stoc

Consolidated Statement of Stockholders' Equity (USD $)	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings (Accumulated Deficit)	Total USMD Holdings Inc.	Noncontrolling Interests in Subsidiaries
Beginning balance at Dec. 31, 2012	$169,447,000	$100,000	$153,444,000	($16,000)	$12,671,000	$166,199,000	$3,248,000
Beginning balance (in shares) at Dec. 31, 2012		10,034,000
Net income (loss)	10,730,000				979,000	979,000	9,751,000
Other comprehensive income	14,000			14,000		14,000
Share-based payment expense - stock options	933,000		933,000			933,000
Common stock issued for payment of accrued liabilities (in shares)		24,000
Common stock issued for payment of accrued liabilities	580,000		580,000			580,000
Common stock issued for share-based payment awards exercised (in shares)		12,000
Common stock issued for share-based payment awards exercised	200,000		200,000			200,000
Common stock issued in business combinations (in shares)		4,000
Common stock issued in business combinations	133,000		133,000			133,000
Share-based payment expense - common stock issued (in shares)		47,011
Share-based payment expense - common stock issued	647,000	1,000	646,000			647,000
Beneficial conversion debt discount on Convertible Subordinated Notes	3,729,000		3,729,000			3,729,000
Tax effect of beneficial conversion debt discount on Convertible Subordinated Notes	-1,305,000		-1,305,000			-1,305,000
Capital contributions from noncontrolling shareholders	530,000						530,000
Distributions to noncontrolling shareholders	-10,113,000						-10,113,000
Ending balance at Dec. 31, 2013	175,525,000	101,000	158,360,000	-2,000	13,650,000	172,109,000	3,416,000
Ending balance (in shares) at Dec. 31, 2013		10,121,462
Net income (loss)	-22,886,000				-32,400,000	-32,400,000	9,514,000
Share-based payment expense - stock options	1,282,000		1,282,000			1,282,000
Common stock issued for payment of accrued liabilities (in shares)		14,958
Common stock issued for payment of accrued liabilities	243,000		243,000			243,000
Common stock issued for share-based payment awards exercised (in shares)	0
Common stock issued in business combinations (in shares)		12,385
Common stock issued in business combinations	167,000		167,000			167,000
Share-based payment expense - common stock issued (in shares)		33,000
Share-based payment expense - common stock issued	407,000	1,000	406,000			407,000
Capital contributions from noncontrolling shareholders	191,000						191,000
Distributions to noncontrolling shareholders	-9,751,000						-9,751,000
Ending balance at Dec. 31, 2014	$145,178,000	$102,000	$160,458,000	($2,000)	($18,750,000)	$141,808,000	$3,370,000
Ending balance (in shares) at Dec. 31, 2014		10,181,258

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014		Dec. 31, 2013
Cash flows from operating activities:
Net income (loss)	($22,886)		$10,730
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Provision for doubtful accounts	3,675		2,871
Depreciation and amortization	16,192		7,626
Accretion of debt discount and amortization of debt issuance costs	764		421
Loss on extinguishment of debt	171
Loss on sale or disposal of assets, net	209		66
Impairment of goodwill	20,340		0
Equity in income of nonconsolidated affiliates, net	-11,521		-9,769
Distributions from nonconsolidated affiliates	13,563		8,395
Share-based payment expense	2,130		1,513
Deferred income tax benefit	-8,692		-1,163
Change in operating assets and liabilities, net of effects of business combinations:
Accounts receivable	-4,303		-6,226
Inventories	-894		-787
Prepaid expenses and other assets	-1,122		-593
Accounts payable	5,140		-818
Accrued and other current liabilities	8,182		8,372
Other noncurrent liabilities	253		283
Net cash provided by operating activities	21,201		20,921
Cash flows from investing activities:
Cash paid for business combinations, net of cash acquired	-104
Capital expenditures	-1,543		-2,848
Investments in nonconsolidated affiliates			-200
Proceeds from sale of property and equipment	102		64
Net cash used in investing activities	-1,545		-2,984
Cash flows from financing activities:
Proceeds from (repayments of) borrowings under revolving credit facility	-3,000		3,000
Proceeds from issuance of long-term debt	6,769		530
Payments on long-term debt and capital lease obligations	-15,915		-5,098
Proceeds from issuance of related party long-term debt	254
Principal payments on related party long-term debt	-157		-594
Restricted cash	5,000
Payment of debt issuance costs	-244		-133
Proceeds from exercise of stock options			200
Capital contributions from noncontrolling interests	191		530
Distributions to noncontrolling interests	-9,751		-10,113
Net cash used in financing activities	-16,853		-11,678
Net increase in cash and cash equivalents	2,803		6,259
Cash and cash equivalents at beginning of year	13,137	[1]	6,878
Cash and cash equivalents at end of year	15,940	[1]	13,137	[1]
Supplemental non-cash investing and financing information:
Equipment acquired through capital lease financing	1,628		491
Equipment acquired on account	68
Record convertible debt beneficial conversion discount, net of tax			2,424
Investment in nonconsolidated affiliate financed with debt			24,342
Cash paid for-
Interest, net of related parties	1,778		1,203
Interest to related parties	83		365
Income tax	3,828		1,559
Cash received for- Income tax refund	26		909
Accrued Unissued Share-Based Compensation
Supplemental non-cash investing and financing information:
Other significant noncash transaction, value of consideration given	441
Payment for Liabilities
Supplemental non-cash investing and financing information:
Fair value of common stock issued	243		646
Other Liabilities Financed
Supplemental non-cash investing and financing information:
Other significant noncash transaction, value of consideration given			461
Payment for Business Combination
Supplemental non-cash investing and financing information:
Fair value of common stock issued	$167		$133
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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
	Dec. 31, 2014
Description of Business and Basis of Presentation	Note 1 – Description of Business and Basis of Presentation
	Description of Business:
	USMD Holdings, Inc. (“USMD” or the “Company”) is a Delaware corporation formed on May 7, 2010 to facilitate the business combination of USMD Inc., a Texas corporation, Urology Associates of North Texas, L.L.P., a Texas limited liability partnership, and UANT Ventures, L.L.P., a Texas limited liability partnership (“Ventures”) (such transaction, the “Contribution”). USMD described this transaction in its registration statement on Form S-4 filed with the Securities and Exchange Commission (the “SEC”). Prior to the consummation of the Contribution, Ventures and USMD entered into a merger agreement with The Medical Clinic of North Texas, P.A., a Texas professional association (“MCNT”), and 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 USMD as part of the Contribution. USMD 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, USMD and the other parties consummated the Contribution. The Company is an innovative, early-stage physician-led integrated health system. 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.
	Through its subsidiaries and affiliates, the Company provides healthcare services to patients and management and operational services to hospitals and other healthcare service providers. The Company provides healthcare services to patients in physician clinics, hospitals and other healthcare facilities, including cancer treatment centers and anatomical pathology and clinical laboratories. A wholly owned subsidiary of the Company is the sole member of a Texas Certified Non-Profit Health 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 three cancer treatment centers in three states and 22 lithotripsy service providers (i.e., kidney stone treatment) primarily located in the South-Central United States. Of these managed entities, the Company has limited ownership interests in the two hospitals, two cancer treatment centers and 20 lithotripsy service providers. The Company consolidates 18 lithotripsy service providers into its financial statements. In addition, the Company wholly owns and operates two clinical laboratories, one anatomical pathology laboratory, one cancer treatment center and two lithotripsy service providers 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. Certain prior year amounts have been reclassified to conform to current year presentation.
	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.

Summary_of_Significant_Account

Summary of Significant Accounting Policies and Pronouncements

12 Months Ended

Dec. 31, 2014

Summary of Significant Accounting Policies and Pronouncements

Note 2 – Summary of Significant Accounting Policies and Pronouncements

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 service 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 service 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 well as significant regulatory action including fines, penalties and exclusion from the Medicare and Medicaid programs.

Capitated Revenue: The Company’s consolidated VIE, WNI-DFW, Inc. (“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. Capitated revenue is reported as revenue in the month in which members are entitled to receive healthcare. Capitated 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 and Other 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 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 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 or wholly owns. 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 compensation 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, 2014 and 2013, the Company recognized $0.7 million and $1.0 million, respectively, of patient service revenue associated with physician recruitment agreements. At December 31, 2014 and 2013, the Company has on the consolidated balance sheet $0.3 million and $0.8 million, respectively, of deferred revenue associated with physician recruitment agreements included in other current liabilities and $0.3 million and $0.4 million, respectively, of deferred revenue associated with physician recruitment agreements included in other long-term liabilities.

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. The mix of gross patient and customer accounts receivable is as follows:

December 31,

2014

2013

Government-related programs

33

%

29

%

Managed care and commercial payers

54

%

58

%

Self-pay

4

%

3

%

Customer

9

%

10

%

100

%

100

%

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

Provision

Write-offs

Balance at

Beginning

for Doubtful

for

End of

of Year

Accounts

Doubtful

Year

Related to

Accounts

Patient

Service

Revenue

For the years ended December 31,

2014

$

1,758

3,492

183

(3,333

)

$

2,100

2013

$

1,127

2,801

70

(2,240

)

$

1,758

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, 2014:

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 value 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 value 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, 2014 or 2013. 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, 2014, 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 value. If the carrying value of a reporting unit exceeds its estimated fair value, a potential impairment is indicated and step two is performed. Step two compares the carrying value 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 value, 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 values. 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 value.

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.” 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 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

The Company accounts for income taxes under the asset and liability method. Deferred tax assets and liabilities are recognized for 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. The Company’s policy is to record interest and penalties related to income tax matters, net of any applicable related income tax benefit, as a component of income tax expense.

Items required by tax regulations to be included in the tax return may differ from the items reflected in the financial statements. As a result, the effective tax rate reflected in the financial statements may be different than the actual rate applied on the tax return. Some of these differences are permanent such as expenses that are not deductible in the Company’s tax return, and some differences are temporary, reversing over time, such as valuation reserves. Temporary differences create deferred tax assets and liabilities. Deferred tax assets generally represent items that can be used as a tax deduction or credit in future years for which the Company has already recorded the tax benefit in the Company’s income statement. Deferred tax liabilities generally represent tax expense recognized in the Company’s financial statements for which payment has been deferred, or expenditures for which the Company has already taken a deduction in the Company’s tax return but have not yet been recognized in the Company’s financial statements.

The application of GAAP requires the Company to evaluate the recoverability of the Company’s deferred tax assets and establish a valuation allowance if necessary to reduce the Company’s deferred tax assets to an amount that is more likely than not to be realized. Considerable judgment is required in determining whether a valuation allowance is necessary, and if so, the amount of such valuation allowance. In evaluating the need for a valuation allowance, the Company may consider many factors, including: (1) the nature of the deferred tax assets and liabilities; (2) whether they are ordinary or capital; (3) taxable income in prior carryback years as well as projected taxable earnings exclusive of reversing temporary differences and carryforwards; (4) the length of time that carryovers can be utilized in the various taxing jurisdictions; (5) any unique tax rules that would impact the utilization of the deferred tax assets; and (6) any tax planning strategies that the Company would employ to avoid a tax benefit from expiring unused. Although realization is not assured, management believes it is more likely than not that the deferred tax assets will be realized. 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 will not be realized.

GAAP prescribes a comprehensive model for how a company should recognize, measure, present, and disclose in its financial statements uncertain tax positions that a company has taken or expects to take on tax returns. The Company recognizes liabilities for uncertain tax positions based on a two-step process. The first step is to evaluate the tax position for recognition. The Company determines whether it is more likely than not, based upon the technical merits, that a tax position will be sustained on audit, including resolution of related appeals or litigation processes. If the tax position does not meet the more likely than not recognition threshold, the benefit of that position is not recognized in the financial statements. The second step is measurement. The Company measures the tax position as the largest amount of benefit that is greater than 50 percent likely of being realized upon ultimate resolution with a taxing authority that has full knowledge of all relevant information. This measurement considers the amounts and probabilities of the outcomes that could be realized upon the ultimate settlement using the facts, circumstances, and information available at the reporting date. 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 determination and evaluation of the Company’s provision for income taxes and analysis of uncertain tax positions 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.

The Company’s liability for income taxes includes the liability for unrecognized tax benefits, interest and penalties that relate to tax years still subject to review by the Internal Revenue Service or other taxing jurisdictions. Audit periods remain open for review until the statute of limitations has passed. Generally, for tax years that produce net operating losses, capital losses or tax credit carryforwards (“tax attributes”), the statute of limitations does not close, to the extent of these tax attributes, until the expiration of the statute of limitations for the tax year in which they are fully utilized. The completion of review or the expiration of the statute of limitations for a given audit period could result in an adjustment to the liability for income taxes.

Fair Value Measurements

Fair value is the amount that would be received upon sale of 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 the Company’s 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 investee’s net income or loss 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.

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. For the years ended December 31, 2014 and 2013, the Company incurred advertising expense of $0.4 million and $0.3 million, respectively. Advertising expense 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 net patient service revenue, the allowance for doubtful accounts, incurred but not reported (“IBNR”) 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.

Recently Issued Accounting Pronouncements

In February 2015, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2015-02, “Consolidation (Topic 810): Amendments to the Consolidation Analysis” (“ASU 2015-02”). ASU 2015-02 changes the analysis that a company must perform to determine whether it should consolidate certain legal entities. All legal entities are subject to reevaluation under the updated guidance. ASU 2015-02 eliminates the presumption that a general partner should consolidate a limited partnership, eliminates the consolidation model specific to limited partnerships, modifies the evaluation of whether limited partnerships and similar legal entities are VIEs or voting interest entities and affects the evaluation of fee arrangements in the VIE primary beneficiary determination. ASU 2015-02 is effective for reporting periods beginning after December 15, 2015 and for interim periods within the fiscal year. Early adoption is permitted. Management is evaluating the impact that adoption of ASU 2015-02 will have on the Company’s consolidated financial statements.

In August 2014, the FASB issued ASU No. 2014-15, “Presentation of Financial Statements - Going Concern (Subtopic 205-40) - Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern” (“ASU 2014-15”). ASU 2014-15 sets forth management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to provide related footnote disclosures. ASU 2014-15 indicates that, when preparing interim and annual financial statements, management should evaluate whether conditions or events, considered in the aggregate, raise substantial doubt about the entity’s ability to continue as a going concern for one year from the date the financial statements are issued. This evaluation should include consideration of conditions and events that are either known or are reasonably knowable at the date the financial statements are issued, as well as whether it is probable that management’s plans to address the substantial doubt will be implemented and, if so, whether it is probable that the plans will alleviate the substantial doubt. It also requires certain disclosures when substantial doubt is alleviated as a result of consideration of management’s plans and requires an express statement and other disclosures when substantial doubt is not alleviated. ASU 2014-15 is effective for annual periods ending after December 15, 2016 and interim periods and annual periods thereafter. Early adoption is permitted. Adoption of this guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.

In May 2014, the FASB issued ASU No. 2014-09, “Revenue from Contracts with Customers” (“ASU-2014-09”). ASU 2014-09 requires revenue recognition to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. ASU 2014-09 provides a single principles-based, five-step model to be applied to all contracts with customers. The five steps are to identify the contract(s) with the customer, identify the performance obligations in the contact, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when each performance obligation is satisfied. The provisions of ASU 2014-09 may be applied either retrospectively to each prior reporting period presented or retrospectively with the cumulative effect of the update recognized at the date of the initial application along with additional disclosures. ASU 2014-09 is effective for the Company beginning January 1, 2017. Early adoption is not permitted. Management is evaluating the impact that adoption of ASU 2014-09 will have on the Company’s consolidated financial statements.

In April 2014, the FASB issued ASU No. 2014-08, “Presentation of Financial Statements and Property, Plant, and Equipment - Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity” (“ASU 2014-08”). Among other provisions and in addition to expanded disclosures, ASU 2014-08 changes the definition of what components of an entity qualify for discontinued operations treatment and reporting from a reportable segment, operating segment, reporting unit, subsidiary or asset group to only those components of an entity that represent a strategic shift that has, or will have, a major effect on an entity’s operations and financial results. Additionally, ASU 2014-08 requires disclosure about a disposal of an individually significant component of an entity that does not qualify for discontinued operations presentation in the financial statements, including the pretax profit or loss attributable to the component of an entity for the period in which it is disposed or is classified as held for sale. This disclosure is required for all of the same periods that are presented in the entity’s results of operations for the period. The provisions of ASU 2014-08 are effective prospectively for all disposals or classifications as held for sale of components of an entity that occur within annual periods beginning on or after December 15, 2014 and interim periods within those years. Early adoption is permitted. Adoption of this guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.

