Envision Healthcare Inactive 10-K2 Mar 152014 FY Annual reportFinancial data

Company Profile

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
In Billions, except Share data, unless otherwise specified	Dec. 31, 2014	Feb. 20, 2015	Jun. 30, 2014
Document and Entity Information
Entity Registrant Name	Envision Healthcare Holdings, Inc.
Entity Central Index Key	1578318
Document Type	10-K
Document Period End Date	31-Dec-14
Amendment Flag	FALSE
Current Fiscal Year End Date	-19
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Public Float			$2.90
Entity Common Stock, Shares Outstanding		184,138,454
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	FY

CONSOLIDATED_BALANCE_SHEETS

CONSOLIDATED BALANCE SHEETS (USD $)	Dec. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Current assets:
Cash and cash equivalents	$318,895	$204,712
Insurance collateral	32,828	29,619
Trade and other accounts receivable, net	950,115	801,146
Parts and supplies inventory	24,484	23,376
Prepaids and other current assets	36,917	23,430
Total current assets	1,363,239	1,082,283
Non-current assets:
Property, plant and equipment, net	211,276	194,715
Intangible assets, net	524,482	513,698
Insurance collateral	10,568	12,716
Goodwill	2,538,633	2,435,670
Other long-term assets	55,555	60,935
Total assets	4,703,753	4,300,017
Current liabilities:
Accounts payable	47,584	52,588
Accrued liabilities	412,657	350,936
Current deferred tax liabilities	104,278	35,487
Current portion of long-term debt and capital lease obligations	12,349	12,318
Total current liabilities	576,868	451,329
Long-term debt and capital lease obligations	2,025,877	1,895,381
Long-term deferred tax liabilities	130,963	151,130
Insurance reserves	180,639	175,427
Other long-term liabilities	20,365	16,997
Total liabilities	2,934,712	2,690,264
Commitments and contingencies
Equity:
Common stock ($0.01 par value; 2,000,000,000 shares authorized, 183,679,113 and 180,382,885 issued and outstanding at December 31, 2014 and 2013, respectively)	1,837	1,804
Preferred stock ($0.01 par value; 200,000,000 shares authorized, none issued and outstanding at December 31, 2014 and 2013)
Additional paid-in capital	1,616,747	1,575,417
Retained earnings	143,849	18,341
Accumulated other comprehensive income (loss)	-1,856	-839
Total Envision Healthcare Holdings, Inc. equity	1,760,577	1,594,723
Noncontrolling interest	8,464	15,030
Total equity	1,769,041	1,609,753
Total liabilities and equity	$4,703,753	$4,300,017

CONSOLIDATED_BALANCE_SHEETS_Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Aug. 19, 2013
CONSOLIDATED BALANCE SHEETS
Common stock, par value (in dollars per share)	($0.01)	($0.01)	$0.01
Common stock, shares authorized	2,000,000,000	2,000,000,000
Common stock, shares issued	183,679,113	180,382,885
Common stock, shares outstanding	183,679,113	180,382,885
Preferred stock, par value (in dollars per share)	$0.01	$0.01
Preferred stock, shares authorized	200,000,000	200,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0

CONSOLIDATED_STATEMENTS_OF_OPE

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS) (USD $)	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS)
Revenue, net of contractual discounts	$7,884,953	$6,771,522	$5,834,632
Provision for uncompensated care	-3,487,309	-3,043,210	-2,534,511
Net revenue	4,397,644	3,728,312	3,300,121
Compensation and benefits	3,156,480	2,667,439	2,307,628
Operating expenses	487,841	424,865	421,424
Insurance expense	120,983	106,293	97,950
Selling, general and administrative expenses	90,731	106,659	78,540
Depreciation and amortization expense	146,155	140,632	123,751
Restructuring charges	6,968	5,669	14,086
Income from operations	388,486	276,755	256,742
Interest income from restricted assets	1,135	792	625
Interest expense, net	-110,505	-186,701	-182,607
Realized gains (losses) on investments	371	471	394
Other income (expense), net	-3,980	-12,760	1,422
Loss on early debt extinguishment	-66,397	-68,379	-8,307
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	209,110	10,178	68,269
Income tax benefit (expense)	-89,498	994	-27,463
Income (loss) before equity in earnings of unconsolidated subsidiary	119,612	11,172	40,806
Equity in earnings of unconsolidated subsidiary	254	323	379
Net income (loss)	119,866	11,495	41,185
Less: Net (income) loss attributable to noncontrolling interest	5,642	-5,500
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	125,508	5,995	41,185
Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:
Basic (in dollars per share)	$0.69	$0.04	$0.32
Diluted (in dollars per share)	$0.66	$0.04	$0.31
Weighted-average common shares outstanding:
Basic (in shares)	182,019,732	150,156,216	130,228,970
Diluted (in shares)	189,921,434	156,962,385	132,945,862
Comprehensive income (loss):
Net income (loss)	119,866	11,495	41,185
Other comprehensive income (loss), net of tax:
Unrealized holding gains (losses) during the period	-723	-892	1,632
Unrealized gains (losses) on derivative financial instruments	-294	266	857
Total other comprehensive income (loss), net of tax	-1,017	-626	2,489
Comprehensive income (loss)	118,849	10,869	43,674
Less: Comprehensive (income) loss attributable to noncontrolling interest	5,642	-5,500
Comprehensive income (loss) attributable to Envision Healthcare Holdings, Inc.	$124,491	$5,369	$43,674

CONSOLIDATED_STATEMENTS_OF_CHA

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY (USD $)	Common Stock	Additional Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Income (Loss)	Noncontrolling Interest	Total
In Thousands, except Share data, unless otherwise specified	Common Stock	Additional Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Income (Loss)	Noncontrolling Interest	Total
Balance at beginning of period at Dec. 31, 2011	$1,302	$901,871	$13,019	($2,702)		$913,490
Balance (in shares) at Dec. 31, 2011	130,204,113
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares repurchased	-1	-520				-521
Shares repurchased (in shares)	-148,519
Equity-based compensation		4,248				4,248
Exercise of options	6	328				334
Exercise of options (in shares)	606,033
Dividend paid		386,924	41,858			428,782
Excess tax benefits from stock-based compensation		873				873
Tax impact of dividend		4,841				4,841
Net income attributable to Envision Healthcare Holdings, Inc.			41,185			41,185
Fair value of fuel hedge				2,258		2,258
Fair value of interest rate swap agreement				-1,401		-1,401
Unrealized holding gains (losses)				1,632		1,632
Contributions from noncontrolling interest					6,530	6,530
Balance at end of period at Dec. 31, 2012	1,307	524,717	12,346	-213	6,530	544,687
Balance (in shares) at Dec. 31, 2012	130,661,627
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Equity offering, net of issuance costs of $4,031 and 5.5% underwriter discount	483	1,045,769				1,046,252
Equity offering, net of issuance costs of $4,031 and 5.5% underwriter discount (in shares)	48,300,000
Shares repurchased	-4	-1,463				-1,467
Shares repurchased (in shares)	-365,227
Equity-based compensation		4,248				4,248
Exercise of options	18	859				877
Exercise of options (in shares)	1,786,485
Excess tax benefits from stock-based compensation		62				62
Net income attributable to Envision Healthcare Holdings, Inc.			5,995			5,995
Net (income) loss attributable to noncontrolling interest					5,500	5,500
Fair value of fuel hedge				-636		-636
Fair value of interest rate swap agreement				902		902
Unrealized holding gains (losses)				-892		-892
Contributions from noncontrolling interest					3,000	3,000
Other		1,225				1,225
Balance at end of period at Dec. 31, 2013	1,804	1,575,417	18,341	-839	15,030	1,609,753
Balance (in shares) at Dec. 31, 2013	180,382,885
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares repurchased	-6	-16,832				-16,838
Shares repurchased (in shares)	-570,407
Equity-based compensation		5,109				5,109
Exercise of options	39	10,132				10,171
Exercise of options (in shares)	3,866,635
Excess tax benefits from stock-based compensation		44,550				44,550
Net income attributable to Envision Healthcare Holdings, Inc.			125,508			125,508
Net (income) loss attributable to noncontrolling interest					-5,642	-5,642
Fair value of fuel hedge				-1,317		-1,317
Fair value of interest rate swap agreement				1,023		1,023
Unrealized holding gains (losses)				-723		-723
Contributions from noncontrolling interest					1,289	1,289
Distributions to noncontrolling interest					-2,213	-2,213
Other		-1,629				-1,629
Balance at end of period at Dec. 31, 2014	$1,837	$1,616,747	$143,849	($1,856)	$8,464	$1,769,041
Balance (in shares) at Dec. 31, 2014	183,679,113

Recovered_Sheet1

Consolidated Statements of Changes in Equity (Parenthetical) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013
Statement of Stockholders' Equity [Abstract]
Adjustments to Additional Paid in Capital, Stock Issued, Issuance Costs	$4,031
Equity offering, underwriter discount (as a percent)	5.50%

CONSOLIDATED_STATEMENTS_OF_CAS

CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Cash Flows from Operating Activities
Net income (loss)	$119,866	$11,495	$41,185
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	155,629	158,588	141,015
(Gain) loss on disposal of property, plant and equipment	-2,131	-28	-268
Equity-based compensation expense	5,109	4,248	4,248
Excess tax benefits from equity-based compensation	-44,550	-62	-873
Loss on early debt extinguishment	66,397	68,379	8,307
Equity in earnings of unconsolidated subsidiary	-254	-323	-379
Dividends received	430	556	611
Deferred income taxes	44,651	2,416	31,932
Payment of dissenting shareholder settlement		-13,717
Changes in operating assets/liabilities, net of acquisitions:
Trade and other accounts receivable, net	-129,239	-175,968	-81,857
Parts and supplies inventory	-687	-1,326	643
Prepaids and other current assets	-12,157	987	5,839
Accounts payable and accrued liabilities	84,667	-11,596	65,777
Insurance rerserves	-13,683	10,466	255
Net cash provided by (used in) operating activities	274,048	54,115	216,435
Cash Flows from Investing Activities
Purchases of available-for-sale securities	-79,751	-3,156	-39,035
Sales and maturities of available-for-sale securities	62,673	14,096	96,643
Purchases of property, plant and equipment	-78,046	-65,879	-60,215
Proceeds from sale of property, plant and equipment	2,444	744	7,220
Acquisition of businesses, net of cash received	-181,642	-35,098	-193,002
Net change in insurance collateral	481	-7,235	34,332
Other investing activities	-2,977	-2,069	14
Net cash provided by (used in) investing activities	-276,818	-98,597	-154,043
Cash Flows from Financing Activities
Issuance of common stock		1,112,017	334
Borrowings under the Term Loan		150,000
Borrowings under the ABL Facility	50,000	345,440	130,000
Proceeds from issuance of senior notes	740,625		450,000
Repayments of the Term Loan	-13,372	-13,371	-262,884
Repayments of the ABL Facility	-50,000	-470,440	-5,000
Repayments of PIK Notes and senior notes	-607,750	-777,250	-15,000
Payment for debt extinguishment premiums	-37,630	-39,402
Debt issuance costs	-2,224	-5,011	-21,219
Equity issuance costs		-65,131
Proceeds from stock options exercised	7,730
Excess tax benefits from equity-based compensation	44,550	62	873
Class A common stock repurchased as treasury stock			-511
Shares repurchased for tax withholdings	-14,430
Contributions from (Distributions to) noncontrolling interest, net	-924	3,000	6,530
Payment of dissenting shareholder settlement		-38,336
Net change in bank overdrafts		-10,146	7,808
Other financing activities	378	-70	-732
Net cash provided by (used in) financing activities	116,953	191,362	-138,583
Change in cash and cash equivalents	114,183	146,880	-76,191
Cash and cash equivalents, beginning of period	204,712	57,832	134,023
Cash and cash equivalents, end of period	$318,895	$204,712	$57,832

General

General	12 Months Ended
General	Dec. 31, 2014
General
General
	1. General
	Basis of Presentation of Financial Statements
	Envision Healthcare Holdings, Inc. ("EVHC" or the "Company") formerly known as CDRT Holding Corporation, is organized as a holding company that operates through various subsidiaries. Envision Healthcare Corporation, formerly known as Emergency Medical Services Corporation, ("Corporation") is a wholly-owned subsidiary of the Company.
	The consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles ("GAAP") to reflect the consolidated financial position, results of operations and cash flows of the Company.
	On July 29, 2013, the Company effected a 9.3 for 1.0 stock split of its common stock, resulting in 132,082,885 shares of common stock issued. The accompanying consolidated financial statements give retroactive effect to the stock split for all periods presented.
	On August 19, 2013, the Company completed an initial public offering of its common stock, par value $0.01 per share ("Common Stock"). See Note 14 for further information on the Company's initial public offering and its equity.
	The Company operates in two segments, EmCare Holdings, Inc. ("EmCare") in the facility-based and post-acute care physician service business and American Medical Response, Inc. ("AMR") in the healthcare transportation service business. EmCare provides integrated facility-based physician services for emergency departments, anesthesiology, hospitalist/inpatient, radiology, teleradiology and surgery programs with 784 contracts in 41 states and the District of Columbia. EmCare recruits physicians, gathers their credentials, arranges contracts for their services, assists in monitoring their performance and arranges their scheduling. In addition, EmCare assists clients in such operational areas as staff coordination, quality assurance, departmental accreditation, billing, record-keeping, third-party payment programs, and other administrative services. EmCare also offers physician-led care management solutions outside the hospital. AMR operates in 38 states and the District of Columbia, providing a full range of healthcare transportation services from basic patient transit to the most advanced emergency care and pre-hospital assistance. In addition, AMR operates emergency ("911") call and response services for large and small communities all across the United States, offers contracted medical staffing, and provides telephone triage, transportation dispatch and demand management services.

Summary_of_Significant_Account

Summary of Significant Accounting Policies	12 Months Ended
Summary of Significant Accounting Policies	Dec. 31, 2014
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies
	2. Summary of Significant Accounting Policies
	Consolidation
	The consolidated financial statements of the Company include all of its wholly-owned subsidiaries, including Corporation, EmCare and AMR and their respective subsidiaries and affiliated physician groups. All significant intercompany transactions and balances have been eliminated in consolidation.
	Use of Estimates
	The preparation of financial statements requires management to make estimates and assumptions relating to the reporting of results of operations, financial condition and related disclosure of contingent assets and liabilities at the date of the financial statements including, but not limited to, estimates and assumptions for accounts receivable and insurance related reserves. Actual results may differ from those estimates under different assumptions or conditions.
	Cash and Cash Equivalents
	Cash and cash equivalents are comprised of highly liquid investments with a maturity of three months or less at acquisition, and are recorded at market value.
	As of December 31, 2014 and 2013, bank overdrafts of zero and $5.0 million, respectively, were included in accounts payable in the accompanying balance sheets.
	Insurance Collateral
	Insurance collateral is comprised of investments in U.S. Treasuries and marketable equity and debt securities held by the Company's captive insurance subsidiary that supports the Company's insurance program and reserves, as well as cash deposits with third parties. Certain of these investments, if sold or otherwise liquidated, would have to be replaced by other suitable financial assurances and are, therefore, considered restricted. These investments are designated as available-for-sale and reported at fair value with the related temporary unrealized gains and losses reported as a separate component of accumulated other comprehensive income, net of deferred income tax. Declines in the fair value of a marketable investment security which are determined to be other-than-temporary are recognized in the statements of operations, thus establishing a new cost basis for such investment. Investment income earned on these investments is reported as interest income from restricted assets in the statements of operations.
	Realized gains and losses are determined based on an average cost basis.
	Insurance collateral also includes a receivable from insurers of $1.5 million and $1.3 million as of December 31, 2014 and 2013, respectively, for liabilities in excess of the Company's self-insured retention.
	Trade and Other Accounts Receivable, net
	The Company estimates its allowances based on payor reimbursement schedules, historical collections and write-off experience and other economic data. Patient-related accounts receivable are recorded net of estimated allowances for contractual discounts and uncompensated care in the period in which services are performed. Account balances are charged off against the uncompensated care allowance, which relates principally to receivables recorded for self-pay patients, when it is probable the receivable will not be recovered. Write- offs to the contractual allowance occur when payment is received. As a result of the estimates used in recording the allowances, the nature of healthcare collections, which may involve lengthy delays, and the current uncertainty in the economy, there is a reasonable possibility that recorded estimates will change materially in the short-term.
	The following table presents accounts receivable, net and accounts receivable allowances by segment (in thousands):

			December 31,
			2014			2013
	Accounts receivable, net
	EVHC		$	28		$	1,011
	EmCare			645,427			558,195
	AMR			304,660			241,940

	Total		$	950,115		$	801,146


	Accounts receivable allowances
	EmCare
	Allowance for contractual discounts		$	2,522,622		$	1,807,090
	Allowance for uncompensated care			1,060,270			868,590

	Total		$	3,582,892		$	2,675,680


	AMR
	Allowance for contractual discounts		$	278,230		$	195,614
	Allowance for uncompensated care			167,529			170,243

	Total		$	445,759		$	365,857



	The changes in the allowances for contractual discounts and uncompensated care are primarily a result of changes in the Company's gross fee-for-service rate schedules and gross accounts receivable balances. These gross fee schedules, including any changes to existing fee schedules, generally are negotiated with various contracting entities, including municipalities and facilities. Fee schedule increases are billed for all revenue sources and to all payors under that specific contract; however, reimbursement in the case of certain state, federal, and commercial payors, including Medicare and Medicaid, will not change as a result of the change in gross fee schedules. In certain cases, this results in a higher level of contractual and uncompensated care provisions and allowances, requiring a higher percentage of contractual discount and uncompensated care provisions compared to gross charges.
	Parts and Supplies Inventory
	Parts and supplies inventory is valued at cost, determined on a first-in, first-out basis. Durable medical supplies, including oximeters and other miscellaneous items, are capitalized as inventory and expensed as used.
	Property, Plant and Equipment, net
	Property, plant and equipment are reflected at their estimated fair value as of May 25, 2011 in connection with the acquisition of Corporation led by Clayton, Dubilier & Rice, LLC ("CD&R"). Additions to property, plant and equipment subsequent to this date are recorded at cost. Maintenance and repairs that do not extend the useful life of the property are charged to expense as incurred. Gains and losses from dispositions of property, plant and equipment are recorded in the period incurred. Depreciation of property, plant and equipment is provided substantially on a straight-line basis over their estimated useful lives, which are as follows:

	Buildings		35 to 40 years
	Leasehold improvements		Shorter of expected life or life of lease
	Vehicles		5 to 7 years
	Computer hardware and software		3 to 5 years
	Other		3 to 10 years
	Goodwill and Other Indefinite Lived Intangibles
	Goodwill and other indefinite lived intangibles, including radio frequencies, licenses and trade names, are not amortized, but instead tested for impairment at least annually. The Company performs its annual impairment test in the third quarter for goodwill and other indefinite lived intangibles or more frequently if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. Such indicators include a sustained significant decline in the Company's market capitalization or a significant decline in its expected future cash flows due to changes in company-specific factors or the broader business climate. The evaluation of such factors requires considerable judgment. Any adverse change in these factors could have a significant impact on the recoverability of goodwill and have a material impact on the Company's consolidated financial statements.
	Goodwill and other indefinite lived intangible assets have been allocated to three reporting units. Two of the reporting units are aggregated into the EmCare operating segment and the other reporting unit is the AMR operating segment which the Company determined met the criteria to be classified as a reporting unit. As of December 31, 2014, $1,679.5 million and $859.1 million of goodwill had been allocated to EmCare and AMR, respectively.
	The Company compares the fair value of its reporting units to the carrying amounts on an annual basis to determine if there is potential goodwill impairment. If the fair value of the reporting units is less than the carrying value, an impairment loss is recorded to the extent that the fair value of the goodwill within the reporting unit is less than its carrying value.
	Fair value for each of the reporting units is determined using the estimated future cash flows, discounted at a rate commensurate with the risk involved or the market approach. No impairment indicators were noted in completing the Company's annual impairment assessments in 2014 and no indicators were noted which would indicate that subsequent interim impairment tests were necessary. No impairment charges were recorded as of December 31, 2014, 2013, or 2012.
	Impairment of Long-lived Assets and Other Definite Lived Intangibles
	Long-lived assets and other definite lived intangibles are assessed for impairment whenever events or changes in circumstances indicate that the carrying value may not be recoverable. Important factors that could trigger impairment review include significant underperformance relative to historical or projected future operating results, significant changes in the use of the acquired assets or the strategy for the overall business, and significant negative industry or economic trends. If indicators of impairment are present, management evaluates the carrying value of long-lived assets and other definite lived intangibles in relation to the projection of future undiscounted cash flows of the underlying business. Projected cash flows are based on historical results adjusted to reflect management's best estimate of future market and operating conditions, which may differ from actual cash flows. There were no indicators of impairment in 2014, 2013, or 2012.
	Contract Value
	The Company's contracts and customer relationships, recorded initially at their estimated fair value, represent the amortized value of such assets held by the Company. Consistent with management's expectation of estimated future cash flow, these assets are amortized on a straight-line basis over the average length of the contracts and expected contract renewal period, and range from 5 to 12.5 years depending on the type of contract and customer relationship.
	Claims Liability and Professional Liability Reserves
The Company is self-insured up to certain limits for costs associated with workers compensation claims, automobile claims, professional liability claims and general business liabilities. Reserves are established for estimates of the loss that will ultimately be incurred on claims that have been reported but not paid and claims that have been incurred but not reported. These reserves are established based on consultation with independent actuaries. The actuarial valuations consider a number of factors, including historical claim payment patterns and changes in case reserves, the assumed rate of increase in healthcare costs and property damage repairs. Historical experience and recent stable trends in the historical experience are the most significant factors in the determination of these reserves. Management believes the use of actuarial methods to account for these reserves provides a consistent and effective way to measure these subjective accruals. However, given the magnitude of the claims involved and the length of time until the ultimate cost is known, the use of any estimation technique in this area is inherently sensitive. Accordingly, recorded reserves could differ from ultimate costs related to these claims due to changes in accident reporting, claims payment and settlement practices or claims reserve practices, as well as differences between assumed and future cost increases. Accrued unpaid claims and expenses that are expected to be paid within the next 12 months are classified as current liabilities. All other accrued unpaid claims and expenses are classified as non-current liabilities.
Derivatives and Hedging Activities
All derivative instruments are recorded on the balance sheet at fair value. The Company uses derivative instruments to manage risks associated with interest rate and fuel price volatility. All hedging instruments that qualify for hedge accounting are designated and effective as hedges, in accordance with GAAP. If the underlying hedged transaction ceases to exist, all changes in fair value of the related derivatives that have not been settled are recognized in current earnings. Instruments that do not qualify for hedge accounting and the ineffective portion of hedges are marked to market with changes recognized in current earnings. The Company does not hold or issue derivative financial instruments for trading purposes and is not a party to leveraged derivatives (see Note 12).
EmCare Contractual Arrangements
EmCare structures its contractual arrangements for emergency department management services in various ways. In most states, a wholly-owned subsidiary of EmCare ("EmCare Subsidiary") contracts with hospitals to provide emergency department management services. The EmCare Subsidiary enters into an agreement with a professional association or professional corporation ("PA"), whereby the EmCare Subsidiary provides the PA with management services and the PA agrees to provide physician services for the hospital contract. The PA employs physicians directly or subcontracts with another entity for the physician services. In certain states, the PA contracts directly with the hospital, but provides physician services and obtains management services in the same manner as described above. In consideration for these services, the EmCare Subsidiary receives a monthly fee that may be adjusted from time to time to reflect industry practice, business conditions, and actual expenses for administrative costs and uncollectible accounts. In most states, these fees approximate the excess of the PA's revenues over its expenses. In all arrangements, decisions regarding patient care are made exclusively by the physicians.
Each PA is wholly-owned by a physician who enters into a Stock Transfer and Option Agreement with EmCare. This agreement gives EmCare the right to replace the physician owner with another physician in accordance with the terms of the agreement.
EmCare has determined that these management contracts meet the requirements for consolidation in accordance with GAAP. Accordingly, these financial statements include the accounts of EmCare and its subsidiaries and the PAs. The financial statements of the PAs are consolidated with EmCare and its subsidiaries because EmCare has ultimate control over the assets and business operations of the PAs as described above. Notwithstanding the lack of technical majority ownership, consolidation of the PAs is necessary to present fairly the financial position and results of operations of EmCare because of the existence of a control relationship by means other than record ownership of the PAs' voting stock. Control of a PA by EmCare is perpetual and other than temporary because EmCare may replace the physician owner of the PA at any time and thereby continue EmCare's relationship with the PA.
Financial Instruments and Concentration of Credit Risk
The Company's cash and cash equivalents, accounts receivable, accounts payable, accrued liabilities, insurance collateral, long-term debt and long-term liabilities, other than self-insurance estimates, constitute financial instruments. Based on management's estimates, the carrying value of cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities approximates fair value as of December 31, 2014 and 2013. Concentration of credit risks in accounts receivable is limited, due to the large number of customers comprising the Company's customer base throughout the United States. A significant component of the Company's revenue is derived from Medicare and Medicaid. Given that these are government programs, the credit risk for these customers is considered low. The Company performs ongoing credit evaluations of its other customers, but does not require collateral to support customer accounts receivable. The Company establishes an allowance for uncompensated care based on the credit risk applicable to particular customers, historical trends and other relevant information. For the years ended December 31, 2014 and 2013, the Company derived approximately 33% and 34%, respectively, of its net revenue from Medicare and Medicaid, 64% and 62%, respectively, from insurance providers and contracted payors, and 3% and 4%, respectively, directly from patients.
The Company estimates the fair value of its fixed rate senior notes based on an analysis in which the Company evaluates market conditions, related securities, various public and private offerings, and other publicly available information (Level 2, as defined below). The estimated fair value of the senior notes as of December 31, 2014 was approximately $744.4 million with a carrying amount of $750.0 million.
Revenue Recognition
Fee-for-service revenue is recognized at the time of service and is recorded net of provisions for contractual discounts and estimated uncompensated care. Fee-for-service revenue represents billings for services provided to patients, for which the Company receives payment from the patient or their third-party payor. Provisions for contractual discounts are related to differences between gross charges and specific payor, including governmental, reimbursement schedules. The Company records fee-for-service revenue, net of the contractual discounts based on the information entered into the Company's billing systems from received medical charts. An estimate for unprocessed medical charts for a given service period is made and adjusted in future periods based on actual medical charts processed. Information entered into the billing systems is subject to change, e.g. change in payor status, and may impact recorded fee-for-service revenue, net of the contractual discounts. Such changes are recognized in the period the change is known.
Subsidy and fee revenue primarily represent hospital subsidies and fees at EmCare and fees for stand-by, special event and community subsidies at AMR. Provisions for estimated uncompensated care, or bad debts, are related principally to the number of self-pay patients treated in the period.
Provisions for contractual discounts and estimated uncompensated care by segment, as a percentage of gross revenue and as a percentage of gross revenue less provision for contractual discounts are shown below.

		Year ended December 31,
		2014			2013			2012
EmCare
Gross revenue			100.0	%		100.0	%		100.0	%
Provision for contractual discounts			60.6			57.8			57.7

Revenue net of contractual discounts			39.4			42.2			42.3
Provision for uncompensated care as a percentage of gross revenue			20.1			21.6			21.2

Provision for uncompensated care as a percentage of gross revenue less contractual discounts			51.0	%		51.1	%		50.1	%
AMR
Gross revenue			100.0	%		100.0	%		100.0	%
Provision for contractual discounts			52.8			50.7			49.2

Revenue net of contractual discounts			47.2			49.3			50.8
Provision for uncompensated care as a percentage of gross revenue			11.9			14.7			15.6

Provision for uncompensated care as a percentage of gross revenue less contractual discounts			25.2	%		29.7	%		30.7	%
Total
Gross revenue			100.0	%		100.0	%		100.0	%
Provision for contractual discounts			58.8			56.0			55.1

Revenue net of contractual discounts			41.2			44.0			44.9
Provision for uncompensated care as a percentage of gross revenue			18.2			19.8			19.5

Provision for uncompensated care as a percentage of gross revenue less contractual discounts			44.2	%		44.9	%		43.4	%

During 2014, the Company determined that Medicare and Medicaid managed care programs would be better categorized in the Medicare and Medicaid payor class and has reclassified those encounters in the presentation below and conformed prior periods to current period presentation. Net revenue for the years ended December 31, 2014, 2013 and 2012 consisted of the following (in thousands):

		Year ended December 31,
		2014			2013			2012
Fee-for-service revenue, net of contractual discounts:
Medicare		$	1,181,762		$	982,640		$	792,796
Medicaid			415,771			257,100			224,974
Commercial insurance and managed care (excluding Medicare and Medicaid managed care)			2,551,123			2,241,422			2,027,872
Self-pay			2,993,997			2,660,924			2,221,356

Sub-total			7,142,653			6,142,086			5,266,998
Subsidies and fees			742,300			629,436			567,634

Revenue, net of contractual discounts			7,884,953			6,771,522			5,834,632
Provision for uncompensated care			(3,487,309	)		(3,043,210	)		(2,534,511	)

Net revenue		$	4,397,644		$	3,728,312		$	3,300,121



Healthcare reimbursement is complex and may involve lengthy delays. Third-party payors are continuing their efforts to control expenditures for healthcare, including proposals to revise reimbursement policies. The Company has from time to time experienced delays in reimbursement from third-party payors. In addition, third-party payors may disallow, in whole or in part, claims for payment based on determinations that certain amounts are not reimbursable under plan coverage, determinations of medical necessity, or the need for additional information. Laws and regulations governing the Medicare and Medicaid programs are very complex and subject to interpretation. Revenue is recognized on an estimated basis in the period which related services are rendered. As a result, there is a reasonable possibility that recorded estimates will change materially in the short-term. Such amounts, including adjustments between provisions for contractual discounts and uncompensated care, are adjusted in future periods as adjustments become known. These adjustments in the aggregate increased the contractual discount and uncompensated care provisions (decreased net revenue) by approximately $12.5 million and $1.0 million for the years ended December 31, 2014 and 2013, respectively, and decreased the contractual discount and uncompensated care provisions (increased net revenue) by approximately $10.0 million for the year ended December 31, 2012.
Subsidies and fees in connection with community contracts at AMR are recognized ratably over the service period the payment covers.
The Company also provides services to patients who have no insurance or other third-party payor coverage. In certain circumstances, federal law requires providers to render services to any patient who requires care regardless of their ability to pay. Services to these patients are not considered to be charity care and provisions for uncompensated care for these services are estimated accordingly.
Income Taxes
Deferred income taxes reflect the impact of temporary differences between the reported amounts of assets and liabilities for financial reporting purposes and such amounts as measured by tax laws and regulations. The deferred tax assets and liabilities represent the future tax return consequences of those differences, which will either be taxable or deductible when the assets and liabilities are recovered or settled. A valuation allowance is provided for deferred tax assets when management concludes it is more likely than not that some portion of the deferred tax assets will not be recognized. The respective tax authorities, in the normal course, audit previous tax filings. It is not possible at this time to predict the final outcome of these audits or establish a reasonable estimate of possible additional taxes owing, if any.
Equity Based Compensation
The Company recognizes all share-based payments to employees based on its grant-date fair values and its estimates of forfeitures. The Company recognizes the fair value of outstanding options as a charge to operations over the vesting period. The cash benefits of tax deductions in excess of deferred taxes on recognized compensation expense are reported as a financing cash flow. The Company uses the straight-line method to recognize equity based compensation expense for its outstanding stock awards. Equity based compensation has been issued under the plans described in Note 17.
Fair Value Measurement
The Company classifies its financial instruments that are reported at fair value based on a hierarchal framework that ranks the level of market price observability used in measuring financial instruments at fair value. Market price observability is impacted by a number of factors, including the type of instrument and the characteristics specific to the instrument. Instruments with readily available active quoted prices or for which fair value can be measured from actively quoted prices generally will have a higher degree of market price observability and a lesser degree of judgment used in measuring fair value.
Financial instruments measured and reported at fair value are classified and disclosed in one of the following categories:
Level 1—Quoted prices are available in active markets for identical assets or liabilities as of the reporting date. The Company does not adjust the quoted price for these assets or liabilities, which include investments held in connection with the Company's captive insurance program.
Level 2—Pricing inputs are other than quoted prices in active markets, which are either directly or indirectly observable as of the reporting date, and fair value is determined through the use of models or other valuation methodologies. Balances in this category include corporate bonds and derivatives.
Level 3—Pricing inputs are unobservable as of the reporting date and reflect the Company's own assumptions about the fair value of the asset or liability. Balances in this category include the Company's estimate, using a combination of internal and external fair value analyses, of contingent consideration for acquisitions described in Note 5.
The following table summarizes the valuation of the Company's financial instruments by the above fair value hierarchy levels as of December 31, 2014 and 2013 (in thousands):

		December 31, 2014
Description		Level 1			Level 2			Level 3			Total
Assets:
Available-for-sale securities (insurance collateral)		$	30,243		$	—		$	—		$	30,243
Liabilities:
Contingent consideration			—			—			2,000			2,000
Fuel hedge			—			1,433			—			1,433
Interest rate swap			—			1,493			—			1,493


		December 31, 2013
Description		Level 1			Level 2			Level 3			Total
Assets:
Available-for-sale securities (insurance collateral)		$	12,170		$	517		$	—		$	13,227
Fuel hedge			—			672			—			672
Liabilities:
Contingent consideration			—			—			7,734			7,734
Interest rate swap			—			3,135			—			3,135

The contingent consideration balance classified as a Level 3 liability has decreased by $5.7 million since December 31, 2013 primarily due to payments made, offset by an increase of $2.0 million from recent acquisitions.
During the year ended December 31, 2014 and 2013, the Company had no transfers in and out of Level 1 and Level 2 fair value measurements.
Recent Accounting Pronouncements
In May 2014, the FASB issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers ("ASU 2014-09") to clarify the principles for recognizing revenue and to develop a common revenue standard for GAAP and International Financial Reporting Standards. ASU 2014-09 is effective for public companies for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period. Early application is not permitted. The Company has not yet determined the effects, if any, that adoption of ASU 2014-09 may have on its consolidated financial position or results of operations.
In August 2014, the FASB issued Accounting Standards Update 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) which requires management to evaluate, in connection with preparing financial statements for each annual and interim reporting period, whether there are conditions or events, considered in the aggregate, that raise substantial doubt about an entity's ability to continue as a going concern within one year after the date that the financial statements are issued (or within one year after the date that the financial statements are available to be issued when applicable) and provide related disclosures. ASU 2014-15 is effective for the annual period ending after December 15, 2016, and for annual and interim periods thereafter. The adoption of ASU 2014-15 is not expected to impact the Company's consolidated financial statements.

Basic_and_Diluted_Net_Income_L

Basic and Diluted Net Income (Loss) Per Share	12 Months Ended
Basic and Diluted Net Income (Loss) Per Share	Dec. 31, 2014
Basic and Diluted Net Income (Loss) Per Share
Basic and Diluted Net Income Per Share	3. Basic and Diluted Net Income Per Share
	The Company presents both basic earnings per share ("EPS") and diluted EPS. Basic EPS excludes potential dilution and is computed by dividing "Net income attributable to Envision Healthcare Holdings, Inc." by the "Weighted-average common shares outstanding" for the period. Diluted EPS reflects the potential dilution that could occur if stock awards were exercised. The potential dilution from stock awards was computed using the treasury stock method based on the average market value of the Company's common stock. The following table presents EPS amounts for all periods and the basic and diluted weighted-average shares outstanding used in the calculation (in thousands, except per share amounts).

		Year ended December 31,
		2014		2013		2012
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	125,508	$	5,995	$	41,185
	Weighted-average common shares outstanding—common stock:
	Basic		182,020		150,156		130,229
	Dilutive impact of stock awards outstanding		7,901		6,806		2,717

	Diluted		189,921		156,962		132,946
	Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:

	Basic	$	0.69	$	0.04	$	0.32
	Diluted	$	0.66	$	0.04	$	0.31
	As of December 31, 2014, 2013, and 2012 there were no stock awards of common stock outstanding excluded from the weighted-average common shares outstanding above.

Statements_of_Cash_Flows_Data

Statements of Cash Flows Data	12 Months Ended
Statements of Cash Flows Data	Dec. 31, 2014
Statements of Cash Flows Data
Statements of Cash Flows Data	4. Statements of Cash Flows Data
	The following presents supplemental cash flow statement disclosure (in thousands).

		Year ended December 31,
		2014		2013		2012
	Supplemental cash flow data:
	Cash paid for interest	$	95,079	$	198,098	$	154,984
	Net cash paid (refunds received) for taxes		2,898		13,351		(20,463	)

Acquisitions

Acquisitions	12 Months Ended
Acquisitions	Dec. 31, 2014
Acquisitions
Acquisitions	5. Acquisitions
	2014 Acquisitions
	Phoenix Physicians, LLC ("Phoenix Physicians"). On June 17, 2014, the Company acquired the stock of Phoenix Physicians for a total purchase price of $169.5 million paid in cash (the "Phoenix Physicians Acquisition"). Phoenix Physicians, in part through management services agreements with professional entities, is engaged in providing medical practices support and emergency department management and staffing services to hospitals, physicians and healthcare facilities in Florida. The Company has accounted for the acquisition of Phoenix Physicians using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. All of the goodwill is tax deductible and assigned to the EmCare segment.
	The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations (in thousands):


	Cash and cash equivalents	$	24,795
	Accounts receivable		16,748
	Prepaid and other current assets		139
	Property, plant, and equipment		92
	Acquired intangible assets		57,630
	Goodwill		97,200
	Accounts payable		(1,073	)
	Accrued liabilities		(11,920	)
	Long-term deferred tax liabilities		(445	)
	Insurance reserves		(13,716	)

	Total purchase price	$	169,450



	During the last six months of 2014, the Company made purchase price allocation adjustments that decreased goodwill by $0.5 million and increased cash and cash equivalents by $18.7 million with a corresponding increase to accrued liabilities and insurance reserves of $4.5 million and $13.7 million, respectively, to record the transfer of risk of the malpractice claims liability. Additionally, the Company made other purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $1.6 million.
	The following unaudited pro forma operating results give effect to the Phoenix Physicians Acquisition, as if it had been completed as of January 1, 2013. These pro forma amounts are not necessarily indicative of the operating results that would have occurred if these transactions had occurred on such date. The pro forma adjustments are based on certain assumptions that the Company believes are reasonable.

		Year ended
		December 31,
	(in thousands)	2014			2013
	Net revenue	$	129,614		$	117,655
	Net income		9,007			3,315
	The Company's statements of operations for the year ended December 31, 2014 include net revenue of $68.8 million and net income of $6.8 million attributable to Phoenix Physicians.
	Other 2014 Acquisitions. The Company completed the acquisitions of Life Line Ambulance Service, Inc., an emergency medical transportation service provider with operations in Arizona, on February 6, 2014, MedStat EMS, Inc., an emergency and non-emergency medical ground transportation service provider with operations in Mississippi, on March 7, 2014, and Streamlined Medical Solutions, LLC, a healthcare technology company which has developed proprietary software to enhance patient direct admission and referral management processes, on May 21, 2014 for total aggregate purchase consideration of approximately $38.0 million paid in cash.
	The Company has accounted for these acquisitions using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. During the year ended December 31, 2014, the Company made purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $12.1 million. The total purchase price for these acquisitions was allocated to goodwill of $10.8 million, $6.1 million of which is tax deductible goodwill, other acquired intangible assets of $27.3 million, net current assets of $3.6 million, and long-term deferred tax liabilities of $3.7 million which are subject to adjustment based upon the completion of purchase price allocations.
	Contingent Consideration
	As of December 31, 2014, the Company has accrued $2.0 million as its estimate of the additional payments to be made in future periods as contingent consideration for acquisitions made prior to December 31, 2014. This balance is included in accrued liabilities in the accompanying balance sheets. These payments will be made should the acquired operations achieve the terms as agreed to in the respective acquisition agreements.
	2013 Acquisitions
	During the year ended December 31, 2013, indirect, wholly-owned subsidiaries of the Company completed the acquisitions of CMORx, LLC and Loya Medical Services, PLLC, which provide clinical management software, each of T.M.S. Management Group, Inc. and Transportation Management Services of Brevard, Inc., two related corporations that leverage the provision of non-emergency healthcare transportation services by third-party transportation service providers, Jackson Emergency Consultants, which provides facility based physician staffing in northern Florida, and other smaller acquisitions for a combined purchase price of $34.2 million paid in cash.
	The Company has accounted for these acquisitions using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. During 2014, the Company made purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $5.4 million. The total purchase price for these acquisitions was allocated to goodwill of $20.8 million, all of which is tax deductible goodwill, other acquired intangible assets of $14.9 million, and net current liabilities of $1.5 million.
	2012 Acquisitions
	Guardian Healthcare Group, Inc. ("Guardian"). On December 21, 2012, the Company acquired the stock of Guardian for a total purchase price of $159.0 million paid in cash. Guardian, through its subsidiaries, provides healthcare services to patients at their place of residence. The Company has accounted for the acquisition of Guardian using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. Goodwill from this acquisition was assigned to the EmCare segment. During 2013, the Company made purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $8.7 million, an increase in the federal tax liability of $2.9 million and other adjustments to opening balances for assets and liabilities. Of the goodwill recorded, $78.5 million is tax deductible. The final allocation of the purchase price is in the table below (in thousands):

	Cash	$	428
	Accounts receivable		11,542
	Prepaid and other current assets		379
	Property, plant and equipment		1,792
	Acquired intangible assets		59,810
	Goodwill		111,256
	Other long-term assets		50
	Accounts payable		(729	)
	Accrued liabilities		(5,204	)
	Current deferred tax liabilities		(15,108	)
	Federal tax liability		(5,216	)

	Total purchase price	$	159,000



	The Company began consolidating the results of operations effective December 21, 2012. The acquisition added $3.0 million of operating revenue and $0.3 million of net income for the year ended December 31, 2012. On an unaudited Pro Forma basis, had the Company owned Guardian at the beginning of each fiscal year ended December 31, 2012 $100.1 million of operating revenues and $5.9 million of net income would have been reported for the year ended December 31, 2012. This unaudited Pro Forma information should not be relied upon as necessarily being indicative of the historical results that would have been obtained if the acquisition had actually occurred on those dates, nor of the results that may be obtained in the future.
	Other Acquisitions. On August 31, 2012, the Company acquired the assets of Sage Physician Partners, Inc. d/b/a American Physician Housecalls ("APH"). APH provides primary physician healthcare services to patients at their place of residence. On September 28, 2012 and December 31, 2012, the Company acquired the management services companies of NightRays, P.A. ("Night Rays") and Saint Vincent Anesthesia Medical Group, Inc. / Golden State Anesthesia Consultants, Inc. ("St. Vincent / Golden State"), respectively, both of which provide teleradiology and radiology services to hospitals, healthcare facilities and physician practices. The Company acquired these other acquisitions for a total purchase price of $33.8 million paid in cash.
	The Company has accounted for these other acquisitions using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. During 2013, the Company made purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $4.3 million for Night Rays, a reclassification from net current liabilities to goodwill of $3.7 million for St. Vincent / Golden State and other adjustments to opening balances for assets and liabilities. The total purchase price for these other acquisitions was allocated to goodwill of $31.8 million, of which $22.2 million is tax deductible goodwill, other acquired intangible assets of $12.3 million, and net current liabilities of $10.3 million.

Property_Plant_and_Equipment_n

Property, Plant and Equipment, net	12 Months Ended
Property, Plant and Equipment, net	Dec. 31, 2014
Property, Plant and Equipment, net.
Property, Plant and Equipment, net	6. Property, Plant and Equipment, net
	Property, plant and equipment, net consisted of the following as of December 31 (in thousands):

		2014			2013
	Land	$	4,553		$	5,013
	Building and leasehold improvements		25,516			22,526
	Vehicles		175,082			146,700
	Computer hardware and software		97,978			67,754
	Communication and medical equipment and other		114,849			99,923

			417,978			341,916
	Less: accumulated depreciation and amortization		(206,702	)		(147,201	)

	Property, plant and equipment, net	$	211,276		$	194,715



	Depreciation expense was $65.6 million, $63.9 million, and $56.5 million for the years ended December 31, 2014, 2013, and 2012, respectively.

Intangible_Assets_net

Intangible Assets, net	12 Months Ended
Intangible Assets, net	Dec. 31, 2014
Intangible Assets, net
Intangible Assets, net
	7. Intangible Assets, net
	Intangible Assets, excluding Goodwill
	Intangible assets, net consisted of the following as December 31 (in thousands):

		2014					2013
		Gross		Accumulated			Gross			Accumulated
		Carrying		Amortization			Carrying			Amortization
		Amount					Amount
	Amortized intangible assets
	Contract value	$	651,190	$	(245,803	)	$	590,880		$	(173,975	)
	Physician referral network		58,650		(14,679	)		58,650			(7,515	)
	Covenant not to compete		5,490		(3,725	)		5,101			(2,324	)
	Other		2,470		(167	)		—			—

			717,800		(264,374	)		654,631			(183,814	)
	Unamortized intangible assets
	Unamortized intangible assets
	Trade names		36,045		—			33,740			—
	Radio frequencies		901		—			901			—
	License		34,110		—			8,240			—

	Total	$	788,856	$	(264,374	)	$	697,512		$	(183,814	)



	Amortization expense was $80.6 million, $76.7 million and $67.2 million for the years ended December 31, 2014, 2013 and 2012, respectively. Estimated annual amortization over each of the next five years is expected to be:

	2015	$	82,094
	2016		75,368
	2017		70,540
	2018		63,696
	2019		58,899
	Goodwill
	Changes in the carrying amount of goodwill during 2014 are set forth as below (in thousands):

		January 1,		2014			Deferred			Adjustments			December 31,
		2014		Acquisitions			Taxes			Adjustments			2014
	EmCare	$	1,574,882	$	100,529		$	445		$	3,639		$	1,679,495
	AMR		860,788		2,836			4,173			(8,659	)		859,138

	Total	$	2,435,670	$	103,365			4,618		$	(5,020	)	$	2,538,633



	Changes in the carrying amount of goodwill during 2013 are set forth as below (in thousands):

		January 1,		2013			Adjustments			December 31,
		2013		Acquisitions			Adjustments			2013
	EmCare	$	1,555,924	$	9,018		$	9,940		$	1,574,882
	AMR		857,708		17,157			(14,077	)		860,788

	Total	$	2,413,632	$	26,175		$	(4,137	)	$	2,435,670



	Adjustments in the carrying amount of goodwill during 2014 and 2013 relate to other purchase price allocation adjustments and reclassifications.

Income_Taxes

Income Taxes	12 Months Ended
Income Taxes	Dec. 31, 2014
Income Taxes
Income Taxes	8. Income Taxes
	Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company's deferred taxes were as follows at December 31 (in thousands):

			2014			2013
	Current deferred tax assets (liabilities):
	Accounts receivable		$	8,278		$	1,611
	Accrual to cash			(128,507	)		(89,609	)
	Accrued liabilities			11,171			13,586
	Credit carryforwards			2,375			693
	Net operating loss carryforwards			2,405			38,232

	Net current deferred tax liabilities			(104,278	)		(35,487	)

	Long-term deferred tax assets (liabilities):
	Intangible assets			(160,186	)		(171,315	)
	Insurance and other long-term liabilities			46,760			37,692
	Excess of tax over book depreciation			(39,927	)		(40,729	)
	Net operating loss carryforwards			30,836			27,895
	Credit carryforwards			2,580			2,555
	Valuation allowance			(11,026	)		(7,228	)

	Net long-term deferred tax liabilities			(130,963	)		(151,130	)

	Net deferred tax liabilities		$	(235,241	)	$	(186,617	)



	At December 31, 2014, the Company has net deferred tax liabilities that will increase taxable income in future periods. Net deferred tax liabilities increased by $48.6 million from December 31, 2013. A valuation allowance is established when it is "more likely than not" that all, or a portion, of net deferred tax assets will not be realized. A review of all available positive and negative evidence needs to be considered, including expected reversals of significant deductible temporary differences, a company's recent financial performance, the market environment in which a company operates, tax planning strategies and the length of net operating loss carryforward periods. Furthermore, the weight given to the potential effect of negative and positive evidence should be commensurate with the extent to which it can be objectively verified. Based on the evaluation of such evidence, the Company established an $11.0 million valuation allowance as of December 31, 2014 related to some of its deferred tax assets, an increase of $3.8 million from December 31, 2013.
	The Company has federal net operating loss carryforwards of $40.3 million which expire in the years 2017 to 2033. The decrease to the net operating loss carryforwards is primarily due to tax losses utilized in the tax year ended December 31, 2014. AMR's net operating loss carryforwards generated prior to the Merger are subject to AMR's $1.3 million annual limitation under Section 382 of the Internal Revenue Code of 1986, as amended ("IRC"), increased by its recognized built-in gains. The Company's 2010 net unrealized built-in gain and future recognition of some of these built-in gains has and will continue to accelerate the usage of these net operating loss carryforwards.
	The Company operates in multiple taxing jurisdictions and in the normal course of business is examined by federal and state tax authorities. In preparation for such examinations, the Company establishes reserves for uncertain tax positions, periodically assesses the amount of such reserves and adjusts the reserve balances as necessary. The Company does not expect the final resolution of tax examinations to have a material impact on the Company's financial results. In nearly all jurisdictions, the tax years prior to 2010 are no longer subject to examination.
	A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands):

			Year ended December 31,
			2014			2013			2012
	Balance as of beginning of period		$	614		$	3,467		$	963
	Additions for tax positions of prior years			1,494			216			5,397
	Reductions for tax positions of prior years			—			—			(1,896	)
	Reductions for tax positions due to lapse of statute of limitations			(482	)		(3,069	)		(997	)

	Balance as of end of period		$	1,626		$	614		$	3,467



	The Company does not expect a reduction of unrecognized tax benefits within the next twelve months.
	Accrued interest and penalties on unrecognized tax benefits are recorded as a component of income tax expense. The Company recognized $0.3 million, $0.2 million and $0.7 million for the payments of interest and penalties for the years ended December 31, 2014, 2013 and 2012, respectively. The Company reversed $0.1 million, $0.5 million and $0.2 million of the interest previously recognized for the years ended December 31, 2014, 2013 and 2012, respectively.
	The unrecognized tax benefits recorded by the Company included approximately $1.6 million, $0.2 million and $0.5 million that may reduce future tax expense for the years ended December 31, 2014, 2013 and 2012, respectively.
	The components of income tax expense were as follows (in thousands):

			Year ended December 31,
			2014			2013			2012
	Current tax benefit (expense)
	State		$	(4,602	)	$	(3,937	)	$	(5,131	)
	Federal			(40,245	)		7,347			(34,965	)

	Total			(44,847	)		3,410			(40,096	)

	Deferred tax benefit (expense)
	State			(4,353	)		5,586			(1,004	)
	Federal			(40,298	)		(8,002	)		13,637

	Total			(44,651	)		(2,416	)		12,633

	Total tax benefit (expense)
	State			(8,955	)		1,649			(6,135	)
Federal			(80,543	)		(655	)		(21,328	)

Total		$	(89,498	)	$	994		$	(27,463	)



A reconciliation of the provision for income taxes at the federal statutory rate compared to the effective tax rate is as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
Income tax expense at the statutory rate		$	(73,188	)	$	(3,562	)	$	(23,895	)
Increase in income taxes resulting from:
State taxes, net of federal			(6,453	)		(1,834	)		(4,218	)
Tax settlements and filings			(1,012	)		2,853			638
Tax credits			338			779			—
Dissenting shareholder settlement			—			(3,203	)		—
Change in valuation allowance			(3,816	)		3,126			—
State deferred rate change			1,170			1,161			—
Other			967			(419	)		12

Income tax benefit (expense) before noncontrolling interest			(81,994	)		(1,099	)		(27,463	)
Noncontrolling interests			(7,504	)		2,093			—

Income tax benefit (expense)		$	(89,498	)	$	994		$	(27,463	)



The effective rates for the years ended December 31, 2014, 2013 and 2012, were impacted by nonrecurring items.

Insurance_Collateral

Insurance Collateral	12 Months Ended
Insurance Collateral	Dec. 31, 2014
Insurance Collateral
Insurance Collateral	9. Insurance Collateral
	Insurance collateral consisted of the following as of December 31, 2014 and 2013 (in thousands):

		December 31,		December 31,
		2014		2013
	Available-for-sale securities:
	U.S. Treasuries	$	1,191	$	2,100
	Corporate bonds /Fixed income		15,397		6,372
	Corporate equity		13,655		4,755

	Total available-for-sale securities		30,243		13,227
	Insurance receivable		1,470		1,300
	Cash deposits and other		11,683		27,808

	Total insurance collateral	$	43,396	$	42,335



	Amortized cost basis and aggregate fair value of the Company's available-for-sale securities as of December 31, 2014 and 2013 were as follows (in thousands):

		December 31, 2014
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	1,182	$	12		$	(3	)	$	1,191
	Corporate bonds /Fixed income		15,339		59			(1	)		15,397
	Corporate equity		13,885		27			(257	)		13,655

	Total available-for-sale securities	$	30,406	$	98		$	(261	)	$	30,243




		December 31, 2013
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,064	$	37		$	(1	)	$	2,100
	Corporate bonds /Fixed income		6,384		26			(38	)		6,372
	Corporate equity		4,399		500			(144	)		4,755

	Total available-for-sale securities	$	12,847	$	563		$	(183	)	$	13,227



	As of December 31, 2014, available-for-sale securities included U.S. Treasuries and corporate bonds /fixed income securities of $3.6 million with contractual maturities within one year and $13.0 million with contractual maturities extending longer than one year through five years. Actual maturities may differ from contractual maturities as a result of the Company's ability to sell these securities prior to maturity.
	The Company's temporarily impaired investment securities available-for-sale as of December 31, 2014 and 2013 were as follows (in thousands):

		December 31, 2014					December 31, 2013
		Fair Value		Unrealized			Fair Value			Unrealized
		Fair Value		Loss			Fair Value			Loss
	U.S. Treasuries:
	Less than 12 months	$	—	$	—		$	132		$	(1	)
	12 months or more		130		(3	)		—			—
	Corporate bonds /Fixed income:
	Less than 12 months		1,312		(1	)		2,768			(18	)
	12 months or more		251		—			2,178			(20	)
	Corporate equity:
	Less than 12 months		11,160		(257	)		—			—
	12 months or more		—		—			2,553			(144	)

	Total	$	12,853	$	(261	)	$	7,631		$	(183	)



The Company evaluates the investment securities available-for-sale on a quarterly basis to determine whether declines in the fair value of these securities are other-than-temporary. This quarterly evaluation consists of reviewing the fair value of the security compared to the carrying amount, the historical volatility of the price of each security, and any industry and company specific factors related to each security.
The Company is not aware of any specific factors indicating that the underlying issuers of the U.S. Treasuries and corporate bonds /fixed income securities would not be able to pay interest as it becomes due or repay the principal amount at maturity. Therefore, the Company believes that the changes in the estimated fair values of these debt securities are related to temporary market fluctuations. Additionally, the Company is not aware of any specific factors which indicate the unrealized losses on the investments in corporate equity securities are due to anything other than temporary market fluctuations.
The Company realized net gains of $0.4 million, $0.5 million, and $0.4 million on the sale and maturities of available-for-sale securities for the years ended December 31, 2014, 2013, and 2012, respectively.

Accrued_Liabilities

Accrued Liabilities	12 Months Ended
Accrued Liabilities	Dec. 31, 2014
Accrued Liabilities
Accrued Liabilities	10. Accrued Liabilities
	Accrued liabilities were as follows as of December 31 (in thousands):

		2014		2013
	Accrued wages and benefits	$	190,220	$	161,398
	Accrued paid time-off		27,156		25,713
	Current portion of self-insurance reserve		74,212		73,738
	Accrued restructuring		8,376		5,682
	Current portion of compliance and legal		3,407		2,000
	Accrued billing and collection fees		3,823		2,954
	Accrued incentive compensation		32,324		19,570
	Accrued interest		22,324		6,898
	Other		50,815		52,983