Variable_Interest_Entity

Variable Interest Entity	12 Months Ended
	Dec. 31, 2014
Variable Interest Entity	Note 3 – Variable Interest Entity
	In April 2013, the Company became an equal co-member of a Texas non-profit corporation that has been approved by the Texas Medical Board as a Certified Non-Profit Health Organization (WNI-DFW). 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 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 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 USMD Physician Services to direct such activities. Under the PCP Agreement, USMD Physician Services is responsible for providing many services related to the growth of the patient population of WNI-DFW, 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. The Company performs a qualitative assessment of WNI-DFW on an ongoing basis to determine if it continues 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 sheets (after elimination of intercompany transactions and balances) (in thousands):
		December 31,
		2014		2013
	Current assets:
	Cash and cash equivalents	$	10,169	$	1,257
	Accounts receivable		1,150		175
	Prepaid expenses		61		—
	Deferred tax asset		3,850		671
	Total current assets	$	15,230	$	2,103
	Current liabilities:
	Accounts payable	$	3,517	$	—
	Other accrued liabilities		11,506		2,108
	Total current liabilities	$	15,023	$	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. Upon notification from WNI-DFW, the Company is contractually obligated to fund certain cash requirements of WNI-DFW. Pursuant to such a notification, in January 2014, the Company advanced WNI-DFW $0.7 million.
	Beginning June 1, 2013, the results of operations and cash flows of WNI-DFW are included in the Company’s consolidated financial statements. For the years ended December 31, 2014 and 2013, WNI-DFW contributed capitated revenue of $66.5 million and $7.4 million, respectively, and income before provision for income taxes of $7.0 million and $0.5 million, respectively (after elimination of intercompany transactions).
	Estimated Medical Claims Liability
	In connection with the operations of WNI-DFW, the Company makes estimates related to IBNR medical claims 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 claims 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 services and supplies expense that may be material. At December 31, 2014 and 2013, the Company has recorded IBNR claims payable of $11.4 million and $1.9 million, respectively, which is included in other accrued liabilities.

Business_Combinations

Business Combinations	12 Months Ended
	Dec. 31, 2014
Business Combinations	Note 4 – Business Combinations
	In February, March and August, 2014, the Company acquired four small physician practices, and the physicians became employees or contractors of the Company. As consideration for the acquired practices, the Company paid $104,000 in cash and issued to the former owners of the acquired practices 12,385 shares of the Company’s common stock with an estimated fair value of $167,000. The following table summarizes the estimated fair values of assets acquired at the business combination date. No liabilities were assumed in the transactions.
	Inventories	$	38,022
	Property and equipment		212,565
	Identifiable intangible assets - noncompete agreements		20,536
	Assets acquired	$	271,123
	The physicians entered into employment agreements with the Company and these agreements include covenants not to compete. The Company recorded noncompete agreement intangible assets totaling $20,536 with a weighted-average amortization period of 3.1 years.
	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.

Investments_in_Nonconsolidated

Investments in Nonconsolidated Affiliates	12 Months Ended
	Dec. 31, 2014
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, 2014				December 31, 2013
		Carrying		Ownership		Carrying				Ownership
		Value		Percentage		Value				Percentage
	USMD Hospital at Arlington, L.P.	$	49,518	46.40%		$	50,055			46.40%
	USMD Hospital at Fort Worth, L.P.		9,956	30.88%			11,246			30.88%
	Other		306	4%-34%			521			4%-34%
		$	59,780			$	61,822
	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 partnership 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%.
	Other
	At December 31, 2014, the carrying value of the Company’s investments in USMD Arlington and USMD Hospital at Fort Worth, L.P. (“USMD Fort Worth”) is greater than the Company’s equity in the underlying net assets of the hospitals by $41.0 million due to recording ownership interests at fair value in connection with the acquisition of hospital partnership interests in September 2013, the Contribution in 2012 and deconsolidation of the hospitals from the Company’s consolidated financial statements 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,
		2014		2013
	Current assets	$	33,298	$	43,558
	Noncurrent assets	$	78,835	$	83,895
	Current liabilities	$	16,885	$	19,148
	Noncurrent liabilities	$	48,839	$	55,455
		Years Ended December 31,
		2014		2013
	Revenue	$	143,952	$	141,363
	Income from operations	$	35,807	$	35,925
	Net income	$	32,074	$	33,502
	At December 31, 2014 and 2013, USMD Arlington and USMD Forth Worth were significant equity investees, as that term is defined by SEC Regulation S-X Rule 8-03(b)(3). 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,
		2014		2013				2014			2013
	Current assets	$	22,853	$	26,055			$	6,828		$	13,445
	Noncurrent assets	$	54,992	$	54,205			$	16,812		$	17,439
	Current liabilities	$	9,698	$	9,987			$	4,068		$	5,593
	Noncurrent liabilities	$	35,309	$	36,361			$	9,108		$	10,758
		Years Ended December 31,
		2014		2013				2014			2013
	Revenue	$	93,486	$	90,619			$	36,634		$	39,172
	Income from operations	$	21,878	$	21,367			$	8,721		$	9,311
	Net income	$	19,301	$	20,429			$	7,953		$	8,386

Patient_Service_Revenue

Patient Service Revenue	12 Months Ended
	Dec. 31, 2014
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).
		Years Ended December 31,
		2014						2013
		Amount			Ratio of Net			Amount			Ratio of Net
					Patient Service						Patient Service
					Revenue						Revenue
	Medicare	$	56,091			30.5	%	$	52,003			29.2	%
	Medicaid		1,346			0.7			1,460			0.8
	Managed care and commercial payers		126,362			68.7			123,336			69.2
	Self-pay		3,625			2			4,288			2.4
	Patient service revenue before provision for doubtful accounts		187,424			101.9			181,087			101.6
	Patient service revenue provision for doubtful accounts		(3,492	)		(1.9	)		(2,801	)		(1.6	)
	Net patient service revenue	$	183,932			100	%	$	178,286			100	%

Property_and_Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2014
Property and Equipment	Note 7 – Property and Equipment
	Property and equipment consist of the following (in thousands):
		December 31,
		2014			2013
	Leasehold improvements	$	12,925		$	12,565
	Furniture and equipment		23,764			21,691
	Software		3,426			3,043
	Gross property and equipment		40,115			37,299
	Less: accumulated depreciation and amortization		(19,319	)		(13,808	)
	Property and equipment, net	$	20,796		$	23,491
	Property and equipment depreciation and amortization expense was $5.8 million for both years ended December 31, 2014 and 2013.
	Assets recorded under capital lease arrangements included in property and equipment consist of the following (in thousands):
		December 31,
		2014			2013
	Furniture and equipment	$	3,419		$	1,990
	Less: accumulated amortization		(1,183	)		(854	)
	Net assets recorded under capital leases	$	2,236		$	1,136
	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
	Dec. 31, 2014
Goodwill and Other Intangible Assets	Note 8 – Goodwill and Other Intangible Assets
	Goodwill
	The following table sets forth the goodwill activity for each of the Company’s reporting units during the years ended December 31, 2014 and 2013 (in thousands):
		Physician and			Cancer			Lithotripsy			Total
		Ancillary			Treatment			Services
		Services			Services
	Balance at January 1, 2013:
	Goodwill	$	60,614		$	54,219		$	6,837		$	121,670
	Accumulated impairment losses		—			—			(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 losses		—			—			(3,409	)		(3,409	)
			60,418			54,330			3,428			118,176
	Impairment charge		—			(20,340	)		—			(20,340	)
	Balance at December 31, 2014:
	Goodwill		60,418			54,330			6,837			121,585
	Accumulated impairment losses		—			(20,340	)		(3,409	)		(23,749	)
		$	60,418		$	33,990		$	3,428		$	97,836
	During the Company’s 2014 annual goodwill impairment review, step one of the analysis indicated that the carrying value of the Cancer Treatment Services reporting unit exceeded its estimated fair value. As a result, in order to determine the implied fair value of the reporting unit’s goodwill, management performed the second step of the impairment analysis. The second step analysis indicated that the carrying value of the Cancer Treatment Services reporting unit was in excess of its implied fair value. Accordingly, the Company recorded goodwill impairment of $20.3 million, which was the amount by which the carrying value of the Cancer Treatment Services reporting unit’s goodwill exceeded its implied fair value. The impairment of goodwill is primarily the result of a reduction in the near-term and long-term projected operating results and cash flows utilized in assessing goodwill for impairment. The reduction in forecast amounts is primarily related to delays in the Company’s ability to execute its strategic plan commensurate with its past forecasts exacerbated by a decrease in actual results of the reporting unit in 2014.
	As a result of the Company’s 2013 annual goodwill impairment testing, the Company determined there was no goodwill impairment in 2013.
	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 (see Note 11). 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.
	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.
	Acquired Intangible Assets
	In May 2014, the Company introduced a unified brand – USMD Health System – that will reinforce its physician-led integrated health system message. Over time, the Company will replace the historical brands of acquired companies with the USMD Health System brand. Prior to introduction of the new brand, the Company had on its balance sheet indefinite- and finite-lived intangible assets representing the trade names of acquired companies with carrying values of $10.7 million and $0.3 million, respectively.
	As a result of the branding initiative, management concluded that the indefinite-lived trade names were now finite-lived assets. In connection with this change, the Company performed, with the assistance of independent valuation experts, an impairment test of the carrying value of the trade names to determine whether any impairment existed. The Company concluded that the estimated fair value of the trade names was less than the associated carrying value and that an impairment write-down was required. As a result of this determination, the Company recorded a trade name impairment loss of $8.4 million, which is included in depreciation and amortization on the Company’s consolidated statement of operations for the year ended December 31, 2014. The estimated fair values of the trade names were calculated using an income approach – relief from royalty method, which assumes that in lieu of ownership, a third party would be willing to pay a royalty in order to exploit the related benefits of the trade name asset (see Note 11). The new $2.6 million carrying value of the trade names is being amortized on a straight line basis over the five year estimated useful life of the trade names. The actual useful life of the trade names will vary dependent upon certain factors including the availability of funding to execute the branding initiative.
	The components of amortizable intangible assets consist of the following (in thousands):
		December 31, 2014									December 31, 2013
		Gross			Accumulated			Net			Gross			Accumulated			Net
		Carrying			Amortization			Carrying			Carrying			Amortization			Carrying
		Amount						Amount			Amount						Amount
	Management agreements	$	5,246		$	(738	)	$	4,508		$	5,246		$	(544	)	$	4,702
	Trade names		11,168			(8,845	)		2,323			462			(123	)		339
	Customer relationships		767			(596	)		171			767			(341	)		426
	Noncompete agreements		12,547			(2,936	)		9,611			12,527			(1,667	)		10,860
		$	29,728		$	(13,115	)	$	16,613		$	19,002		$	(2,675	)	$	16,327
	Aggregate acquired intangible asset amortization expense for the years ended December 31, 2014 and 2013, totaled $2.0 million, net of the impairment loss, and $1.8 million, respectively. The weighted average period before the next renewal period for management agreements is 26.7 years. At December 31, 2013, the carrying value of indefinite-lived trade names was $10.7 million.
	Total estimated amortization expense for the Company’s acquired intangible assets during the next five years is as follows (in thousands):
	2015	$	2,144
	2016	$	1,974
	2017	$	1,972
	2018	$	1,972
	2019	$	1,665

Other_Accrued_Liabilities

Other Accrued Liabilities	12 Months Ended
	Dec. 31, 2014
Other Accrued Liabilities	Note 9 – Other Accrued Liabilities
	Other accrued liabilities consist of the following (in thousands):
		December 31,
		2014		2013
	Accrued payables	$	3,246	$	5,285
	Accrued bonus		2,000		1,860
	Other accrued liabilities		1,078		1,299
	IBNR claims payable		11,379		1,918
	Income taxes payable		670		395
		$	18,373	$	10,757