	Total accrued liabilities	$	412,657	$	350,936

Debt

Debt	12 Months Ended
Debt	Dec. 31, 2014
Debt
Debt	11. Debt
	Senior Unsecured Notes due 2019
	On May 25, 2011, Corporation issued $950 million of senior unsecured notes due 2019 ("2019 Notes"). During the second quarter of 2012, the Company's captive insurance subsidiary purchased $15.0 million of the 2019 Notes through an open market transaction and currently holds none of the 2019 Notes subsequent to the redemption of the 2019 Notes on December 30, 2013 and June 18, 2014.
	On December 30, 2013, the Company redeemed $332.5 million in aggregate principal amount of the 2019 Notes of which $5.2 million was held by the Company's captive insurance subsidiary at a redemption price of 108.125%, plus accrued and unpaid interest of $2.2 million. During the year ended December 31, 2013, the Company recorded a loss on early debt extinguishment of $38.7 million related to premiums and unamortized debt issuance costs from the partial redemption of the 2019 Notes.
	On June 18, 2014, Corporation redeemed the remaining $617.5 million in aggregate principal amount of the 2019 Notes of which $9.8 million was held by the Company's captive insurance subsidiary at a redemption price of 106.094%, plus accrued and unpaid interest of $2.4 million. During the year ended December 31, 2014, the Company recorded a loss on early debt extinguishment of $66.4 million related to premiums, financing fees paid to the creditors of the unsecured senior notes due 2022, and unamortized debt issuance costs from the redemption of the 2019 Notes.
	Senior Secured Credit Facilities
	On May 25, 2011, Corporation entered into $1.8 billion of senior secured credit facilities ("Senior Secured Credit Facilities") that consisted of a $1.44 billion senior secured term loan facility due 2018 (the "Term Loan Facility") and a $350 million asset-backed revolving credit facility due 2016 (the "ABL Facility"). The Senior Secured Credit Facilities are secured by substantially all of the assets of the Company.
	During the year ended December 31, 2012 the Company made unscheduled payments totaling $250 million on the senior secured term loan and recorded a loss on early debt extinguishment of $8.3 million related to unamortized debt issuance costs.
	Term Loan Facility
	Prior to February 7, 2013, loans under the Term Loan Facility bore interest at Company's election at a rate equal to (i) the highest of (x) the rate for deposits in U.S. dollars in the London interbank market (adjusted for maximum reserves) for the applicable interest period ("Term Loan LIBOR rate") and (y) 1.50%, plus, in each case, 3.75%, or (ii) the base rate, which will be the highest of (w) the corporate base rate established by the administrative agent from time to time, (x) 0.50% in excess of the overnight federal funds rate, (y) the one-month Term Loan LIBOR rate (adjusted for maximum reserves) plus 1.00% per annum and (x) 2.50%, plus, in each case, 2.75%.
	On February 7, 2013, Corporation, the borrower under the Term Loan Facility, entered into a First Amendment (the "Term Loan Amendment") to the credit agreement governing the Term Loan Facility (as amended, the "Term Loan Credit Agreement"). Under the Term Loan Amendment, Corporation incurred an additional $150 million in incremental borrowings under the Term Loan Facility, the proceeds of which were used to pay down the ABL Facility. In addition, the rate at which the loans under the Term Loan Credit Agreement bear interest was amended to equal (i) the higher of (x) LIBOR and (y) 1.00%, plus, in each case, 3.00% (with a step-down to 2.75% in the event that the Company meets a consolidated first lien net leverage ratio of 2.50:1.00), or (ii) the alternate base rate, which will be the highest of (w) the corporate base rate established by the administrative agent from time to time, (x) 0.50% in excess of the overnight federal funds rate, (y) the one-month LIBOR (adjusted for maximum reserves) plus 1.00% and (z) 2.00%, plus, in each case, 2.00% (with a step-down to 1.75% in the event that the Company meets a consolidated first lien net leverage ratio of 2.50:1.00). Corporation recorded a loss on early debt extinguishment of $0.1 million related to unamortized debt issuance costs as a result of this modification. The Company recorded a loss on early debt extinguishment of $0.1 million related to unamortized debt issuance costs as a result of this modification.
	The credit agreement governing the Term Loan Facility contains customary representations and warranties and customary affirmative and negative covenants. The negative covenants are limited to the following: limitations on the incurrence of debt, liens, fundamental changes, restrictions on subsidiary distributions, transactions with affiliates, further negative pledge, asset sales, restricted payments, investments and acquisitions, repayment of certain junior debt (including the senior notes) or amendments of junior debt documents related thereto and line of business. The negative covenants are subject to the customary exceptions.
	ABL Facility
	Prior to February 27, 2013, loans under the ABL Facility bore interest at the Company's election at a rate equal to (i) the rate for deposits in U.S. dollars in the London interbank market (adjusted for maximum reserves) for the applicable interest period ("ABL LIBOR rate"), plus an applicable margin that ranges from 2.25% to 2.75% based on the average available loan commitments, or (ii) the base rate, which is the highest of (x) the corporate base rate established by the administrative agent from time to time, (y) the overnight federal funds rate plus 0.5% and (z) the one-month ABL LIBOR rate plus 1.0% per annum, plus, in each case, an applicable margin that ranges from 1.25% to 1.75% based on the average available loan commitments.
	On February 27, 2013, Corporation entered into a First Amendment to the credit agreement governing the ABL Facility (as amended, the "ABL Credit Agreement"), under which the lenders under the ABL Facility increased the commitments available to Corporation under the ABL Facility to $450 million and extended the term to 2018. In addition, the rate at which the loans under the ABL Credit Agreement bear interest was amended to equal (i) LIBOR plus, (x) 2.00% in the event that average daily excess availability is less than or equal to 33% of availability, (y) 1.75% in the event that average daily excess availability is greater than 33% but less than or equal to 66% of availability and (z) 1.50% in the event that average daily excess availability is greater than 66% of availability, or (ii) the alternate base rate, which will be the highest of (x) the corporate base rate established by the administrative agent from time to time, (y) 0.50% in excess of the overnight federal funds rate and (z) the one-month LIBOR (adjusted for maximum reserves) plus 1.00% plus, in each case, (A) 1.00% in the event that average daily excess availability is less than or equal to 33% of availability, (B) 0.75% in the event that average daily excess availability is greater than 33% but less than or equal to 66% of availability and (C) 0.50% in the event that average daily excess availability is greater than 66% of availability.
	On February 6, 2015, Corporation entered into a Second Amendment to the ABL Credit Agreement, under which certain lenders under the ABL Facility increased the commitments available to Corporation under the ABL Facility to $550 million.
	The ABL Facility bears a commitment fee that ranges from 0.500% to 0.375%, payable quarterly in arrears, based on the utilization of the ABL Facility. The ABL Facility also bears customary letter of credit fees.
	As of December 31, 2014, letters of credit outstanding which impact the available credit under the ABL Facility were $112.3 million and the maximum available under the ABL Facility was $337.7 million.
	The credit agreement governing the ABL Facility contains customary representations and warranties and customary affirmative and negative covenants. The negative covenants are limited to the following: limitations on indebtedness, dividends and distributions, investments, acquisitions, prepayments or redemptions of junior indebtedness, amendments of junior indebtedness, transactions with affiliates, asset sales, mergers, consolidations and sales of all or substantially all assets, liens, negative pledge clauses, changes in fiscal periods, changes in line of business and hedging transactions. The negative covenants are subject to the customary exceptions and also permit the payment of dividends and distributions, investments, permitted acquisitions and payments or redemptions of junior indebtedness upon satisfaction of a "payment condition." The payment condition is deemed satisfied upon 30-day average excess availability exceeding agreed upon thresholds and, in certain cases, the absence of specified events of default and compliance with a fixed charge coverage ratio of 1.0 to 1.0.
	In 2013, the Company recorded $5.0 million of debt issuance expense related to the Term Loan Amendment and ABL Amendment.
	Senior PIK Toggle Notes
	On October 1, 2012, the Company issued $450 million of Senior PIK Toggle Notes due 2017 (the "PIK Notes") and used the proceeds from the offering to pay an extraordinary dividend to its stockholders, pay debt issuance costs and make certain payments to members of management with rollover options in the Company.
	On August 30, 2013, the Company redeemed all of the PIK Notes at a redemption price equal to 102.75% of the aggregate principal amount of the PIK Notes, plus accrued and unpaid interest of $17.2 million. During the year ended December 31, 2013, the Company recorded a loss on early debt extinguishment of $29.5 million related to premiums and unamortized debt issuance costs from the redemption of the PIK Notes.
	Senior Unsecured Notes due 2022
	On June 18, 2014, Corporation issued $750.0 million of senior unsecured notes due 2022 ("2022 Notes") the proceeds of which were used to redeem the 2019 Notes and for other general corporate purposes. The Company paid $9.4 million in financing fees to the creditors of the 2022 Notes which was recorded to loss on early debt extinguishment in the second quarter of 2014.
	The 2022 Notes have a fixed interest rate of 5.125%, payable semi-annually on January 1 and July 1 with the principal due at maturity on July 1, 2022. The 2022 Notes are general unsecured obligations of the Company and are guaranteed by each of the Company's domestic subsidiaries, except for any of the Company's subsidiaries subject to regulation as an insurance company, including the Company's captive insurance subsidiary.
	The Company may redeem the 2022 Notes, in whole or in part, at any time prior to July 1, 2017, at a price equal to 100% of the principal amount thereof, plus accrued and unpaid interest, if any, to the redemption date, plus the applicable make-whole premium. The Company may redeem the 2022 Notes, in whole or in part, at any time (i) on and after July 1, 2017 and prior to July 1, 2018, at a price equal to 103.844% of the principal amount of the 2022 Notes, (ii) on or after July 1, 2018 and prior to July 1, 2019, at a price equal to 102.563% of the principal amount of the 2022 Notes, (iii) on or after July 1, 2019 and prior to July 1, 2020, at a price equal to 101.281% of the principal amount of the 2022 Notes, and (iv) on or after July 1, 2020, at a price equal to 100.000% of the principal amount of the 2022 Notes, in each case, plus accrued and unpaid interest, if any, to the redemption date. In addition, at any time prior to July 1, 2017, the Company at its option may redeem up to 40% of the aggregate principal amount of the 2022 Notes with the proceeds of certain equity offerings at a redemption price of 105.125%, plus accrued and unpaid interest, if any, to the applicable redemption date.
	The indenture governing the 2022 Notes contains covenants that, among other things, limit the Company's ability and the ability of its restricted subsidiaries to: incur additional indebtedness or issue certain preferred shares; pay dividends on, redeem or repurchase stock or make other distributions in respect of its capital stock; repurchase, prepay or redeem subordinated indebtedness; make investments; create restrictions on the ability of the Company's restricted subsidiaries to pay dividends to the Company or make other intercompany transfers; create liens; transfer or sell assets; consolidate, merge or sell or otherwise dispose of all or substantially all of its assets; enter into certain transactions with affiliates; and designate subsidiaries as unrestricted subsidiaries. Upon the occurrence of certain events constituting a change of control, the Company is required to make an offer to repurchase all of the 2022 Notes (unless otherwise redeemed) at a purchase price equal to 101% of their principal amount, plus accrued and unpaid interest, if any to the repurchase date. If the Company sells assets under certain circumstances, it must use the proceeds to make an offer to purchase the 2022 Notes at a price equal to 100% of their principal amount, plus accrued and unpaid interest, if any, to the date of purchase.
	Long-term debt and capital leases consisted of the following (in thousands):

		December 31,			December 31,
		2014			2013
	Senior unsecured notes due 2019	$	—		$	607,750
	Senior unsecured notes due 2022		750,000			—
	Senior secured term loan due 2018 (4.00% as of December 31, 2014 and 2013)		1,289,575			1,302,945
	Discount on senior secured term loan		(3,317	)		(4,217	)
	ABL Facility		—			—
	Notes due at various dates from 2015 to 2022 with interest rates from 6% to 10%		482			852
	Capital lease obligations due at various dates from 2015 to 2018		1,486			369

	Total		2,038,226			1,907,699
	Less current portion		(12,349	)		(12,318	)

	Total long-term debt and capital lease obligations	$	2,025,877		$	1,895,381



	The aggregate amount of minimum payments required on long-term debt and capital lease obligations (see Note 18) in each of the years indicated is shown in the table below. The $3.3 million difference between total payments shown below and the total outstanding debt is due to certain fees paid by the Company which have been classified as a reduction in the principal balance and are being amortized over the term of the related debt instruments.

	Year ending December 31, (in thousands)
	2015	$	13,850
	2016		13,883
	2017		13,999
	2018		1,249,539
	2019		64
	Thereafter		750,208

		$	2,041,543

Derivative_Instruments_and_Hed

Derivative Instruments and Hedging Activities	12 Months Ended
Derivative Instruments and Hedging Activities	Dec. 31, 2014
Derivative Instruments and Hedging Activities
Derivative Instruments and Hedging Activities	12. Derivative Instruments and Hedging Activities
	The Company manages its exposure to changes in market interest rates and fuel prices and from time to time uses highly effective derivative instruments to manage well-defined risk exposures. The Company monitors its positions and the credit ratings of its counterparties and does not anticipate non-performance by the counterparties. The Company does not use derivative instruments for speculative purposes.
	At December 31, 2014, the Company was party to a series of fuel hedge transactions with a major financial institution under one master agreement. Each of the transactions effectively fixes the cost of diesel fuel at prices ranging from $3.30 to $3.58 per gallon. The Company purchases the diesel fuel at the market rate and periodically settles with its counterparty for the difference between the national average price for the period published by the Department of Energy and the agreed upon fixed price. The transactions fix the price for a total of 3.0 million gallons, which represents approximately 11.1% of the Company's total estimated usage during the periods hedged, through December 2016. The Company recorded, as a component of other comprehensive income (loss) before applicable tax impacts, a liability associated with the fair value of the fuel hedge in the amount of $1.4 million and an asset of $0.7 million as of December 31, 2014 and 2013, respectively. Over the next 12 months, the Company expects to reclassify $0.7 million of deferred loss from accumulated other comprehensive income (loss) as the related fuel hedge transactions mature. Settlement of hedge agreements are included in operating expenses and resulted in net payments to the counterparty of $0.3 million, and net receipts from the counterparty of $0.5 million and $1.0 million for the years ended December 31, 2014, 2013 and 2012, respectively.
	In October 2011, the Company entered into interest rate swap agreements that mature on August 31, 2015. The swap agreements are with major financial institutions and effectively convert a total of $400 million in variable rate debt to fixed rate debt with an effective rate of 4.49%. The Company continues to make interest payments based on the variable rate associated with the debt (based on LIBOR, but not less than 1.0%) and periodically settles with its counterparties for the difference between the rate paid and the fixed rate. The Company recorded, as a component of other comprehensive income (loss) before applicable tax impacts, a liability associated with the fair value of the interest rate swap in the amount of $1.5 million and $3.1 million as of December 31, 2014 and 2013, respectively. Over the next 12 months, the Company expects to reclassify $1.5 million of deferred loss from accumulated other comprehensive income (loss) to interest expense as the related interest rate swap transactions mature. Settlement of interest rate swap agreements are included in interest expense and resulted in net payments to the counterparties of $2.0 million, $2.0 million and $0.5 million for the years ended December 31, 2014, 2013 and 2012, respectively.

Changes_in_Accumulated_Other_C

Changes in Accumulated Other Comprehensive Income (Loss) by Component	12 Months Ended
	Dec. 31, 2014
Changes in Accumulated Other Comprehensive Income (Loss) by Component
Changes in Accumulated Other Comprehensive Income (Loss) by Component	13. Changes in Accumulated Other Comprehensive Income (Loss) by Component
	The following table summarizes the changes in the Company's AOCI by component for the year ended December 31, 2014 and 2013 (in thousands). All amounts are after tax.

		Fuel hedge			Interest			Unrealized			Total
					rate swap			holding gains on
								available-for-sale
								securities
	Balance as of January 1, 2013	$	1,057		$	(2,861	)	$	1,591		$	(213	)
	Other comprehensive income (loss) before reclassifications		(396	)		(336	)		(598	)		(1,330	)
	Amounts reclassified from accumulated other comprehensive income (loss)		(241	)		1,239			(294	)		704

	Net current-period other comprehensive income (loss)		(637	)		903			(892	)		(626	)

	Balance as of December 31, 2013		420			(1,958	)		699			(839	)
	Other comprehensive income (loss) before reclassifications		(1,130	)		(216	)		(491	)		(1,837	)
	Amounts reclassified from accumulated other comprehensive income (loss)		(187	)		1,239			(232	)		820

	Net current-period other comprehensive income (loss)		(1,317	)		1,023			(723	)		(1,017	)

	Balance as of December 31, 2014	$	(897	)	$	(935	)	$	(24	)	$	(1,856	)



	The following table shows the line item on the Consolidated Statements of Operations affected by reclassifications out of AOCI (in thousands):

		Amount reclassified
		from AOCI
		Year ended
		December 31,
	Details about AOCI components	2014			2013			Statements of Operations
	Gains and losses on cash flow hedges
	Fuel hedge	$	300		$	386		Operating expenses
	Interest rate swap		(1,986	)		(1,986	)	Interest expense, net

			(1,686	)		(1,600	)	Total before tax
			634			602		Tax benefit (expense)

		$	(1,052	)	$	(998	)	Net of tax


	Unrealized holding gains on available-for-sale securities	$	371		$	471		Realized gains (losses) on investments

			371			471		Total before tax
			(139	)		(177	)	Tax benefit (expense)

		$	232		$	294		Net of tax

Equity

Equity	12 Months Ended
	Dec. 31, 2014
Equity
Equity	14. Equity
	Equity Structure and Initial Public Offering
	On August 19, 2013, the Company completed its initial public offering of 42,000,000 shares of Common Stock and an additional 6,300,000 shares of Common Stock, at a price of $23 per share, for an aggregate offering price of $1,110.9 million. The Company received net proceeds of approximately $1,025.9 million, after deducting the underwriters' discounts and commissions paid and offering expenses of approximately $85.0 million, including a $20.0 million payment to CD&R in connection with the termination of the consulting agreement with CD&R ("Consulting Agreement") which was recorded to "Selling, general and administrative expenses" in the accompanying consolidated statements of operations as of December 31, 2013, see Note 19.
	Net proceeds from the initial public offering were used to (i) redeem in full Holding's PIK Notes for a total of $479.6 million, which included a call premium pursuant to the indenture governing the PIK Notes and all accrued but unpaid interest, (ii) pay CD&R the fee of $20.0 million to terminate the Consulting Agreement, (iii) pay $16.5 million to repay all outstanding revolving credit facility borrowings, and (iv) redeem $332.5 million of aggregate principal amount of the 2019 Notes of which $5.2 million was held by the Company's captive insurance subsidiary for a total of $356.5 million, which included a call premium pursuant to the indenture governing the 2019 Notes and all accrued but unpaid interest. The remaining proceeds were used for general corporate purposes including, among other things, repayment of indebtedness and acquisitions.
	On each of February 5, 2014 and July 10, 2014, the Company registered the offering and sale of 27,500,000 shares of Common Stock, respectively, and an additional 4,125,000 shares of Common Stock upon the underwriters' exercise of their overallotment option in each offering, which were sold by certain stockholders of the Company, including the CD&R Affiliates, to the underwriters at $30.50 per share and $34.00 per share, respectively, less the underwriting discount. Additionally, on September 30, 2014, the Company registered the offering and sale of 17,500,000 shares of Common Stock by certain stockholders of the Company, including the CD&R Affiliates, to the underwriters at $34.97 per share.
	The underwriters in these selling stockholder transactions offered the shares to the public from time to time at prevailing market prices or at negotiated prices. The Company did not receive any of the proceeds from the sale of the shares sold by the selling stockholders in these transactions, including any shares sold pursuant to any exercise of the underwriters' overallotment option.
	Common Stock
	Holders of Common Stock are entitled:
	•	To cast one vote for each share held of record on all matters submitted to a vote of the stockholders;
	•	To receive, on a pro rata basis, dividends and distributions, if any, that the Board of Directors may declare out of legally available funds, subject to preferences that may be applicable to preferred stock, if any, then outstanding; and
	•	Upon the Company's liquidation, dissolution or winding up, to share equally and ratably in any assets remaining after the payment of all debt and other liabilities, subject to the prior rights, if any, of holders of any outstanding shares of preferred stock.
	The Company's ability to pay dividends on its Common Stock is subject to its subsidiaries' ability to pay dividends, which is in turn subject to the restrictions set forth in the Senior Secured Credit Facilities and the indentures governing the 2019 Notes and 2022 Notes.
	Preferred Stock
	Under the Company's amended and restated certificate of incorporation, the Company's Board of Directors has the authority, without further action by its stockholders, to issue up to 200,000,000 shares of preferred stock in one or more series and to fix the voting powers, designations, preferences and the relative participating, optional or other special rights and qualifications, limitations and restrictions of each series, including dividend rights, dividend rates, conversion rights, voting rights, terms of redemption, liquidation preferences and the number of shares constituting any series.

Restructuring_Charges

Restructuring Charges	12 Months Ended
Restructuring Charges	Dec. 31, 2014
Restructuring
Restructuring	15. Restructuring
	The Company recorded restructuring charges of $7.0 million, $5.7 million and $14.1 million during the years ended December 31, 2014, 2013 and 2012, respectively, related to continuing efforts to re-align AMR's operations and billing functions. Payments currently under this plan are expected to be complete by March 2015.

		AMR
		Lease and						EmCare			EVHC
		other contract
		termination
		costs			Severance			Severance			Severance			Total
								(in thousands)
	Balance as of January 1, 2013	$	8,122		$	3,015		$	773		$	408		$	12,318
	Incurred		1,876			2,890			913			20			5,699
	Paid		(6,989	)		(3,765	)		(1,204	)		(377	)		(12,335	)

	Balance as of December 31, 2013	$	3,009		$	2,140		$	482		$	51		$	5,682
	Incurred		3,153			2,779			1,036			—			6,968
	Paid		(615	)		(2,278	)		(1,330	)		(51	)		(4,274	)

	Balance as of December 31, 2014	$	5,547		$	2,641		$	188		$	—		$	8,376

Retirement_Plans_and_Employee_

Retirement Plans and Employee Benefits	12 Months Ended
Retirement Plans and Employee Benefits	Dec. 31, 2014
Retirement Plans and Employee Benefits
Retirement Plans and Employee Benefits	16. Retirement Plans and Employee Benefits
	The Company maintains two 401(k) plans (the "401(k) Plans") and a money purchase plan, collectively "the Plans", for its employees and employees of certain subsidiaries who meet the eligibility requirements set forth in the Plans. The money purchase plan is frozen to new participants. Employees may contribute a maximum of 40% of their compensation each year up to the annual limit established by the Internal Revenue Service ($17,500 in 2014). The 401(k) Plans provide a 50% match on up to 6% of eligible compensation.
	The Company's contributions to the Plans were $12.9 million, $9.3 million and $12.3 million for the years ended December 31, 2014, 2013 and 2012, respectively. Contributions are included in compensation and benefits in the accompanying consolidated statements of operations.
	EmCare serves as Plan Administrator on a qualified retirement plan established in March 1998 called the Associated Physicians' Retirement Plan (the "Plan"). This plan provides retirement benefits to employed physicians and clinicians in the professional corporations that have adopted this multiple employer plan. Eligible employees may immediately elect to contribute 1% to 25% of their annual compensation on a tax-deferred basis subject to limits established by the Internal Revenue Service through the 401(k) component of the Plan. The Plan also has a separate component that allows participants the ability to make a one-time irrevocable election to reduce their annual compensation up to 20% in exchange for a contribution made to their retirement account from their respective employer company. Total contributions from the subscribing employers were $2.9 million, $2.0 million and $2.5 million for the years ended December 31, 2014, 2013 and 2012, respectively.

Equity_Based_Compensation

Equity Based Compensation	12 Months Ended
Equity Based Compensation	Dec. 31, 2014
Equity Based Compensation
Equity Based Compensation	17. Equity Based Compensation
	Omnibus Incentive Plan
	Upon completion of the Company's initial public offering, the previous stock compensation plan ("Stock Compensation Plan") terminated and the Envision Healthcare Holdings, Inc. 2013 Omnibus Incentive Plan ("Omnibus Incentive Plan") was adopted pursuant to which options and awards with respect to a total of 16,708,289 shares of Common Stock are available for grant. As of December 31, 2014, a total of 16,534,218 shares remained available for grant under the Omnibus Incentive Plan. Awards under the Omnibus Incentive Plan include both performance and non-performance based awards. As of December 31, 2014, no grants of performance based awards under the Omnibus Incentive Plan had been made. Options are granted with exercise prices equal to the fair value of the Company's common stock at the date of grant. No participant may be granted in any calendar year awards covering more than 2.5 million shares of Common Stock or 1.5 million performance awards up to a maximum dollar value of $5.0 million. Non-performance based awards have time-based vesting and performance-based awards vest upon achievement of certain company-wide objectives. All options have 10 year terms.
	Stock Compensation Plan
	Awards previously granted under the Stock Compensation Plan were unaffected by the termination of the Stock Compensation Plan; however no future grants will be made under the Stock Compensation Plan.
	Management of Corporation was allowed to rollover stock options they held prior to the Merger into fully vested options of the Company. Additionally, the Company established a stock compensation plan after the Merger whereby certain members of management, officers, and directors were awarded stock options in the Company. These options have a $3.69 strike price, which was reduced from the original strike price of $6.88 in connection with a dividend paid by the Company in October 2012. They vest ratably through December 2015 and have a maximum term of 10 years.
	Equity Based Compensation
	A compensation charge of $5.1 million, $4.2 million and $4.2 million was recorded for shares vested during the years ended December 31, 2014, 2013 and 2012, respectively, in "Selling, general and administrative expenses" included in the accompanying consolidated statements of operations.
	The Company realized approximately $46.2 million of tax benefits from stock awards exercised during the year ended December 31, 2014 and less than $1.0 million of tax benefits from stock awards exercised during each of the years ended December 31, 2013 and 2012.
	Equity Award Activity
	Stock option activity for the year ended December 31, 2014 was as follows (in thousands):

		Class A			Weighted		Aggregate		Weighted
		Shares			Average		Intrinsic Value		Average
					Exercise				Remaining Life
					Price
	Outstanding at beginning of year		16,322,148		$	3.7	$	519,325		6.6 years
	Granted		34,304		$	33.25
	Exercised		(3,855,797	)	$	2.64
	Forfeited		(125,757	)	$	6.31

	Outstanding at end of year		12,374,898		$	4.1	$	378,574		6.3 years


	Exercisable at end of year		9,625,258		$	3.93	$	296,038		6.1 years



	In August 2011, the non-employee directors of the Company, other than the Chairman of the Board, were given the option to defer a portion of their director fees and receive it in the form of restricted stock units ("RSUs"). These RSUs are fully vested when granted. All other grants of RSUs have time based vesting.
	The Company granted 45,370 RSUs during the year ended December 31, 2014 with a weighted average market price of $33.32. The Company granted 23,623 RSUs during the year ended December 31, 2013 with a weighted average market price of $7.39. The Company granted 19,004 RSUs during the year ended December 31, 2012 with a weighted average market price of $6.64.
	Valuation
	The fair value of each stock option award is estimated on the grant date, using the Black-Scholes valuation model with the following assumptions indicated in the below table. The volatility assumptions were based on the historical stock volatility of the Company, the stock volatility of publicly traded peer companies and in consultation with a valuation specialist.

		2014		2013		2012
	Volatility	35%		30% - 35%		30%
	Risk free rate	0.33% - 2.17%		0.67% - 1.56%		0.2% - 0.82%
	Expected dividend yield	0%		0%		0%
	Expected term of options in years	6.3 - 7.0		5		2.0 - 5.0
	The weighted average fair values of stock options granted during 2014 and 2013 were $11.03 and $2.44 per share, respectively. The total intrinsic value of stock options exercised during the years ended December 31, 2014 and 2013 was $115.0 million and $9.4 million, respectively.
	As of December 31, 2014, total unrecognized compensation cost related to unvested stock awards was $5.1 million which will be recognized over the weighted average remaining vesting life of approximately 1.1 years.

Commitments_and_Contingencies

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2014
Commitments and Contingencies
Commitments and Contingencies	18. Commitments and Contingencies
	Lease Commitments
	The Company leases various facilities and equipment under operating lease agreements. Rental expense incurred under these leases was $45.7 million, $44.8 million and $42.9 million for the years ended December 31, 2014, 2013 and 2012, respectively.
	The Company also records certain leasehold improvements under capital leases. Assets under capital leases are capitalized using inherent interest rates at the inception of each lease. Capital leases are collateralized by the underlying assets.
	Future commitments under non-cancelable capital and operating leases for premises, equipment and other recurring commitments are as follows (in thousands):

		Capital			Operating
		Leases			Leases &
					Other
	Year ending December 31,
	2015	$	519		$	63,676
	2016		519			41,897
	2017		589			38,385
	2018		19			31,510
	2019		—			21,155
	Thereafter		—			40,716

			1,646		$	237,339


	Less imputed interest		(160	)

	Total capital lease obligations		1,486
	Less current portion		(433	)

	Long-term capital lease obligations	$	1,053



	Services
	The Company is subject to the Medicare and Medicaid fraud and abuse laws which prohibit, among other things, any false claims, or any bribe, kickback or rebate in return for the referral of Medicare and Medicaid patients. Violation of these prohibitions may result in civil and criminal penalties and exclusion from participation in the Medicare and Medicaid programs. Management has implemented policies and procedures that management believes will assure that the Company is in substantial compliance with these laws and regulations but there can be no assurance the Company will not be found to have violated certain of these laws and regulations. From time to time, the Company receives requests for information from government agencies pursuant to their regulatory or investigational authority. Such requests can include subpoenas or demand letters for documents to assist the government agencies in audits or investigations. The Company is cooperating with the government agencies conducting these investigations and is providing requested information to the government agencies. Other than the proceedings described below, management believes that the outcome of any of these investigations would not have a material adverse effect on the Company.
	Like other ambulance companies, AMR has provided discounts to its healthcare facility customers (nursing homes and hospitals) in certain circumstances. The Company has attempted to comply with applicable law where such discounts are provided. During the first quarter of fiscal 2004, the Company was advised by the U.S. Department of Justice ("DOJ") that it was investigating certain business practices at AMR. The specific practices at issue were (i) whether ambulance transports involving Medicare eligible patients complied with the "medical necessity" requirement imposed by Medicare regulations, (ii) whether patient signatures, when required, were properly obtained from Medicare eligible patients, and (iii) whether discounts in violation of the federal Anti-Kickback Statute were provided by AMR in exchange for referrals involving Medicare eligible patients. In connection with the third issue, the government alleged that certain of AMR's hospital and nursing home contracts in effect in Texas in periods prior to 2002 contained discounts in violation of the federal Anti-Kickback Statute. The Company negotiated a settlement with the government pursuant to which the Company paid $9 million and obtained a release of all claims related to such conduct alleged to have occurred in Texas in periods prior to 2002. In connection with the settlement, AMR entered into a Corporate Integrity Agreement ("CIA") which was effective for a period of five years beginning September 12, 2006, and which was released in February 2012.
	In July 2011, AMR received a subpoena from the Civil Division of the U.S. Attorney's Office for the Central District of California ("USAO") seeking certain documents concerning AMR's provision of ambulance services within the City of Riverside, California. The USAO indicated that it, together with the OIG, was investigating whether AMR violated the federal False Claims Act and/or the federal Anti-Kickback Statute in connection with AMR's provision of ambulance transport services within the City of Riverside. The California Attorney General's Office conducted a parallel state investigation for possible violations of the California False Claims Act. In December 2012, AMR was notified that both investigations were concluded and that the agencies had closed the matter. There were no findings made against AMR, and the closure of the matter did not require any payments from AMR.
	Letters of Credit
	As of December 31, 2014 and 2013, the Company had $112.3 million and $132.5 million, respectively, in outstanding letters of credit.
	Other Legal Matters
	In December 2006, AMR received a subpoena from the U.S. Department of Justice ("DOJ"). The subpoena requested copies of documents for the period from January 2000 through the present. The subpoena required AMR to produce a broad range of documents relating to the operations of certain AMR affiliates in New York. The Company produced documents responsive to the subpoena. The government identified claims for reimbursement that the government believes lack support for the level billed, and invited the Company to respond to the identified areas of concern. The Company reviewed the information provided by the government and provided its response. On May 20, 2011, AMR entered into a settlement agreement with the DOJ and a Corporate Integrity Agreement ("CIA") with the Office of Inspector General of the Department of Health and Human Services ("OIG") in connection with this matter. Under the terms of the settlement, AMR paid $2.7 million to the federal government. In connection with the settlement, the Company entered into a CIA with a five-year period beginning May 20, 2011. Pursuant to this CIA, the Company is required to maintain a compliance program, which includes, among other elements, the appointment of a compliance officer and committee, training of employees nationwide, safeguards for its billing operations as they relate to services provided in New York, including specific training for operations and billing personnel providing services in New York, review by an independent review organization and reporting of certain reportable events. The Company entered into the settlement in order to avoid the uncertainties of litigation, and has not admitted any wrongdoing. In May 2013, a subsidiary of the Company entered into an agreement to divest substantially all the assets underlying AMR's services in New York, although the obligations of the Company's compliance program will remain in effect following the expected divestiture. The divesture was completed on July 1, 2013.
	Four different putative class action lawsuits have been filed against AMR and certain subsidiaries in California alleging violations of California wage and hour laws. On April 16, 2008, Laura Bartoni commenced a suit in the Superior Court for the State of California, County of Alameda; on July 8, 2008, Vaughn Banta filed suit in the Superior Court of the State of California, County of Los Angeles; on January 22, 2009, Laura Karapetian filed suit in the Superior Court of the State of California, County of Los Angeles: and on March 11, 2010, Melanie Aguilar filed suit in Superior Court of the State of California, County of Los Angeles. The Banta, Aguilar and Karapetian cases have been coordinated in the Superior Court for the State of California, County of Los Angeles, and the Aguilar and Karapetian cases have subsequently been consolidated into a single action. In these cases, the plaintiffs allege principally that the AMR entities failed to pay wages, including overtime wages, in compliance with California law, and failed to provide required meal breaks, rest breaks or pay premium compensation for missed breaks. The plaintiffs are seeking to certify classes on these claims and are seeking lost wages, various penalties, and attorneys' fees under California law. The Court has certified classes in the consolidated Karapetian /Aguilar case on claims alleging that AMR has not provided meal periods in compliance with the law as to dispatchers and call takers, that AMR has an unlawful time round policy, and that AMR has an unlawful practice of setting rates for those employees; the Court denied certification of the rest period claims of these employees. In Banta, the Court denied certification of the meal and rest period claims as to EMTs and paramedics, a decision that is being appealed; the Court indicated that it would certify a class on overtime claims, but plaintiff's counsel have indicated that they intend to dismiss that claim as AMR's policy complies with a recent Court of Appeals decision. In Bartoni, the Court denied certification on the meal and rest period claims of all unionized employees in Northern California, a decision that is being appealed. While the Court certified a class on the overtime claims, plaintiffs' counsel stipulated to decertify and dismiss those claims as AMR's policy complies with a recent Court of Appeals decision. The Company is unable at this time to estimate the amount of potential damages, if any.
	Merion Capital, L.P. ("Merion"), a former stockholder of Corporation, filed an action in the Delaware Court of Chancery seeking to exercise its right to appraisal of its holdings in Corporation prior to the Merger. During the year ended December 31, 2013, the Company expensed $8.4 million of legal settlement costs and $1.9 million of interest. On April 15, 2013, the Company paid $52.1 million in a settlement of Merion's appraisal action, in which Merion agreed to release its claims against the Company. $13.7 million of this payment is included in cash flows from operations and $38.3 million is included in cash flows from financing activities on the statements of cash flows for the year ended December 31, 2013.
	On August 7, 2012, EmCare received a subpoena from the OIG requesting copies of documents for the period from January 1, 2007 through the present that appears to primarily be focused on EmCare's contracts for services at hospitals that are affiliated with Health Management Associates, Inc. ("HMA"). The Company has been cooperating with the government during its investigation and, as such, continues to gather responsive documents. During the months of December 2013 and January 2014, several lawsuits filed by whistleblowers on behalf of the federal and certain state governments against HMA have been unsealed; the Company is a named defendant in two of these lawsuits. Although the federal government intervened in these lawsuits in connection with certain of the allegations against HMA, the federal government has not, at this time, disclosed whether it will intervene in these matters as they relate to the Company. The Company continues to engage in meaningful dialogue with the relevant government representatives and, at this time, the Company is unable to determine the potential impact, if any, that will result from this investigation.
	On February 5, 2013, Air Ambulance Specialists, Inc. received a subpoena from the Federal Aviation Administration ("FAA") relating to its operations as an indirect air carrier and its relationships with Part 135 direct air carriers. The Company cooperated with the government during its investigation, providing written responses to the subpoena and engaging in dialogue with the relevant government representatives. The Company believes this investigation has been concluded by the FAA.
	On February 14, 2013, EmCare received a subpoena from the OIG requesting documents and other information relating to EmCare's relationship with Community Health Services, Inc. ("CHS"). The Company is cooperating with the government during its investigation, has provided responsive documents, and is engaged in a meaningful dialogue with the relevant government representatives regarding additional requests. At this time, the Company is unable to determine the potential impact, if any, that will result from these investigations.
	In November 2013, AMR received a subpoena from the New Hampshire Department of Insurance (the "Department") directed to American Medical Response of Massachusetts, Inc. The subpoena requested documents relating to ambulance services provided to approximately 150 patients residing in the state of New Hampshire who had been involved in motor vehicle accidents and who were ultimately transported by AMR. In addition, the subpoena requested information relating to any agreements for reimbursement between AMR and Progressive Insurance. The Company cooperated with the Department during its investigation and, in March 2014, it was notified that the investigation was concluded and closed without further action by the Department.
	The Company is involved in other litigation arising in the ordinary course of business. Management believes the outcome of these legal proceedings will not have a material adverse impact on its financial condition, results of operations or liquidity.

Related_Party_Transactions

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2014
Related Party Transactions
Related Party Transactions	19. Related Party Transactions
	CD&R Affiliates
	Stockholders Agreement
	In connection with the Company's initial public offering, the Company entered into a stockholders agreement ("Stockholders Agreement") with CD&R Affiliates. Under the Stockholders Agreement, CD&R Affiliates were granted the right to designate for nomination for election a number of CD&R-designated directors equal to: (i) at least a majority of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 50% of the outstanding shares of Common Stock, (ii) at least 40% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 40% but less than 50% of the outstanding shares of Common Stock, (iii) at least 30% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 30% but less than 40% of the outstanding shares of Common Stock, (iv) at least 20% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 20% but less than 30% of the outstanding shares of Common Stock, and (v) at least 5% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 5% but less than 20% of the outstanding shares of Common Stock. Additionally, a CD&R-designated director will serve as the Chairman of the board of directors as long as the CD&R Affiliates own at least 30% of the outstanding shares of Common Stock. As of December 31, 2014, the CD&R Affiliates owned approximately 27.7% of the outstanding shares of Common Stock.
	Registration Rights Agreement
	In connection with the closing of the Merger, the Company entered into a registration rights agreement ("Registration Rights Agreement") with the CD&R Affiliates which grants the CD&R Affiliates specified demand and piggyback registration rights with respect to the Company's Common Stock. Under the Registration Rights Agreement, if the Company registers Common Stock under the Securities Act of 1933, as amended (the "Securities Act"), holders of the Common Stock, including CD&R Affiliates, have the right to require the Company's to use reasonable best efforts to include in the Company's registration statement shares of Common Stock held by them, subject to certain limitations and at the expense of the Company.
	Indemnification Agreements
	In connection with the closing of the Merger, the Company entered into separate indemnification agreements with CD&R and CD&R Affiliates (the "CD&R Entities"). Under the indemnification agreement with the CD&R Entities, Holding and the Company, subject to certain limitations, jointly and severally agreed to indemnify the CD&R Entities and certain of their affiliates against certain liabilities arising out of performance of the Consulting Agreement and certain other claims and liabilities.
	Other
	On November 25, 2008, the Company entered into a corporate account agreement with The Hertz Corporation pursuant to which it agreed to spend a minimum total amount of $460,000 per year for the rental of cars from The Hertz Corporation and its subsidiaries and licensees. For the years ended December 31, 2014 and 2013, the Company spent less than $1.0 million under this contract. The agreement had an initial one-year term, and renews automatically until terminated by either party. Investment funds associated with CD&R had been affiliated with Hertz Global Holdings.
	Other Transactions
	In connection with the closing of the Merger, Holding and Corporation entered into separate indemnification agreements with each of Richard J. Schnall, Ronald A. Williams, William A. Sanger, and Kenneth A. Giuriceo as the directors of Holding and Corporation. Under the indemnification agreements with the directors of Holding and Corporation, Holding and Corporation, subject to certain limitations, jointly and severally agreed to indemnify the directors against certain liabilities arising out of service as a director.
	The executive employment agreements include indemnification provisions whereby the Company agrees to indemnify each of these individuals against claims arising out of events or occurrences related to that individual's service as the Company's agent or the agent of any of its subsidiaries to the fullest extent legally permitted.
	In connection with the Company's initial public offering, the Company entered into new indemnification agreements with each of its directors. On November 11, 2013, the Company entered into an indemnification agreement with Mark V. Mactas. Under these agreements, the Company agrees to indemnify each of these individuals against claims arising out of events or occurrences related to that individual's service as the Company's agent or the agent of any of its subsidiaries to the fullest extent legally permitted.

Variable_Interest_Entities

Variable Interest Entities	12 Months Ended
	Dec. 31, 2014
Variable Interest Entities
Variable Interest Entities	20. Variable Interest Entities
	GAAP requires the assets, liabilities, noncontrolling interests and activities of Variable Interest Entities ("VIEs") to be consolidated if an entity's interest in the VIE has specific characteristics including: voting rights not proportional to ownership and the right to receive a majority of expected income or absorb a majority of expected losses. In addition, the entity exposed to the majority of the risks and rewards associated with the VIE is deemed its primary beneficiary and must consolidate the entity.
	UHS-EmCare JV
	EmCare entered into an agreement in 2014 with Universal Health Services, Inc. to form an entity which would provide physician services to various healthcare facilities ("UHS-EmCare JV"). UHS-EmCare JV began providing services to healthcare facilities during the second quarter of 2014 and meets the definition of a VIE. The Company determined that, although EmCare holds 50% voting control, EmCare is the primary beneficiary and must consolidate this VIE because:
	•	EmCare provides management services to UHS-EmCare JV including recruiting, credentialing, scheduling, billing, payroll, accounting and other various administrative services and therefore substantially all of UHS-EmCare JV's activities involve EmCare; and
	•	as payment for management services, EmCare is entitled to receive a variable management fee from UHS-EmCare JV.
	The following table summarizes the UHS-EmCare JV assets and liabilities as of December 31, 2014, which are included in the Company's consolidated financial statements (in thousands):

			December 31,
			2014
	Current assets		$	21,427
	Current liabilities			6,748
	During the year ended December 31, 2014, cash contributions of $0.3 million were made to UHS-EmCare JV by each of the parties for working capital requirements.
	HCA-EmCare JV
	EmCare entered into an agreement in 2011 with an indirect wholly-owned subsidiary of HCA Holdings Inc. to form an entity which would provide physician services to various healthcare facilities ("HCA-EmCare JV"). HCA-EmCare JV began providing services to healthcare facilities during the first quarter of 2012 and meets the definition of a VIE. The Company determined that, although EmCare only holds 50% voting control, EmCare is the primary beneficiary and must consolidate this VIE because:
	•	EmCare provides management services to HCA-EmCare JV including recruiting, credentialing, scheduling, billing, payroll, accounting and other various administrative services and therefore substantially all of HCA-EmCare JV's activities involve EmCare; and
	•	as payment for management services, EmCare is entitled to receive a base management fee from HCA-EmCare JV as well as a bonus management fee.
	The following is a summary of the HCA-EmCare JV assets and liabilities as of December 31, 2014 and 2013, which are included in the Company's consolidated financial statements (in thousands).

			December 31,		December 31,
			2014		2013
	Current assets		$	155,041	$	88,479
	Current liabilities			31,163		22,005
	During the year ended December 31, 2014, 2013, and 2012, cash contributions of $1.0 million, $3.0 million, and $6.5 million, respectively, were made to HCA-EmCare JV by each of the parties for working capital requirements.

Insurance

Insurance	12 Months Ended
Insurance	Dec. 31, 2014
Insurance
Insurance	21. Insurance
	Insurance reserves are established for automobile, workers compensation, general liability and professional liability claims utilizing policies with both fully- insured and self-insured components. This includes the use of an off- shore captive insurance program through a wholly-owned subsidiary for certain professional (medical malpractice), auto, workers' compensation and general liability programs for both EmCare and AMR. In those instances where the Company has obtained third-party insurance coverage, the Company normally retains liability for the first $1 to $3 million of the loss. Insurance reserves cover known claims and incidents within the level of Company retention that may result in the assertion of additional claims, as well as claims from unknown incidents that may be asserted arising from activities through December 31, 2014.
	The Company establishes reserves for claims based upon an assessment of claims reported and claims incurred but not reported. The reserves are established based on consultation with third-party independent actuaries using actuarial principles and assumptions that consider a number of factors, including historical claim payment patterns (including legal costs) and changes in case reserves and the assumed rate of inflation in health care costs and property damage repairs. Claims, other than general liability claims, are discounted at a rate of 1.5%. General liability claims are not discounted.
	Provisions for insurance expense included in the statements of operations include annual provisions determined in consultation with third-party actuaries and premiums paid to third-party insurers.
	The table below summarizes the non-health and welfare insurance reserves included in the accompanying balance sheets (in thousands):

		Accrued			Insurance			Total
		Liabilities			Reserves			Liabilities
	December 31, 2014
	Automobile	$	7,469		$	6,230		$	13,699
	Workers compensation		18,299			30,826			49,125
	General/Professional liability		48,444			143,583			192,027

		$	74,212		$	180,639		$	254,851
	December 31, 2013
	December 31, 2013
	Automobile	$	7,034		$	5,779		$	12,813
	Workers compensation		21,876			32,097			53,973
	General/Professional liability		44,828			137,551			182,379

		$	73,738		$	175,427		$	249,165



	The changes to the Company's estimated losses under self-insured programs were as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
	Balance, beginning of period	$	249,165		$	238,597		$	247,872
	Expense for current period reserves		62,836			74,501			77,003
	Unfavorable (favorable) changes to prior reserves		7,539			9,141			(2,480	)
	Changes in losses covered by commercial insurance programs		17,532			—			(9,185	)
	Increase in reserves from acquisitions		18,217			—			—
	Payments for claims		(100,438	)		(73,074	)		(74,613	)

	Balance, end of period		254,851			249,165			238,597
	Discount factor		7,045			8,418			8,485

	Undiscounted reserve, end of period	$	261,896		$	257,583		$	247,082



	The following table reflects a summary of expected future claim payments relating to non-health and welfare insurance reserves (in thousands):

	Year	Amount
	2015	$	74,212
	2016		58,942
	2017		41,294
	2018		28,497
	2019		16,915
	Thereafter		34,991

	Total	$	254,851

Segment_Information

Segment Information	12 Months Ended
Segment Information	Dec. 31, 2014
Segment Information
Segment Information	22. Segment Information
	The Company is organized around two separately managed business units: facility- based physician services and healthcare transportation services, which have been identified as operating segments. The facility-based physician services reportable segment provides physician services to hospitals primarily for emergency department, anesthesiology, hospitalist/inpatient, radiology, teleradiology and surgery services. It also offers physician-led care management solutions outside the hospital. The healthcare transportation services reportable segment focuses on providing a full range of healthcare transportation services from basic patient transit to the most advanced emergency care and pre-hospital assistance. The Chief Executive Officer has been identified as the chief operating decision maker ("CODM") as he assesses the performance of the business units and decides how to allocate resources to the business units.
	Net income (loss) before equity in earnings of unconsolidated subsidiary, income tax benefit (expense), loss on early debt extinguishment, other income (expense), net, realized gains (losses) on investments, interest expense, net, equity-based compensation expense, transaction costs related to acquisition activity, related party management fees, restructuring charges, adjustment to net (income) loss attributable to noncontrolling interest due to deferred taxes, and depreciation and amortization expense ("Adjusted EBITDA") is the measure of profit and loss that the CODM uses to assess performance and make decisions. Adjusted EBITDA is not considered a measure of financial performance under GAAP and the items excluded from Adjusted EBITDA are significant components in understanding and assessing the Company's financial performance. Adjusted EBITDA should not be considered in isolation or as an alternative to such GAAP measures as net income, cash flows provided by or used in operating, investing or financing activities or other financial statement data presented in the Company's financial statements as an indicator of financial performance. Since Adjusted EBITDA is not a measure determined to be in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. Pre-tax income from continuing operations represents net revenue less direct operating expenses incurred within the operating segments. The accounting policies for reported segments are the same as for the Company as a whole (see Note 2).
	The Company's operating segment results were as follows (in thousands):

			Year ended December 31,
			2014			2013			2012
	Facility-Based Physician Services
	Net revenue		$	2,842,458		$	2,358,787		$	1,915,148
	Income from operations			282,495			219,842			199,300
	Adjusted EBITDA			363,333			294,033			260,657
	Goodwill			1,679,495			1,574,882			1,555,924
	Intangible Assets, net			365,094			370,897			407,184
	Total identifiable assets			2,884,250			2,624,161			2,468,605
	Capital expenditures			15,480			8,215			12,229
	Healthcare Transportation Services
	Healthcare Transportation Services
	Net revenue		$	1,555,186		$	1,369,525		$	1,384,973
	Income from operations			105,991			56,986			57,641
	Adjusted EBITDA			192,891			151,745			143,994
	Goodwill			859,138			860,788			857,708
	Intangible Assets, net			159,388			142,801			157,034
	Total identifiable assets			1,616,200			1,515,162			1,544,908
	Capital expenditures			56,460			51,449			42,688
	Segment Totals
	Segment Totals
	Net revenue		$	4,397,644		$	3,728,312		$	3,300,121
	Income from operations			388,486			276,828			256,941
	Adjusted EBITDA			556,224			445,778			404,651
	Goodwill			2,538,633			2,435,670			2,413,632
	Intangible Assets, net			524,482			513,698			564,218
	Total identifiable assets			4,500,450			4,139,323			4,013,513
	Capital expenditures			71,940			59,664			54,917
	A reconciliation of net income (loss) to Adjusted EBITDA (in thousands):

			Year ended December 31,
			2014			2013			2012
	Net income (loss)		$	119,866		$	11,495		$	41,185
	Add-back of non-operating expense (income):
	Interest expense, net			110,505			186,701			182,607
	Income tax expense (benefit)			89,498			(994	)		27,463
	Loss on early debt extinguishment			66,397			68,379			8,307
	Realized losses (gains) on investments			(371	)		(471	)		(394	)
	Interest income from restricted assets			(1,135	)		(792	)		(625	)
	Equity in earnings of unconsolidated subsidiary			(254	)		(323	)		(379	)
	Other expense (income), net			3,980			12,760			(1,422	)
	Corporate operating expense			—			73			199

	Income from operations—segment totals			388,486			276,828			256,941
	Add-back of operating expense (income):
	Add-back of operating expense (income):
	Depreciation and amortization expense			146,155			140,632			123,751
	Restructuring charges			6,968			5,669			14,086
	Net (income) loss attributable to noncontrolling interest			5,642			(5,500	)		—
	Adjustment to net (income) loss attributable to noncontrolling interest due to deferred taxes			(2,259	)		—			—
	Interest income from restricted assets			1,135			792			625
	Equity-based compensation expense			5,109			4,248			4,248
	Transaction costs			4,988			—			—
	Related party management fees			—			23,109			5,000

	Adjusted EBITDA—segment totals			556,224			445,778			404,651

	Corporate operating expense			—			(73	)		(199	)

Adjusted EBITDA		$	556,224		$	445,705		$	404,452



A reconciliation of segment assets to total assets and segment capital expenditures to total capital expenditures is as follows as of December 31 (in thousands):

		December 31,			December 31,
		2014			2013
Segment total identifiable assets		$	4,500,450		$	4,139,323
Corporate cash			167,345			133,792
Other corporate assets			35,958			26,902

Total identifiable assets		$	4,703,753		$	4,300,017



Other corporate assets principally consist of property, plant and equipment, and other assets.

		Year ended December 31,
		2014			2013			2012
Segment total capital expenditures		$	71,940		$	59,664		$	54,917
Corporate capital expenditures			6,106			6,215			5,298

Total capital expenditures		$	78,046		$	65,879		$	60,215



Collective Bargaining Agreements
Approximately 43% of AMR employees are represented by 42 active collective bargaining agreements. There are 23 operational locations representing approximately 3,150 employees currently in the process of negotiations, or will be subject to negotiation in 2015. In addition, nine collective bargaining agreements, representing approximately 1,800 employees will be subject to negotiations in 2016. While the Company believes it maintains a good working relationship with its employees, the Company has experienced some union work actions. The Company does not expect these actions to have a material adverse effect on its ability to provide service to its patients and communities.
Major Customers
One customer, Hospital Corporation of America, comprised 27.5%, 21.7%, and 14.9% of EmCare's total net revenue as of December 31, 2014, 2013 and 2012, respectively. No other customer (including all facility contracts under a single hospital system) comprised more than 10% of consolidated total net revenue.

Valuation_and_Qualifying_Accou

Valuation and Qualifying Accounts	12 Months Ended
Valuation and Qualifying Accounts	Dec. 31, 2014
Valuation and Qualifying Accounts
Valuation and Qualifying Accounts	23. Valuation and Qualifying Accounts

		Allowance for			Allowance for			Total
		Contractual			Uncompensated			Accounts
		Discounts			Care			Receivable
								Allowances
		(in thousands)
	Balance at January 1, 2012	$	1,254,452		$	655,419		$	1,909,871
	Additions		7,169,942			2,534,511			9,704,453
	Reductions		(6,804,906	)		(2,348,176	)		(9,153,082	)

	Balance as of December 31, 2012		1,619,488			841,754			2,461,242
	Additions		8,607,966			3,043,210			11,651,176
	Reductions		(8,224,750	)		(2,846,131	)		(11,070,881	)

	Balance as of December 31, 2013		2,002,704			1,038,833			3,041,537
	Additions		11,255,851			3,487,309			14,743,160
	Reductions		(10,457,703	)		(3,298,343	)		(13,756,046	)

	Balance as of December 31, 2014	$	2,800,852		$	1,227,799		$	4,028,651

Consolidating_Financial_Inform

Consolidating Financial Information	12 Months Ended
Consolidating Financial Information	Dec. 31, 2014
Consolidating Financial Information
Consolidating Financial Information	24. Consolidating Financial Information
	Pursuant to the indenture governing the 2022 Notes, so long as any of the 2022 Notes are outstanding, the Company is required to provide condensed consolidating financial information with a separate column for (i) the Company and its subsidiaries (other than Corporation and its subsidiaries) on a combined basis, (ii) Corporation and its subsidiaries, (iii) consolidating adjustments on a combined basis, and (iv) the total consolidated amount. The consolidating adjustments column represents the elimination of any intercompany activity between EVHC (excluding Corporation and its subsidiaries) and Corporation.
	Consolidating Balance Sheet
	As of December 31, 2014
	(in thousands)

			EVHC			Corporation			Consolidating			Total
			(excluding			and			Adjustments
			Corporation)			Subsidiaries
	Assets
	Current assets:
	Cash and cash equivalents		$	5		$	318,890		$	—		$	318,895
	Insurance collateral			—			32,828			—			32,828
	Trade and other accounts receivable, net			—			950,115			—			950,115
	Parts and supplies inventory			—			24,484			—			24,484
	Prepaids and other current assets			5,019			36,917			(5,019	)		36,917

	Total current assets			5,024			1,363,234			(5,019	)		1,363,239
	Property, plant, and equipment, net			—			211,276			—			211,276
	Intangible assets, net			—			524,482			—			524,482
	Long-term deferred tax assets			145			—			(145	)		—
	Insurance collateral			—			10,568			—			10,568
	Goodwill			—			2,538,633			—			2,538,633
	Other long-term assets			—			55,555			—			55,555
	Investment in wholly owned subsidiary			1,756,407			—			(1,756,407	)		—

	Total assets		$	1,761,576		$	4,703,748		$	(1,761,571	)	$	4,703,753


	Liabilities and Equity
	Current liabilities:
	Accounts payable		$	999		$	46,585		$	—		$	47,584
	Accrued liabilities			—			416,307			(3,650	)		412,657
	Current deferred tax liabilities			—			105,647			(1,369	)		104,278
	Current portion of long-term debt and capital lease obligations			—			12,349			—			12,349

	Total current liabilities			999			580,888			(5,019	)		576,868
	Long-term debt and capital lease obligations			—			2,025,877			—			2,025,877
	Long-term deferred tax liabilities			—			131,108			(145	)		130,963
	Insurance reserves			—			180,639			—			180,639
	Other long-term liabilities			—			20,365			—			20,365

	Total liabilities			999			2,938,877			(5,164	)		2,934,712

	Equity:
	Common stock			1,837			—			—			1,837
	Preferred stock			—			—			—			—
	Additional paid-in capital			1,616,747			1,544,222			(1,544,222	)		1,616,747
	Retained earnings			143,849			214,041			(214,041	)		143,849
	Accumulated other comprehensive income (loss)			(1,856	)		(1,856	)		1,856			(1,856	)

	Total Envision Healthcare Holdings, Inc. equity			1,760,577			1,756,407			(1,756,407	)		1,760,577
	Noncontrolling interest			—			8,464			—			8,464

	Total equity			1,760,577			1,764,871			(1,756,407	)		1,769,041

	Total liabilities and equity		$	1,761,576		$	4,703,748		$	(1,761,571	)	$	4,703,753


	Consolidating Balance Sheet
	As of December 31, 2013
	(in thousands)


		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
Assets
Current assets:
Cash and cash equivalents		$	81,722		$	122,990		$	—		$	204,712
Insurance collateral			—			29,619			—			29,619
Trade and other accounts receivable, net			—			801,146			—			801,146
Parts and supplies inventory			—			23,376			—			23,376
Prepaids and other current assets			26,860			23,925			(27,355	)		23,430

Total current assets			108,582			1,001,056			(27,355	)		1,082,283
Property, plant, and equipment, net			—			194,715			—			194,715
Intangible assets, net			—			513,698			—			513,698
Long-term deferred tax assets			128			—			(128	)		—
Insurance collateral			—			12,716			—			12,716
Goodwill			—			2,435,670			—			2,435,670
Other long-term assets			—			60,935			—			60,935
Investment in wholly owned subsidiary			1,486,129			—			(1,486,129	)		—

Total assets		$	1,594,839		$	4,218,790		$	(1,513,612	)	$	4,300,017


Liabilities and Equity
Current liabilities:
Accounts payable		$	116		$	52,472		$	—		$	52,588
Accrued liabilities			—			357,979			(7,043	)		350,936
Current deferred tax liabilities			—			55,799			(20,312	)		35,487
Current portion of long-term debt and capital lease obligations			—			12,318			—			12,318

Total current liabilities			116			478,568			(27,355	)		451,329
Long-term debt and capital lease obligations			—			1,895,381			—			1,895,381
Long-term deferred tax liabilities			—			151,258			(128	)		151,130
Insurance reserves			—			175,427			—			175,427
Other long-term liabilities			—			16,997			—			16,997

Total liabilities			116			2,717,631			(27,483	)		2,690,264

Equity:
Common stock			1,804			—			—			1,804
Preferred stock			—			—			—			—
Additional paid-in capital			1,575,417			1,402,861			(1,402,861	)		1,575,417
Retained earnings			18,341			84,107			(84,107	)		18,341
Accumulated other comprehensive income (loss)			(839	)		(839	)		839			(839	)

Total Envision Healthcare Holdings, Inc. equity			1,594,723			1,486,129			(1,486,129	)		1,594,723
Noncontrolling interest			—			15,030			—			15,030

Total equity			1,594,723			1,501,159			(1,486,129	)		1,609,753

Total liabilities and equity		$	1,594,839		$	4,218,790		$	(1,513,612	)	$	4,300,017


Condensed Consolidating Statements of Operations
(in thousands)


		Year ended December 31, 2014
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
Net revenue		$	—		$	4,397,644		$	—		$	4,397,644

Compensation and benefits			—			3,156,480			—			3,156,480
Operating expenses			—			487,841			—			487,841
Insurance expense			—			120,983			—			120,983
Selling, general and administrative expenses			—			90,731			—			90,731
Depreciation and amortization expense			—			146,155			—			146,155
Restructuring charges			—			6,968			—			6,968

Income (loss) from operations			—			388,486			—			388,486
Interest income from restricted assets			—			1,135			—			1,135
Interest expense, net			—			(110,505	)		—			(110,505	)
Realized gains (losses) on investments			—			371			—			371
Other income (expense), net			(4,153	)		173			—			(3,980	)
Loss on early debt extinguishment			—			(66,397	)		—			(66,397	)

Income (loss) before taxes and equity in earnings of unconsolidated subsidiary			(4,153	)		213,263			—			209,110
Income tax benefit (expense)			(273	)		(89,225	)		—			(89,498	)

Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary			(4,426	)		124,038			—			119,612
Equity in net income (loss) of subsidiary			129,934			—			(129,934	)		—
Equity in earnings of unconsolidated subsidiary			—			254			—			254

Net income (loss)			125,508			124,292			(129,934	)		119,866
Less: Net (income) loss attributable to noncontrolling interest			—			5,642			—			5,642

Net income (loss) attributable to Envision Healthcare Holdings, Inc.		$	125,508		$	129,934		$	(129,934	)	$	125,508



Condensed Consolidating Statements of Operations
(in thousands)

		Year ended December 31, 2013
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
Net revenue		$	—		$	3,728,312		$	—		$	3,728,312

Compensation and benefits			—			2,667,439			—			2,667,439
Operating expenses			70			424,795			—			424,865
Insurance expense			—			106,293			—			106,293
Selling, general and administrative expenses			3			106,656			—			106,659
Depreciation and amortization expense			—			140,632			—			140,632
Restructuring charges			—			5,669			—			5,669

Income from operations			(73	)		276,828			—			276,755
Interest income from restricted assets			—			792			—			792
Interest expense, net			(30,567	)		(156,134	)		—			(186,701	)
Realized gains (losses) on investments			—			471			—			471
Other income (expense), net			—			(12,760	)		—			(12,760	)
Loss on early debt extinguishment			(29,519	)		(38,860	)		—			(68,379	)

Income (loss) before taxes and equity in earnings of unconsolidated subsidiary			(60,159	)		70,337			—			10,178
Income tax benefit (expense)			17,881			(16,887	)		—			994

Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary			(42,278	)		53,450			—			11,172
Equity in net income (loss) of subsidiary			48,273			—			(48,273	)		—
Equity in earnings of unconsolidated subsidiary			—			323			—			323

Net income (loss)			5,995			53,773			(48,273	)		11,495
Less: Net (income) loss attributable to noncontrolling interest			—			(5,500	)		—			(5,500	)

Net income (loss) attributable to Envision Healthcare Holdings, Inc.		$	5,995		$	48,273		$	(48,273	)	$	5,995



Condensed Consolidating Statements of Operations
(in thousands)

		Year ended December 31, 2012
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
Net revenue		$	—		$	3,300,121		$	—		$	3,300,121

Compensation and benefits			—			2,307,628			—			2,307,628
Operating expenses			—			421,424			—			421,424
Insurance expense			—			97,950			—			97,950
Selling, general and administrative expenses			199			78,341			—			78,540
Depreciation and amortization expense			—			123,751			—			123,751
Restructuring charges			—			14,086			—			14,086

Income from operations			(199	)		256,941			—			256,742
Interest income from restricted assets			—			625			—			625
Interest expense, net			(11,462	)		(171,145	)		—			(182,607	)
Realized gains (losses) on investments			—			394			—			394
Other income (expense), net			—			1,422			—			1,422
Loss on early debt extinguishment			—			(8,307	)		—			(8,307	)

Income (loss) before taxes and equity in earnings of unconsolidated subsidiary			(11,661	)		79,930			—			68,269
Income tax benefit (expense)			4,387			(31,850	)		—			(27,463	)

Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary			(7,274	)		48,080			—			40,806
Equity in net income (loss) of subsidiary			48,459			—			(48,459	)		—
Equity in earnings of unconsolidated subsidiary			—			379			—			379

Net income (loss)			41,185			48,459			(48,459	)		41,185
Less: Net (income) loss attributable to noncontrolling interest			—			—			—			—

Net income (loss) attributable to Envision Healthcare Holdings, Inc.		$	41,185		$	48,459		$	(48,459	)	$	41,185



Condensed Consolidating Statements of Cash Flows
(in thousands)

		Year ended December 31, 2014
		EVHC			Corporation			Total
		(excluding			and
		Corporation)			Subsidiaries
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities		$	17,057		$	256,991		$	274,048

Cash Flows from Investing Activities
Purchases of available-for-sale securities			—			(79,751	)		(79,751	)
Sales and maturities of available-for-sale securities			—			62,673			62,673
Purchase of property, plant and equipment			—			(78,046	)		(78,046	)
Proceeds from sale of property, plant and equipment			—			2,444			2,444
Acquisition of businesses, net of cash received			—			(181,642	)		(181,642	)
Net change in insurance collateral			—			481			481
Other investing activities			—			(2,977	)		(2,977	)

Net cash provided by (used in) investing activities			—			(276,818	)		(276,818	)

Cash Flows from Financing Activities
Borrowings under the ABL Facility			—			50,000			50,000
Proceeds from issuance of senior notes			—			740,625			740,625
Repayments of the Term Loan			—			(13,372	)		(13,372	)
Repayments of the ABL Facility			—			(50,000	)		(50,000	)
Repayments of PIK Notes and senior notes			—			(607,750	)		(607,750	)
Payment for debt extinguishment premiums			—			(37,630	)		(37,630	)
Debt issuance costs			—			(2,224	)		(2,224	)
Proceeds from stock options exercised			—			7,730			7,730
Excess tax benefits from equity-based compensation			—			44,550			44,550
Shares repurchased for tax withholdings			—			(14,430	)		(14,430	)
Distributions to noncontrolling interest, net			—			(924	)		(924	)
Other financing activities			—			378			378
Net intercompany borrowings (payments)			(98,774	)		98,774			—

Net cash provided by (used in) financing activities			(98,774	)		215,727			116,953

Change in cash and cash equivalents			(81,717	)		195,900			114,183
Cash and cash equivalents, beginning of period			81,722			122,990			204,712

Cash and cash equivalents, end of period		$	5		$	318,890		$	318,895



Condensed Consolidating Statements of Cash Flows
(in thousands)

		Year ended December 31, 2013
		EVHC			Corporation			Total
		(excluding			and
		Corporation)			Subsidiaries
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities		$	(33,425	)	$	87,540		$	54,115

Cash Flows from Investing Activities
Purchases of available-for-sale securities			—			(3,156	)		(3,156	)
Sales and maturities of available-for-sale securities			—			14,096			14,096
Purchase of property, plant and equipment			—			(65,879	)		(65,879	)
Proceeds from sale of property, plant and equipment			—			744			744
Acquisition of businesses, net of cash received			—			(35,098	)		(35,098	)
Net change in insurance collateral			—			(7,235	)		(7,235	)
Other investing activities			—			(2,069	)		(2,069	)

Net cash provided by (used in) investing activities			—			(98,597	)		(98,597	)

Cash Flows from Financing Activities
Issuance of common stock			1,110,900			1,117			1,112,017
Borrowings under the Term Loan			—			150,000			150,000
Borrowings under the ABL Facility			—			345,440			345,440
Repayments of the Term Loan			—			(13,371	)		(13,371	)
Repayments of the ABL Facility			—			(470,440	)		(470,440	)
Repayments of PIK Notes and senior notes			(450,000	)		(327,250	)		(777,250	)
Payment for debt extinguishment premiums			(12,386	)		(27,016	)		(39,402	)
Dividend paid			20,813			(20,813	)		—
Debt issuance costs			(4	)		(5,007	)		(5,011	)
Equity issuance costs			(65,131	)		—			(65,131	)
Excess tax benefits from equity-based compensation			—			62			62
Contributions from noncontrolling interest, net			—			3,000			3,000
Payment of dissenting shareholder settlement			—			(38,336	)		(38,336	)
Net change in bank overdrafts			—			(10,146	)		(10,146	)
Other financing activities			—			(70	)		(70	)
Net intercompany borrowings (payments)			(489,326	)		489,326			—

Net cash provided by (used in) financing activities			114,866			76,496			191,362

Change in cash and cash equivalents			81,441			65,439			146,880
Cash and cash equivalents, beginning of period			281			57,551			57,832

Cash and cash equivalents, end of period		$	81,722		$	122,990		$	204,712



Condensed Consolidating Statements of Cash Flows
(in thousands)

		Year ended December 31, 2012
		EVHC			Corporation and			Total
		(excluding			Subsidiaries
		Corporation)
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities		$	187		$	216,248		$	216,435

Cash Flows from Investing Activities
Purchases of available-for-sale securities			—			(39,035	)		(39,035	)
Sales and maturities of available-for-sale securities			—			96,643			96,643
Purchase of property, plant and equipment			—			(60,215	)		(60,215	)
Proceeds from sale of property, plant and equipment			—			7,220			7,220
Acquisition of businesses, net of cash received			—			(193,002	)		(193,002	)
Net change in insurance collateral			—			34,332			34,332
Other investing activities			—			14			14

Net cash provided by (used in) investing activities			—			(154,043	)		(154,043	)

Cash Flows from Financing Activities
Issuance of common stock			—			334			334
Borrowings under the ABL Facility			—			130,000			130,000
Proceeds from issuance of PIK Notes and senior notes			450,000			—			450,000
Repayments of the Term Loan			—			(262,884	)		(262,884	)
Repayments of the ABL Facility			—			(5,000	)		(5,000	)
Repayments of PIK Notes and senior notes			—			(15,000	)		(15,000	)
Dividend paid			(428,782	)		—			(428,782	)
Debt issuance costs			(21,124	)		(95	)		(21,219	)
Excess tax benefits from equity-based compensation			—			873			873
Class A common stock repurchased as treasury stock			—			(511	)		(511	)
Contributions from noncontrolling interest, net			—			6,530			6,530
Net change in bank overdrafts			—			7,808			7,808
Other financing activities			—			(732	)		(732	)
Net intercompany borrowings (payments)			—			—			—

Net cash provided by (used in) financing activities			94			(138,677	)		(138,583	)

Change in cash and cash equivalents			281			(76,472	)		(76,191	)
Cash and cash equivalents, beginning of period			—			134,023			134,023

Cash and cash equivalents, end of period		$	281		$	57,551		$	57,832

Quarterly_Financial_Informatio

Quarterly Financial Information (unaudited)	12 Months Ended
Quarterly Financial Information (unaudited)	Dec. 31, 2014
Quarterly Financial Information (unaudited)
Quarterly Financial Information (unaudited)	25. Quarterly Financial Information (unaudited)
	The following tables summarize unaudited results for each quarter in the years ended December 31, 2014 and 2013 (in thousands, except per share amounts).

		2014
		For the quarter ended
		March 31,			June 30,			September 30,			December 31,
	Net revenue	$	1,014,211		$	1,075,327		$	1,150,329		$	1,157,777
	Income from operations		68,318			93,139			113,901			113,128
	Net income (loss)		21,525			(1,992	)		52,843			47,490
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.		24,825			(1,992	)		52,776			49,899
	Earnings (loss) per share attributable to Envision Healthcare Holdings, Inc.:
	Basic		0.14			(0.01	)		0.29			0.27
	Diluted		0.13			(0.01	)		0.28			0.26


		2013
		For the quarter ended
		March 31,			June 30,			September 30,			December 31,
	Net revenue	$	888,324		$	899,255		$	955,888		$	984,845
	Income from operations		62,862			65,703			63,503			84,687
	Net income (loss)		(3,847	)		9,597			(7,663	)		13,408
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.		(3,847	)		9,597			(7,663	)		7,908
	Earnings (loss) per share attributable to Envision Healthcare Holdings, Inc.:
	Basic		(0.03	)		0.07			(0.05	)		0.04
	Diluted		(0.03	)		0.07			(0.05	)		0.04

Subsequent_Events

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2014
Subsequent Events
Subsequent Events	26. Subsequent Events
	EmCare completed the acquisitions of Emergency Medical Associates ("EMA") of Parsippany, New Jersey, on February 27, 2015 and Scottsdale Emergency Associates, LTD ("SEA") of Phoenix, Arizona on January 30, 2015 for aggregate purchase consideration of $380 million paid in cash. EMA provides emergency department, hospitalist and urgent care services at 47 facilities in New Jersey, New York, Rhode Island, and North Carolina. SEA is an emergency physician group serving the greater Phoenix market, with 40 physicians and more than a dozen mid-level providers.
	Additionally, EmCare completed the acquisition of VISTA Staffing Solutions, a leading provider of locum tenens staffing and permanent placement services for physicians, nurse practitioners and physician assistances, on February 1, 2015 for purchase consideration of $123 million paid in cash.
	Purchase consideration for these acquisitions was funded through cash on hand and amounts borrowed under the Company's ABL Facility. As of February 28, 2015, we had available borrowing capacity of approximately $144.4 million under the ABL Facility and $120.6 million of letters of credit issued under the ABL Facility.

Schedule_II_Registrants_Conden

Schedule II - Registrant's Condensed Financial Statements	12 Months Ended
Schedule II - Registrant's Condensed Financial Statements	Dec. 31, 2014
Schedule II - Registrant's Condensed Financial Statements
Schedule II - Registrant's Condensed Financial Statements	Schedule II—Registrant's Condensed Financial Statements
	Envision Healthcare Holdings, Inc.
	Parent Company Only
	Condensed Balance Sheets
	(in thousands, except share and per share amounts)

			December 31,
			2014			2013
	Assets
	Current assets:
	Cash and cash equivalents		$	5		$	81,722
	Prepaids and other current assets			5,019			26,860

	Total current assets			5,024			108,582

	Non-current assets:
	Investment in wholly owned subsidiary			1,756,407			1,486,129
	Long-term deferred tax assets			145			128
	Other long-term assets			—			—

	Total assets		$	1,761,576		$	1,594,839


	Liabilities and Equity
	Current liabilities:
	Accounts payable		$	999		$	116
	Accrued liabilities			—			—

	Total current liabilities			999			116
	Long-term debt			—			—

	Total liabilities			999			116

	Equity:
	Common stock ($0.01 par value; 2,000,000,000 shares authorized, 183,679,113 and 180,382,885 issued and outstanding as of December 31, 2014 and 2013, respectively)			1,837			1,804
	Preferred stock ($0.01 par value; 200,000,000 shares authorized, none issued and outstanding as of December 31, 2014 and 2013)			—			—
	Additional paid-in capital			1,616,747			1,575,417
	Retained earnings			143,849			18,341
	Accumulated other comprehensive income (loss)			(1,856	)		(839	)

	Total stockholders' equity			1,760,577			1,594,723

	Total liabilities and stockholders' equity		$	1,761,576		$	1,594,839




	Envision Healthcare Holdings, Inc.
	Parent Company Only
	Condensed Statements of Operations and Comprehensive Income
	(in thousands)

			Year ended			Year ended
			December 31,			December 31,
			2014			2013
	Equity in net income (loss) of subsidiary		$	124,292		$	48,942
	Operating expenses			—			70
	Selling, general and administrative expenses			—			3
	Interest expense, net			—			30,567
	Other income (expense), net			4,153			—
	Loss on early debt extinguishment			—			29,519

	Income (loss) before income taxes			120,139			(11,217	)
	Income tax benefit (expense)			(273	)		22,712

Net income (loss)			119,866			11,495
Other comprehensive income (loss), net of tax:			(1,017	)		(626	)

Comprehensive income (loss)		$	118,849		$	10,869




Envision Healthcare Holdings, Inc.
Parent Company Only
Condensed Statements of Cash Flows
(in thousands)

		Year ended			Year ended
		December 31,			December 31,
		2014			2013
Cash Flows from Operating Activities
Net income (loss)		$	119,866		$	11,495
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in net income (loss) of subsidiary			(124,292	)		(48,942	)
Depreciation and amortization			—			2,817
Loss on early debt extinguishment			—			29,519
Deferred income taxes			18,926			(25,184	)
Changes in operating assets/liabilities			2,557			(3,130	)

Net cash provided by (used in) operating activities			17,057			(33,425	)

Cash Flows from Investing Activities
Net cash provided by (used in) investing activities			—			—

Cash Flows from Financing Activities
Issuance of common stock			—			1,110,900
Repayments of PIK Notes			—			(450,000	)
Payments for debt extinguishment premiums			—			(12,386	)
Distribution to Corporation			(98,774	)		(489,326	)
Dividend received			—			20,813
Equity issuance costs			—			(65,131	)
Debt issue costs			—			(4	)

Net cash provided by (used in) financing activities			(98,774	)		114,866

Change in cash and cash equivalents			(81,717	)		81,441
Cash and cash equivalents, beginning of period			81,722			281

Cash and cash equivalents, end of period		$	5		$	81,722




Notes to Condensed Parent Company Only Financial Statements

1. Description of Envision Healthcare Holdings, Inc.
Envision Healthcare Holdings, Inc. (the "Parent") was incorporated in Delaware on February 28, 2011 in connection with the merger of CDRT Merger Sub, Inc., a wholly-owned subsidiary of Envision Healthcare Intermediate Corporation, a wholly-owned subsidiary of Parent, with and into Envision Healthcare Corporation ("Corporation"). The Parent has no significant operations or assets other than its indirect ownership of the equity of Corporation. Accordingly, the Parent is dependent upon distributions from Corporation to fund its obligations. However, under the terms of Corporation's credit agreements governing Corporation's ABL Facility and Term Loan and the Indenture governing Corporation's 2019 Notes, Corporation's ability to pay dividends or lend to the Parent is restricted, except that Corporation may pay specified amounts to Parent to fund the payment of the Company's tax obligations. Corporation has no obligation to pay dividends to Parent.
2. Basis of Presentation
The accompanying condensed financial statements (parent company only) include the accounts of Parent and its investment in Corporation, which is stated at cost plus equity in undistributed earnings of Corporation since the date of acquisition, and do not present the financial statements of the parent and its subsidiary on a consolidated basis. These parent company only financial statements should be read in conjunction with the Envision Healthcare Holdings, Inc. consolidated financial statements.
3. Debt
On October 1, 2012, the Company issued $450 million of Senior PIK Toggle Notes due 2017 (the "PIK Notes") and used the proceeds from the offering to pay an extraordinary dividend to its stockholders, pay debt issuance costs and make certain payments to members of management with rollover options in the Company.
On August 30, 2013, the Company redeemed all of the PIK Notes at a redemption price equal to 102.75% of the aggregate principal amount of the PIK Notes, plus accrued and unpaid interest of $17.2 million. During the year ended December 31, 2013, the Company recorded a loss on early debt extinguishment of $29.5 million related to premiums and unamortized debt issuance costs from the redemption of the PIK Notes.
4. Equity
On August 19, 2013, the Company completed its initial public offering of 42,000,000 shares of Common Stock and an additional 6,300,000 shares of Common Stock, at a price of $23 per share, for an aggregate offering price of $1,110.9 million. The Company received net proceeds of approximately $1,025.9 million, after deducting the underwriters' discounts and commissions paid and offering expenses of approximately $85.0 million, including a $20.0 million payment to CD&R in connection with the termination of the consulting agreement with CD&R ("Consulting Agreement") which was recorded to "Selling, general and administrative expenses" in the accompanying consolidated statements of operations as of December 31, 2013.
Net proceeds from the initial public offering were used to (i) redeem in full Parent's PIK Notes for a total of $479.6 million, which included a call premium pursuant to the indenture governing the PIK Notes and all accrued but unpaid interest, (ii) pay CD&R the fee of $20.0 million to terminate the Consulting Agreement, (iii) pay $16.5 million to repay all outstanding revolving credit facility borrowings, and (iv) redeem $332.5 million of aggregate principal amount of the 2019 Notes of which $5.2 million was held by the Company's captive insurance subsidiary for a total of $356.5 million, which included a call premium pursuant to the indenture governing the 2019 Notes and all accrued but unpaid interest. The remaining proceeds were used for general corporate purposes including, among other things, repayment of indebtedness and acquisitions.
On each of February 5, 2014 and July 10, 2014, the Company registered the offering and sale of 27,500,000 shares of Common Stock, respectively, and an additional 4,125,000 shares of Common Stock upon the underwriters' exercise of their overallotment option in each offering, which were sold by certain stockholders of the Company, including the CD&R Affiliates, to the underwriters at $30.50 per share and $34.00 per share, respectively, less the underwriting discount. Additionally, on September 30, 2014, the Company registered the offering and sale of 17,500,000 shares of Common Stock by certain stockholders of the Company, including the CD&R Affiliates, to the underwriters at $34.97 per share.
The underwriters in these selling stockholder transactions offered the shares to the public from time to time at prevailing market prices or at negotiated prices. The Company did not receive any of the proceeds from the sale of the shares sold by the selling stockholders in these transactions, including any shares sold pursuant to any exercise of the underwriters' overallotment option.
Common Stock
Holders of Common Stock are entitled:
•	To cast one vote for each share held of record on all matters submitted to a vote of the stockholders;
•	To receive, on a pro rata basis, dividends and distributions, if any, that the Board of Directors may declare out of legally available funds, subject to preferences that may be applicable to preferred stock, if any, then outstanding; and
•	Upon Parent's liquidation, dissolution or winding up, to share equally and ratably in any assets remaining after the payment of all debt and other liabilities, subject to the prior rights, if any, of holders of any outstanding shares of preferred stock.
Parent's ability to pay dividends on its Common Stock is subject to its subsidiaries' ability to pay dividends to Parent, which is in turn subject to the restrictions set forth in the Senior Secured Credit Facilities and the indentures governing the 2019 Notes and 2022 Notes.
Preferred Stock
Under Parent's amended and restated certificate of incorporation, Parent's Board of Directors has the authority, without further action by its stockholders, to issue up to 200,000,000 shares of preferred stock in one or more series and to fix the voting powers, designations, preferences and the relative participating, optional or other special rights and qualifications, limitations and restrictions of each series, including dividend rights, dividend rates, conversion rights, voting rights, terms of redemption, liquidation preferences and the number of shares constituting any series.

Summary_of_Significant_Account1

Summary of Significant Accounting Policies (Policies)	12 Months Ended
Summary of Significant Accounting Policies (Policies)	Dec. 31, 2014
Summary of Significant Accounting Policies
Consolidation	Consolidation
	The consolidated financial statements of the Company include all of its wholly-owned subsidiaries, including Corporation, EmCare and AMR and their respective subsidiaries and affiliated physician groups. All significant intercompany transactions and balances have been eliminated in consolidation.

Use of Estimates	Use of Estimates
	The preparation of financial statements requires management to make estimates and assumptions relating to the reporting of results of operations, financial condition and related disclosure of contingent assets and liabilities at the date of the financial statements including, but not limited to, estimates and assumptions for accounts receivable and insurance related reserves. Actual results may differ from those estimates under different assumptions or conditions.

Cash and Cash Equivalents	Cash and Cash Equivalents
	Cash and cash equivalents are comprised of highly liquid investments with a maturity of three months or less at acquisition, and are recorded at market value.
	As of December 31, 2014 and 2013, bank overdrafts of zero and $5.0 million, respectively, were included in accounts payable in the accompanying balance sheets.

Insurance Collateral	Insurance Collateral
	Insurance collateral is comprised of investments in U.S. Treasuries and marketable equity and debt securities held by the Company's captive insurance subsidiary that supports the Company's insurance program and reserves, as well as cash deposits with third parties. Certain of these investments, if sold or otherwise liquidated, would have to be replaced by other suitable financial assurances and are, therefore, considered restricted. These investments are designated as available-for-sale and reported at fair value with the related temporary unrealized gains and losses reported as a separate component of accumulated other comprehensive income, net of deferred income tax. Declines in the fair value of a marketable investment security which are determined to be other-than-temporary are recognized in the statements of operations, thus establishing a new cost basis for such investment. Investment income earned on these investments is reported as interest income from restricted assets in the statements of operations.
	Realized gains and losses are determined based on an average cost basis.
	Insurance collateral also includes a receivable from insurers of $1.5 million and $1.3 million as of December 31, 2014 and 2013, respectively, for liabilities in excess of the Company's self-insured retention.

Trade and Other Accounts Receivable, net	Trade and Other Accounts Receivable, net
	The Company estimates its allowances based on payor reimbursement schedules, historical collections and write-off experience and other economic data. Patient-related accounts receivable are recorded net of estimated allowances for contractual discounts and uncompensated care in the period in which services are performed. Account balances are charged off against the uncompensated care allowance, which relates principally to receivables recorded for self-pay patients, when it is probable the receivable will not be recovered. Write- offs to the contractual allowance occur when payment is received. As a result of the estimates used in recording the allowances, the nature of healthcare collections, which may involve lengthy delays, and the current uncertainty in the economy, there is a reasonable possibility that recorded estimates will change materially in the short-term.
	The following table presents accounts receivable, net and accounts receivable allowances by segment (in thousands):

		December 31,
		2014			2013
	Accounts receivable, net
	EVHC	$	28		$	1,011
	EmCare		645,427			558,195
	AMR		304,660			241,940

	Total	$	950,115		$	801,146


	Accounts receivable allowances
	EmCare
	Allowance for contractual discounts	$	2,522,622		$	1,807,090
	Allowance for uncompensated care		1,060,270			868,590

	Total	$	3,582,892		$	2,675,680


	AMR
	Allowance for contractual discounts	$	278,230		$	195,614
	Allowance for uncompensated care		167,529			170,243

	Total	$	445,759		$	365,857



	The changes in the allowances for contractual discounts and uncompensated care are primarily a result of changes in the Company's gross fee-for-service rate schedules and gross accounts receivable balances. These gross fee schedules, including any changes to existing fee schedules, generally are negotiated with various contracting entities, including municipalities and facilities. Fee schedule increases are billed for all revenue sources and to all payors under that specific contract; however, reimbursement in the case of certain state, federal, and commercial payors, including Medicare and Medicaid, will not change as a result of the change in gross fee schedules. In certain cases, this results in a higher level of contractual and uncompensated care provisions and allowances, requiring a higher percentage of contractual discount and uncompensated care provisions compared to gross charges.

Parts and Supplies Inventory	Parts and Supplies Inventory
	Parts and supplies inventory is valued at cost, determined on a first-in, first-out basis. Durable medical supplies, including oximeters and other miscellaneous items, are capitalized as inventory and expensed as used.

Property, Plant and Equipment, net	Property, Plant and Equipment, net
	Property, plant and equipment are reflected at their estimated fair value as of May 25, 2011 in connection with the acquisition of Corporation led by Clayton, Dubilier & Rice, LLC ("CD&R"). Additions to property, plant and equipment subsequent to this date are recorded at cost. Maintenance and repairs that do not extend the useful life of the property are charged to expense as incurred. Gains and losses from dispositions of property, plant and equipment are recorded in the period incurred. Depreciation of property, plant and equipment is provided substantially on a straight-line basis over their estimated useful lives, which are as follows:

	Buildings	35 to 40 years
	Leasehold improvements	Shorter of expected life or life of lease
	Vehicles	5 to 7 years
	Computer hardware and software	3 to 5 years
	Other	3 to 10 years


Goodwill and Other Indefinite Lived Intangibles	Goodwill and Other Indefinite Lived Intangibles
	Goodwill and other indefinite lived intangibles, including radio frequencies, licenses and trade names, are not amortized, but instead tested for impairment at least annually. The Company performs its annual impairment test in the third quarter for goodwill and other indefinite lived intangibles or more frequently if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. Such indicators include a sustained significant decline in the Company's market capitalization or a significant decline in its expected future cash flows due to changes in company-specific factors or the broader business climate. The evaluation of such factors requires considerable judgment. Any adverse change in these factors could have a significant impact on the recoverability of goodwill and have a material impact on the Company's consolidated financial statements.
	Goodwill and other indefinite lived intangible assets have been allocated to three reporting units. Two of the reporting units are aggregated into the EmCare operating segment and the other reporting unit is the AMR operating segment which the Company determined met the criteria to be classified as a reporting unit. As of December 31, 2014, $1,679.5 million and $859.1 million of goodwill had been allocated to EmCare and AMR, respectively.
	The Company compares the fair value of its reporting units to the carrying amounts on an annual basis to determine if there is potential goodwill impairment. If the fair value of the reporting units is less than the carrying value, an impairment loss is recorded to the extent that the fair value of the goodwill within the reporting unit is less than its carrying value.
	Fair value for each of the reporting units is determined using the estimated future cash flows, discounted at a rate commensurate with the risk involved or the market approach. No impairment indicators were noted in completing the Company's annual impairment assessments in 2014 and no indicators were noted which would indicate that subsequent interim impairment tests were necessary. No impairment charges were recorded as of December 31, 2014, 2013, or 2012.

Impairment of Long lived Assets and Other Definite Lived Intangibles	Impairment of Long-lived Assets and Other Definite Lived Intangibles
	Long-lived assets and other definite lived intangibles are assessed for impairment whenever events or changes in circumstances indicate that the carrying value may not be recoverable. Important factors that could trigger impairment review include significant underperformance relative to historical or projected future operating results, significant changes in the use of the acquired assets or the strategy for the overall business, and significant negative industry or economic trends. If indicators of impairment are present, management evaluates the carrying value of long-lived assets and other definite lived intangibles in relation to the projection of future undiscounted cash flows of the underlying business. Projected cash flows are based on historical results adjusted to reflect management's best estimate of future market and operating conditions, which may differ from actual cash flows. There were no indicators of impairment in 2014, 2013, or 2012.

Contract Value	Contract Value
	The Company's contracts and customer relationships, recorded initially at their estimated fair value, represent the amortized value of such assets held by the Company. Consistent with management's expectation of estimated future cash flow, these assets are amortized on a straight-line basis over the average length of the contracts and expected contract renewal period, and range from 5 to 12.5 years depending on the type of contract and customer relationship.

Claims Liability and Professional Liability Reserves	Claims Liability and Professional Liability Reserves
	The Company is self-insured up to certain limits for costs associated with workers compensation claims, automobile claims, professional liability claims and general business liabilities. Reserves are established for estimates of the loss that will ultimately be incurred on claims that have been reported but not paid and claims that have been incurred but not reported. These reserves are established based on consultation with independent actuaries. The actuarial valuations consider a number of factors, including historical claim payment patterns and changes in case reserves, the assumed rate of increase in healthcare costs and property damage repairs. Historical experience and recent stable trends in the historical experience are the most significant factors in the determination of these reserves. Management believes the use of actuarial methods to account for these reserves provides a consistent and effective way to measure these subjective accruals. However, given the magnitude of the claims involved and the length of time until the ultimate cost is known, the use of any estimation technique in this area is inherently sensitive. Accordingly, recorded reserves could differ from ultimate costs related to these claims due to changes in accident reporting, claims payment and settlement practices or claims reserve practices, as well as differences between assumed and future cost increases. Accrued unpaid claims and expenses that are expected to be paid within the next 12 months are classified as current liabilities. All other accrued unpaid claims and expenses are classified as non-current liabilities.

Derivatives and Hedging Activities	Derivatives and Hedging Activities
	All derivative instruments are recorded on the balance sheet at fair value. The Company uses derivative instruments to manage risks associated with interest rate and fuel price volatility. All hedging instruments that qualify for hedge accounting are designated and effective as hedges, in accordance with GAAP. If the underlying hedged transaction ceases to exist, all changes in fair value of the related derivatives that have not been settled are recognized in current earnings. Instruments that do not qualify for hedge accounting and the ineffective portion of hedges are marked to market with changes recognized in current earnings. The Company does not hold or issue derivative financial instruments for trading purposes and is not a party to leveraged derivatives (see Note 12).

EmCare Contractual Arrangements	EmCare Contractual Arrangements
	EmCare structures its contractual arrangements for emergency department management services in various ways. In most states, a wholly-owned subsidiary of EmCare ("EmCare Subsidiary") contracts with hospitals to provide emergency department management services. The EmCare Subsidiary enters into an agreement with a professional association or professional corporation ("PA"), whereby the EmCare Subsidiary provides the PA with management services and the PA agrees to provide physician services for the hospital contract. The PA employs physicians directly or subcontracts with another entity for the physician services. In certain states, the PA contracts directly with the hospital, but provides physician services and obtains management services in the same manner as described above. In consideration for these services, the EmCare Subsidiary receives a monthly fee that may be adjusted from time to time to reflect industry practice, business conditions, and actual expenses for administrative costs and uncollectible accounts. In most states, these fees approximate the excess of the PA's revenues over its expenses. In all arrangements, decisions regarding patient care are made exclusively by the physicians.
	Each PA is wholly-owned by a physician who enters into a Stock Transfer and Option Agreement with EmCare. This agreement gives EmCare the right to replace the physician owner with another physician in accordance with the terms of the agreement.
	EmCare has determined that these management contracts meet the requirements for consolidation in accordance with GAAP. Accordingly, these financial statements include the accounts of EmCare and its subsidiaries and the PAs. The financial statements of the PAs are consolidated with EmCare and its subsidiaries because EmCare has ultimate control over the assets and business operations of the PAs as described above. Notwithstanding the lack of technical majority ownership, consolidation of the PAs is necessary to present fairly the financial position and results of operations of EmCare because of the existence of a control relationship by means other than record ownership of the PAs' voting stock. Control of a PA by EmCare is perpetual and other than temporary because EmCare may replace the physician owner of the PA at any time and thereby continue EmCare's relationship with the PA.