LongTerm_Debt_and_Capital_Leas

Long-Term Debt and Capital Lease Obligations	12 Months Ended
	Dec. 31, 2014
Long-Term Debt and Capital Lease Obligations	Note 10 – Long-Term Debt and Capital Lease Obligations
	Long-term debt and capital lease obligations consist of the following (in thousands):
		December 31,
		2014			2013
	USMD Holdings, Inc.:
	Credit Agreement:
	Term debt	$	7,500		$	15,687
	Revolving credit facility		—			3,000
	Convertible Subordinated Notes, net of unamortized discount of $2,978 and $3,503 at December 31, 2014 and 2013, respectively		21,364			20,839
	Subordinated related party notes payable		3,831			3,734
	Other notes payable		212			120
	Capital lease obligation		1,032			—
			33,939			43,380
	Consolidated lithotripsy entities:
	Notes payable		1,228			1,766
	Capital lease obligations		1,294			1,052
			2,522			2,818
	Total long-term debt and capital lease obligations		36,461			46,198
	Less: current portion		(3,323	)		(8,492	)
	Long-term debt and capital lease obligations, less current portion	$	33,138		$	37,706
	USMD Holdings, Inc.
	Credit Agreement
	On August 31, 2012, in connection with the Contribution, the Company and its wholly owned subsidiaries entered into that certain credit agreement (the “Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent, and additional lenders. The Credit Agreement originally provided for a term loan credit facility of $21.0 million (the “Term Loans”) and a $10.0 million revolving credit facility (the “Revolver”). Proceeds from borrowings under the Term Loans were used to repay existing debt of the businesses acquired in the Contribution and to repay in whole or in part certain of the Company’s related party debt. The Term Loans consisted of a $12.5 million Tranche A Term Loan, a $3.5 million Tranche B Term Loan and a $5.0 million Tranche C Term Loan. Pursuant to the Credit Agreement, the Company was required to maintain a $5.0 million compensating balance with the administrative agent as collateral for its borrowings under the Credit Agreement. The obligations under the Credit Agreement are secured by substantially all of the assets of the Company and its wholly owned subsidiaries, subject to certain exceptions. On February 25, 2014, the Company and the lenders amended the Credit Agreement to, among other things, extend the maturity date of the Revolver from February 28, 2014 to June 30, 2015, reduce the minimum fixed charge coverage ratio and establish a maximum senior leverage ratio requirement.
	In March 2014, the Company determined that it was not in compliance with its fixed charge coverage ratio or senior leverage ratio covenants. Effective April 14, 2014, the lenders permanently waived the existing covenant violations and amended the Credit Agreement. The amendment modified the fixed charge coverage ratio and senior leverage ratio covenants and established a minimum adjusted EBITDA financial covenant. In addition, the amendment reduced the Revolver commitment amount from $10.0 million to $3.0 million and prohibited scheduled payments of principal and interest payable through September 30, 2014 on the Company’s subordinated related party notes payable. The amendment accelerated the maturity date of the Tranche C Term Loan to April 21, 2014. The amendment also modified the payment terms of the $5.0 million Tranche C Term Loan to allow the lender to utilize the $5.0 million compensating balance to pay off the Tranche C Term Loan on or before its amended April 21, 2014 maturity date. On April 18, 2014, the Company used the $5.0 million in compensating balance funds to pay in full the Tranche C Term Loan.
	On September 2, 2014, the Company paid in full the Tranche B Term Loan.
	Effective September 23, 2014, the Company and its lenders amended the Credit Agreement to delay commencement of principal and interest payments on the Company’s subordinated related party notes payable from September 30, 2014 through December 31, 2014. The amendment also required the Company to repay $1.5 million in principal under the Revolver. This payment was made on September 22, 2014.
	On December 22, 2014, Southwest Bank replaced JPMorgan Chase Bank, N.A. as the administrative agent and refinanced the debt payable to the other lenders party to the Credit Agreement. As a result, Southwest Bank is the sole lender to the Company under the Credit Agreement. In connection with this restructuring, the Company and Southwest Bank amended the Credit Agreement to revise the structure of the Tranche A Term Loan and Revolver. As amended, the maturity date of the Tranche A Term Loan is December 21, 2016, rather than August 31, 2017 and the Tranche A Term Loan bears interest at a fixed rate of 5.00%. Principal payments of $375,000 plus interest are due quarterly, with any principal still outstanding due at maturity. Proceeds from borrowings under the restructured Southwest Bank Tranche A Term Loan were used to repay in full the other lenders previously party to the Tranche A Term Loan.
	Further, the maturity date of the Revolver is December 21, 2016, rather than June 30, 2015. Interest on the Revolver is due monthly and accrues, at the Company’s option, at the 30-Day London Interbank Offered Rate (“LIBOR”) plus 3.50%, or the U.S. prime rate plus 0.50%, with a floor of 4.00% in either case. An unused commitment fee is payable quarterly on the undrawn portion of the Revolver at a rate of 0.50% per annum. Proceeds from borrowings under the Revolver are available to finance the working capital needs of the Company and its wholly owned subsidiaries and to finance up to $1.5 million of capital expenditures each year.
	The Credit Agreement contains a number of covenants that, among other things, limit or restrict the ability of the Company and its wholly owned subsidiaries to dispose of assets, incur additional indebtedness, make dividend and other restricted payments, create liens securing other indebtedness and enter into restrictive agreements. The amendment eliminated the minimum adjusted EBITDA financial covenant; however, the Company is subject to financial covenants that require it to maintain a fixed charge coverage ratio of at least 1.25:1.00 and a senior leverage ratio no greater than 1.50:1.00, each calculated quarterly for the previous four consecutive fiscal quarters. However, not more than once during any period of four consecutive fiscal quarters, the Company is permitted to maintain compliance with its financial covenants if its fixed charge coverage ratio is at least 1.00:1.00 and its senior leverage ratio is no greater than 1.75:1.00. As of December 31, 2014, the Company was in compliance with its Credit Agreement covenant requirements.
	Prior to amendment, four lenders were party to the Credit Agreement. The Company had individual term note and revolving credit facility debt instruments with each lender. The Company analyzed the amendment to the Credit Agreement and resulting restructuring of the Tranche A Term Loan and the Revolver under the debt modification and extinguishment accounting guidance (ASC 470-50) and concluded that modifications to the Southwest Bank debt instruments were required to be accounted for as debt modifications and that the modifications to the debt instruments of the other lenders previously party to the Credit Agreement were required to be accounted for as debt extinguishments. The Company recognized a loss on debt extinguishment of $171,000 related to the write-off of unamortized deferred debt issuance costs associated with the other lenders’ debt instruments under the Credit Agreement.
	In connection with this amendment, the Company incurred debt issuance costs of $69,000 directly with Southwest Bank, which were added to existing unamortized Southwest Bank deferred debt issuance costs and will be amortized through December 21, 2016. In addition, the Company incurred $42,000 of third party financing costs associated with the amendment that were expensed as incurred.
	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 has the right at any time after September 1, 2014 to convert all or any part of the unpaid principal balance of its Convertible Subordinated Note into shares of common stock of the Company 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 Convertible Subordinated Notes are convertible into 1,041,581 common shares of the Company at a conversion price of $23.37 per share and have an effective interest rate of 8.50%. The indebtedness represented by the Convertible Subordinated Notes is expressly subordinate to all senior indebtedness of the Company currently outstanding or incurred in the future, which includes its indebtedness under the Credit Agreement.
	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 the Company’s 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 is being accreted to the Convertible Subordinated Notes using the effective interest method until the notes mature on March 1, 2019. At December 31, 2014, the unamortized discount of $3.0 million has a remaining amortizable life of 50 months. Recognition of the beneficial conversion discount results in a temporary book-tax basis difference in the debt instrument. Accordingly, on September 1, 2013, the Company recorded a $1.3 million deferred tax liability with an offsetting entry to additional paid-in capital.
	In connection with the borrowings under the Convertible Subordinated Notes, the Company incurred debt issuance costs of $70,000, which are being amortized through March 2019 using the effective interest method. For the year ended December 31, 2014, the Company recognized interest expense related to the Convertible Subordinated Notes of $1.7 million, comprised of $1.2 million related to the contractual interest rate and $0.5 million related to discount accretion. 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.
	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 (the “Subordinated Related Party Notes”). Two of the notes were paid in full on August 31, 2012. The Subordinated Related Party Notes are due to two individuals who are current members of the Company’s Board of Directors, one of which is the Chief Executive Officer of the Company. 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 is expressly subordinate to all senior indebtedness of the Company currently outstanding or incurred in the future, which includes its indebtedness under the Credit Agreement. Interest accrues at a fixed rate of 9.00%, subject to a premium of 1.00% under certain payment options available to the Company.
	In connection with amendments to the Credit Agreement described above, the Company was prohibited from making scheduled payments of principal and interest on the Subordinated Related Party Notes through December 31, 2014. Interest accrued during this period in the amount of $254,000 was recognized at the premium rate of 10.00% and added to the principal balance of the notes. Until payments under the Subordinated Related Party Notes are current, interest will continue to accrue on the full balance of the notes at the premium rate of 10%. Average monthly principal and interest payments of $88,000 are due on the notes through September 2017, at which point the deferred payments and accumulated interest are scheduled to be paid. Subsequent to that, monthly principal and interest payments of $80,000 will be due on the notes through maturity on October 31, 2018.
	Other Notes Payable
	Concurrent with a capital lease of medical equipment for newly leased medical office building space at USMD Arlington (discussed below), the Company financed $157,000 of training and implementation services provided by the equipment vendor prior to the lease commencement date. The arrangement requires 25 quarterly principal and interest payments of $8,300 beginning three quarters after the equipment is installed and operating; the installation date is currently anticipated to be in July 2015. The arrangement bears interest at a fixed rate of 5.6%. From inception to the first payment date, interest charges will be added to the note balance.
	Consolidated Lithotripsy Entities
	Six of the Company’s consolidated lithotripsy partnerships have entered into notes payable for equipment. Aggregate principal and interest payments of $54,400 are due monthly and the notes have a weighted average maturity of September 2017. The notes bear fixed interest rates at a weighted average fixed rate of 4.2%. The notes are secured by the financed equipment.
	Long-Term Debt Maturities
	Maturities of the Company’s long-term debt at December 31, 2014, excluding unamortized debt discounts, are as follows for the years indicated (in thousands):
	2015	$	2,786
	2016		7,217
	2017		1,857
	2018		813
	2019		24,368
	Thereafter		72
	Total	$	37,113
	Capital Lease Obligations
	In connection with the build out of newly leased medical office building space at USMD Arlington, the Company has entered into a capital lease to finance the purchase of medical equipment totaling $0.6 million. Payments are variable subject to a defined per-use minimum. The lease requires 25 minimum quarterly payments of $30,000 beginning three quarters after the equipment is installed and operating; the installation date is currently anticipated to be in July 2015. From lease inception to the first payment date, interest will be added to the capital lease balance.
	In November 2014, a wholly owned subsidiary of the Company entered into a capital lease for lithotripsy equipment totaling $0.4 million. Beginning December 2014, three monthly payments of $2,100 are due followed by 58 monthly payments of $8,900. The capital lease matures December, 2019. In addition, four of the Company’s consolidated lithotripsy partnerships have entered into capital leases for equipment. Aggregate payments of $47,000 are due monthly and the leases have a weighted average maturity of October 2018.
	The future minimum lease payments required under the capital leases and the present value of the net minimum lease payments as of December 31, 2014 are as follows for the years indicated (in thousands):
	2015	$	626
	2016		456
	2017		477
	2018		477
	2019		360
	Thereafter		298
	Total minimum lease payments		2,694
	Less: amount representing interest		(368	)
Present value of minimum lease payments		2,326
Less: current portion of capital lease obligations		(537	)
Capital lease obligations, less current portion	$	1,789

Fair_Value_of_Financial_Instru

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2014
Fair Value of Financial Instruments	Note 11 – Fair Value of Financial Instruments
	Financial Instruments Measured at Fair Value on a Nonrecurring Basis
	The Company measures certain financial and nonfinancial assets, including property and equipment, goodwill, intangible assets other than goodwill and investments in nonconsolidated affiliates, at fair value on a nonrecurring basis. These assets are not measured at fair value on an ongoing basis, but are subject to fair value adjustments in certain circumstances. Generally, assets are recorded at fair value on a nonrecurring basis as a result of impairment charges or similar adjustments made to the carrying value of the applicable assets.
	- Goodwill
	As a result of its 2014 goodwill impairment review, the Company recorded goodwill impairment of $20.3 million in its Cancer Treatment Services reporting unit. In estimating the fair value of the reporting unit 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. The valuation of goodwill is considered a Level 3 fair value measurement under the fair value measurement hierarchy, which means that the valuation of assets and liabilities reflect management’s own judgments regarding the assumptions market participants would use in determining the fair value of the assets and liabilities.
	In performing its impairment analyses, the Company relied primarily on an income approach, specifically a discounted cash flow analysis. Under the discounted cash flow method, cash flows beyond discrete forecasts were estimated using a terminal growth rate, which considered the long-term earnings growth rates specific to the respective reporting units. The estimated future cash flows were discounted to present value using a discount rate that was the value-weighted average of the reporting unit’s estimated cost of equity and debt derived using both known and estimated market metrics, and was adjusted to reflect risk factors that considered both the timing and risks associated with the estimated cash flows. The tax rate used in the discounted cash flow method reflected the structure currently in place, which is consistent with the market participant perspective.
	- Trade Names
	In connection with the Company’s branding initiative announced in May 2014, certain acquired trade names with a carrying value of $11.0 million were written down to their estimated fair value of $2.6 million, resulting in an impairment loss of $8.4 million (Level 3 fair value measurement). Fair value was estimated using an income approach – relief from royalty method, which assumes that in lieu of ownership, a third party would be willing to pay a royalty in order to exploit the related benefits of the trade name asset. The cash flow model the Company used to estimate the fair value of the trade names involves several assumptions, most significantly, projected revenue growth rates, a pre-tax royalty rate of 1.0% declining to 0.1% over the estimated five year life of the asset and a discount rate of 17%.
	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, 2014				December 31, 2013
		Carrying		Fair		Carrying		Fair
		Value		Value		Value		Value
	Convertible Subordinated Notes	$	21,364	$	19,857	$	20,839	$	25,985
	Tranche A Term Debt	$	7,500	$	7,500	$	7,500	$	7,500
	Subordinated Related Party Notes	$	3,831	$	3,689	$	3,734	$	3,481
	Other notes payable	$	212	$	213	$	120	$	124
	Consolidated lithotripsy entity notes payable	$	1,227	$	1,227	$	1,766	$	1,767
	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 (Level 3 fair value measurement). 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. Quoted market prices are not available for the Convertible Subordinated Notes.
	At December 31, 2014, the carrying value of the Company’s Tranche A Term Debt approximates fair value due to recent inception of the fixed rate debt. At December 31, 2013, the carrying value of the Company’s Tranche A Term Debt approximates fair value due to its variable rate nature. The Company estimates the fair value of its Subordinated Related Party Notes 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 and its other 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). If the creditworthiness of an individual lithotripsy entity has significantly changed from the debt inception date, management estimates the applicable borrowing rate based on the current facts and circumstances. Quoted market prices are not available for the Company’s notes payable.

Deferred_Compensation_Plans

Deferred Compensation Plans	12 Months Ended
	Dec. 31, 2014
Deferred Compensation Plans	Note 12 – Deferred Compensation Plans
	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 debt or as otherwise deemed necessary by the Company’s management. At December 31, 2014, the Company’s deferred compensation obligation under the Savings Plan totaled $4.6 million with $0.2 million included in other current liabilities and $4.4 million included in deferred compensation payable in the accompanying consolidated balance sheet.

Income_Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2014
Income Taxes	Note 13 – Income Taxes
	Significant components of the provision (benefit) for income taxes are as follows (in thousands):
		Years Ended December 31,
		2014			2013
	Current:
	Federal	$	2,908		$	1,067
	State		240			228
	Total current income tax provision		3,148			1,295
	Deferred:
	Federal		(8,692	)		(1,224	)
	State		—			—
	Total deferred income tax benefit		(8,692	)		(1,224	)
	Provision (benefit) for income taxes	$	(5,544	)	$	71
	A reconciliation of the Company’s effective tax rate from operations to the U.S. federal income tax rate is as follows:
		Years Ended December 31,
		2014			2013
	Federal statutory rate		35	%		35	%
	State income taxes, net of federal tax benefit		(0.6	)		1.4
	Net income attributable to noncontrolling interests		11.7			(31.6	)
	Goodwill amortization		0.8			(2.0	)
	Impairment of goodwill		(25.0	)		—
	Other		(2.3	)		(2.5	)
	Permanent differences		(0.1	)		0.4
	Effective tax rate for income (loss) from operations		19.5	%		0.7	%
	The tax effects of cumulative temporary differences that give rise to significant components of deferred tax assets and liabilities are as follows (in thousands):
		December 31,
		2014			2013
	Deferred tax assets:
	Net operating losses	$	617		$	290
	Deferred revenue		114			150
	Share-based payment expense		1,252			850
	Deferred compensation		1,642			1,624
	Other compensation		1,630			477
	Allowance for doubtful accounts		680			578
	IBNR claims liability		3,850			671
	Facilitative acquisition costs		385			385
	Intangible assets		397			572
	Other		645			538
	Total deferred tax assets		11,212			6,135
	Deferred tax liabilities:
	Partnership investments		(14,778	)		(13,922	)
	Property and equipment		(3,544	)		(4,321	)
	Tax impact of beneficial conversion feature of debt		(1,042	)		(1,226	)
	Intangible assets		(5,815	)		(9,301	)
	Other		(287	)		(311	)
	Total deferred tax liabilities		(25,466	)		(29,081	)
	Net deferred tax liabilities	$	(14,254	)	$	(22,946	)
		December 31,
		2014			2013
	Current deferred tax assets	$	6,160		$	1,725
	Current deferred tax liabilities		(287	)		(312	)
	Net current deferred tax assets		5,873			1,413
	Noncurrent deferred tax assets		5,052			4,410
	Noncurrent deferred tax liabilities		(25,179	)		(28,769	)
	Net noncurrent deferred tax liabilities		(20,127	)		(24,359	)
	Net deferred tax liabilities	$	(14,254	)	$	(22,946	)
	The Company has recorded a liability for an unrecognized tax benefit related to a position taken on one of its 2013 income tax returns. If recognized, the entire amount of these unrecognized tax benefits would favorably impact the effective tax rate that is reported in future periods. As of December 31, 2014, the Company had $142,000 of total unrecognized tax benefits, including accrued interest and penalties, which is included in current deferred tax assets in the accompanying consolidated balance sheet and deferred tax schedules above. The Company anticipates that the total unrecognized tax benefit will increase $426,000 within the next twelve months due to an increase in the balance underlying the tax position. No other uncertain tax positions were noted during the Company’s evaluation of uncertain tax positions, which was performed for the tax years that remain subject to examination by major tax jurisdictions as of December 31, 2014, which includes the tax years 2011 through 2014.
	Although realization is not assured, the Company believes that the realization of the recognized deferred tax assets of $11.2 million at December 31, 2014 is more likely than not based upon the projected future reversals of existing taxable temporary differences and the potential to carryback all or a portion of its deferred tax net operating losses. The Company has significant deferred tax liabilities related to finite-lived intangible assets that will reverse at a rate similar to the reversal of its significant deferred tax assets, such that, even if the Company fails to generate future positive cumulative book taxable income, it will generate sufficient taxable income to realize the benefit of its deferred tax assets. The Company may also carryback net operating losses to the 2013 tax year. Management considered the magnitude and duration of recent taxable losses and profitability and concluded that, although management expects future taxable income in 2015 and following years, due to the cumulative taxable loss incurred over the three years ended December 31, 2014, management could not conclude that future taxable income alone would support not having a valuation allowance.
	At December 31, 2014, the Company had available unused net operating loss carryforwards of $1.8 million that may be available to reduce future income tax liabilities. These loss carryforwards expire in 2031.

ShareBased_Payment

Share-Based Payment	12 Months Ended
	Dec. 31, 2014
Share-Based Payment	Note 14 – Share-Based Payment
	Pursuant to the USMD Holdings, Inc. 2010 Equity Compensation Plan (the “Equity Compensation 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. Effective, June 6, 2014, at the annual meeting of stockholders, the stockholders approved an amendment to the Equity Compensation Plan that increased the aggregate number of shares that may be issued under the Equity Compensation Plan from 1.0 million to 2.5 million. Stock options may be granted with a contractual life of up to ten years. At December 31, 2014, the Company had 1.4 million shares available for grant under the Equity Compensation 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,
		2014			2013
	Risk-free interest rate		1.87	%		1.78	%
	Expected volatility of common stock		42.1	%		45.2	%
	Expected life of options		5.8 years			6.2 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, 2014 is as follows:
	Options	Number of			Weighted-			Weighted-		Aggregate
		Shares			Average			Average		Intrinsic
					Exercise			Remaining		Value
					Price			Contractual
								Term
								(in years)
	Outstanding as of December 31, 2013		583,697		$	25.39
	Granted		300,000			14.13
	Exercised		—			—				$	—
	Forfeited		(11,385	)		23.61
	Outstanding as of December 31, 2014		872,312		$	21.54			6.33	$	—
	Vested and expected to vest at December 31, 2014		421,267		$	23.49			5.64	$	—
	Exercisable at December 31, 2014		279,678		$	23.59			5.32	$	—
	The weighted-average grant-date fair value of stock options granted during the years ended December 31, 2014 and 2013 was $5.57 and $10.94 per option, respectively. The fair value of stock options vested and share-based payment expense recognized for the years ended December 31, 2014 and 2013 was $1.3 million and $0.9 million, respectively, and is included in salaries, wages and employee benefits. At December 31, 2014, the total unrecognized compensation cost related to nonvested share-based payment awards was $3.1 million, which is expected to be recognized over a remaining weighted-average period of 3.2 years.
	In addition to stock options described above, the Company has outstanding options to purchase 68,982 shares of its common stock. These stock options were granted as consideration in the Contribution and have an exercise price of $24.84 per share. The options were fully vested upon issuance and have a remaining contractual term of 2.7 years. These stock options have no aggregate intrinsic value.
	Payments in Common Stock
	- 2014 Activity
	For services rendered as members of the Company’s Board of Directors, the Company has elected to compensate directors in common stock of the Company. Grant dates occur on the last day of each month and shares granted are fully vested and non-forfeitable. Shares are generally issued in arrears in three month blocks. Pursuant to the Equity Compensation Plan, during the year ended December 31, 2014, the Company granted to members of its Board of Directors an aggregate 60,324 shares of its common stock with a grant date fair value of $646,000, which is included in other operating expenses on the Company’s statement of operations. During the year ended December 31, 2014, in payment of the Board of Directors’ compensation earned January 1, 2014 through July 31, 2014, the Company issued 29,600 previously granted shares of its common stock with an aggregate grant date fair value of $373,000.
	Pursuant to the Equity Compensation Plan, on March 5 and 6, 2014, the Company issued an aggregate 14,958 shares of its common stock with a grant date fair value of $243,000 to a member of senior management and members of the Company’s Board of Directors. The shares were issued in payment of certain compensation accrued at December 31, 2013.
	A consultant to the Company has agreed to be partially compensated in common stock for services rendered. Grant dates occur on the last day of each month and shares granted are fully vested and non-forfeitable. Pursuant to the Equity Compensation Plan, during the year ended December 31, 2014, the Company granted to the consultant 4,842 shares of common stock with a grant date fair value of $52,000. During the year ended December 31, 2014, the Company issued to the consultant 2,853 of those shares with a grant date fair value of $34,000.
	Of the shares of common stock described as issued above, 19,501 shares have not been registered under the Securities Act of 1933, as amended, and may not be transferred without an effective registration statement or pursuant to an appropriate exemption from such act.
	- 2013 Activity
	Pursuant to the Equity Compensation Plan, on March 11, 2013, the Company issued 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 issued 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 USMD’s common stock with a fair value of $386,000, which is included in salaries, wages and employee benefits on the Company’s statement of operations. The shares were issued in October 2013.
	Effective December 31, 2013, the Company issued 9,086 shares of its common stock with a fair value of $182,000 to two members of senior management in payment of certain accrued compensation.
	The common shares granted and issued in 2013 have not been registered under the Securities Act of 1933, as amended, and may not be transferred without an effective registration statement or pursuant to an appropriate exemption from such act.
	Salary Deferral Plan
	On May 5, 2014, USMD’s Board of Directors approved and established the Salary Deferral Plan (the “Deferral Plan”). On July 18, 2014, the holder of a majority of USMD’s outstanding voting stock approved the Deferral Plan by written consent in lieu of a special meeting. The Company mailed an information statement on Schedule 14C to shareholders on or about July 22, 2014 informing the shareholders of the creation of the Deferral Plan. The Deferral Plan went into effect on August 11, 2014, 20 days after the information statement was mailed as required by law. The Deferral Plan permits the Company to defer the payment of a predetermined portion of a participant’s base salary each calendar quarter. The plan administrator will decide after the end of each quarter whether deferred amounts will be paid in the form of cash, shares of common stock or a combination of both. Any shares of common stock issued under the Deferral Plan will be issued from the shares of common stock authorized for issuance under the Equity Compensation Plan, as amended.
	In August 2014, pursuant to the Deferral Plan, the Company granted 15,700 shares of its common stock with a grant date fair value of $150,000 to certain of its executives in payment of salary amounts deferred during the second quarter of 2014.
	Registration of Common Shares
	On July 14, 2014, USMD filed a registration statement on Form S-8 to register with the SEC approximately 1.7 million shares of USMD common stock available for issuance under the Equity Compensation Plan and the Deferral Plan. The registration statement became effective upon filing.

Earnings_per_Share

Earnings per Share	12 Months Ended
	Dec. 31, 2014
Earnings per Share	Note 15 – Earnings per Share
	Basic earnings (loss) per share is computed by dividing net income (loss) attributable to the Company’s stockholders by the weighted-average number of common shares outstanding during the period, including fully vested and unissued common shares. Diluted earnings (loss) 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 (loss) 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 a 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.
	The following table presents a reconciliation of the numerators and denominators of basic and diluted earnings (loss) per share and the computation of basic and diluted earnings (loss) per share (in thousands, except per share data):
		Years Ended December 31,
		2014			2013
	Numerator:
	Net earnings (loss) attributable to USMD Holdings, Inc. - basic	$	(32,400	)	$	979
	Effect of potentially dilutive securities:
	Interest on Convertible Subordinated Notes, net of tax		—			—
	Net earnings (loss) attributable to USMD Holdings, Inc. - diluted	$	(32,400	)	$	979
	Denominator:
	Weighted-average common shares outstanding		10,168			10,080
	Effect of potentially dilutive securities:
	Stock options		—			4
	Convertible Subordinated Notes		—			—
	Weighted-average common shares outstanding assuming dilution		10,168			10,084
	Earnings (loss) per share attributable to USMD Holdings, Inc.:
	Basic	$	(3.19	)	$	0.1
	Diluted	$	(3.19	)	$	0.1
	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,
		2014			2013
	Stock options		941			643
	Convertible Subordinated Notes		1,042			1,042
			1,983			1,685

Commitments_and_Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2014
Commitments and Contingencies
	Note 16 – Commitments and Contingencies
	Financial Guarantees
	As of December 31, 2014, 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 $19.2 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 24 to 161 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.
	Purchase Obligation
	In connection with a capital lease entered into for newly leased medical office building space at USMD Arlington, the Company entered into an associated arrangement for ongoing maintenance of the equipment and software leased. Payments are variable subject to a defined per-use minimum. The arrangement requires 25 quarterly minimum payments of $26,000 beginning three quarters after the equipment is installed and operating; the installation date is currently anticipated to be in July 2015.
	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. Significant 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 medical loss claims. For lawsuits and claims where the Company can reasonably estimate a range of loss, the Company estimates a reasonably possible range of loss of $0.3 million to $1.6 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, results of operations or cash flows of the Company.
	Resolution Agreement
	On October 26, 2012, a subsidiary of the Company entered into a Mediation 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 Mediation Settlement Agreement required the entity to pay the Company $100,000 in November 2012 and to make 55 monthly payments of $10,000 on the first day of each month beginning December 2012. The Company concluded that collection of the settlement amount was not reasonably assured and recorded the gain as amounts were collected. Effective April 11, 2014, the Company and the entity entered into a Lump Sum Settlement Agreement, whereby for one lump sum payment of $342,500 received and recorded by the Company on April 18, 2014, all outstanding liabilities due under the Mediation Settlement Agreement were deemed to be fully paid and satisfied.
	Financial Advisory Commitment
	The Company has in place with an investment banking firm a financial advisory services agreement, as amended, (“FAS Agreement”). Under the FAS Agreement, the Company may be obligated to compensate the firm in cash for certain financial transactions, depending on the transaction type and size, in amounts generally equal to the greater of a minimum $1.0 million to $2.5 million, a percentage of the potential transaction value, or a fee to be determined in the future based on prevailing market rates for the services provided, subject to the review and restrictions imposed by the Financial Industry Regulatory Authority as further defined in the FAS Agreement. If the Company enters into a qualifying financial transaction during a one year to thirty month period subsequent to termination of the FAS Agreement, depending on the transaction type and size, the investment banking firm may be entitled to compensation under the terms of the FAS Agreement. The FAS Agreement remains in effect until terminated by either party. As of December 31, 2014, the Company has not closed any transaction for which compensation is due to the investment banking firm.
	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. Facility leases may or may not include a provision for a tenant allowance to be used for the build out of the leased space. Typically, the lessor does not provide the tenant allowance as an upfront payment to the Company, and, except for normal tenant improvements, the Company has not historically been involved in the construction of leasehold facilities. Therefore, the Company does not record the tenant allowance as deferred rent, nor does it record the leasehold improvements associated with a tenant allowance.
	Future minimum cash lease payments under non-cancelable operating leases with an initial or remaining lease term in excess of one year are as follows for the years indicated (in thousands):
	2015	$	12,792
	2016		12,195
	2017		10,616
	2018		9,717
	2019		9,052
	Thereafter		43,790
	Total	$	98,162
	Aggregate future minimum rentals to be received under non-cancelable subleases as of December 31, 2014 were $1.2 million.

Related_Party_Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2014
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 and other services revenue and accounts receivable from these entities are as follows:
		Management and Other				Accounts Receivable
		Services Revenue
		Years Ended December 31,				December 31,
		2014		2013		2014		2013
		(in thousands)
	USMD Arlington	$	10,619	$	10,423	$	472	$	2,625
	USMD Fort Worth		3,840		4,434		300		1,221
	Other equity method investees		1,818		1,379		230		435
		$	16,277	$	16,236	$	1,002	$	4,281
	One consolidated lithotripsy entity provides lithotripsy services to USMD Arlington and USMD Fort Worth. For both years ended December 31, 2014 and 2013, the Company recognized lithotripsy revenues from USMD Arlington and USMD Fort Worth totaling $2.2 million.
	The Company leases space from USMD Arlington for certain of its physicians and its Arlington-based cancer treatment center. For the years ended December 31, 2014 and 2013, the Company recorded rent expense related to USMD Arlington totaling $1.9 million and $1.7 million, respectively.

Employee_Benefit_Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2014
Employee Benefit Plans	Note 18 – Employee Benefit Plans
	The Company provides a 401(k) defined contribution plan for all eligible employees. Beginning January 1, 2014, the Company provides participants 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. 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 $3.2 million and $3.1 million in 2014 and 2013, respectively.

OneTime_Termination_Benefits

One-Time Termination Benefits	12 Months Ended
	Dec. 31, 2014
One-Time Termination Benefits	Note 19 – One-Time Termination Benefits
	In September 2014, in order to improve flexibility in the revenue cycle process, the Company entered into an arrangement to outsource the majority of its revenue cycle function to an external provider. Employees were first advised of the outsourcing in September; however, an approved termination benefit plan was not yet in place. During the fourth quarter of 2014, the Company approved a termination plan and notified the 75 impacted employees of the plan and its benefits. The Company recognized severance expense of $0.5 million related to this termination, which is included in salaries, wages and employee benefits on the accompanying consolidated statement of operations. As of December 31, 2014, all impacted employees were terminated and paid in full.

Subsequent_Events

Subsequent Events	12 Months Ended
	Dec. 31, 2014
Subsequent Events	Note 20 – Subsequent Events
	Medical Benefit Plan Self-Insurance
	Beginning January 1, 2015, the Company is primarily self-insured for its employee medical benefit plan. The Company contracts with a separate administrative service company to supervise and administer the program and to participate in its provider network. The claims incurred under the plans are self-funded for the first $200,000 of each claim. The Company purchased individual stop loss reinsurance to limit its claims liability to $200,000 per claim. Each reporting period, the Company records the costs of its medical benefit plan, including paid claims and an estimate of the IBNR claims. The estimated IBNR claims are not discounted and are based upon (i) a recent average level of paid claims under the plan, (ii) an estimated lag factor and (iii) an estimated growth factor to provide for those claims that have been incurred but not yet reported and paid. The Company uses an actuary to determine the claims lag and estimated liability for IBNR claims. Actual claims experience may differ from the Company’s estimates. If the underlying facts and circumstances of the claims change or if the historical trend is not indicative of future trends, then the Company may be required to record additional expense or a reduction in expense, which could be material to its reported financial condition and results of operations. Costs related to the administration of the plan and related claims are expensed as incurred.
	Share-Based Payment
	On February 20, 2015, in payment of Board of Directors’ compensation earned through December 31, 2014, the Company issued to members of the Company’s Board of Directors, 30,724 previously granted shares of its common stock with an aggregate grant date fair value of $273,000. The shares were issued pursuant to the Company’s Equity Compensation Plan.
	On March 4, 2015, in payment of certain compensation accrued at December 31, 2014, the Company granted 40,311 shares of its common stock to certain executives and members of senior management. The shares had a grant date fair value of $548,000. The shares were issued on March 6, 2015, pursuant to the Company’s Equity Compensation Plan.
	On March 5, 2015, in payment of salaries deferred in 2014 under the Company’s Salary Deferral Plan, the Company issued 15,700 shares of its common stock to certain executives and members of senior management. The shares had a grant date fair value of $150,000 and were issued pursuant to the Company’s Equity Compensation Plan.
	Sale of Equity Method Investee
	Effective January 31, 2015, a subsidiary of the Company sold for $1.6 million its interest in a cancer treatment center that it accounted for under the equity method of accounting and that had a carrying value of $159,000. The interest was sold to the other owner of the cancer treatment center. The Company and buyer executed a note receivable for the $1.6 million sale price; however, the Company concluded that only $159,000 of the note is reasonably assured of collection and has recorded a note receivable in that amount, net of a valuation allowance. The Company will recognize proportionate gain on the sale as payments are received. The Company had provided management services to the cancer treatment center under a long term contract and the contract was terminated with the sale of interest.
	Issuance of Convertible Debt
	On March 27, 2015, the Company issued convertible subordinated notes payable in the aggregate principal amount of $3.5 million (the “2020 Notes”) to four individual Taiwanese investors. The 2020 Notes bear interest at a fixed rate of 7.75% per annum and mature on September 1, 2020. Interest payments are due and payable on the last day of each month and may be paid in cash or in shares of common stock of the Company. Principal is due upon maturity. The Company may prepay the 2020 Notes, in whole or in part, at any time after March 13, 2016 without penalty. Each noteholder has the right at any time after March 13, 2016 to convert all or any part of the unpaid principal balance of its 2020 Note into shares of common stock of the Company at the rate of one share of common stock for each $12.02 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 2020 Notes are convertible into 291,181 common shares of the Company at a conversion price of $12.02 per share. The indebtedness represented by the 2020 Notes is expressly subordinate to all senior indebtedness of the Company currently outstanding or incurred in the future, which includes its indebtedness under the Credit Agreement. Management is evaluating the impact of the 2020 Notes on the Company’s consolidated financial statements.
	Lease Arrangement
	In connection with the build out of newly leased medical office building space at USMD Arlington, in March 2015, the Company entered into a leasing arrangement for medical equipment and associated services totaling $5.9 million. The company is obligated to the terms of the arrangement; however, the lease does not commence until the delivery and acceptance of the equipment, currently anticipated to be July 2015. The arrangement requires 44 minimum monthly payments of $134,000 beginning six months after the commencement date. Prior to the commencement date, the Company anticipates adding $0.9 million of additional equipment and services to the arrangement. This addition will require 44 minimum monthly payments of $23,000 beginning six months after the commencement date. Payment terms and the total amount of the arrangement may change dependent upon the final components and services. Management is evaluating the impact of this lease arrangement on the Company’s consolidated financial statements.

Description_of_Business_and_Ba1

Description of Business and Basis of Presentation (Policies)

12 Months Ended

Dec. 31, 2014

Description of Business

Description of Business:

USMD Holdings, Inc. (“USMD” or the “Company”) is a Delaware corporation formed on May 7, 2010 to facilitate the business combination of USMD Inc., a Texas corporation, Urology Associates of North Texas, L.L.P., a Texas limited liability partnership, and UANT Ventures, L.L.P., a Texas limited liability partnership (“Ventures”) (such transaction, the “Contribution”). USMD described this transaction in its registration statement on Form S-4 filed with the Securities and Exchange Commission (the “SEC”). Prior to the consummation of the Contribution, Ventures and USMD entered into a merger agreement with The Medical Clinic of North Texas, P.A., a Texas professional association (“MCNT”), and 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 USMD as part of the Contribution. USMD 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, USMD and the other parties consummated the Contribution. The Company is an innovative, early-stage physician-led integrated health system. 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.