Financial Instruments and Concentration of Credit Risk	Financial Instruments and Concentration of Credit Risk
	The Company's cash and cash equivalents, accounts receivable, accounts payable, accrued liabilities, insurance collateral, long-term debt and long-term liabilities, other than self-insurance estimates, constitute financial instruments. Based on management's estimates, the carrying value of cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities approximates fair value as of December 31, 2014 and 2013. Concentration of credit risks in accounts receivable is limited, due to the large number of customers comprising the Company's customer base throughout the United States. A significant component of the Company's revenue is derived from Medicare and Medicaid. Given that these are government programs, the credit risk for these customers is considered low. The Company performs ongoing credit evaluations of its other customers, but does not require collateral to support customer accounts receivable. The Company establishes an allowance for uncompensated care based on the credit risk applicable to particular customers, historical trends and other relevant information. For the years ended December 31, 2014 and 2013, the Company derived approximately 33% and 34%, respectively, of its net revenue from Medicare and Medicaid, 64% and 62%, respectively, from insurance providers and contracted payors, and 3% and 4%, respectively, directly from patients.
	The Company estimates the fair value of its fixed rate senior notes based on an analysis in which the Company evaluates market conditions, related securities, various public and private offerings, and other publicly available information (Level 2, as defined below). The estimated fair value of the senior notes as of December 31, 2014 was approximately $744.4 million with a carrying amount of $750.0 million.

Revenue Recognition	Revenue Recognition
	Fee-for-service revenue is recognized at the time of service and is recorded net of provisions for contractual discounts and estimated uncompensated care. Fee-for-service revenue represents billings for services provided to patients, for which the Company receives payment from the patient or their third-party payor. Provisions for contractual discounts are related to differences between gross charges and specific payor, including governmental, reimbursement schedules. The Company records fee-for-service revenue, net of the contractual discounts based on the information entered into the Company's billing systems from received medical charts. An estimate for unprocessed medical charts for a given service period is made and adjusted in future periods based on actual medical charts processed. Information entered into the billing systems is subject to change, e.g. change in payor status, and may impact recorded fee-for-service revenue, net of the contractual discounts. Such changes are recognized in the period the change is known.
	Subsidy and fee revenue primarily represent hospital subsidies and fees at EmCare and fees for stand-by, special event and community subsidies at AMR. Provisions for estimated uncompensated care, or bad debts, are related principally to the number of self-pay patients treated in the period.
	Provisions for contractual discounts and estimated uncompensated care by segment, as a percentage of gross revenue and as a percentage of gross revenue less provision for contractual discounts are shown below.

		Year ended December 31,
		2014			2013			2012
	EmCare
	Gross revenue		100.0	%		100.0	%		100.0	%
	Provision for contractual discounts		60.6			57.8			57.7

	Revenue net of contractual discounts		39.4			42.2			42.3
	Provision for uncompensated care as a percentage of gross revenue		20.1			21.6			21.2

	Provision for uncompensated care as a percentage of gross revenue less contractual discounts		51.0	%		51.1	%		50.1	%
	AMR
	Gross revenue		100.0	%		100.0	%		100.0	%
	Provision for contractual discounts		52.8			50.7			49.2

	Revenue net of contractual discounts		47.2			49.3			50.8
	Provision for uncompensated care as a percentage of gross revenue		11.9			14.7			15.6

	Provision for uncompensated care as a percentage of gross revenue less contractual discounts		25.2	%		29.7	%		30.7	%
	Total
	Gross revenue		100.0	%		100.0	%		100.0	%
	Provision for contractual discounts		58.8			56.0			55.1

	Revenue net of contractual discounts		41.2			44.0			44.9
	Provision for uncompensated care as a percentage of gross revenue		18.2			19.8			19.5

	Provision for uncompensated care as a percentage of gross revenue less contractual discounts		44.2	%		44.9	%		43.4	%

	During 2014, the Company determined that Medicare and Medicaid managed care programs would be better categorized in the Medicare and Medicaid payor class and has reclassified those encounters in the presentation below and conformed prior periods to current period presentation. Net revenue for the years ended December 31, 2014, 2013 and 2012 consisted of the following (in thousands):

		Year ended December 31,
		2014			2013			2012
	Fee-for-service revenue, net of contractual discounts:
	Medicare	$	1,181,762		$	982,640		$	792,796
	Medicaid		415,771			257,100			224,974
	Commercial insurance and managed care (excluding Medicare and Medicaid managed care)		2,551,123			2,241,422			2,027,872
	Self-pay		2,993,997			2,660,924			2,221,356

	Sub-total		7,142,653			6,142,086			5,266,998
	Subsidies and fees		742,300			629,436			567,634

	Revenue, net of contractual discounts		7,884,953			6,771,522			5,834,632
	Provision for uncompensated care		(3,487,309	)		(3,043,210	)		(2,534,511	)

	Net revenue	$	4,397,644		$	3,728,312		$	3,300,121



	Healthcare reimbursement is complex and may involve lengthy delays. Third-party payors are continuing their efforts to control expenditures for healthcare, including proposals to revise reimbursement policies. The Company has from time to time experienced delays in reimbursement from third-party payors. In addition, third-party payors may disallow, in whole or in part, claims for payment based on determinations that certain amounts are not reimbursable under plan coverage, determinations of medical necessity, or the need for additional information. Laws and regulations governing the Medicare and Medicaid programs are very complex and subject to interpretation. Revenue is recognized on an estimated basis in the period which related services are rendered. As a result, there is a reasonable possibility that recorded estimates will change materially in the short-term. Such amounts, including adjustments between provisions for contractual discounts and uncompensated care, are adjusted in future periods as adjustments become known. These adjustments in the aggregate increased the contractual discount and uncompensated care provisions (decreased net revenue) by approximately $12.5 million and $1.0 million for the years ended December 31, 2014 and 2013, respectively, and decreased the contractual discount and uncompensated care provisions (increased net revenue) by approximately $10.0 million for the year ended December 31, 2012.
	Subsidies and fees in connection with community contracts at AMR are recognized ratably over the service period the payment covers.
	The Company also provides services to patients who have no insurance or other third-party payor coverage. In certain circumstances, federal law requires providers to render services to any patient who requires care regardless of their ability to pay. Services to these patients are not considered to be charity care and provisions for uncompensated care for these services are estimated accordingly.

Income Taxes	Income Taxes
	Deferred income taxes reflect the impact of temporary differences between the reported amounts of assets and liabilities for financial reporting purposes and such amounts as measured by tax laws and regulations. The deferred tax assets and liabilities represent the future tax return consequences of those differences, which will either be taxable or deductible when the assets and liabilities are recovered or settled. A valuation allowance is provided for deferred tax assets when management concludes it is more likely than not that some portion of the deferred tax assets will not be recognized. The respective tax authorities, in the normal course, audit previous tax filings. It is not possible at this time to predict the final outcome of these audits or establish a reasonable estimate of possible additional taxes owing, if any.

Equity Based Compensation	Equity Based Compensation
	The Company recognizes all share-based payments to employees based on its grant-date fair values and its estimates of forfeitures. The Company recognizes the fair value of outstanding options as a charge to operations over the vesting period. The cash benefits of tax deductions in excess of deferred taxes on recognized compensation expense are reported as a financing cash flow. The Company uses the straight-line method to recognize equity based compensation expense for its outstanding stock awards. Equity based compensation has been issued under the plans described in Note 17.

Fair Value Measurement	Fair Value Measurement
	The Company classifies its financial instruments that are reported at fair value based on a hierarchal framework that ranks the level of market price observability used in measuring financial instruments at fair value. Market price observability is impacted by a number of factors, including the type of instrument and the characteristics specific to the instrument. Instruments with readily available active quoted prices or for which fair value can be measured from actively quoted prices generally will have a higher degree of market price observability and a lesser degree of judgment used in measuring fair value.
	Financial instruments measured and reported at fair value are classified and disclosed in one of the following categories:
	Level 1—Quoted prices are available in active markets for identical assets or liabilities as of the reporting date. The Company does not adjust the quoted price for these assets or liabilities, which include investments held in connection with the Company's captive insurance program.
	Level 2—Pricing inputs are other than quoted prices in active markets, which are either directly or indirectly observable as of the reporting date, and fair value is determined through the use of models or other valuation methodologies. Balances in this category include corporate bonds and derivatives.
	Level 3—Pricing inputs are unobservable as of the reporting date and reflect the Company's own assumptions about the fair value of the asset or liability. Balances in this category include the Company's estimate, using a combination of internal and external fair value analyses, of contingent consideration for acquisitions described in Note 5.
	The following table summarizes the valuation of the Company's financial instruments by the above fair value hierarchy levels as of December 31, 2014 and 2013 (in thousands):

		December 31, 2014
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	30,243		$	—		$	—		$	30,243
	Liabilities:
	Contingent consideration		—			—			2,000			2,000
	Fuel hedge		—			1,433			—			1,433
	Interest rate swap		—			1,493			—			1,493


		December 31, 2013
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	12,170		$	517		$	—		$	13,227
	Fuel hedge		—			672			—			672
	Liabilities:
	Contingent consideration		—			—			7,734			7,734
	Interest rate swap		—			3,135			—			3,135

	The contingent consideration balance classified as a Level 3 liability has decreased by $5.7 million since December 31, 2013 primarily due to payments made, offset by an increase of $2.0 million from recent acquisitions.
	During the year ended December 31, 2014 and 2013, the Company had no transfers in and out of Level 1 and Level 2 fair value measurements.

Recent Accounting Pronouncements	Recent Accounting Pronouncements
	In May 2014, the FASB issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers ("ASU 2014-09") to clarify the principles for recognizing revenue and to develop a common revenue standard for GAAP and International Financial Reporting Standards. ASU 2014-09 is effective for public companies for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period. Early application is not permitted. The Company has not yet determined the effects, if any, that adoption of ASU 2014-09 may have on its consolidated financial position or results of operations.
	In August 2014, the FASB issued Accounting Standards Update 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) which requires management to evaluate, in connection with preparing financial statements for each annual and interim reporting period, whether there are conditions or events, considered in the aggregate, that raise substantial doubt about an entity's ability to continue as a going concern within one year after the date that the financial statements are issued (or within one year after the date that the financial statements are available to be issued when applicable) and provide related disclosures. ASU 2014-15 is effective for the annual period ending after December 15, 2016, and for annual and interim periods thereafter. The adoption of ASU 2014-15 is not expected to impact the Company's consolidated financial statements.

Summary_of_Significant_Account2

Summary of Significant Accounting Policies (Tables)	12 Months Ended
Summary of Significant Accounting Policies (Tables)	Dec. 31, 2014
Summary of Significant Accounting Policies
Schedule of accounts receivable, net and accounts receivable allowances by segment	The following table presents accounts receivable, net and accounts receivable allowances by segment (in thousands):

		December 31,
		2014			2013
	Accounts receivable, net
	EVHC	$	28		$	1,011
	EmCare		645,427			558,195
	AMR		304,660			241,940

	Total	$	950,115		$	801,146


	Accounts receivable allowances
	EmCare
	Allowance for contractual discounts	$	2,522,622		$	1,807,090
	Allowance for uncompensated care		1,060,270			868,590

	Total	$	3,582,892		$	2,675,680


	AMR
	Allowance for contractual discounts	$	278,230		$	195,614
	Allowance for uncompensated care		167,529			170,243

	Total	$	445,759		$	365,857





Schedule of estimated useful lives of property, plant and equipment

	Buildings	35 to 40 years
	Leasehold improvements	Shorter of expected life or life of lease
	Vehicles	5 to 7 years
	Computer hardware and software	3 to 5 years
	Other	3 to 10 years


Schedule of provisions for contractual discounts and estimated uncompensated care by segment

		Year ended December 31,
		2014			2013			2012
	EmCare
	Gross revenue		100.0	%		100.0	%		100.0	%
	Provision for contractual discounts		60.6			57.8			57.7

	Revenue net of contractual discounts		39.4			42.2			42.3
	Provision for uncompensated care as a percentage of gross revenue		20.1			21.6			21.2

	Provision for uncompensated care as a percentage of gross revenue less contractual discounts		51.0	%		51.1	%		50.1	%
	AMR
	Gross revenue		100.0	%		100.0	%		100.0	%
	Provision for contractual discounts		52.8			50.7			49.2

	Revenue net of contractual discounts		47.2			49.3			50.8
	Provision for uncompensated care as a percentage of gross revenue		11.9			14.7			15.6

	Provision for uncompensated care as a percentage of gross revenue less contractual discounts		25.2	%		29.7	%		30.7	%
	Total
	Gross revenue		100.0	%		100.0	%		100.0	%
	Provision for contractual discounts		58.8			56.0			55.1

	Revenue net of contractual discounts		41.2			44.0			44.9
	Provision for uncompensated care as a percentage of gross revenue		18.2			19.8			19.5

	Provision for uncompensated care as a percentage of gross revenue less contractual discounts		44.2	%		44.9	%		43.4	%


Schedule of net revenue	Net revenue for the years ended December 31, 2014, 2013 and 2012 consisted of the following (in thousands):

		Year ended December 31,
		2014			2013			2012
	Fee-for-service revenue, net of contractual discounts:
	Medicare	$	1,181,762		$	982,640		$	792,796
	Medicaid		415,771			257,100			224,974
	Commercial insurance and managed care (excluding Medicare and Medicaid managed care)		2,551,123			2,241,422			2,027,872
	Self-pay		2,993,997			2,660,924			2,221,356

	Sub-total		7,142,653			6,142,086			5,266,998
	Subsidies and fees		742,300			629,436			567,634

	Revenue, net of contractual discounts		7,884,953			6,771,522			5,834,632
	Provision for uncompensated care		(3,487,309	)		(3,043,210	)		(2,534,511	)

	Net revenue	$	4,397,644		$	3,728,312		$	3,300,121




Summary of the valuation of the Company's financial instruments by the fair value hierarchy levels	The following table summarizes the valuation of the Company's financial instruments by the above fair value hierarchy levels as of December 31, 2014 and 2013 (in thousands):

		December 31, 2014
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	30,243		$	—		$	—		$	30,243
	Liabilities:
	Contingent consideration		—			—			2,000			2,000
	Fuel hedge		—			1,433			—			1,433
	Interest rate swap		—			1,493			—			1,493


		December 31, 2013
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	12,170		$	517		$	—		$	13,227
	Fuel hedge		—			672			—			672
	Liabilities:
	Contingent consideration		—			—			7,734			7,734
	Interest rate swap		—			3,135			—			3,135

Basic_and_Diluted_Net_Income_L1

Basic and Diluted Net Income (Loss) Per Share (Tables)	12 Months Ended
Basic and Diluted Net Income (Loss) Per Share (Tables)	Dec. 31, 2014
Basic and Diluted Net Income (Loss) Per Share
EPS amounts and the basic and diluted weighted-average shares outstanding used in the calculation	The following table presents EPS amounts for all periods and the basic and diluted weighted-average shares outstanding used in the calculation (in thousands, except per share amounts).

		Year ended December 31,
		2014		2013		2012
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	125,508	$	5,995	$	41,185
	Weighted-average common shares outstanding—common stock:
	Basic		182,020		150,156		130,229
	Dilutive impact of stock awards outstanding		7,901		6,806		2,717

	Diluted		189,921		156,962		132,946
	Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:

	Basic	$	0.69	$	0.04	$	0.32
	Diluted	$	0.66	$	0.04	$	0.31

Statements_of_Cash_Flows_Data_

Statements of Cash Flows Data (Tables)	12 Months Ended
Statements of Cash Flows Data (Tables)	Dec. 31, 2014
Statements of Cash Flows Data
Schedule of supplemental cash flow statement disclosure	The following presents supplemental cash flow statement disclosure (in thousands).

		Year ended December 31,
		2014		2013		2012
	Supplemental cash flow data:
	Cash paid for interest	$	95,079	$	198,098	$	154,984
	Net cash paid (refunds received) for taxes		2,898		13,351		(20,463	)

Acquisitions_Tables

Acquisitions (Tables)	12 Months Ended
Acquisitions (Tables)	Dec. 31, 2014
Phoenix Physicians
Schedule of allocation of the purchase price	The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations (in thousands):

	Cash and cash equivalents	$	24,795
	Accounts receivable		16,748
	Prepaid and other current assets		139
	Property, plant, and equipment		92
	Acquired intangible assets		57,630
	Goodwill		97,200
	Accounts payable		(1,073	)
	Accrued liabilities		(11,920	)
	Long-term deferred tax liabilities		(445	)
	Insurance reserves		(13,716	)

	Total purchase price	$	169,450




Schedule of unaudited pro forma operating results	The pro forma adjustments are based on certain assumptions that the Company believes are reasonable.

		Year ended
		December 31,
	(in thousands)	2014			2013
	Net revenue	$	129,614		$	117,655
	Net income		9,007			3,315


Guardian
Schedule of allocation of the purchase price	The final allocation of the purchase price is in the table below (in thousands):

	Cash	$	428
	Accounts receivable		11,542
	Prepaid and other current assets		379
	Property, plant and equipment		1,792
	Acquired intangible assets		59,810
	Goodwill		111,256
	Other long-term assets		50
	Accounts payable		(729	)
	Accrued liabilities		(5,204	)
	Current deferred tax liabilities		(15,108	)
	Federal tax liability		(5,216	)

	Total purchase price	$	159,000

Property_Plant_and_Equipment_n1

Property, Plant and Equipment, net (Tables)	12 Months Ended
Property, Plant and Equipment, net (Tables)	Dec. 31, 2014
Property, Plant and Equipment, net.
Schedule of Property, plant and equipment, net	Property, plant and equipment, net consisted of the following as of December 31 (in thousands):

		2014			2013
	Land	$	4,553		$	5,013
	Building and leasehold improvements		25,516			22,526
	Vehicles		175,082			146,700
	Computer hardware and software		97,978			67,754
	Communication and medical equipment and other		114,849			99,923

			417,978			341,916
	Less: accumulated depreciation and amortization		(206,702	)		(147,201	)

	Property, plant and equipment, net	$	211,276		$	194,715

Intangible_Assets_net_Tables

Intangible Assets, net (Tables)	12 Months Ended
Intangible Assets, net (Tables)	Dec. 31, 2014
Intangible Assets, net
Schedule of intangible assets, net	Intangible assets, net consisted of the following as December 31 (in thousands):

		2014					2013
		Gross		Accumulated			Gross			Accumulated
		Carrying		Amortization			Carrying			Amortization
		Amount					Amount
	Amortized intangible assets
	Contract value	$	651,190	$	(245,803	)	$	590,880		$	(173,975	)
	Physician referral network		58,650		(14,679	)		58,650			(7,515	)
	Covenant not to compete		5,490		(3,725	)		5,101			(2,324	)
	Other		2,470		(167	)		—			—

			717,800		(264,374	)		654,631			(183,814	)
	Unamortized intangible assets
	Unamortized intangible assets
	Trade names		36,045		—			33,740			—
	Radio frequencies		901		—			901			—
	License		34,110		—			8,240			—

	Total	$	788,856	$	(264,374	)	$	697,512		$	(183,814	)




Schedule of estimated annual amortization over each of the next five years

	2015	$	82,094
	2016		75,368
	2017		70,540
	2018		63,696
	2019		58,899


Schedule of changes in the carrying amount of goodwill	Changes in the carrying amount of goodwill during 2014 are set forth as below (in thousands):

		January 1,		2014			Deferred			Adjustments			December 31,
		2014		Acquisitions			Taxes			Adjustments			2014
	EmCare	$	1,574,882	$	100,529		$	445		$	3,639		$	1,679,495
	AMR		860,788		2,836			4,173			(8,659	)		859,138

	Total	$	2,435,670	$	103,365			4,618		$	(5,020	)	$	2,538,633


	Changes in the carrying amount of goodwill during 2013 are set forth as below (in thousands):

		January 1,		2013			Adjustments			December 31,
		2013		Acquisitions			Adjustments			2013
	EmCare	$	1,555,924	$	9,018		$	9,940		$	1,574,882
	AMR		857,708		17,157			(14,077	)		860,788

	Total	$	2,413,632	$	26,175		$	(4,137	)	$	2,435,670

Income_Taxes_Tables

Income Taxes (Tables)	12 Months Ended
Income Taxes (Tables)	Dec. 31, 2014
Income Taxes
Schedule of the significant components of the Company's deferred taxes	Significant components of the Company's deferred taxes were as follows at December 31 (in thousands):

		2014			2013
	Current deferred tax assets (liabilities):
	Accounts receivable	$	8,278		$	1,611
	Accrual to cash		(128,507	)		(89,609	)
	Accrued liabilities		11,171			13,586
	Credit carryforwards		2,375			693
	Net operating loss carryforwards		2,405			38,232

	Net current deferred tax liabilities		(104,278	)		(35,487	)

	Long-term deferred tax assets (liabilities):
	Intangible assets		(160,186	)		(171,315	)
	Insurance and other long-term liabilities		46,760			37,692
	Excess of tax over book depreciation		(39,927	)		(40,729	)
	Net operating loss carryforwards		30,836			27,895
	Credit carryforwards		2,580			2,555
	Valuation allowance		(11,026	)		(7,228	)

	Net long-term deferred tax liabilities		(130,963	)		(151,130	)

	Net deferred tax liabilities	$	(235,241	)	$	(186,617	)




Schedule of the reconciliation of beginning and ending amount of unrecognized tax benefits	A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
	Balance as of beginning of period	$	614		$	3,467		$	963
	Additions for tax positions of prior years		1,494			216			5,397
	Reductions for tax positions of prior years		—			—			(1,896	)
	Reductions for tax positions due to lapse of statute of limitations		(482	)		(3,069	)		(997	)

	Balance as of end of period	$	1,626		$	614		$	3,467




Schedule of the components of income tax expense	The components of income tax expense were as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
	Current tax benefit (expense)
	State	$	(4,602	)	$	(3,937	)	$	(5,131	)
	Federal		(40,245	)		7,347			(34,965	)

	Total		(44,847	)		3,410			(40,096	)

	Deferred tax benefit (expense)
	State		(4,353	)		5,586			(1,004	)
	Federal		(40,298	)		(8,002	)		13,637

	Total		(44,651	)		(2,416	)		12,633

	Total tax benefit (expense)
	State		(8,955	)		1,649			(6,135	)
	Federal		(80,543	)		(655	)		(21,328	)

	Total	$	(89,498	)	$	994		$	(27,463	)




Schedule of the reconciliation of provision for income taxes at the federal statutory rate compared to the Company's effective tax rate	A reconciliation of the provision for income taxes at the federal statutory rate compared to the effective tax rate is as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
	Income tax expense at the statutory rate	$	(73,188	)	$	(3,562	)	$	(23,895	)
	Increase in income taxes resulting from:
	State taxes, net of federal		(6,453	)		(1,834	)		(4,218	)
	Tax settlements and filings		(1,012	)		2,853			638
	Tax credits		338			779			—
	Dissenting shareholder settlement		—			(3,203	)		—
	Change in valuation allowance		(3,816	)		3,126			—
	State deferred rate change		1,170			1,161			—
	Other		967			(419	)		12

	Income tax benefit (expense) before noncontrolling interest		(81,994	)		(1,099	)		(27,463	)
	Noncontrolling interests		(7,504	)		2,093			—

	Income tax benefit (expense)	$	(89,498	)	$	994		$	(27,463	)

Insurance_Collateral_Tables

Insurance Collateral (Tables)	12 Months Ended
Insurance Collateral (Tables)	Dec. 31, 2014
Insurance Collateral
Schedule of insurance collateral	Insurance collateral consisted of the following as of December 31, 2014 and 2013 (in thousands):

		December 31,		December 31,
		2014		2013
	Available-for-sale securities:
	U.S. Treasuries	$	1,191	$	2,100
	Corporate bonds /Fixed income		15,397		6,372
	Corporate equity		13,655		4,755

	Total available-for-sale securities		30,243		13,227
	Insurance receivable		1,470		1,300
	Cash deposits and other		11,683		27,808

	Total insurance collateral	$	43,396	$	42,335




Schedule of amortized cost basis and aggregate fair value of the entity's available-for-sale securities	Amortized cost basis and aggregate fair value of the Company's available-for-sale securities as of December 31, 2014 and 2013 were as follows (in thousands):

		December 31, 2014
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	1,182	$	12		$	(3	)	$	1,191
	Corporate bonds /Fixed income		15,339		59			(1	)		15,397
	Corporate equity		13,885		27			(257	)		13,655

	Total available-for-sale securities	$	30,406	$	98		$	(261	)	$	30,243




		December 31, 2013
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,064	$	37		$	(1	)	$	2,100
	Corporate bonds /Fixed income		6,384		26			(38	)		6,372
	Corporate equity		4,399		500			(144	)		4,755

	Total available-for-sale securities	$	12,847	$	563		$	(183	)	$	13,227




Schedule of the entity's temporarily impaired investment securities available-for-sale	The Company's temporarily impaired investment securities available-for-sale as of December 31, 2014 and 2013 were as follows (in thousands):

		December 31, 2014					December 31, 2013
		Fair Value		Unrealized			Fair Value			Unrealized
		Fair Value		Loss			Fair Value			Loss
	U.S. Treasuries:
	Less than 12 months	$	—	$	—		$	132		$	(1	)
	12 months or more		130		(3	)		—			—
	Corporate bonds /Fixed income:
	Less than 12 months		1,312		(1	)		2,768			(18	)
	12 months or more		251		—			2,178			(20	)
	Corporate equity:
	Less than 12 months		11,160		(257	)		—			—
	12 months or more		—		—			2,553			(144	)

	Total	$	12,853	$	(261	)	$	7,631		$	(183	)

Accrued_Liabilities_Tables

Accrued Liabilities (Tables)	12 Months Ended
Accrued Liabilities (Tables)	Dec. 31, 2014
Accrued Liabilities
Schedule of accrued liabilities	Accrued liabilities were as follows as of December 31 (in thousands):

		2014		2013
	Accrued wages and benefits	$	190,220	$	161,398
	Accrued paid time-off		27,156		25,713
	Current portion of self-insurance reserve		74,212		73,738
	Accrued restructuring		8,376		5,682
	Current portion of compliance and legal		3,407		2,000
	Accrued billing and collection fees		3,823		2,954
	Accrued incentive compensation		32,324		19,570
	Accrued interest		22,324		6,898
	Other		50,815		52,983

	Total accrued liabilities	$	412,657	$	350,936

Debt_Tables

Debt (Tables)	12 Months Ended
Debt (Tables)	Dec. 31, 2014
Debt
Schedule of long-term debt and capital leases	Long-term debt and capital leases consisted of the following (in thousands):

		December 31,			December 31,
		2014			2013
	Senior unsecured notes due 2019	$	—		$	607,750
	Senior unsecured notes due 2022		750,000			—
	Senior secured term loan due 2018 (4.00% as of December 31, 2014 and 2013)		1,289,575			1,302,945
	Discount on senior secured term loan		(3,317	)		(4,217	)
	ABL Facility		—			—
	Notes due at various dates from 2015 to 2022 with interest rates from 6% to 10%		482			852
	Capital lease obligations due at various dates from 2015 to 2018		1,486			369

	Total		2,038,226			1,907,699
	Less current portion		(12,349	)		(12,318	)

	Total long-term debt and capital lease obligations	$	2,025,877		$	1,895,381




Schedule of aggregate amount of minimum payments required on long-term debt and capital lease obligations

	Year ending December 31, (in thousands)
	2015	$	13,850
	2016		13,883
	2017		13,999
	2018		1,249,539
	2019		64
	Thereafter		750,208

		$	2,041,543

Changes_in_Accumulated_Other_C1

Changes in Accumulated Other Comprehensive Income (Loss) by Component (Tables)	12 Months Ended
	Dec. 31, 2014
Changes in Accumulated Other Comprehensive Income (Loss) by Component
Summary of changes in the Company's accumulated other comprehensive income ("AOCI") by component, after tax	The following table summarizes the changes in the Company's AOCI by component for the year ended December 31, 2014 and 2013 (in thousands). All amounts are after tax.

		Fuel hedge			Interest			Unrealized			Total
					rate swap			holding gains on
								available-for-sale
								securities
	Balance as of January 1, 2013	$	1,057		$	(2,861	)	$	1,591		$	(213	)
	Other comprehensive income (loss) before reclassifications		(396	)		(336	)		(598	)		(1,330	)
	Amounts reclassified from accumulated other comprehensive income (loss)		(241	)		1,239			(294	)		704

	Net current-period other comprehensive income (loss)		(637	)		903			(892	)		(626	)

	Balance as of December 31, 2013		420			(1,958	)		699			(839	)
	Other comprehensive income (loss) before reclassifications		(1,130	)		(216	)		(491	)		(1,837	)
	Amounts reclassified from accumulated other comprehensive income (loss)		(187	)		1,239			(232	)		820

	Net current-period other comprehensive income (loss)		(1,317	)		1,023			(723	)		(1,017	)

	Balance as of December 31, 2014	$	(897	)	$	(935	)	$	(24	)	$	(1,856	)




Schedule of Consolidated Statements of Operations affected by reclassifications out of AOCI	The following table shows the line item on the Consolidated Statements of Operations affected by reclassifications out of AOCI (in thousands):

		Amount reclassified
		from AOCI
		Year ended
		December 31,
	Details about AOCI components	2014			2013			Statements of Operations
	Gains and losses on cash flow hedges
	Fuel hedge	$	300		$	386		Operating expenses
	Interest rate swap		(1,986	)		(1,986	)	Interest expense, net

			(1,686	)		(1,600	)	Total before tax
			634			602		Tax benefit (expense)

		$	(1,052	)	$	(998	)	Net of tax


	Unrealized holding gains on available-for-sale securities	$	371		$	471		Realized gains (losses) on investments

			371			471		Total before tax
			(139	)		(177	)	Tax benefit (expense)

		$	232		$	294		Net of tax

Restructuring_Charges_Tables

Restructuring Charges (Tables)	12 Months Ended
Restructuring Charges (Tables)	Dec. 31, 2014
Restructuring
Schedule of restructuring charges

		AMR
		Lease and						EmCare			EVHC
		other contract
		termination
		costs			Severance			Severance			Severance			Total
								(in thousands)
	Balance as of January 1, 2013	$	8,122		$	3,015		$	773		$	408		$	12,318
	Incurred		1,876			2,890			913			20			5,699
	Paid		(6,989	)		(3,765	)		(1,204	)		(377	)		(12,335	)

	Balance as of December 31, 2013	$	3,009		$	2,140		$	482		$	51		$	5,682
	Incurred		3,153			2,779			1,036			—			6,968
	Paid		(615	)		(2,278	)		(1,330	)		(51	)		(4,274	)

	Balance as of December 31, 2014	$	5,547		$	2,641		$	188		$	—		$	8,376

Equity_Based_Compensation_Tabl

Equity Based Compensation (Tables)	12 Months Ended
Equity Based Compensation (Tables)	Dec. 31, 2014
Equity Based Compensation
Schedule of stock option activity	Stock option activity for the year ended December 31, 2014 was as follows (in thousands):

		Class A			Weighted		Aggregate		Weighted
		Shares			Average		Intrinsic Value		Average
					Exercise				Remaining Life
					Price
	Outstanding at beginning of year		16,322,148		$	3.7	$	519,325		6.6 years
	Granted		34,304		$	33.25
	Exercised		(3,855,797	)	$	2.64
	Forfeited		(125,757	)	$	6.31

	Outstanding at end of year		12,374,898		$	4.1	$	378,574		6.3 years


	Exercisable at end of year		9,625,258		$	3.93	$	296,038		6.1 years




Schedule of range of assumptions estimated to calculate fair value of each stock option award

		2014		2013		2012
	Volatility	35%		30% - 35%		30%
	Risk free rate	0.33% - 2.17%		0.67% - 1.56%		0.2% - 0.82%
	Expected dividend yield	0%		0%		0%
	Expected term of options in years	6.3 - 7.0		5		2.0 - 5.0

Commitments_and_Contingencies_

Commitments and Contingencies (Tables)	12 Months Ended
Commitments and Contingencies (Tables)	Dec. 31, 2014
Commitments and Contingencies
Schedule of future commitments under non-cancelable capital and operating leases for premises, equipment and other recurring commitments	Future commitments under non-cancelable capital and operating leases for premises, equipment and other recurring commitments are as follows (in thousands):

		Capital			Operating
		Leases			Leases &
					Other
	Year ending December 31,
	2015	$	519		$	63,676
	2016		519			41,897
	2017		589			38,385
	2018		19			31,510
	2019		—			21,155
	Thereafter		—			40,716

			1,646		$	237,339


	Less imputed interest		(160	)

	Total capital lease obligations		1,486
	Less current portion		(433	)

	Long-term capital lease obligations	$	1,053

Variable_Interest_Entities_Tab

Variable Interest Entities (Tables)	12 Months Ended
	Dec. 31, 2014
UHS-EmCare JV
Variable Interest Entities
Summary of the variable interest entity assets and liabilities which are included in the Company's consolidated financial statements	The following table summarizes the UHS-EmCare JV assets and liabilities as of December 31, 2014, which are included in the Company's consolidated financial statements (in thousands):

		December 31,
		2014
	Current assets	$	21,427
	Current liabilities		6,748


HCA-EmCare JV
Variable Interest Entities
Summary of the variable interest entity assets and liabilities which are included in the Company's consolidated financial statements	The following is a summary of the HCA-EmCare JV assets and liabilities as of December 31, 2014 and 2013, which are included in the Company's consolidated financial statements (in thousands).