Through its subsidiaries and affiliates, the Company provides healthcare services to patients and management and operational services to hospitals and other healthcare service providers. The Company provides healthcare services to patients in physician clinics, hospitals and other healthcare facilities, including cancer treatment centers and anatomical pathology and clinical laboratories. A wholly owned subsidiary of the Company is the sole member of a Texas Certified Non-Profit Health 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 three cancer treatment centers in three states and 22 lithotripsy service providers (i.e., kidney stone treatment) primarily located in the South-Central United States. Of these managed entities, the Company has limited ownership interests in the two hospitals, two cancer treatment centers and 20 lithotripsy service providers. The Company consolidates 18 lithotripsy service providers into its financial statements. In addition, the Company wholly owns and operates two clinical laboratories, one anatomical pathology laboratory, one cancer treatment center and two lithotripsy service providers in the Dallas-Fort Worth, Texas metropolitan area.

Basis of Presentation

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. Certain prior year amounts have been reclassified to conform to current year presentation.

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.

Patient Service Revenue

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 service 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 service 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 well as significant regulatory action including fines, penalties and exclusion from the Medicare and Medicaid programs.

Capitated Revenue

Capitated Revenue: The Company’s consolidated VIE, WNI-DFW, Inc. (“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. Capitated revenue is reported as revenue in the month in which members are entitled to receive healthcare. Capitated 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 and Other Services Revenue

Management and Other 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 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 recognized as the services are provided and contractual terms are met.

Lithotripsy Services Revenue

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 or wholly owns. Lithotripsy services revenue is recognized as services are provided and reported based on actual contract price or estimated net realizable amounts.

Physician Recruitment Agreements

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 compensation 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, 2014 and 2013, the Company recognized $0.7 million and $1.0 million, respectively, of patient service revenue associated with physician recruitment agreements. At December 31, 2014 and 2013, the Company has on the consolidated balance sheet $0.3 million and $0.8 million, respectively, of deferred revenue associated with physician recruitment agreements included in other current liabilities and $0.3 million and $0.4 million, respectively, of deferred revenue associated with physician recruitment agreements included in other long-term liabilities.

Concentrations and Credit Risk

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.

Allowance for Doubtful Accounts

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

Provision

Write-offs

Balance at

Beginning

for Doubtful

for

End of

of Year

Accounts

Doubtful

Year

Related to

Accounts

Patient

Service

Revenue

For the years ended December 31,

2014

$

1,758

3,492

183

(3,333

)

$

2,100

2013

$

1,127

2,801

70

(2,240

)

$

1,758

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 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

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, 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, 2014:

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

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 value 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 value 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, 2014 or 2013. 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, 2014, none of the Company’s finite-lived intangible assets had an estimated residual value.

Goodwill and Other Indefinite-Lived Intangible Assets

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 value. If the carrying value of a reporting unit exceeds its estimated fair value, a potential impairment is indicated and step two is performed. Step two compares the carrying value 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 value, 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 values. 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 value.

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

Electronic Health Record Incentive Income

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.” 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 from amounts recorded.

Share-Based Payments

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

The Company accounts for income taxes under the asset and liability method. Deferred tax assets and liabilities are recognized for 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. The Company’s policy is to record interest and penalties related to income tax matters, net of any applicable related income tax benefit, as a component of income tax expense.

Items required by tax regulations to be included in the tax return may differ from the items reflected in the financial statements. As a result, the effective tax rate reflected in the financial statements may be different than the actual rate applied on the tax return. Some of these differences are permanent such as expenses that are not deductible in the Company’s tax return, and some differences are temporary, reversing over time, such as valuation reserves. Temporary differences create deferred tax assets and liabilities. Deferred tax assets generally represent items that can be used as a tax deduction or credit in future years for which the Company has already recorded the tax benefit in the Company’s income statement. Deferred tax liabilities generally represent tax expense recognized in the Company’s financial statements for which payment has been deferred, or expenditures for which the Company has already taken a deduction in the Company’s tax return but have not yet been recognized in the Company’s financial statements.

The application of GAAP requires the Company to evaluate the recoverability of the Company’s deferred tax assets and establish a valuation allowance if necessary to reduce the Company’s deferred tax assets to an amount that is more likely than not to be realized. Considerable judgment is required in determining whether a valuation allowance is necessary, and if so, the amount of such valuation allowance. In evaluating the need for a valuation allowance, the Company may consider many factors, including: (1) the nature of the deferred tax assets and liabilities; (2) whether they are ordinary or capital; (3) taxable income in prior carryback years as well as projected taxable earnings exclusive of reversing temporary differences and carryforwards; (4) the length of time that carryovers can be utilized in the various taxing jurisdictions; (5) any unique tax rules that would impact the utilization of the deferred tax assets; and (6) any tax planning strategies that the Company would employ to avoid a tax benefit from expiring unused. Although realization is not assured, management believes it is more likely than not that the deferred tax assets will be realized. 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 will not be realized.

GAAP prescribes a comprehensive model for how a company should recognize, measure, present, and disclose in its financial statements uncertain tax positions that a company has taken or expects to take on tax returns. The Company recognizes liabilities for uncertain tax positions based on a two-step process. The first step is to evaluate the tax position for recognition. The Company determines whether it is more likely than not, based upon the technical merits, that a tax position will be sustained on audit, including resolution of related appeals or litigation processes. If the tax position does not meet the more likely than not recognition threshold, the benefit of that position is not recognized in the financial statements. The second step is measurement. The Company measures the tax position as the largest amount of benefit that is greater than 50 percent likely of being realized upon ultimate resolution with a taxing authority that has full knowledge of all relevant information. This measurement considers the amounts and probabilities of the outcomes that could be realized upon the ultimate settlement using the facts, circumstances, and information available at the reporting date. 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 determination and evaluation of the Company’s provision for income taxes and analysis of uncertain tax positions 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.

The Company’s liability for income taxes includes the liability for unrecognized tax benefits, interest and penalties that relate to tax years still subject to review by the Internal Revenue Service or other taxing jurisdictions. Audit periods remain open for review until the statute of limitations has passed. Generally, for tax years that produce net operating losses, capital losses or tax credit carryforwards (“tax attributes”), the statute of limitations does not close, to the extent of these tax attributes, until the expiration of the statute of limitations for the tax year in which they are fully utilized. The completion of review or the expiration of the statute of limitations for a given audit period could result in an adjustment to the liability for income taxes.

Fair Value Measurements

Fair Value Measurements

Fair value is the amount that would be received upon sale of 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 the Company’s 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 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 investee’s net income or loss 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

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.

Segment Reporting

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

Advertising Expense

The Company expenses all advertising costs when incurred. For the years ended December 31, 2014 and 2013, the Company incurred advertising expense of $0.4 million and $0.3 million, respectively. Advertising expense is included in other operating expenses in the accompanying consolidated statements of operations.

Use of Estimates

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 net patient service revenue, the allowance for doubtful accounts, incurred but not reported (“IBNR”) 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.

Recently Issued Accounting Pronouncements

Recently Issued Accounting Pronouncements

In February 2015, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2015-02, “Consolidation (Topic 810): Amendments to the Consolidation Analysis” (“ASU 2015-02”). ASU 2015-02 changes the analysis that a company must perform to determine whether it should consolidate certain legal entities. All legal entities are subject to reevaluation under the updated guidance. ASU 2015-02 eliminates the presumption that a general partner should consolidate a limited partnership, eliminates the consolidation model specific to limited partnerships, modifies the evaluation of whether limited partnerships and similar legal entities are VIEs or voting interest entities and affects the evaluation of fee arrangements in the VIE primary beneficiary determination. ASU 2015-02 is effective for reporting periods beginning after December 15, 2015 and for interim periods within the fiscal year. Early adoption is permitted. Management is evaluating the impact that adoption of ASU 2015-02 will have on the Company’s consolidated financial statements.

In August 2014, the FASB issued ASU No. 2014-15, “Presentation of Financial Statements - Going Concern (Subtopic 205-40) - Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern” (“ASU 2014-15”). ASU 2014-15 sets forth management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to provide related footnote disclosures. ASU 2014-15 indicates that, when preparing interim and annual financial statements, management should evaluate whether conditions or events, considered in the aggregate, raise substantial doubt about the entity’s ability to continue as a going concern for one year from the date the financial statements are issued. This evaluation should include consideration of conditions and events that are either known or are reasonably knowable at the date the financial statements are issued, as well as whether it is probable that management’s plans to address the substantial doubt will be implemented and, if so, whether it is probable that the plans will alleviate the substantial doubt. It also requires certain disclosures when substantial doubt is alleviated as a result of consideration of management’s plans and requires an express statement and other disclosures when substantial doubt is not alleviated. ASU 2014-15 is effective for annual periods ending after December 15, 2016 and interim periods and annual periods thereafter. Early adoption is permitted. Adoption of this guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.

In May 2014, the FASB issued ASU No. 2014-09, “Revenue from Contracts with Customers” (“ASU-2014-09”). ASU 2014-09 requires revenue recognition to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. ASU 2014-09 provides a single principles-based, five-step model to be applied to all contracts with customers. The five steps are to identify the contract(s) with the customer, identify the performance obligations in the contact, determine the transaction price, allocate the transaction price to the performance obligations in the contract and recognize revenue when each performance obligation is satisfied. The provisions of ASU 2014-09 may be applied either retrospectively to each prior reporting period presented or retrospectively with the cumulative effect of the update recognized at the date of the initial application along with additional disclosures. ASU 2014-09 is effective for the Company beginning January 1, 2017. Early adoption is not permitted. Management is evaluating the impact that adoption of ASU 2014-09 will have on the Company’s consolidated financial statements.

In April 2014, the FASB issued ASU No. 2014-08, “Presentation of Financial Statements and Property, Plant, and Equipment - Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity” (“ASU 2014-08”). Among other provisions and in addition to expanded disclosures, ASU 2014-08 changes the definition of what components of an entity qualify for discontinued operations treatment and reporting from a reportable segment, operating segment, reporting unit, subsidiary or asset group to only those components of an entity that represent a strategic shift that has, or will have, a major effect on an entity’s operations and financial results. Additionally, ASU 2014-08 requires disclosure about a disposal of an individually significant component of an entity that does not qualify for discontinued operations presentation in the financial statements, including the pretax profit or loss attributable to the component of an entity for the period in which it is disposed or is classified as held for sale. This disclosure is required for all of the same periods that are presented in the entity’s results of operations for the period. The provisions of ASU 2014-08 are effective prospectively for all disposals or classifications as held for sale of components of an entity that occur within annual periods beginning on or after December 15, 2014 and interim periods within those years. Early adoption is permitted. Adoption of this guidance is not expected to have a material impact on the Company’s consolidated financial position, results of operations or cash flows.

Summary_of_Significant_Account1

Summary of Significant Accounting Policies and Pronouncements (Tables)	12 Months Ended
	Dec. 31, 2014
Percentage of Patient and Customer Accounts Receivable	The mix of gross patient and customer accounts receivable is as follows:
		December 31,
		2014			2013
	Government-related programs		33	%		29	%
	Managed care and commercial payers		54	%		58	%
	Self-pay		4	%		3	%
	Customer		9	%		10	%
			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			Provision		Write-offs			Balance at
		Beginning			for Doubtful			for					End of
		of Year			Accounts			Doubtful					Year
					Related to			Accounts
					Patient
					Service
					Revenue
	For the years ended December 31,
	2014	$	1,758			3,492			183		(3,333	)	$	2,100
	2013	$	1,127			2,801			70		(2,240	)	$	1,758
Estimated Useful Lives of Assets	Estimated useful lives of assets follow American Hospital Association guidelines where applicable and are as follows at December 31, 2014:
	Leasehold improvements	1-15 years
	Furniture and equipment	2-15 years
	Software	1-5 years

Variable_Interest_Entity_Table

Variable Interest Entity (Tables)	12 Months Ended
	Dec. 31, 2014
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 sheets (after elimination of intercompany transactions and balances) (in thousands):
		December 31,
		2014		2013
	Current assets:
	Cash and cash equivalents	$	10,169	$	1,257
	Accounts receivable		1,150		175
	Prepaid expenses		61		—
	Deferred tax asset		3,850		671
	Total current assets	$	15,230	$	2,103
	Current liabilities:
	Accounts payable	$	3,517	$	—
	Other accrued liabilities		11,506		2,108
	Total current liabilities	$	15,023	$	2,108

Business_Combinations_Tables

Business Combinations (Tables)	12 Months Ended
	Dec. 31, 2014
Estimated Fair Values of Assets Acquired at Business Combination Date	The following table summarizes the estimated fair values of assets acquired at the business combination date. No liabilities were assumed in the transactions.
	Inventories	$	38,022
	Property and equipment		212,565
	Identifiable intangible assets - noncompete agreements		20,536
	Assets acquired	$	271,123

Investments_in_Nonconsolidated1

Investments in Nonconsolidated Affiliates (Tables)	12 Months Ended
	Dec. 31, 2014
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, 2014				December 31, 2013
		Carrying		Ownership		Carrying				Ownership
		Value		Percentage		Value				Percentage
	USMD Hospital at Arlington, L.P.	$	49,518	46.40%		$	50,055			46.40%
	USMD Hospital at Fort Worth, L.P.		9,956	30.88%			11,246			30.88%
	Other		306	4%-34%			521			4%-34%
		$	59,780			$	61,822
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,
		2014		2013
	Current assets	$	33,298	$	43,558
	Noncurrent assets	$	78,835	$	83,895
	Current liabilities	$	16,885	$	19,148
	Noncurrent liabilities	$	48,839	$	55,455
		Years Ended December 31,
		2014		2013
	Revenue	$	143,952	$	141,363
	Income from operations	$	35,807	$	35,925
	Net income	$	32,074	$	33,502
USMD Arlington and USMD Fort Worth
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,
		2014		2013				2014			2013
	Current assets	$	22,853	$	26,055			$	6,828		$	13,445
	Noncurrent assets	$	54,992	$	54,205			$	16,812		$	17,439
	Current liabilities	$	9,698	$	9,987			$	4,068		$	5,593
	Noncurrent liabilities	$	35,309	$	36,361			$	9,108		$	10,758
		Years Ended December 31,
		2014		2013				2014			2013
	Revenue	$	93,486	$	90,619			$	36,634		$	39,172
	Income from operations	$	21,878	$	21,367			$	8,721		$	9,311
	Net income	$	19,301	$	20,429			$	7,953		$	8,386

Patient_Service_Revenue_Tables

Patient Service Revenue (Tables)	12 Months Ended
	Dec. 31, 2014
Patient Service Revenue	The Company’s patient service revenue by payer is summarized in the table that follows (dollars in thousands).
		Years Ended December 31,
		2014						2013
		Amount			Ratio of Net			Amount			Ratio of Net
					Patient Service						Patient Service
					Revenue						Revenue
	Medicare	$	56,091			30.5	%	$	52,003			29.2	%
	Medicaid		1,346			0.7			1,460			0.8
	Managed care and commercial payers		126,362			68.7			123,336			69.2
	Self-pay		3,625			2			4,288			2.4
	Patient service revenue before provision for doubtful accounts		187,424			101.9			181,087			101.6
	Patient service revenue provision for doubtful accounts		(3,492	)		(1.9	)		(2,801	)		(1.6	)
	Net patient service revenue	$	183,932			100	%	$	178,286			100	%

Property_and_Equipment_Tables

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2014
Summary of Property and Equipment	Property and equipment consist of the following (in thousands):
		December 31,
		2014			2013
	Leasehold improvements	$	12,925		$	12,565
	Furniture and equipment		23,764			21,691
	Software		3,426			3,043
	Gross property and equipment		40,115			37,299
	Less: accumulated depreciation and amortization		(19,319	)		(13,808	)
	Property and equipment, net	$	20,796		$	23,491
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,
		2014			2013
	Furniture and equipment	$	3,419		$	1,990
	Less: accumulated amortization		(1,183	)		(854	)
	Net assets recorded under capital leases	$	2,236		$	1,136

Goodwill_and_Other_Intangible_1

Goodwill and Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2014
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, 2014 and 2013 (in thousands):
		Physician and			Cancer			Lithotripsy			Total
		Ancillary			Treatment			Services
		Services			Services
	Balance at January 1, 2013:
	Goodwill	$	60,614		$	54,219		$	6,837		$	121,670
	Accumulated impairment losses		—			—			(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 losses		—			—			(3,409	)		(3,409	)
			60,418			54,330			3,428			118,176
	Impairment charge		—			(20,340	)		—			(20,340	)
	Balance at December 31, 2014:
	Goodwill		60,418			54,330			6,837			121,585
	Accumulated impairment losses		—			(20,340	)		(3,409	)		(23,749	)
		$	60,418		$	33,990		$	3,428		$	97,836
Components of Amortizable Intangible Assets	The components of amortizable intangible assets consist of the following (in thousands):
		December 31, 2014									December 31, 2013
		Gross			Accumulated			Net			Gross			Accumulated			Net
		Carrying			Amortization			Carrying			Carrying			Amortization			Carrying
		Amount						Amount			Amount						Amount
	Management agreements	$	5,246		$	(738	)	$	4,508		$	5,246		$	(544	)	$	4,702
	Trade names		11,168			(8,845	)		2,323			462			(123	)		339
	Customer relationships		767			(596	)		171			767			(341	)		426
	Noncompete agreements		12,547			(2,936	)		9,611			12,527			(1,667	)		10,860
		$	29,728		$	(13,115	)	$	16,613		$	19,002		$	(2,675	)	$	16,327
Estimated Amortization Expense for Intangible Assets during Next Five Years	Total estimated amortization expense for the Company’s acquired intangible assets during the next five years is as follows (in thousands):
	2015	$	2,144
	2016	$	1,974
	2017	$	1,972
	2018	$	1,972
	2019	$	1,665

Other_Accrued_Liabilities_Tabl

Other Accrued Liabilities (Tables)	12 Months Ended
	Dec. 31, 2014
Summary of Other Accrued Liabilities	Other accrued liabilities consist of the following (in thousands):
		December 31,
		2014		2013
	Accrued payables	$	3,246	$	5,285
	Accrued bonus		2,000		1,860
	Other accrued liabilities		1,078		1,299
	IBNR claims payable		11,379		1,918
	Income taxes payable		670		395
		$	18,373	$	10,757

LongTerm_Debt_and_Capital_Leas1

Long-Term Debt and Capital Lease Obligations (Tables)	12 Months Ended
	Dec. 31, 2014
Schedule of Long-Term Debt Instruments	Long-term debt and capital lease obligations consist of the following (in thousands):
		December 31,
		2014			2013
	USMD Holdings, Inc.:
	Credit Agreement:
	Term debt	$	7,500		$	15,687
	Revolving credit facility		—			3,000
	Convertible Subordinated Notes, net of unamortized discount of $2,978 and $3,503 at December 31, 2014 and 2013, respectively		21,364			20,839
	Subordinated related party notes payable		3,831			3,734
	Other notes payable		212			120
	Capital lease obligation		1,032			—
			33,939			43,380
	Consolidated lithotripsy entities:
	Notes payable		1,228			1,766
	Capital lease obligations		1,294			1,052
			2,522			2,818
	Total long-term debt and capital lease obligations		36,461			46,198
	Less: current portion		(3,323	)		(8,492	)
	Long-term debt and capital lease obligations, less current portion	$	33,138		$	37,706
Maturities of Long-Term Debt	Maturities of the Company’s long-term debt at December 31, 2014, excluding unamortized debt discounts, are as follows for the years indicated (in thousands):
	2015	$	2,786
	2016		7,217
	2017		1,857
	2018		813
	2019		24,368
	Thereafter		72
	Total	$	37,113
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, 2014 are as follows for the years indicated (in thousands):
	2015	$	626
	2016		456
	2017		477
	2018		477
	2019		360
	Thereafter		298
	Total minimum lease payments		2,694
	Less: amount representing interest		(368	)
	Present value of minimum lease payments		2,326
	Less: current portion of capital lease obligations		(537	)
	Capital lease obligations, less current portion	$	1,789

Fair_Value_of_Financial_Instru1

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2014
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, 2014				December 31, 2013
		Carrying		Fair Value		Carrying		Fair Value
		Value				Value
	Convertible Subordinated Notes	$	21,364	$	19,857	$	20,839	$	25,985
	Tranche A Term Debt	$	7,500	$	7,500	$	7,500	$	7,500
	Subordinated Related Party Notes	$	3,831	$	3,689	$	3,734	$	3,481
	Other notes payable	$	212	$	213	$	120	$	124
	Consolidated lithotripsy entity notes payable	$	1,227	$	1,227	$	1,766	$	1,767

Income_Taxes_Tables

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2014
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,
		2014			2013
	Current:
	Federal	$	2,908		$	1,067
	State		240			228
	Total current income tax provision		3,148			1,295
	Deferred:
	Federal		(8,692	)		(1,224	)
	State		—			—
	Total deferred income tax benefit		(8,692	)		(1,224	)
	Provision (benefit) for income taxes	$	(5,544	)	$	71
Reconciliation of Actual Tax Rate	A reconciliation of the Company’s effective tax rate from operations to the U.S. federal income tax rate is as follows:
		Years Ended December 31,
		2014			2013
	Federal statutory rate		35	%		35	%
	State income taxes, net of federal tax benefit		(0.6	)		1.4
	Net income attributable to noncontrolling interests		11.7			(31.6	)
	Goodwill amortization		0.8			(2.0	)
	Impairment of goodwill		(25.0	)		—
	Other		(2.3	)		(2.5	)
	Permanent differences		(0.1	)		0.4
	Effective tax rate for income (loss) from operations		19.5	%		0.7	%
Schedule of Components of Deferred Tax Assets and Liabilities	The tax effects of cumulative temporary differences that give rise to significant components of deferred tax assets and liabilities are as follows (in thousands):
		December 31,
		2014			2013
	Deferred tax assets:
	Net operating losses	$	617		$	290
	Deferred revenue		114			150
	Share-based payment expense		1,252			850
	Deferred compensation		1,642			1,624
	Other compensation		1,630			477
	Allowance for doubtful accounts		680			578
	IBNR claims liability		3,850			671
	Facilitative acquisition costs		385			385
	Intangible assets		397			572
	Other		645			538
	Total deferred tax assets		11,212			6,135
	Deferred tax liabilities:
	Partnership investments		(14,778	)		(13,922	)
	Property and equipment		(3,544	)		(4,321	)
	Tax impact of beneficial conversion feature of debt		(1,042	)		(1,226	)
	Intangible assets		(5,815	)		(9,301	)
	Other		(287	)		(311	)
	Total deferred tax liabilities		(25,466	)		(29,081	)
	Net deferred tax liabilities	$	(14,254	)	$	(22,946	)
		December 31,
		2014			2013
	Current deferred tax assets	$	6,160		$	1,725
	Current deferred tax liabilities		(287	)		(312	)
	Net current deferred tax assets		5,873			1,413
	Noncurrent deferred tax assets		5,052			4,410
	Noncurrent deferred tax liabilities		(25,179	)		(28,769	)
	Net noncurrent deferred tax liabilities		(20,127	)		(24,359	)
	Net deferred tax liabilities	$	(14,254	)	$	(22,946	)

ShareBased_Payment_Tables

Share-Based Payment (Tables)	12 Months Ended
	Dec. 31, 2014
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,
		2014			2013
	Risk-free interest rate		1.87	%		1.78	%
	Expected volatility of common stock		42.1	%		45.2	%
	Expected life of options		5.8 years			6.2 years
	Dividend yield		0	%		0	%
Summary of Stock Option Activity	A summary of stock option activity for the year ended December 31, 2014 is as follows:
	Options	Number of			Weighted-			Weighted-		Aggregate
		Shares			Average			Average		Intrinsic
					Exercise			Remaining		Value
					Price			Contractual
								Term
								(in years)
	Outstanding as of December 31, 2013		583,697		$	25.39
	Granted		300,000			14.13
	Exercised		—			—				$	—
	Forfeited		(11,385	)		23.61
	Outstanding as of December 31, 2014		872,312		$	21.54			6.33	$	—
	Vested and expected to vest at December 31, 2014		421,267		$	23.49			5.64	$	—
	Exercisable at December 31, 2014		279,678		$	23.59			5.32	$	—

Earnings_per_Share_Tables

Earnings per Share (Tables)	12 Months Ended
	Dec. 31, 2014
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 (loss) per share and the computation of basic and diluted earnings (loss) per share (in thousands, except per share data):
		Years Ended December 31,
		2014			2013
	Numerator:
	Net earnings (loss) attributable to USMD Holdings, Inc. - basic	$	(32,400	)	$	979
	Effect of potentially dilutive securities:
	Interest on Convertible Subordinated Notes, net of tax		—			—
	Net earnings (loss) attributable to USMD Holdings, Inc. - diluted	$	(32,400	)	$	979
	Denominator:
	Weighted-average common shares outstanding		10,168			10,080
	Effect of potentially dilutive securities:
	Stock options		—			4
	Convertible Subordinated Notes		—			—
	Weighted-average common shares outstanding assuming dilution		10,168			10,084
	Earnings (loss) per share attributable to USMD Holdings, Inc.:
	Basic	$	(3.19	)	$	0.1
	Diluted	$	(3.19	)	$	0.1
Potential Shares Excluded from Diluted 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,
		2014			2013
	Stock options		941			643
	Convertible Subordinated Notes		1,042			1,042
			1,983			1,685

Commitments_and_Contingencies_

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2014
Schedule of Future Minimum Lease Commitments under Operating Leases	Future minimum cash lease payments under non-cancelable operating leases with an initial or remaining lease term in excess of one year are as follows for the years indicated (in thousands):
	2015	$	12,792
	2016		12,195
	2017		10,616
	2018		9,717
	2019		9,052
	Thereafter		43,790
	Total	$	98,162

Related_Party_Transactions_Tab

Related Party Transactions (Tables)	12 Months Ended
	Dec. 31, 2014
Management and Other Services Revenue and Accounts Receivable	Management and other services revenue and accounts receivable from these entities are as follows:
		Management and Other				Accounts Receivable
		Services Revenue
		Years Ended December 31,				December 31,
		2014		2013		2014		2013
		(in thousands)
	USMD Arlington	$	10,619	$	10,423	$	472	$	2,625
	USMD Fort Worth		3,840		4,434		300		1,221
	Other equity method investees		1,818		1,379		230		435
		$	16,277	$	16,236	$	1,002	$	4,281

Description_of_Business_and_Ba2

Description of Business and Basis of Presentation - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2014
	State
	TreatmentCenter
	Hospital
	Lab
Description Of Company And Significant Accounting Policies [Line Items]
Providing management and operational services to hospitals	2
Number of cancer treatment center	3
Number of states for cancer treatment	3
Number of lithotripsy service providers	22
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 lithotripsy service providers consolidated into financial statements	18
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	2

Summary_of_Significant_Account2

Summary of Significant Accounting Policies and Pronouncements - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
	Segment
	Entity
Significant Accounting Policies [Line Items]
Patient service revenue from physician recruitment agreements	$187,424,000	$181,087,000
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
Physician Recruitment Agreements
Significant Accounting Policies [Line Items]
Patient service revenue from physician recruitment agreements	700,000	1,000,000
Other Operating Expenses
Significant Accounting Policies [Line Items]
Advertising expense	400,000	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
Other Current Liabilities | Physician Recruitment Agreements
Significant Accounting Policies [Line Items]
Deferred revenue associated with physician recruitment agreements	300,000	800,000
Other Long Term Liabilities | Physician Recruitment Agreements
Significant Accounting Policies [Line Items]
Deferred revenue associated with physician recruitment agreements	$300,000	$400,000

Percentage_of_Patient_and_Cust

Percentage of Patient and Customer Accounts Receivable (Detail) (Accounts Receivable, Credit Concentration Risk [Member])	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Concentration Risk [Line Items]
Percentage of accounts receivable	100.00%	100.00%
Government-related programs
Concentration Risk [Line Items]
Percentage of accounts receivable	33.00%	29.00%
Managed care and commercial payers
Concentration Risk [Line Items]
Percentage of accounts receivable	54.00%	58.00%
Self-pay
Concentration Risk [Line Items]
Percentage of accounts receivable	4.00%	3.00%
Customer
Concentration Risk [Line Items]
Percentage of accounts receivable	9.00%	10.00%

Summary_of_Accounts_Receivable

Summary of Accounts Receivable Allowance (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Allowance for Doubtful Accounts [Line Items]
Beginning balance	$1,758	$1,127
Provision for Doubtful Accounts Related to Patient Service Revenue	3,492	2,801
Provision for doubtful accounts	183	70
Write-offs, net of Recoveries	-3,333	-2,240
Ending balance	$2,100	$1,758

Estimated_Useful_Lives_of_Asse

Estimated Useful Lives of Assets (Detail)	12 Months Ended
	Dec. 31, 2014
Leasehold Improvements | Minimum
Property, Plant and Equipment [Line Items]
Estimated useful lives of assets	1 year
Leasehold Improvements | 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

Variable_Interest_Entity_Addit

Variable Interest Entity - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Jan. 31, 2014	31-May-13
Variable Interest Entity [Line Items]
Net capitated revenue	$66,544,000	$9,524,000
Income before provision for income taxes	-28,430,000	10,801,000
Accrued medical claims IBNR	11,400,000	1,900,000
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Advance to WNI-DFW			700,000	100,000
Net capitated revenue	66,500,000	7,400,000
Income before provision for income taxes	$7,000,000	$500,000

Carrying_Amount_of_Assets_and_

Carrying Amount of Assets and Liabilities of WNI-DFW (Detail) (USD $)	Dec. 31, 2014		Dec. 31, 2013		Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$15,940	[1]	$13,137	[1]	$6,878
Accounts receivable	24,673	[1]	23,970	[1]
Total current assets	53,464	[1]	48,277	[1]
Current liabilities:
Accounts payable	7,708	[2]	2,500	[2]
Other accrued liabilities	1,078		1,299
Total current liabilities	43,826	[2]	35,407	[2]
Variable Interest Entity, Primary Beneficiary
Current assets:
Cash and cash equivalents	10,169		1,257
Accounts receivable	1,150		175
Prepaid expenses	61
Deferred tax asset	3,850		671
Total current assets	15,230		2,103
Current liabilities:
Accounts payable	3,517
Other accrued liabilities	11,506		2,108
Total current liabilities	$15,023		$2,108
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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 the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Business_Combinations_Addition

Business Combinations - Additional Information (Detail) (Physician Practice, USD $)	5 Months Ended	12 Months Ended
	Nov. 30, 2013	Dec. 31, 2014
	Entity	Entity
Physician Practice
Business Acquisition [Line Items]
Number of businesses acquired	2	4
Cash paid or payable as consideration in the business combination		$104,000
Number of equity instruments paid as consideration in the business combination	4,502	12,385
Business combination consideration, payable in common stock	133,000	167,000
Total noncompete agreement intangible assets		$20,536
Weighted-average amortization period of acquired intangible assets		3 years 1 month 6 days

Estimated_Fair_Values_of_Asset

Estimated Fair Values of Assets Acquired at Business Combination Date (Detail) (USD $)	Dec. 31, 2014
In Thousands, unless otherwise specified
Business Acquisition [Line Items]
Inventories	$38,022
Property and equipment	212,565
Identifiable intangible assets - noncompete agreements	20,536
Assets acquired	$271,123

Net_Carrying_Values_and_Owners

Net Carrying Values and Ownership Percentages of Nonconsolidated Affiliates Accounted for Under Equity Method (Detail) (USD $)	Dec. 31, 2014		Dec. 31, 2013		Sep. 01, 2013
In Thousands, unless otherwise specified
Schedule of Equity Method Investments [Line Items]
Equity method investments	$59,780	[1]	$61,822	[1]
USMD Hospital at Arlington, L.P.
Schedule of Equity Method Investments [Line Items]
Equity method investments	49,518		50,055
Percentage of wholly owned subsidiary	46.40%		46.40%		46.40%
USMD Hospital at Fort Worth, L.P.
Schedule of Equity Method Investments [Line Items]
Equity method investments	9,956		11,246
Percentage of wholly owned subsidiary	30.88%		30.88%
Other
Schedule of Equity Method Investments [Line Items]
Equity method investments	$306		$521
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 the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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
	Dec. 31, 2013	Sep. 01, 2013	Dec. 31, 2014
Schedule of Equity Method Investments [Line Items]
Investments in Equity Method Investees	$200,000
Difference between carrying amount of investments and company's equity in underlying net assets			41,000,000
USMD Hospital at Arlington, L.P.
Schedule of Equity Method Investments [Line Items]
Investments in Equity Method Investees		$24,300,000
Acquired ownership interest, percentage	46.40%	46.40%	46.40%

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, 2014	Dec. 31, 2013
Schedule of Equity Method Investments [Line Items]
Current assets	$33,298	$43,558
Noncurrent assets	78,835	83,895
Current liabilities	16,885	19,148
Noncurrent liabilities	48,839	55,455
Revenue	143,952	141,363
Income from operations	35,807	35,925
Net income	$32,074	$33,502