		December 31,		December 31,
		2014		2013
	Current assets	$	155,041	$	88,479
	Current liabilities		31,163		22,005

Insurance_Tables

Insurance (Tables)	12 Months Ended
Insurance (Tables)	Dec. 31, 2014
Insurance
Summary of the non-health and welfare insurance reserves	The table below summarizes the non-health and welfare insurance reserves included in the accompanying balance sheets (in thousands):

		Accrued			Insurance			Total
		Liabilities			Reserves			Liabilities
	December 31, 2014
	Automobile	$	7,469		$	6,230		$	13,699
	Workers compensation		18,299			30,826			49,125
	General/Professional liability		48,444			143,583			192,027

		$	74,212		$	180,639		$	254,851
	December 31, 2013
	December 31, 2013
	Automobile	$	7,034		$	5,779		$	12,813
	Workers compensation		21,876			32,097			53,973
	General/Professional liability		44,828			137,551			182,379

		$	73,738		$	175,427		$	249,165




Schedule of changes to the Company's estimated losses under self-insured programs	The changes to the Company's estimated losses under self-insured programs were as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
	Balance, beginning of period	$	249,165		$	238,597		$	247,872
	Expense for current period reserves		62,836			74,501			77,003
	Unfavorable (favorable) changes to prior reserves		7,539			9,141			(2,480	)
	Changes in losses covered by commercial insurance programs		17,532			—			(9,185	)
	Increase in reserves from acquisitions		18,217			—			—
	Payments for claims		(100,438	)		(73,074	)		(74,613	)

	Balance, end of period		254,851			249,165			238,597
	Discount factor		7,045			8,418			8,485

	Undiscounted reserve, end of period	$	261,896		$	257,583		$	247,082




Summary of expected future claim payments relating to the entity's non-health and welfare insurance reserves	The following table reflects a summary of expected future claim payments relating to non-health and welfare insurance reserves (in thousands):

	Year	Amount
	2015	$	74,212
	2016		58,942
	2017		41,294
	2018		28,497
	2019		16,915
	Thereafter		34,991

	Total	$	254,851

Segment_Information_Tables

Segment Information (Tables)	12 Months Ended
Segment Information (Tables)	Dec. 31, 2014
Segment Information
Schedule of the Company's operating segment results	The Company's operating segment results were as follows (in thousands):

		Year ended December 31,
		2014			2013			2012
	Facility-Based Physician Services
	Net revenue	$	2,842,458		$	2,358,787		$	1,915,148
	Income from operations		282,495			219,842			199,300
	Adjusted EBITDA		363,333			294,033			260,657
	Goodwill		1,679,495			1,574,882			1,555,924
	Intangible Assets, net		365,094			370,897			407,184
	Total identifiable assets		2,884,250			2,624,161			2,468,605
	Capital expenditures		15,480			8,215			12,229
	Healthcare Transportation Services
	Healthcare Transportation Services
	Net revenue	$	1,555,186		$	1,369,525		$	1,384,973
	Income from operations		105,991			56,986			57,641
	Adjusted EBITDA		192,891			151,745			143,994
	Goodwill		859,138			860,788			857,708
	Intangible Assets, net		159,388			142,801			157,034
	Total identifiable assets		1,616,200			1,515,162			1,544,908
	Capital expenditures		56,460			51,449			42,688
	Segment Totals
	Segment Totals
	Net revenue	$	4,397,644		$	3,728,312		$	3,300,121
	Income from operations		388,486			276,828			256,941
	Adjusted EBITDA		556,224			445,778			404,651
	Goodwill		2,538,633			2,435,670			2,413,632
	Intangible Assets, net		524,482			513,698			564,218
	Total identifiable assets		4,500,450			4,139,323			4,013,513
	Capital expenditures		71,940			59,664			54,917


Schedule of reconciliation of net income (loss) to Adjusted EBITDA	A reconciliation of net income (loss) to Adjusted EBITDA (in thousands):

		Year ended December 31,
		2014			2013			2012
	Net income (loss)	$	119,866		$	11,495		$	41,185
	Add-back of non-operating expense (income):
	Interest expense, net		110,505			186,701			182,607
	Income tax expense (benefit)		89,498			(994	)		27,463
	Loss on early debt extinguishment		66,397			68,379			8,307
	Realized losses (gains) on investments		(371	)		(471	)		(394	)
	Interest income from restricted assets		(1,135	)		(792	)		(625	)
	Equity in earnings of unconsolidated subsidiary		(254	)		(323	)		(379	)
	Other expense (income), net		3,980			12,760			(1,422	)
	Corporate operating expense		—			73			199

	Income from operations—segment totals		388,486			276,828			256,941
	Add-back of operating expense (income):
	Add-back of operating expense (income):
	Depreciation and amortization expense		146,155			140,632			123,751
	Restructuring charges		6,968			5,669			14,086
	Net (income) loss attributable to noncontrolling interest		5,642			(5,500	)		—
	Adjustment to net (income) loss attributable to noncontrolling interest due to deferred taxes		(2,259	)		—			—
	Interest income from restricted assets		1,135			792			625
	Equity-based compensation expense		5,109			4,248			4,248
	Transaction costs		4,988			—			—
	Related party management fees		—			23,109			5,000

	Adjusted EBITDA—segment totals		556,224			445,778			404,651

	Corporate operating expense		—			(73	)		(199	)

	Adjusted EBITDA	$	556,224		$	445,705		$	404,452




Schedule of reconciliation of segment assets to total assets	A reconciliation of segment assets to total assets and segment capital expenditures to total capital expenditures is as follows as of December 31 (in thousands):

		December 31,			December 31,
		2014			2013
	Segment total identifiable assets	$	4,500,450		$	4,139,323
	Corporate cash		167,345			133,792
	Other corporate assets		35,958			26,902

	Total identifiable assets	$	4,703,753		$	4,300,017




Schedule of reconciliation of segment capital expenditures to total capital expenditures	Other corporate assets principally consist of property, plant and equipment, and other assets.

		Year ended December 31,
		2014			2013			2012
	Segment total capital expenditures	$	71,940		$	59,664		$	54,917
	Corporate capital expenditures		6,106			6,215			5,298

	Total capital expenditures	$	78,046		$	65,879		$	60,215

Valuation_and_Qualifying_Accou1

Valuation and Qualifying Accounts (Tables)	12 Months Ended
Valuation and Qualifying Accounts (Tables)	Dec. 31, 2014
Valuation and Qualifying Accounts
Schedule of valuation and qualifying accounts

		Allowance for			Allowance for			Total
		Contractual			Uncompensated			Accounts
		Discounts			Care			Receivable
								Allowances
		(in thousands)
	Balance at January 1, 2012	$	1,254,452		$	655,419		$	1,909,871
	Additions		7,169,942			2,534,511			9,704,453
	Reductions		(6,804,906	)		(2,348,176	)		(9,153,082	)

	Balance as of December 31, 2012		1,619,488			841,754			2,461,242
	Additions		8,607,966			3,043,210			11,651,176
	Reductions		(8,224,750	)		(2,846,131	)		(11,070,881	)

	Balance as of December 31, 2013		2,002,704			1,038,833			3,041,537
	Additions		11,255,851			3,487,309			14,743,160
	Reductions		(10,457,703	)		(3,298,343	)		(13,756,046	)

	Balance as of December 31, 2014	$	2,800,852		$	1,227,799		$	4,028,651

Consolidating_Financial_Inform1

Consolidating Financial Information (Tables)	12 Months Ended
Consolidating Financial Information (Tables)	Dec. 31, 2014
Consolidating Financial Information
Schedule of Consolidating Balance Sheet
	Consolidating Balance Sheet
	As of December 31, 2014
	(in thousands)

			EVHC			Corporation			Consolidating			Total
			(excluding			and			Adjustments
			Corporation)			Subsidiaries
	Assets
	Current assets:
	Cash and cash equivalents		$	5		$	318,890		$	—		$	318,895
	Insurance collateral			—			32,828			—			32,828
	Trade and other accounts receivable, net			—			950,115			—			950,115
	Parts and supplies inventory			—			24,484			—			24,484
	Prepaids and other current assets			5,019			36,917			(5,019	)		36,917

	Total current assets			5,024			1,363,234			(5,019	)		1,363,239
	Property, plant, and equipment, net			—			211,276			—			211,276
	Intangible assets, net			—			524,482			—			524,482
	Long-term deferred tax assets			145			—			(145	)		—
	Insurance collateral			—			10,568			—			10,568
	Goodwill			—			2,538,633			—			2,538,633
	Other long-term assets			—			55,555			—			55,555
	Investment in wholly owned subsidiary			1,756,407			—			(1,756,407	)		—

	Total assets		$	1,761,576		$	4,703,748		$	(1,761,571	)	$	4,703,753


	Liabilities and Equity
	Current liabilities:
	Accounts payable		$	999		$	46,585		$	—		$	47,584
	Accrued liabilities			—			416,307			(3,650	)		412,657
	Current deferred tax liabilities			—			105,647			(1,369	)		104,278
	Current portion of long-term debt and capital lease obligations			—			12,349			—			12,349

	Total current liabilities			999			580,888			(5,019	)		576,868
	Long-term debt and capital lease obligations			—			2,025,877			—			2,025,877
	Long-term deferred tax liabilities			—			131,108			(145	)		130,963
	Insurance reserves			—			180,639			—			180,639
	Other long-term liabilities			—			20,365			—			20,365

	Total liabilities			999			2,938,877			(5,164	)		2,934,712

	Equity:
	Common stock			1,837			—			—			1,837
	Preferred stock			—			—			—			—
	Additional paid-in capital			1,616,747			1,544,222			(1,544,222	)		1,616,747
	Retained earnings			143,849			214,041			(214,041	)		143,849
	Accumulated other comprehensive income (loss)			(1,856	)		(1,856	)		1,856			(1,856	)

	Total Envision Healthcare Holdings, Inc. equity			1,760,577			1,756,407			(1,756,407	)		1,760,577
	Noncontrolling interest			—			8,464			—			8,464

	Total equity			1,760,577			1,764,871			(1,756,407	)		1,769,041

	Total liabilities and equity		$	1,761,576		$	4,703,748		$	(1,761,571	)	$	4,703,753


	Consolidating Balance Sheet
	As of December 31, 2013
	(in thousands)

			EVHC			Corporation			Consolidating			Total
			(excluding			and			Adjustments
Corporation)			Subsidiaries
Assets
Current assets:
Cash and cash equivalents		$	81,722		$	122,990		$	—		$	204,712
Insurance collateral			—			29,619			—			29,619
Trade and other accounts receivable, net			—			801,146			—			801,146
Parts and supplies inventory			—			23,376			—			23,376
Prepaids and other current assets			26,860			23,925			(27,355	)		23,430

Total current assets			108,582			1,001,056			(27,355	)		1,082,283
Property, plant, and equipment, net			—			194,715			—			194,715
Intangible assets, net			—			513,698			—			513,698
Long-term deferred tax assets			128			—			(128	)		—
Insurance collateral			—			12,716			—			12,716
Goodwill			—			2,435,670			—			2,435,670
Other long-term assets			—			60,935			—			60,935
Investment in wholly owned subsidiary			1,486,129			—			(1,486,129	)		—

Total assets		$	1,594,839		$	4,218,790		$	(1,513,612	)	$	4,300,017


Liabilities and Equity
Current liabilities:
Accounts payable		$	116		$	52,472		$	—		$	52,588
Accrued liabilities			—			357,979			(7,043	)		350,936
Current deferred tax liabilities			—			55,799			(20,312	)		35,487
Current portion of long-term debt and capital lease obligations			—			12,318			—			12,318

Total current liabilities			116			478,568			(27,355	)		451,329
Long-term debt and capital lease obligations			—			1,895,381			—			1,895,381
Long-term deferred tax liabilities			—			151,258			(128	)		151,130
Insurance reserves			—			175,427			—			175,427
Other long-term liabilities			—			16,997			—			16,997

Total liabilities			116			2,717,631			(27,483	)		2,690,264

Equity:
Common stock			1,804			—			—			1,804
Preferred stock			—			—			—			—
Additional paid-in capital			1,575,417			1,402,861			(1,402,861	)		1,575,417
Retained earnings			18,341			84,107			(84,107	)		18,341
Accumulated other comprehensive income (loss)			(839	)		(839	)		839			(839	)

Total Envision Healthcare Holdings, Inc. equity			1,594,723			1,486,129			(1,486,129	)		1,594,723
Noncontrolling interest			—			15,030			—			15,030

Total equity			1,594,723			1,501,159			(1,486,129	)		1,609,753

Total liabilities and equity		$	1,594,839		$	4,218,790		$	(1,513,612	)	$	4,300,017




Schedule of Condensed Consolidating Statements of Operations	Condensed Consolidating Statements of Operations
	(in thousands)

			Year ended December 31, 2014
			EVHC			Corporation			Consolidating			Total
			(excluding			and			Adjustments
			Corporation)			Subsidiaries
	Net revenue		$	—		$	4,397,644		$	—		$	4,397,644

	Compensation and benefits			—			3,156,480			—			3,156,480
	Operating expenses			—			487,841			—			487,841
	Insurance expense			—			120,983			—			120,983
	Selling, general and administrative expenses			—			90,731			—			90,731
	Depreciation and amortization expense			—			146,155			—			146,155
	Restructuring charges			—			6,968			—			6,968

	Income (loss) from operations			—			388,486			—			388,486
	Interest income from restricted assets			—			1,135			—			1,135
	Interest expense, net			—			(110,505	)		—			(110,505	)
	Realized gains (losses) on investments			—			371			—			371
	Other income (expense), net			(4,153	)		173			—			(3,980	)
	Loss on early debt extinguishment			—			(66,397	)		—			(66,397	)

	Income (loss) before taxes and equity in earnings of unconsolidated subsidiary			(4,153	)		213,263			—			209,110
	Income tax benefit (expense)			(273	)		(89,225	)		—			(89,498	)

	Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary			(4,426	)		124,038			—			119,612
	Equity in net income (loss) of subsidiary			129,934			—			(129,934	)		—
	Equity in earnings of unconsolidated subsidiary			—			254			—			254

	Net income (loss)			125,508			124,292			(129,934	)		119,866
	Less: Net (income) loss attributable to noncontrolling interest			—			5,642			—			5,642

	Net income (loss) attributable to Envision Healthcare Holdings, Inc.		$	125,508		$	129,934		$	(129,934	)	$	125,508


	Condensed Consolidating Statements of Operations
	(in thousands)

			Year ended December 31, 2013
			EVHC			Corporation			Consolidating			Total
			(excluding			and			Adjustments
			Corporation)			Subsidiaries
	Net revenue		$	—		$	3,728,312		$	—		$	3,728,312

	Compensation and benefits			—			2,667,439			—			2,667,439
	Operating expenses			70			424,795			—			424,865
	Insurance expense			—			106,293			—			106,293
	Selling, general and administrative expenses			3			106,656			—			106,659
	Depreciation and amortization expense			—			140,632			—			140,632
	Restructuring charges			—			5,669			—			5,669

	Income from operations			(73	)		276,828			—			276,755
	Interest income from restricted assets			—			792			—			792
	Interest expense, net			(30,567	)		(156,134	)		—			(186,701	)
	Realized gains (losses) on investments			—			471			—			471
	Other income (expense), net			—			(12,760	)		—			(12,760	)
	Loss on early debt extinguishment			(29,519	)		(38,860	)		—			(68,379	)

	Income (loss) before taxes and equity in earnings of unconsolidated subsidiary			(60,159	)		70,337			—			10,178
	Income tax benefit (expense)			17,881			(16,887	)		—			994

	Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary			(42,278	)		53,450			—			11,172
	Equity in net income (loss) of subsidiary			48,273			—			(48,273	)		—
Equity in earnings of unconsolidated subsidiary			—			323			—			323

Net income (loss)			5,995			53,773			(48,273	)		11,495
Less: Net (income) loss attributable to noncontrolling interest			—			(5,500	)		—			(5,500	)

Net income (loss) attributable to Envision Healthcare Holdings, Inc.		$	5,995		$	48,273		$	(48,273	)	$	5,995


Condensed Consolidating Statements of Operations
(in thousands)

		Year ended December 31, 2012
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
Net revenue		$	—		$	3,300,121		$	—		$	3,300,121

Compensation and benefits			—			2,307,628			—			2,307,628
Operating expenses			—			421,424			—			421,424
Insurance expense			—			97,950			—			97,950
Selling, general and administrative expenses			199			78,341			—			78,540
Depreciation and amortization expense			—			123,751			—			123,751
Restructuring charges			—			14,086			—			14,086

Income from operations			(199	)		256,941			—			256,742
Interest income from restricted assets			—			625			—			625
Interest expense, net			(11,462	)		(171,145	)		—			(182,607	)
Realized gains (losses) on investments			—			394			—			394
Other income (expense), net			—			1,422			—			1,422
Loss on early debt extinguishment			—			(8,307	)		—			(8,307	)

Income (loss) before taxes and equity in earnings of unconsolidated subsidiary			(11,661	)		79,930			—			68,269
Income tax benefit (expense)			4,387			(31,850	)		—			(27,463	)

Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary			(7,274	)		48,080			—			40,806
Equity in net income (loss) of subsidiary			48,459			—			(48,459	)		—
Equity in earnings of unconsolidated subsidiary			—			379			—			379

Net income (loss)			41,185			48,459			(48,459	)		41,185
Less: Net (income) loss attributable to noncontrolling interest			—			—			—			—

Net income (loss) attributable to Envision Healthcare Holdings, Inc.		$	41,185		$	48,459		$	(48,459	)	$	41,185




Schedule of Condensed Consolidating Statement of Cash Flows	Condensed Consolidating Statements of Cash Flows
	(in thousands)

			Year ended December 31, 2014
			EVHC			Corporation			Total
			(excluding			and
			Corporation)			Subsidiaries
	Cash Flows from Operating Activities
	Net cash provided by (used in) operating activities		$	17,057		$	256,991		$	274,048

	Cash Flows from Investing Activities
	Purchases of available-for-sale securities			—			(79,751	)		(79,751	)
	Sales and maturities of available-for-sale securities			—			62,673			62,673
	Purchase of property, plant and equipment			—			(78,046	)		(78,046	)
	Proceeds from sale of property, plant and equipment			—			2,444			2,444
	Acquisition of businesses, net of cash received			—			(181,642	)		(181,642	)
	Net change in insurance collateral			—			481			481
	Other investing activities			—			(2,977	)		(2,977	)

	Net cash provided by (used in) investing activities			—			(276,818	)		(276,818	)

	Cash Flows from Financing Activities
	Borrowings under the ABL Facility			—			50,000			50,000
	Proceeds from issuance of senior notes			—			740,625			740,625
	Repayments of the Term Loan			—			(13,372	)		(13,372	)
	Repayments of the ABL Facility			—			(50,000	)		(50,000	)
	Repayments of PIK Notes and senior notes			—			(607,750	)		(607,750	)
	Payment for debt extinguishment premiums			—			(37,630	)		(37,630	)
	Debt issuance costs			—			(2,224	)		(2,224	)
	Proceeds from stock options exercised			—			7,730			7,730
	Excess tax benefits from equity-based compensation			—			44,550			44,550
	Shares repurchased for tax withholdings			—			(14,430	)		(14,430	)
	Distributions to noncontrolling interest, net			—			(924	)		(924	)
	Other financing activities			—			378			378
	Net intercompany borrowings (payments)			(98,774	)		98,774			—

	Net cash provided by (used in) financing activities			(98,774	)		215,727			116,953

	Change in cash and cash equivalents			(81,717	)		195,900			114,183
	Cash and cash equivalents, beginning of period			81,722			122,990			204,712

	Cash and cash equivalents, end of period		$	5		$	318,890		$	318,895


	Condensed Consolidating Statements of Cash Flows
	(in thousands)

			Year ended December 31, 2013
			EVHC			Corporation			Total
			(excluding			and
			Corporation)			Subsidiaries
	Cash Flows from Operating Activities
	Net cash provided by (used in) operating activities		$	(33,425	)	$	87,540		$	54,115

	Cash Flows from Investing Activities
	Purchases of available-for-sale securities			—			(3,156	)		(3,156	)
	Sales and maturities of available-for-sale securities			—			14,096			14,096
	Purchase of property, plant and equipment			—			(65,879	)		(65,879	)
	Proceeds from sale of property, plant and equipment			—			744			744
	Acquisition of businesses, net of cash received			—			(35,098	)		(35,098	)
	Net change in insurance collateral			—			(7,235	)		(7,235	)
	Other investing activities			—			(2,069	)		(2,069	)

	Net cash provided by (used in) investing activities			—			(98,597	)		(98,597	)

Cash Flows from Financing Activities
Issuance of common stock			1,110,900			1,117			1,112,017
Borrowings under the Term Loan			—			150,000			150,000
Borrowings under the ABL Facility			—			345,440			345,440
Repayments of the Term Loan			—			(13,371	)		(13,371	)
Repayments of the ABL Facility			—			(470,440	)		(470,440	)
Repayments of PIK Notes and senior notes			(450,000	)		(327,250	)		(777,250	)
Payment for debt extinguishment premiums			(12,386	)		(27,016	)		(39,402	)
Dividend paid			20,813			(20,813	)		—
Debt issuance costs			(4	)		(5,007	)		(5,011	)
Equity issuance costs			(65,131	)		—			(65,131	)
Excess tax benefits from equity-based compensation			—			62			62
Contributions from noncontrolling interest, net			—			3,000			3,000
Payment of dissenting shareholder settlement			—			(38,336	)		(38,336	)
Net change in bank overdrafts			—			(10,146	)		(10,146	)
Other financing activities			—			(70	)		(70	)
Net intercompany borrowings (payments)			(489,326	)		489,326			—

Net cash provided by (used in) financing activities			114,866			76,496			191,362

Change in cash and cash equivalents			81,441			65,439			146,880
Cash and cash equivalents, beginning of period			281			57,551			57,832

Cash and cash equivalents, end of period		$	81,722		$	122,990		$	204,712


Condensed Consolidating Statements of Cash Flows
(in thousands)

		Year ended December 31, 2012
		EVHC			Corporation and			Total
		(excluding			Subsidiaries
		Corporation)
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities		$	187		$	216,248		$	216,435

Cash Flows from Investing Activities
Purchases of available-for-sale securities			—			(39,035	)		(39,035	)
Sales and maturities of available-for-sale securities			—			96,643			96,643
Purchase of property, plant and equipment			—			(60,215	)		(60,215	)
Proceeds from sale of property, plant and equipment			—			7,220			7,220
Acquisition of businesses, net of cash received			—			(193,002	)		(193,002	)
Net change in insurance collateral			—			34,332			34,332
Other investing activities			—			14			14

Net cash provided by (used in) investing activities			—			(154,043	)		(154,043	)

Cash Flows from Financing Activities
Issuance of common stock			—			334			334
Borrowings under the ABL Facility			—			130,000			130,000
Proceeds from issuance of PIK Notes and senior notes			450,000			—			450,000
Repayments of the Term Loan			—			(262,884	)		(262,884	)
Repayments of the ABL Facility			—			(5,000	)		(5,000	)
Repayments of PIK Notes and senior notes			—			(15,000	)		(15,000	)
Dividend paid			(428,782	)		—			(428,782	)
Debt issuance costs			(21,124	)		(95	)		(21,219	)
Excess tax benefits from equity-based compensation			—			873			873
Class A common stock repurchased as treasury stock			—			(511	)		(511	)
Contributions from noncontrolling interest, net			—			6,530			6,530
Net change in bank overdrafts			—			7,808			7,808
Other financing activities			—			(732	)		(732	)
Net intercompany borrowings (payments)			—			—			—

Net cash provided by (used in) financing activities			94			(138,677	)		(138,583	)

Change in cash and cash equivalents			281			(76,472	)		(76,191	)
Cash and cash equivalents, beginning of period			—			134,023			134,023

Cash and cash equivalents, end of period		$	281		$	57,551		$	57,832

Quarterly_Financial_Informatio1

Quarterly Financial Information (unaudited) (Tables)	12 Months Ended
Quarterly Financial Information (unaudited) (Tables)	Dec. 31, 2014
Quarterly Financial Information (unaudited)
Summary of unaudited results for each quarter	The following tables summarize unaudited results for each quarter in the years ended December 31, 2014 and 2013 (in thousands, except per share amounts).