Summarized_Financial_Informati

Summarized Financial Information for Individually Significant Equity Method Investees (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Schedule of Equity Method Investments [Line Items]
Current assets	$33,298	$43,558
Noncurrent assets	78,835	83,895
Current liabilities	16,885	19,148
Noncurrent liabilities	48,839	55,455
Revenue	143,952	141,363
Income from operations	35,807	35,925
Net income	32,074	33,502
USMD Hospital at Arlington, L.P.
Schedule of Equity Method Investments [Line Items]
Current assets	22,853	26,055
Noncurrent assets	54,992	54,205
Current liabilities	9,698	9,987
Noncurrent liabilities	35,309	36,361
Revenue	93,486	90,619
Income from operations	21,878	21,367
Net income	19,301	20,429
USMD Hospital at Fort Worth, L.P.
Schedule of Equity Method Investments [Line Items]
Current assets	6,828	13,445
Noncurrent assets	16,812	17,439
Current liabilities	4,068	5,593
Noncurrent liabilities	9,108	10,758
Revenue	36,634	39,172
Income from operations	8,721	9,311
Net income	$7,953	$8,386

Patient_Service_Revenue_Detail

Patient Service Revenue (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Health care organization patient service revenue one	$187,424	$181,087
Patient service revenue provision for doubtful accounts, Amount	-3,492	-2,801
Net patient service revenue, Amount	183,932	178,286
Health care organization patient service revenue percentage	101.90%	101.60%
Patient service revenue provision for doubtful accounts, percentage	-1.90%	-1.60%
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	56,091	52,003
Health care organization patient service revenue percentage	30.50%	29.20%
Medicaid
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Health care organization patient service revenue one	1,346	1,460
Health care organization patient service revenue percentage	0.70%	0.80%
Managed care and commercial payers
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Health care organization patient service revenue one	126,362	123,336
Health care organization patient service revenue percentage	68.70%	69.20%
Self-pay
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Health care organization patient service revenue one	$3,625	$4,288
Health care organization patient service revenue percentage	2.00%	2.40%

Summary_of_Property_and_Equipm

Summary of Property and Equipment (Detail) (USD $)	Dec. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Property and Equipment
Gross property and equipment	$40,115		$37,299
Less: accumulated depreciation and amortization	-19,319		-13,808
Property and equipment, net	20,796	[1]	23,491	[1]
Leasehold Improvements
Property and Equipment
Gross property and equipment	12,925		12,565
Furniture and Equipment
Property and Equipment
Gross property and equipment	23,764		21,691
Software
Property and Equipment
Gross property and equipment	$3,426		$3,043
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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, 2014	Dec. 31, 2013
Property, Plant and Equipment [Line Items]
Property and equipment depreciation	$5.80	$5.80

Assets_Recorded_under_Capital_

Assets Recorded under Capital Lease Arrangements Included in Property and Equipment (Detail) (USD $)	Dec. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Capital Leased Assets [Line Items]
Less: accumulated amortization	($1,183)	($854)
Net assets recorded under capital leases	2,236	1,136
Furniture and Equipment
Capital Leased Assets [Line Items]
Gross assets recorded under capital leases	$3,419	$1,990

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, 2014		Dec. 31, 2013		Dec. 31, 2012
Goodwill [Line Items]
Impairment charge		($20,340)		$0
Adjustments related to business combination	111			-85
Goodwill		121,585		121,585		121,670
Accumulated impairment losses		-23,749		-3,409		-3,409
Goodwill, net		97,836	[1]	118,176	[1]	118,261
Physician Practice
Goodwill [Line Items]
Impairment charge		0
Adjustments related to business combination				-196
Goodwill		60,418		60,418		60,614
Accumulated impairment losses		0
Goodwill, net		60,418		60,418		60,614
Cancer Treatment Services
Goodwill [Line Items]
Impairment charge		-20,340
Adjustments related to business combination				111
Goodwill		54,330		54,330		54,219
Accumulated impairment losses		-20,340
Goodwill, net		33,990		54,330		54,219
Lithotripsy Entity
Goodwill [Line Items]
Goodwill		6,837		6,837		6,837
Accumulated impairment losses		-3,409		-3,409		-3,409
Goodwill, net		$3,428		$3,428		$3,428
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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, 2014	Dec. 31, 2013	15-May-14	31-May-14
Goodwill and Other Intangible Assets [Line Items]
Goodwill impairment charge		$20,340,000	$0
Business acquisition fixed assets adjustment	171,000
Increase/decrease in goodwill	111,000		-85,000
Indefinite-lived intangible asset, trade name				10,700,000
Finite-lived intangible asset, trade name				300,000
Gross value of all acquired intangible assets		29,728,000	19,002,000
Amortization of intangible assets		2,000,000	1,800,000
Indefinite-lived intangible assets			10,700,000
Weighted average period for management agreements		26 years 8 months 12 days
Physician Practice
Goodwill and Other Intangible Assets [Line Items]
Goodwill impairment charge		0
Increase/decrease in goodwill			-196,000
Cancer Treatment Services
Goodwill and Other Intangible Assets [Line Items]
Goodwill impairment charge		20,340,000
Increase/decrease in goodwill			111,000
Trade names
Goodwill and Other Intangible Assets [Line Items]
Trade name impairment loss		8,400,000
Gross value of all acquired intangible assets		$11,168,000	$462,000		$2,600,000
Estimated useful life of trade names		5 years

Components_of_Amortizable_Inta

Components of Amortizable Intangible Assets (Detail) (USD $)	Dec. 31, 2014	31-May-14	Dec. 31, 2013
In Thousands, unless otherwise specified
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$29,728		$19,002
Accumulated Amortization	-13,115		-2,675
Net Carrying Amount	16,613		16,327
Management agreement
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	5,246		5,246
Accumulated Amortization	-738		-544
Net Carrying Amount	4,508		4,702
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,168	2,600	462
Accumulated Amortization	-8,845		-123
Net Carrying Amount	2,323		339
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	767		767
Accumulated Amortization	-596		-341
Net Carrying Amount	171		426
Noncompete agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	12,547		12,527
Accumulated Amortization	-2,936		-1,667
Net Carrying Amount	$9,611		$10,860

Estimated_Amortization_Expense

Estimated Amortization Expense for Intangible Assets during Next Five Years (Detail) (USD $)	Dec. 31, 2014
In Thousands, unless otherwise specified
Finite-Lived Intangible Assets [Line Items]
2015	$2,144
2016	1,974
2017	1,972
2018	1,972
2019	$1,665

Summary_of_Other_Accrued_Liabi

Summary of Other Accrued Liabilities (Detail) (USD $)	Dec. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Other Accrued Liabilities
Accrued payables	$3,246		$5,285
Accrued bonus	2,000		1,860
Other accrued liabilities	1,078		1,299
IBNR claims payable	11,379		1,918
Income taxes payable	670		395
Other accrued liabilities	$18,373	[1]	$10,757	[1]
[1]	Liabilities of consolidated VIE included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

LongTerm_Debt_and_Capital_Leas2

Long-Term Debt and Capital Lease Obligations (Detail) (USD $)	Dec. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Schedule of Long-term Debt Instruments
Total long-term debt and capital lease obligations	$36,461	$46,198
Less: current portion	-3,323	-8,492
Long-term debt and capital lease obligations, less current portion	33,138	37,706
Total long-term debt and capital lease obligations	36,461	46,198
USMD Holdings
Schedule of Long-term Debt Instruments
Term debt	7,500	15,687
Revolving credit facility		3,000
Convertible Subordinated Notes	21,364	20,839
Subordinated related party notes payable	3,831	3,734
Other notes payable	212	120
Capital lease obligation	1,032
Total long-term debt and capital lease obligations	33,939	43,380
Total long-term debt and capital lease obligations	33,939	43,380
Lithotripsy Entity
Schedule of Long-term Debt Instruments
Notes payable	1,228	1,766
Capital lease obligation	1,294	1,052
Total long-term debt and capital lease obligations	2,522	2,818
Total long-term debt and capital lease obligations	$2,522	$2,818

LongTerm_Debt_and_Capital_Leas3

Long-Term Debt and Capital Lease Obligations (Parenthetical) (Detail) (USMD Holdings, USD $)	Dec. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
USMD Holdings
Debt Instrument [Line Items]
Convertible Subordinated Notes, unamortized discount	$2,978	$3,503

LongTerm_Debt_and_Capital_Leas4

Long-Term Debt and Capital Lease Obligations - Additional Information - Credit Agreement (Detail) (USD $)	12 Months Ended	0 Months Ended
	Dec. 31, 2014	Dec. 22, 2014	Sep. 22, 2014	Apr. 18, 2014	Apr. 21, 2014	Aug. 31, 2012	Apr. 14, 2014
Debt Instrument [Line Items]
Credit agreement compensating balance					$5,000,000	$5,000,000
Ratio covenant description	The Company is subject to financial covenants that require it to maintain a fixed charge coverage ratio of at least 1.25:1.00 and a senior leverage ratio no greater than 1.50:1.00, each calculated quarterly for the previous four consecutive fiscal quarters. However, not more than once during any period of four consecutive fiscal quarters, the Company is permitted to maintain compliance with its financial covenants if its fixed charge coverage ratio is at least 1.00:1.00 and/or its senior leverage ratio is no greater than 1.75:1.00.
Loss on debt extinguishment related to write off of unamortized deferred debt issuance costs associated with the other lenders	171,000
Minimum | Four Scheduled Quarterly [Member]
Debt Instrument [Line Items]
Debt instrument fixed charge coverage ratio	125.00%
Minimum | Quarterly [Member]
Debt Instrument [Line Items]
Debt instrument fixed charge coverage ratio	100.00%
Maximum | Four Scheduled Quarterly [Member]
Debt Instrument [Line Items]
Debt instrument senior leverage ratio	150.00%
Maximum | Quarterly [Member]
Debt Instrument [Line Items]
Debt instrument senior leverage ratio	175.00%
Southwest Bank [Member]
Debt Instrument [Line Items]
Debt issue cost	69,000
Third Party [Member]
Debt Instrument [Line Items]
Debt issue cost	42,000
Term Loan [Member]
Debt Instrument [Line Items]
Aggregate principal amount						21,000,000
Revolving Credit Facility
Debt Instrument [Line Items]
Aggregate principal amount						10,000,000
Revised principal amount							3,000,000
Repayment of principal credit amount			1,500,000
Revolver termination date	21-Dec-16
Interest rate description		30-Day London Interbank Offered Rate ("LIBOR") plus 3.50%, or the U.S. prime rate plus 0.50%, with a floor of 4.00%
Floor rate		4.00%
Commitment fee payable		0.50%
Maximum annual financing of Capital Expenditures		1,500,000
Revolving Credit Facility | Libor Rate
Debt Instrument [Line Items]
Margin in addition to LIBOR		3.50%
Revolving Credit Facility | Prime Rate
Debt Instrument [Line Items]
Margin in addition to LIBOR		0.50%
Tranche Term Loan A [Member]
Debt Instrument [Line Items]
Aggregate principal amount						12,500,000
Maturity date of Tranche B Term Loan		21-Dec-16
Fixed interest rate of Tranche A Term Loan		5.00%
Principal payment		375,000
Frequency of principal and interest payments		Quarterly
Tranche B Term Loan [Member]
Debt Instrument [Line Items]
Aggregate principal amount						3,500,000
Tranche C Term Loan [Member]
Debt Instrument [Line Items]
Aggregate principal amount						5,000,000
Tranche Term Loan C [Member]
Debt Instrument [Line Items]
Repayment of debt with compensating balance				$5,000,000
Tranche Term Loan B [Member]
Debt Instrument [Line Items]
Maturity date of Tranche B Term Loan	2-Sep-14

LongTerm_Debt_and_Capital_Leas5

Long-Term Debt and Capital Lease Obligations - Additional Information - Convertible Subordinated Notes (Detail) (USD $)	0 Months Ended	12 Months Ended
	Sep. 01, 2013	Dec. 31, 2014	Dec. 31, 2013	Sep. 01, 2013
Debt Instrument [Line Items]
Intrinsic value of the conversion option			$3,729,000
Debt instrument deferred tax liability			-1,305,000
Convertible Debt [Member]
Debt Instrument [Line Items]
Debt instrument face amount	24,300,000			24,300,000
Debt instrument interest rate	5.00%			5.00%
Debt instrument maturity date	1-Mar-19
Conversion price of common stock, per share		$23.37
Convertible subordinated notes convertible in to common share		1,041,581
Convertible subordinated notes, effective interest rate		8.50%
Intrinsic value of the conversion option	3,729,000
Unamortized discount		2,978,000
Remaining amortized period		50 months
Debt instrument deferred tax liability	-1,305,000
Debt issuance cost		70,000
Convertible subordinated notes interest expenses		1,700,000	600,000
Convertible subordinated notes interest expenses, contractual interest rate		1,200,000	400,000
Convertible subordinated notes interest expenses, discount accretion		$500,000	$200,000

LongTerm_Debt_and_Capital_Leas6

Long-Term Debt and Capital Lease Obligations - Additional Information - Subordinated Related Party Notes Payable (Detail) (Usmd Lithotripsy Division, USD $)	0 Months Ended	3 Months Ended
	Jan. 01, 2007	Dec. 31, 2014
Debt Instrument [Line Items]
Partnership interests acquired	59.40%
Cash paid to predecessor owners	$1,200,000
Notes payable issued to predecessor owners	9,700,000
Notes Payable, Other Payables
Debt Instrument [Line Items]
Accrued Interest fixed rate	9.00%
Debt instrument premium rate option	1.00%
Debt instrument, accrued interest recognized		254,000
Premium interest rate until payments under the subordinated related party notes are current		10.00%
Debt instrument maturity date		31-Oct-18
Notes Payable, Other Payables | Before October First 2017 [Member]
Debt Instrument [Line Items]
Average monthly principal and interest payments		88,000
Notes Payable, Other Payables | After September Thirtieth 2017 [Member]
Debt Instrument [Line Items]
Average monthly principal and interest payments		$80,000

LongTerm_Debt_and_Capital_Leas7

Long-Term Debt and Capital Lease Obligations - Additional Information - Other Notes Payable (Detail) (Notes Payable, Other Payables Financed Training [Member], USD $)	12 Months Ended
	Dec. 31, 2014
Notes Payable, Other Payables Financed Training [Member]
Debt Instrument [Line Items]
Company financed training	$157,000
Fixed interest rate	5.60%
Principal and interest payments	$8,300
Debt instrument, frequency of periodic payment	25 quarterly principal and interest payments
Debt instrument payment terms	The arrangement requires 25 quarterly principal and interest payments of $8,300 beginning three quarters after the equipment is installed and operating

LongTerm_Debt_and_Capital_Leas8

Long-Term Debt and Capital Lease Obligations - Additional Information - Consolidated Lithotripsy Entities (Detail) (Lithotripsy Partnership [Member], Notes Payable, Other Payables Financed Equipment [Member], USD $)	12 Months Ended
	Dec. 31, 2014
	Entity
Lithotripsy Partnership [Member] | Notes Payable, Other Payables Financed Equipment [Member]
Debt Instrument [Line Items]
Number of Lithotripsy partnerships	6
Debt Instrument Periodic Payment	$54,400
Weighted average fixed interest rate	4.20%

Maturities_of_LongTerm_Debt_De

Maturities of Long-Term Debt (Detail) (USD $)	Dec. 31, 2014
In Thousands, unless otherwise specified
Debt Instrument [Line Items]
2015	$2,786
2016	7,217
2017	1,857
2018	813
2019	24,368
Thereafter	72
Total	$37,113

LongTerm_Debt_and_Capital_Leas9

Long-Term Debt and Capital Lease Obligations - Additional Information (Detail) (USD $)	12 Months Ended	1 Months Ended
	Dec. 31, 2014	Dec. 31, 2014	Nov. 30, 2014
		Installment
Debt Instrument [Line Items]
Purchased lithotripsy equipment	$2,326,000	$2,326,000
Capital Lease Obligations
Debt Instrument [Line Items]
Monthly Lease Payment	30,000
Debt instrument, frequency of periodic payment	25 minimum quarterly
Purchased equipment	600,000
Debt instrument payment terms	The lease requires 25 minimum quarterly payments of $30,000 beginning three quarters after the equipment is installed and operating
Capital Lease Obligations | Wholly Owned Subsidiary
Debt Instrument [Line Items]
Purchased lithotripsy equipment			400,000
Number of payments	61	61
Lease maturity date		31-Dec-19
Description of lithotripsy equipment lease		Beginning December 2014, three monthly payments of $2,100 are due followed by 58 monthly payments of $8,900.
Capital Lease Obligations | Wholly Owned Subsidiary | One to Three Monthly Payment
Debt Instrument [Line Items]
Monthly Lease Payment		2,100
Capital Lease Obligations | Wholly Owned Subsidiary | Four to Sixty One Monthly Payment
Debt Instrument [Line Items]
Monthly Lease Payment		8,900
Capital Lease Obligations | Lithotripsy Partnership [Member]
Debt Instrument [Line Items]
Monthly Lease Payment		$47,000
Lease maturity date		18-Oct-18
Number of Lithotripsy partnerships	4	4

Future_Minimum_Lease_Payments_

Future Minimum Lease Payments under Capital Leases and Present Value of Net Minimum Lease Payments (Detail) (USD $)	Dec. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
2015	$626
2016	456
2017	477
2018	477
2019	360
Thereafter	298
Total minimum lease payments	2,694
Less: amount representing interest	-368
Present value of minimum lease payments	2,326
Less: current portion of capital lease obligations	-537	[1]	-369	[1]
Capital lease obligations, less current portion	1,789	[1]	683	[1]
Present value of minimum lease payments	$2,326
[1]	Liabilities of consolidated VIE included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Fair_Value_of_Financial_Instru2

Fair Value of Financial Instruments - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	15-May-14
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Goodwill impairment charge	$20,340,000	$0
Discount rate on trade name royalty	17.00%
Physician Practice
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Goodwill impairment charge	0
Cancer Treatment Services
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Goodwill impairment charge	20,340,000
Trade names
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Intangible asset, trade name			11,000,000
Estimated fair value of acquired trade names	2,600,000
Impairment loss	$8,400,000
Estimated useful life of trade names	5 years
Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Pre-tax royalty rate	1.00%
Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Pre-tax royalty rate	0.10%

Carrying_Value_and_Estimated_F

Carrying Value and Estimated Fair Value of Financial Instruments (Detail) (USD $)	Dec. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Carrying Value | Convertible subordinated notes Payable
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	$21,364	$20,839
Carrying Value | Tranche A
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	7,500	7,500
Carrying Value | Subordinated Related Party Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	3,831	3,734
Carrying Value | Notes Payable, Other Payables
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	212	120
Carrying Value | Lithotripsy Entity
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	1,227	1,766
Fair Value | Convertible subordinated notes Payable
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	19,857	25,985
Fair Value | Tranche A
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	7,500	7,500
Fair Value | Subordinated Related Party Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	3,689	3,481
Fair Value | Notes Payable, Other Payables
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	213	124
Fair Value | Lithotripsy Entity
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Notes payable	$1,227	$1,767

Deferred_Compensation_Plans_Ad

Deferred Compensation Plans - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2014		Dec. 31, 2013
	Installment
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]
Number of installments of distribution	5
Deferred compensation obligation	$4,600,000
Deferred compensation obligation, long-term	4,491,000	[1]	4,641,000	[1]
Deferred compensation obligation, current	$200,000
[1]	Liabilities of consolidated VIE included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

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, 2014	Dec. 31, 2013
Current:
Federal	$2,908	$1,067
State	240	228
Total current income tax provision	3,148	1,295
Deferred:
Federal	-8,692	-1,224
State	0	0
Total deferred income tax benefit	-8,692	-1,224
Provision (benefit) for income taxes	($5,544)	$71

Reconciliation_of_Actual_Tax_R

Reconciliation of Actual Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
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	-0.60%	1.40%
Net income attributable to noncontrolling interests	11.70%	-31.60%
Goodwill amortization	0.80%	-2.00%
Impairment of goodwill	-25.00%
Other	-2.30%	-2.50%
Permanent differences	-0.10%	0.40%
Effective tax rate for income (loss) from operations	19.50%	0.70%

Schedule_of_Components_of_Defe

Schedule of Components of Deferred Tax Assets and Liabilities (Detail) (USD $)	Dec. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Deferred tax assets:
Net operating losses	$617		$290
Deferred revenue	114		150
Share-based payment expense	1,252		850
Deferred compensation	1,642		1,624
Other compensation	1,630		477
Allowance for doubtful accounts	680		578
IBNR claims liability	3,850		671
Facilitative acquisition costs	385		385
Intangible assets	397		572
Other	645		538
Total deferred tax assets	11,212		6,135
Deferred tax liabilities:
Partnership investments	-14,778		-13,922
Property and equipment	-3,544		-4,321
Tax impact of beneficial conversion feature of debt	-1,042		-1,226
Intangible assets	-5,815		-9,301
Other	-287		-311
Total deferred tax liabilities	-25,466		-29,081
Net deferred tax liabilities	-14,254		-22,946
Current deferred tax assets	6,160		1,725
Current deferred tax liabilities	-287		-312
Net current deferred tax assets	5,873	[1]	1,413	[1]
Noncurrent deferred tax assets	5,052		4,410
Noncurrent deferred tax liabilities	-25,179		-28,769
Net noncurrent deferred tax liabilities	-20,127	[2]	-24,359	[2]
Net deferred tax liabilities	($14,254)		($22,946)
[1]	Assets of consolidated variable interest entity ("VIE") included in the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Cash and cash equivalents $ 10,169 $ 1,257 Accounts receivable 1,150 175 Prepaid expenses 61 - Deferred tax asset 3,850 671 Total current assets $ 15,230 $ 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 the consolidated balance sheets above (after elimination of intercompany transactions and balances) consist of: Accounts payable $ 3,517 $ - Other accrued liabilities 11,506 2,108 Total current liabilities $ 15,023 $ 2,108 The liabilities of the consolidated VIE are obligations of the VIE and the creditors have no recourse to USMD Holdings, Inc.

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Income Taxes [Line Items]
Total unrecognized tax benefits	$142,000
Unrecognized tax benefit, expected increase within the next twelve months	426,000
Recognized deferred tax assets	11,212,000	6,135,000
Unused net operating loss carryforwards	$1,800,000
Unused net operating loss carryforwards, expiration year	2031

ShareBased_Payment_Additional_

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

12 Months Ended

1 Months Ended

0 Months Ended

1 Months Ended

0 Months Ended

7 Months Ended

9 Months Ended

Dec. 31, 2014

Dec. 31, 2013

Aug. 31, 2014

Mar. 11, 2013

Aug. 31, 2013

Jun. 06, 2014

Dec. 31, 2013

Mar. 06, 2014

Jul. 31, 2014

Sep. 30, 2013

Jul. 14, 2014

Jun. 05, 2014

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

Remaining contractual term, stock options vested

5 years 7 months 21 days

Aggregate intrinsic value of stock options

$0

Number of shares, granted

300,000

Common stock fair value

407,000

647,000

Common stock fair value

243,000

580,000

Number of common stock not registered under Securities Act

19,501

Salary Deferral Plan

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

Number of shares, granted

15,700

Common stock fair value

150,000

Contribution

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

Venture option to purchase company's common stock

68,982

Exercise price

$24.84

Remaining contractual term, stock options vested

2 years 8 months 12 days

Aggregate intrinsic value of stock options

0

USMD Holdings

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

Holdings reserved shares for grant

1,700,000

Stock option granted weighted average fair value

$5.57

$10.94

Salaries, wages and employee benefits

1,300,000

900,000

Unrecognized compensation cost related to unvested share-based compensation awards

3,100,000

Share-based payment remaining weighted-average period

3 years 2 months 12 days

Number of common stock issued

47,011

706

Common stock fair value

646,000

12,000

USMD Holdings | Equity Compensation Plan

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

Common stock for issuance

2,500,000

1,000,000

Stock options, contractual life

10 years

Holdings reserved shares for grant

1,400,000

USMD Holdings | Senior Management

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

Number of common stock issued

9,086

Common stock fair value

182,000

USMD Holdings | Senior Management | Equity Compensation Plan

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

Number of shares, issued

14,958

Common stock fair value

243,000

USMD Holdings | Board of Directors | Equity Compensation Plan

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

Number of shares, granted

60,324

Common stock fair value

646,000

Number of common stock issued

29,600

Common stock fair value

373,000

USMD Holdings | Consultant | Equity Compensation Plan

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

Number of shares granted to consultant in payment of service rendered

4,842

Grant date fair value of shares granted to consultant in payment of service rendered

52,000

Number of shares issued to consultant in payment of service rendered

2,853

Grant date fair value of shares issued to consultant in payment of service rendered

34,000

USMD Holdings | Company's executive

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

Number of shares, granted

14,583

Common stock fair value

$386,000

WeightedAverage_Assumptions_Us

Weighted-Average Assumptions Used in Black-Scholes Model for Stock Options (Detail)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	1.87%	1.78%
Expected volatility of common stock	42.10%	45.20%
Expected life of options	5 years 9 months 18 days	6 years 2 months 12 days
Dividend yield	0.00%	0.00%

Summary_of_Stock_Option_Activi

Summary of Stock Option Activity (Detail) (USD $)	12 Months Ended
	Dec. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Opening balance of Number of Shares Outstanding	583,697
Number of shares, granted	300,000
Number of Shares, Exercised	0
Number of Shares, Forfeited	-11,385
Ending balance of Number of Shares Outstanding	872,312
Ending balance of Number of Shares, Vested and expected to vest	421,267
Ending balance of Number of Shares, Exercisable	279,678
Opening balance of Weighted-Average Exercise Price Outstanding	$25.39
Weighted-Average Exercise Price, Granted	$14.13
Weighted-Average Exercise Price, Exercised	$0
Weighted-Average Exercise Price, Forfeited	$23.61
Ending balance of Weighted-Average Exercise Price, Outstanding	$21.54
Ending balance of Weighted-Average Exercise Price, Vested and expected to vest	$23.49
Ending balance of Weighted-Average Exercise Price, Exercisable	$23.59
Ending balance of Weighted-Average Remaining Contractual Term, Outstanding	6 years 3 months 29 days
Ending balance of Weighted-Average Remaining Contractual Term, Vested and expected to vest	5 years 7 months 21 days
Ending balance of Weighted-Average Remaining Contractual Term, Exercisable	5 years 3 months 26 days
Exercised, Aggregate Intrinsic Value	$0
Ending balance of Aggregate Intrinsic Value, Outstanding	0
Ending balance of Aggregate Intrinsic Value, Vested and expected to vest	0
Ending balance of Aggregate Intrinsic Value, Exercisable	$0

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, 2014	Dec. 31, 2013
Numerator:
Net earnings (loss) attributable to USMD Holdings, Inc. - basic	($32,400)	$979
Interest on Convertible Subordinated Notes, net of tax	0	0
Net earnings (loss) attributable to USMD Holdings, Inc. - diluted	($32,400)	$979
Denominator:
Weighted-average common shares outstanding	10,168	10,080
Stock options		4
Convertible Subordinated Notes	0	0
Weighted-average common shares outstanding assuming dilution	10,168	10,084
Earnings (loss) per share attributable to USMD Holdings, Inc.:
Basic	($3.19)	$0.10
Diluted	($3.19)	$0.10

Potential_Shares_Excluded_from

Potential Shares Excluded from Diluted Loss per share Calculation (Detail)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded From Computation of Earnings Per Share	1,983	1,685
Stock Option
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded From Computation of Earnings Per Share	941	643
Convertible Subordinated Notes
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded From Computation of Earnings Per Share	1,042	1,042

Commitments_and_Contingencies_1

Commitments and Contingencies - Additional Information (Detail) (USD $)	0 Months Ended		1 Months Ended	12 Months Ended
	Apr. 18, 2014	Oct. 26, 2012	Nov. 30, 2012	Dec. 31, 2014	Oct. 26, 2012
					Installment
Commitments and Contingencies Disclosure [Line Items]
Maximum aggregate payments to pay the obligations due				$19,200,000
Remaining terms of guarantees				The remaining terms of these guarantees range from 24 to 161 months.
Minimum payments under purchase commitment				26,000
Unrecorded unconditional purchase obligation, description				The arrangement requires 25 quarterly minimum payments of $26,000 beginning three quarters after the equipment is installed and operating; the installation date is currently anticipated to be in July 2015.
Claim settlement amount		650,000			650,000
Number of installments to pay settlement amount		55			55
Installments on the first day of each of month		10,000
Cash received associated with the settlement	342,500		100,000
Lease expiration				Non-cancelable operating lease agreements expiring at various dates through 2028
Future minimum rentals to be received under non-cancelable subleases				1,200,000
Medical Negligence Lawsuits
Commitments and Contingencies Disclosure [Line Items]
Estimate range of loss, minimum				300,000
Estimate range of loss, maximum				1,600,000
Minimum
Commitments and Contingencies Disclosure [Line Items]
Remaining terms of guarantees				24 months
Financial transactions amounts				1,000,000
Maximum
Commitments and Contingencies Disclosure [Line Items]
Remaining terms of guarantees				161 months
Financial transactions amounts				$2,500,000

Future_Minimum_Lease_Commitmen

Future Minimum Lease Commitments Under Operating Leases (Detail) (USD $)	Dec. 31, 2014
In Thousands, unless otherwise specified
Commitments and Contingencies Disclosure [Line Items]
Minimum Lease Commitments 2015	$12,792
Minimum Lease Commitments 2016	12,195
Minimum Lease Commitments 2017	10,616
Minimum Lease Commitments 2018	9,717
Minimum Lease Commitments 2019	9,052
Minimum Lease Commitments Thereafter	43,790
Minimum Lease Commitments Total	$98,162

Management_and_Other_Services_

Management and Other Services Revenue and Accounts Receivable (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Related Party Transaction [Line Items]
Management and Other Services Revenue	$16,277	$16,236
Accounts Receivable	1,002	4,281
USMD Hospital at Arlington, L.P.
Related Party Transaction [Line Items]
Management and Other Services Revenue	10,619	10,423
Accounts Receivable	472	2,625
USMD Hospital at Fort Worth, L.P.
Related Party Transaction [Line Items]
Management and Other Services Revenue	3,840	4,434
Accounts Receivable	300	1,221
Other
Related Party Transaction [Line Items]
Management and Other Services Revenue	1,818	1,379
Accounts Receivable	$230	$435

Related_Party_Transactions_Add

Related Party Transactions - Additional Information (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Related Party Transaction [Line Items]
Lithotripsy revenue	$21,568	$21,381
Leased space rent expense	15,869	15,034
USMD Arlington and USMD Fort Worth
Related Party Transaction [Line Items]
Lithotripsy revenue	2,200	2,200
USMD Hospital at Arlington, L.P.
Related Party Transaction [Line Items]
Leased space rent expense	$1,900	$1,700

Employee_Benefit_Plans_Additio

Employee Benefit Plans - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-elective contribution percentage on employees compensation	3.00%
Non-elective contribution vesting period	2 years
Company's contributions to 401(k) plan	$3.20	$3.10
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Defined contribution plan, maximum employer's contribution percentage		6.00%

OneTime_Termination_Benefits_A

One-Time Termination Benefits - Additional Information (Detail) (One-time Termination Benefits, USD $)	1 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2014
	Employee
One-time Termination Benefits
Related Party Transaction [Line Items]
Number of impacted employees by termination	75
Severance expense	$0.50

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (Subsequent Event, USD $)	0 Months Ended		1 Months Ended		0 Months Ended
	Mar. 06, 2015	Jan. 31, 2014	Jul. 31, 2015	Mar. 31, 2015	Mar. 27, 2015	Mar. 05, 2015	Feb. 20, 2015	Jan. 01, 2015
			Installment	Installment
Subsequent Event [Line Items]
Employee medical benefit plan self-insurance, threshold for self-funded claims								$200,000
Employee medical benefit plan self-insurance, individual stop loss reinsurance per claim								200,000
Share-based compensation grant at fair value	548,000
Sale of subsidiary		1,600,000
Equity method investment carrying value		159,000
Notes received from sale of equity method investment, gross		1,600,000
Notes received from sale of equity method investment, net		159,000
Lease arrangement, amount			900,000	5,900,000
Lease arrangement, required monthly payment			23,000	134,000
Lease arrangement, required monthly payments			44	44
2020 Convertible Notes
Subsequent Event [Line Items]
Debt instrument face amount					3,500,000
Debt instrument interest rate					7.75%
Debt instrument maturity date					1-Sep-20
Conversion price of common stock, per share					$12.02
Number of common shares converted from convertible notes					291,181
Common Stock
Subsequent Event [Line Items]
Share-based compensation, stock issued	40,311					15,700	30,724
Previously Accrued Share-Based Payment
Subsequent Event [Line Items]
Share-based compensation grant at fair value						150,000	273,000