		2014
		For the quarter ended
		March 31,			June 30,			September 30,			December 31,
	Net revenue	$	1,014,211		$	1,075,327		$	1,150,329		$	1,157,777
	Income from operations		68,318			93,139			113,901			113,128
	Net income (loss)		21,525			(1,992	)		52,843			47,490
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.		24,825			(1,992	)		52,776			49,899
	Earnings (loss) per share attributable to Envision Healthcare Holdings, Inc.:
	Basic		0.14			(0.01	)		0.29			0.27
	Diluted		0.13			(0.01	)		0.28			0.26


		2013
		For the quarter ended
		March 31,			June 30,			September 30,			December 31,
	Net revenue	$	888,324		$	899,255		$	955,888		$	984,845
	Income from operations		62,862			65,703			63,503			84,687
	Net income (loss)		(3,847	)		9,597			(7,663	)		13,408
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.		(3,847	)		9,597			(7,663	)		7,908
	Earnings (loss) per share attributable to Envision Healthcare Holdings, Inc.:
	Basic		(0.03	)		0.07			(0.05	)		0.04
	Diluted		(0.03	)		0.07			(0.05	)		0.04

General_Details

General (Details) (USD $)	0 Months Ended
General (Details) (USD $)	Jul. 29, 2013	Dec. 31, 2014	Dec. 31, 2013	Aug. 19, 2013
General
Common stock, par value (in dollars per share)		($0.01)	($0.01)	$0.01
Stock split ratio	9.3
Shares of common stock issued	132,082,885

General_Details_2

General (Details 2)	12 Months Ended
	Dec. 31, 2014
	item
General
Number of operating segments	2
EmCare
General
Number of contracts entered into by the entity	784
Number of states in which the entity operates	41
AMR
General
Number of states in which the entity operates	38

Summary_of_Significant_Account3

Summary of Significant Accounting Policies (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013
Cash and Cash Equivalents
Bank Overdrafts	$0	$5,000,000
Insurance Collateral
Reinsurance receivable	1,470,000	1,300,000
Trade and Other Accounts Receivable, net
Trade and other accounts receivable, net	950,115,000	801,146,000
EVHC.
Trade and Other Accounts Receivable, net
Trade and other accounts receivable, net	28,000	1,011,000
EmCare
Trade and Other Accounts Receivable, net
Allowance for contractual discounts	2,522,622,000	1,807,090,000
Allowance for uncompensated care	1,060,270,000	868,590,000
Trade accounts receivable, net	3,582,892,000	2,675,680,000
Trade and other accounts receivable, net	645,427,000	558,195,000
AMR
Trade and Other Accounts Receivable, net
Allowance for contractual discounts	278,230,000	195,614,000
Allowance for uncompensated care	167,529,000	170,243,000
Trade accounts receivable, net	445,759,000	365,857,000
Trade and other accounts receivable, net	$304,660,000	$241,940,000

Summary_of_Significant_Account4

Summary of Significant Accounting Policies (Details 2)	12 Months Ended
Summary of Significant Accounting Policies (Details 2)	Dec. 31, 2014
Minimum \| Building
Property, plant and equipment, net
Estimated useful lives	35 years
Minimum \| Vehicles
Property, plant and equipment, net
Estimated useful lives	5 years
Minimum \| Computer hardware and software
Property, plant and equipment, net
Estimated useful lives	3 years
Minimum \| Other
Property, plant and equipment, net
Estimated useful lives	3 years
Maximum \| Building
Property, plant and equipment, net
Estimated useful lives	40 years
Maximum \| Vehicles
Property, plant and equipment, net
Estimated useful lives	7 years
Maximum \| Computer hardware and software
Property, plant and equipment, net
Estimated useful lives	5 years
Maximum \| Other
Property, plant and equipment, net
Estimated useful lives	10 years

Summary_of_Significant_Account5

Summary of Significant Accounting Policies (Details 3) (USD $)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
	item	Dec. 31, 2013	Dec. 31, 2012
Goodwill and Other Indefinite Lived Intangibles
Number of reporting units	3
Goodwill	$2,538,633,000	$2,435,670,000	$2,413,632,000
Impairment charges recorded	0	0	0
EmCare
Goodwill and Other Indefinite Lived Intangibles
Number of reporting units	2
Goodwill	1,679,495,000	1,574,882,000	1,555,924,000
AMR
Goodwill and Other Indefinite Lived Intangibles
Goodwill	$859,138,000	$860,788,000	$857,708,000

Summary_of_Significant_Account6

Summary of Significant Accounting Policies (Details 4) (Contract value)	12 Months Ended
	Dec. 31, 2014
Minimum
Contract value
Useful life	5 years
Maximum
Contract value
Useful life	12 years 6 months

Summary_of_Significant_Account7

Summary of Significant Accounting Policies (Details 5) (Net revenue, Customer concentration risk)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Medicare and Medicaid
Concentration of Credit Risk
Percentage of concentration risk	33.00%	34.00%
Insurance providers and contracted payors
Concentration of Credit Risk
Percentage of concentration risk	64.00%	62.00%
Self-pay
Concentration of Credit Risk
Percentage of concentration risk	3.00%	4.00%

Summary_of_Significant_Account8

Summary of Significant Accounting Policies (Details 6) (Senior subordinated unsecured notes purchased by the Company's subsidiary, USD $)	Dec. 31, 2014
In Millions, unless otherwise specified	Dec. 31, 2014
Senior subordinated unsecured notes purchased by the Company's subsidiary
Financial Instruments
Estimated fair value of the senior subordinate notes	$744.40
Carrying value of the senior subordinate notes	$750

Summary_of_Significant_Account9

Summary of Significant Accounting Policies (Details 7)	12 Months Ended
Summary of Significant Accounting Policies (Details 7)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Segment Information
Gross revenue (as a percent)	100.00%	100.00%	100.00%
Provision for contractual discounts (as a percent)	58.80%	56.00%	55.10%
Revenue net of contractual discounts (as a percent)	41.20%	44.00%	44.90%
Provision for uncompensated care as a percentage of gross revenue	18.20%	19.80%	19.50%
Provision for uncompensated care as a percentage of gross revenue less contractual discounts	44.20%	44.90%	43.40%
EmCare
Segment Information
Gross revenue (as a percent)	100.00%	100.00%	100.00%
Provision for contractual discounts (as a percent)	60.60%	57.80%	57.70%
Revenue net of contractual discounts (as a percent)	39.40%	42.20%	42.30%
Provision for uncompensated care as a percentage of gross revenue	20.10%	21.60%	21.20%
Provision for uncompensated care as a percentage of gross revenue less contractual discounts	51.00%	51.10%	50.10%
AMR
Segment Information
Gross revenue (as a percent)	100.00%	100.00%	100.00%
Provision for contractual discounts (as a percent)	52.80%	50.70%	49.20%
Revenue net of contractual discounts (as a percent)	47.20%	49.30%	50.80%
Provision for uncompensated care as a percentage of gross revenue	11.90%	14.70%	15.60%
Provision for uncompensated care as a percentage of gross revenue less contractual discounts	25.20%	29.70%	30.70%

Recovered_Sheet2

Summary of Significant Accounting Policies (Details 8) (USD $)	3 Months Ended								12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Revenue Recognition
Fee-for-service revenue, net of contractual discounts:									$7,142,653,000	$6,142,086,000	$5,266,998,000
Subsidies and fees									742,300,000	629,436,000	567,634,000
Revenue, net of contractual discounts									7,884,953,000	6,771,522,000	5,834,632,000
Provision for uncompensated care									-3,487,309,000	-3,043,210,000	-2,534,511,000
Net revenue	1,157,777,000	1,150,329,000	1,075,327,000	1,014,211,000	984,845,000	955,888,000	899,255,000	888,324,000	4,397,644,000	3,728,312,000	3,300,121,000
Revenue Recognition
Increase (decrease) in contractual discount or uncompensated care provisions									12,500,000	1,000,000	-10,000,000
Medicare
Revenue Recognition
Fee-for-service revenue, net of contractual discounts:									1,181,762,000	982,640,000	792,796,000
Medicaid
Revenue Recognition
Fee-for-service revenue, net of contractual discounts:									415,771,000	257,100,000	224,974,000
Commercial insurance and managed care (excluding Medicare and Medicaid managed care)
Revenue Recognition
Fee-for-service revenue, net of contractual discounts:									2,551,123,000	2,241,422,000	2,027,872,000
Self-pay
Revenue Recognition
Fee-for-service revenue, net of contractual discounts:									$2,993,997,000	$2,660,924,000	$2,221,356,000

Recovered_Sheet3

Summary of Significant Accounting Policies (Details 9) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Payments related to new acquisitions which offset the contingent consideration	$2,000,000
Transfers in assets from Level 1 to level 2 fair value measurements	0	0
Transfers in assets from Level 2 to level 1 fair value measurements	0	0
Transfers in liabilities from Level 1 to level 2 fair value measurements	0	0
Transfers in liabilities from Level 2 to level 1 fair value measurements	0	0
Level 1 \| Available-for-sale securities (insurance collateral)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets	12,170,000	30,243,000
Level 2 \| Available-for-sale securities (insurance collateral)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets	517,000
Level 2 \| Fuel hedge
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets	672,000	1,433,000
Level 2 \| Interest rate swap agreements
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Liabilities	3,135,000	1,493,000
Level 3 \| Contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Liabilities	7,734,000	2,000,000
Decrease in a level 3 liability of the contingent consideration	5,700,000
Total \| Available-for-sale securities (insurance collateral)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets	13,227,000	30,243,000
Total \| Fuel hedge
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets	672,000	1,433,000
Total \| Contingent consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Liabilities	7,734,000	2,000,000
Total \| Interest rate swap agreements
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Liabilities	$3,135,000	$1,493,000

Basic_and_Diluted_Net_Income_L2

Basic and Diluted Net Income (Loss) Per Share (Details) (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Basic and Diluted Net Income (Loss) Per Share
Net income (loss)									$125,508	$5,995	$41,185
Weighted-average common shares outstanding - common stock:
Basic (in shares)									182,019,732	150,156,216	130,228,970
Dilutive impact of stock awards outstanding (in shares)									7,901,000	6,806,000	2,717,000
Diluted (in shares)									189,921,434	156,962,385	132,945,862
Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:
Basic (in dollars per share)	$0.27	$0.29	($0.01)	$0.14	$0.04	($0.05)	$0.07	($0.03)	$0.69	$0.04	$0.32
Diluted (in dollars per share)	$0.26	$0.28	($0.01)	$0.13	$0.04	($0.05)	$0.07	($0.03)	$0.66	$0.04	$0.31
Stock awards of common stock outstanding excluded from the computations of diluted loss per share and weighted-average common shares outstanding									0	0	0

Statements_of_Cash_Flows_Data_1

Statements of Cash Flows Data (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Supplemental Cash Flow Information [Abstract]
Cash paid for interest	$95,079	$198,098	$154,984
Net cash paid (refunds received) for taxes	$2,898	$13,351	($20,463)

Acquisitions_Details

Acquisitions (Details) (USD $)	3 Months Ended								12 Months Ended			0 Months Ended	6 Months Ended	0 Months Ended
Acquisitions (Details) (USD $)	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Jun. 17, 2014	Dec. 31, 2014	21-May-14	Dec. 21, 2012	Mar. 07, 2014
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Goodwill	$2,538,633,000				$2,435,670,000				$2,538,633,000	$2,435,670,000	$2,413,632,000		$2,538,633,000
Operating revenue	113,128,000	113,901,000	93,139,000	68,318,000	84,687,000	63,503,000	65,703,000	62,862,000	388,486,000	276,755,000	256,742,000
Net income (loss)									125,508,000	5,995,000	41,185,000
Unaudited pro forma operating results
Net revenue									129,614,000	117,655,000
Net income									9,007,000	3,315,000
Net revenue									68,800,000
Net income									6,800,000
Contingent consideration payable for acquisitions made prior to December 31, 2014	2,000,000								2,000,000				2,000,000
Phoenix Physicians
Acquisitions
Total consideration of acquisitions paid in cash												169,500,000
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents												24,795,000
Accounts receivable												16,748,000
Prepaid and other current assets												139,000
Property, plant and equipment												92,000
Acquired intangible assets	1,600,000								1,600,000			57,630,000	1,600,000
Goodwill												97,200,000
Accounts payable												-1,073,000
Accrued liabilities												-11,920,000
Insurance reserves												-13,716,000
Long-term deferred tax liabilities												-445,000
Total purchase price												169,450,000
Decrease in goodwill													-500,000
Increase in cash and cash equivalents													18,700,000
Increase in accrued liabilities													4,500,000
Increase in insurance reserves													13,700,000
Life Line Ambulance Service, Inc. and MedStat EMS, Inc.
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Acquired intangible assets																27,300,000
Goodwill																10,800,000
Long-term deferred tax liabilities																3,700,000
Unaudited pro forma operating results
Tax deductible goodwill																6,100,000
Net current assets																3,600,000
CMORx, LLC and Loya Medical Services, PLLC
Acquisitions
Total consideration of acquisitions paid in cash										34,200,000
Number of related corporations which leverage the provision of non-emergency medical transportation services										2
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Acquired intangible assets	5,400,000				14,900,000				5,400,000	14,900,000			5,400,000
Goodwill					20,800,000					20,800,000
Unaudited pro forma operating results
Tax deductible goodwill					20,800,000					20,800,000
Net current liabilities					1,500,000					1,500,000
Other 2014 Acquisition
Acquisitions
Total consideration of acquisitions paid in cash														38,000,000
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Acquired intangible assets	12,100,000								12,100,000				12,100,000
Guardian
Acquisitions
Total consideration of acquisitions paid in cash															159,000,000
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents															428,000
Accounts receivable															11,542,000
Prepaid and other current assets															379,000
Property, plant and equipment															1,792,000
Acquired intangible assets					8,700,000					8,700,000					59,810,000
Goodwill															111,256,000
Other long-term assets															50,000
Accounts payable															-729,000
Accrued liabilities															-5,204,000
Current deferred tax liabilities															-15,108,000
Federal tax liability					-2,900,000					-2,900,000					-5,216,000
Total purchase price															159,000,000
Operating revenue											3,000,000
Net income (loss)											300,000
Unaudited pro forma operating results
Net revenue											100,100,000
Net income											5,900,000
Tax deductible goodwill					78,500,000					78,500,000
APH and NightRays
Acquisitions
Total consideration of acquisitions paid in cash											33,800,000
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Acquired intangible assets											12,300,000
Goodwill											31,800,000
Unaudited pro forma operating results
Tax deductible goodwill											22,200,000
Net current liabilities											10,300,000
NightRays
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Acquired intangible assets					4,300,000					4,300,000
St. Vincent / Golden State
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Goodwill					$3,700,000					$3,700,000

Property_Plant_and_Equipment_n2

Property, Plant and Equipment, net (Details) (USD $)	12 Months Ended
Property, Plant and Equipment, net (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Property, plant and equipment, net
Property, plant and equipment, gross	$417,978,000	$341,916,000
Less: accumulated depreciation and amortization	-206,702,000	-147,201,000
Property, Plant and Equipment, Net, Total	211,276,000	194,715,000
Depreciation expense	65,600,000	63,900,000	56,500,000
Land
Property, plant and equipment, net
Property, plant and equipment, gross	4,553,000	5,013,000
Building and leasehold improvements
Property, plant and equipment, net
Property, plant and equipment, gross	25,516,000	22,526,000
Vehicles
Property, plant and equipment, net
Property, plant and equipment, gross	175,082,000	146,700,000
Computer hardware and software
Property, plant and equipment, net
Property, plant and equipment, gross	97,978,000	67,754,000
Communication and medical equipment and other
Property, plant and equipment, net
Property, plant and equipment, gross	$114,849,000	$99,923,000

Intangible_Assets_net_Details

Intangible Assets, net (Details) (USD $)	12 Months Ended
Intangible Assets, net (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Contract value
Gross Carrying Amount	$717,800,000	$654,631,000
Accumulated Amortization	-264,374,000	-183,814,000
Amortization expense	80,600,000	76,700,000	67,200,000
Unamortized intangible assets, Carrying Amount
Trade names	36,045,000	33,740,000
Radio frequencies	901,000	901,000
License	34,110,000	8,240,000
Total	788,856,000	697,512,000
Estimated annual amortization over each of the next five years
2015	82,094,000
2016	75,368,000
2017	70,540,000
2018	63,696,000
2019	58,899,000
Contract value
Contract value
Gross Carrying Amount	651,190,000	590,880,000
Accumulated Amortization	-245,803,000	-173,975,000
Physician referral network
Contract value
Gross Carrying Amount	58,650,000	58,650,000
Accumulated Amortization	-14,679,000	-7,515,000
Covenant not to compete
Contract value
Gross Carrying Amount	5,490,000
Accumulated Amortization	-3,725,000
Other.
Contract value
Gross Carrying Amount	2,470,000	5,101,000
Accumulated Amortization	($167,000)	($2,324,000)

Intangible_Assets_net_Details_

Intangible Assets, net (Details 2) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013
Changes in the carrying amount of goodwill
Balance at beginning of period	$2,538,633	$2,435,670
Acquisitions	103,365	26,175
Deferred Taxes	4,618
Adjustments	-5,020	-4,137
Balance at end of period	2,435,670	2,413,632
EmCare
Changes in the carrying amount of goodwill
Balance at beginning of period	1,679,495	1,574,882
Acquisitions	100,529	9,018
Deferred Taxes	445
Adjustments	3,639	9,940
Balance at end of period	1,574,882	1,555,924
AMR
Changes in the carrying amount of goodwill
Balance at beginning of period	859,138	860,788
Acquisitions	2,836	17,157
Deferred Taxes	4,173
Adjustments	-8,659	-14,077
Balance at end of period	$860,788	$857,708

Income_Taxes_Details

Income Taxes (Details) (USD $)	12 Months Ended
Income Taxes (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013
Current deferred tax assets (liabilities):
Accounts receivable	$8,278,000	$1,611,000
Accrual to cash	-128,507,000	-89,609,000
Accrued liabilities	11,171,000	13,586,000
Credit carryforwards	2,375,000	693,000
Net operating loss carryforwards	2,405,000	38,232,000
Net current deferred tax liabilities	-104,278,000	-35,487,000
Long-term deferred tax liabilities (assets):
Intangible assets	-160,186,000	-171,315,000
Insurance and other long-term liabilities	46,760,000	37,692,000
Excess of tax over book depreciation	-39,927,000	-40,729,000
Net operating loss carryforwards	30,836,000	27,895,000
Credit carryforwards	2,580,000	2,555,000
Valuation allowance	-11,026,000	-7,228,000
Net long-term deferred tax liabilities	-130,963,000	-151,130,000
Net deferred tax liabilities	-235,241,000	-186,617,000
Increase in deferred tax liabilities, net	48,600,000
Decrease in valuation allowance	$3,800,000

Income_Taxes_Details_2

Income Taxes (Details 2) (USD $)	Dec. 31, 2014
In Millions, unless otherwise specified	Dec. 31, 2014
AMR
Income Taxes
Net operating loss carryforwards, annual limitation on use	$1.30
Federal
Income Taxes
Net operating loss carryforwards	$40.30

Income_Taxes_Details_3

Income Taxes (Details 3) (USD $)	12 Months Ended
Income Taxes (Details 3) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Reconciliation of the beginning and ending amount of unrecognized tax benefits
Balance at the beginning of the period	$614,000	$3,467,000	$963,000
Additions for tax positions of prior years	1,494,000	216,000	5,397,000
Reductions for tax positions of prior years			-1,896,000
Reductions for tax positions due to lapse of statute of limitations	-482,000	-3,069,000	-997,000
Balance at the end of the period	1,626,000	614,000	3,467,000
Recognition of interest and penalties expense	300,000	200,000	700,000
Reversal of interest previously recognized	100,000	500,000	200,000
Amount of penalties and interest included in unrecognized tax benefits	1,600,000	200,000	500,000
Current tax (benefit) expense
State	-4,602,000	-3,937,000	-5,131,000
Federal	-40,245,000	7,347,000	-34,965,000
Total	-44,847,000	3,410,000	-40,096,000
Deferred tax (benefit) expense
State	-4,353,000	5,586,000	-1,004,000
Federal	-40,298,000	-8,002,000	13,637,000
Total	-44,651,000	-2,416,000	12,633,000
Total tax (benefit) expense
State	-8,955,000	1,649,000	-6,135,000
Federal	-80,543,000	-655,000	-21,328,000
Total	-89,498,000	994,000	-27,463,000
Reconciliation of the provision for income taxes at the federal statutory rate compared to the entity's effective tax rate
Income tax expense at the statutory rate	-73,188,000	-3,562,000	-23,895,000
Increase in income taxes resulting from:
State taxes, net of federal	-6,453,000	-1,834,000	-4,218,000
Tax settlements and filings	-1,012,000	2,853,000	638,000
Tax credits	338,000	779,000
Dissenting shareholder settlement		-3,203,000
Change in valuation allowance	-3,816,000	3,126,000
State deferred rate change	1,170,000	1,161,000
Other	-967,000	419,000	-12,000
Income tax benefit (expense) before noncontrolling interest	-81,994,000	-1,099,000	-27,463,000
Noncontrolling interests	-7,504,000	2,093,000
Total	($89,498,000)	$994,000	($27,463,000)

Insurance_Collateral_Details

Insurance Collateral (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013
Insurance collateral
Available-for-sale securities	$30,243,000	$13,227,000
Insurance receivable	1,470,000	1,300,000
Cash deposits and other	11,683,000	27,808,000
Total insurance collateral	43,396,000	42,335,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Cost Basis	30,406,000	12,847,000
Gross Unrealized Gains	98,000	563,000
Gross Unrealized Losses	-261,000	-183,000
Fair Value	30,243,000	13,227,000
U.S. Treasuries
Insurance collateral
Available-for-sale securities	1,191,000	2,100,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Cost Basis	1,182,000	2,064,000
Gross Unrealized Gains	12,000	37,000
Gross Unrealized Losses	-3,000	-1,000
Fair Value	1,191,000	2,100,000
Corporate bonds / Fixed income
Insurance collateral
Available-for-sale securities	15,397,000	6,372,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Cost Basis	15,339,000	6,384,000
Gross Unrealized Gains	59,000	26,000
Gross Unrealized Losses	-1,000	-38,000
Fair Value	15,397,000	6,372,000
Corporate equity
Insurance collateral
Available-for-sale securities	13,655,000	4,755,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Cost Basis	13,885,000	4,399,000
Gross Unrealized Gains	27,000	500,000
Gross Unrealized Losses	-257,000	-144,000
Fair Value	13,655,000	4,755,000
U.S. Treasuries and Corporate bonds / Fixed income securities
Contractual maturities of available-for-sale securities
Within one year	3,600,000
Longer than one year through five years	$13,000,000

Insurance_Collateral_Details_2

Insurance Collateral (Details 2) (USD $)	12 Months Ended
Insurance Collateral (Details 2) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Insurance collateral
Securities available-for-sale, Fair Value, Total	$12,853,000	$7,631,000
Securities available-for-sale, Unrealized Loss, Total	-261,000	-183,000
Realized net gains on the sale and maturities of available-for-sale securities	400,000	500,000	400,000
U.S. Treasuries
Insurance collateral
Securities available-for-sale, Less than 12 months, Fair Value		132,000
Securities available-for-sale, 12 months or more, Fair Value	130,000
Securities available-for-sale, Less than 12 months, Unrealized Loss		-1,000
Securities available-for-sale, 12 months or more, Unrealized Loss	-3,000
Corporate bonds / Fixed income
Insurance collateral
Securities available-for-sale, Less than 12 months, Fair Value	1,312,000	2,768,000
Securities available-for-sale, 12 months or more, Fair Value	251,000	2,178,000
Securities available-for-sale, Less than 12 months, Unrealized Loss	-1,000	-18,000
Securities available-for-sale, 12 months or more, Unrealized Loss		-20,000
Corporate equity
Insurance collateral
Securities available-for-sale, Less than 12 months, Fair Value	11,160,000
Securities available-for-sale, 12 months or more, Fair Value		2,553,000
Securities available-for-sale, Less than 12 months, Unrealized Loss	-257,000
Securities available-for-sale, 12 months or more, Unrealized Loss		($144,000)

Accrued_Liabilities_Details

Accrued Liabilities (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Accrued wages and benefits	$190,220	$161,398
Accrued paid time-off	27,156	25,713
Current portion of self-insurance reserve	74,212	73,738
Accrued restructuring	8,376	5,682	12,318
Current portion of compliance and legal	3,407	2,000
Accrued billing and collection fees	3,823	2,954
Accrued incentive compensation	32,324	19,570
Accrued interest	22,324	6,898
Other	50,815	52,983
Total accrued liabilities	$412,657	$350,936

Debt_Details

Debt (Details) (USD $)

12 Months Ended

0 Months Ended

2 Months Ended

1 Months Ended

0 Months Ended

2 Months Ended

3 Months Ended

0 Months Ended

Dec. 31, 2014

Dec. 31, 2013

Dec. 31, 2012

Jun. 18, 2014

Dec. 30, 2013

25-May-11

Feb. 07, 2013

Feb. 28, 2013

Feb. 06, 2013

Feb. 27, 2013

Feb. 26, 2013

Jun. 30, 2014

Jun. 18, 2014

Jun. 30, 2012

Feb. 06, 2015

Long-Term Debt

Amount of debt held

$2,038,226,000

$1,907,699,000

Loss on early debt extinguishment

66,397,000

68,379,000

8,307,000

Outstanding debt

112,300,000

132,500,000

Debt issuance expense related to amendments

2,224,000

5,011,000

21,219,000

Senior unsecured notes due 2019

Long-Term Debt

Principal amount of debt redeemed

332,500,000

Redemption price (as a percent)

106.09%

108.13%

Repayments of debt and capital lease obligations

2,400,000

2,200,000

Loss on early debt extinguishment

66,400,000

38,700,000

617,500,000

Senior unsecured notes due 2019 | Corporation

Long-Term Debt

Debt issued

950,000,000

Senior unsecured notes due 2019 | Captive insurance subsidiary

Long-Term Debt

Amount of debt held

5,200,000

9,800,000

5,200,000

9,800,000

Senior unsecured notes purchased by EMSC subsidiary

Long-Term Debt

Amount of debt held

15,000,000

Credit Facilities | Corporation

Long-Term Debt

Maximum borrowing capacity

1,800,000

Term Loan Facility

Long-Term Debt

Debt issued

150,000,000

Amount of debt held

1,289,575,000

1,302,945,000

Repayments of debt and capital lease obligations

250,000,000

Loss on early debt extinguishment

8,300,000

100,000

Interest rate (as a percent)

4.00%

Term Loan Facility | Corporation

Long-Term Debt

Maximum borrowing capacity

1,440,000,000

Term Loan Facility | Option one

Long-Term Debt

Reference rate (as a percent)

1.50%

Interest rate margin (as a percent)

3.75%

Term Loan Facility | Option one | Corporation

Long-Term Debt

Interest rate margin (as a percent)

3.00%

Interest rate in the event of meeting specified consolidated first lien net leverage ratio (as a percent)

2.75%

Consolidated first lien net leverage ratio

2.5

Term Loan Facility | Option one | Overnight federal funds rate | Corporation

Long-Term Debt

Interest rate margin (as a percent)

0.50%

Term Loan Facility | Option two

Long-Term Debt

Reference rate (as a percent)

2.50%

Interest rate margin (as a percent)

2.75%

Term Loan Facility | Option two | Corporation

Long-Term Debt

Reference rate (as a percent)

2.00%

Interest rate margin (as a percent)

2.00%

Interest rate in the event of meeting specified consolidated first lien net leverage ratio (as a percent)

1.75%

Consolidated first lien net leverage ratio

2.5

Term Loan Facility | Option two | Adjusted LIBOR rate

Long-Term Debt

Variable interest rate basis

One-month Term Loan LIBOR rate

Term Loan Facility | Option two | Adjusted LIBOR rate | Corporation

Long-Term Debt

Reference rate (as a percent)

1.00%

Term Loan Facility | Option two | LIBOR rate

Long-Term Debt

Variable interest rate basis

One-month LIBOR rate

Interest rate margin (as a percent)

1.00%

ABL Facility

Long-Term Debt

Maximum borrowing capacity

450,000,000

550,000,000

Outstanding debt

112,300,000

Available borrowing capacity

337,700,000

Period of average excess availability exceeding agreed upon thresholds

30 days

Fixed charge coverage ratio

ABL Facility | Minimum

Long-Term Debt

Commitment fee (as a percent)

0.38%

ABL Facility | Maximum

Long-Term Debt

Commitment fee (as a percent)

0.50%

ABL Facility | Corporation

Long-Term Debt

Maximum borrowing capacity

350,000,000

ABL Facility | Option one | Overnight federal funds rate | Corporation

Long-Term Debt

Interest rate margin (as a percent)

0.50%

ABL Facility | Option one | Adjusted LIBOR rate | Minimum

Long-Term Debt

Interest rate margin (as a percent)

2.25%

Average daily excess availability as a percentage of availability

33.00%

ABL Facility | Option one | Adjusted LIBOR rate | Maximum

Long-Term Debt

Interest rate margin (as a percent)

2.75%

ABL Facility | Option one | Adjusted LIBOR rate | Average daily excess availability less than or equal to 33% of availability | Maximum

Long-Term Debt

Average daily excess availability as a percentage of availability

33.00%

ABL Facility | Option one | Adjusted LIBOR rate | Average daily excess availability greater than 33% but less than or equal to 66% of availability | Maximum

Long-Term Debt

Average daily excess availability as a percentage of availability

66.00%

ABL Facility | Option one | Adjusted LIBOR rate | Average daily excess availability greater than 66% of availability | Minimum

Long-Term Debt

Average daily excess availability as a percentage of availability

66.00%

ABL Facility | Option one | Adjusted LIBOR rate | Corporation | Average daily excess availability less than or equal to 33% of availability

Long-Term Debt

Interest rate margin (as a percent)

2.00%

ABL Facility | Option one | Adjusted LIBOR rate | Corporation | Average daily excess availability greater than 33% but less than or equal to 66% of availability

Long-Term Debt

Interest rate margin (as a percent)

1.75%

ABL Facility | Option one | Adjusted LIBOR rate | Corporation | Average daily excess availability greater than 66% of availability

Long-Term Debt

Interest rate margin (as a percent)

1.50%

ABL Facility | Option two | Minimum

Long-Term Debt

Interest rate margin (as a percent)

1.25%

ABL Facility | Option two | Maximum

Long-Term Debt

Interest rate margin (as a percent)

1.75%

ABL Facility | Option two | Overnight federal funds rate

Long-Term Debt

Interest rate margin (as a percent)

0.50%

ABL Facility | Option two | Adjusted LIBOR rate | Average daily excess availability less than or equal to 33% of availability | Maximum

Long-Term Debt

Average daily excess availability as a percentage of availability

33.00%

ABL Facility | Option two | Adjusted LIBOR rate | Average daily excess availability greater than 33% but less than or equal to 66% of availability

Long-Term Debt

Average daily excess availability as a percentage of availability

33.00%

ABL Facility | Option two | Adjusted LIBOR rate | Average daily excess availability greater than 33% but less than or equal to 66% of availability | Maximum

Long-Term Debt

Average daily excess availability as a percentage of availability

66.00%

ABL Facility | Option two | Adjusted LIBOR rate | Average daily excess availability greater than 66% of availability | Minimum

Long-Term Debt

Average daily excess availability as a percentage of availability

66.00%

ABL Facility | Option two | Adjusted LIBOR rate | Corporation

Long-Term Debt

Variable interest rate basis

One-month LIBOR rate

Interest rate margin (as a percent)

1.00%

ABL Facility | Option two | Adjusted LIBOR rate | Corporation | Average daily excess availability less than or equal to 33% of availability

Long-Term Debt

Interest rate margin (as a percent)

1.00%

ABL Facility | Option two | Adjusted LIBOR rate | Corporation | Average daily excess availability greater than 33% but less than or equal to 66% of availability

Long-Term Debt

Interest rate margin (as a percent)

0.75%

ABL Facility | Option two | Adjusted LIBOR rate | Corporation | Average daily excess availability greater than 66% of availability

Long-Term Debt

Interest rate margin (as a percent)

0.50%

ABL Facility | Option two | LIBOR rate

Long-Term Debt

Variable interest rate basis

One-month ABL LIBOR

Interest rate margin (as a percent)

1.00%

Senior Unsecured Notes due 2022

Long-Term Debt

Amount of debt held

750,000,000

Loss on early debt extinguishment

-9,400,000

Repurchase price of debt instrument as a percentage of principal amount in the event of a change of control

101.00%

Repurchase price of debt instrument as a percentage of principal amount in the event of sale of assets

100.00%

Senior Unsecured Notes due 2022 | Period prior to July 1, 2017

Long-Term Debt

Redemption price (as a percent)

100.00%

Interest rate margin (as a percent)

1.00%

Percentage of aggregate principal amount of debt instrument that may be redeemed

40.00%

Redemption price of debt instrument as a percentage of principal amount with proceeds of certain equity offerings

105.13%

Senior Unsecured Notes due 2022 | Period on and after July 1, 2017 and prior to July 1, 2018

Long-Term Debt

Redemption price (as a percent)

103.84%

Senior Unsecured Notes due 2022 | Period on or after July 1, 2018 and prior to July 1, 2019

Long-Term Debt

Redemption price (as a percent)

102.56%

Senior Unsecured Notes due 2022 | Period on or after July 1, 2019 and prior to July 1, 2020

Long-Term Debt

Redemption price (as a percent)

101.28%

Senior Unsecured Notes due 2022 | Period on or after July 1, 2020

Long-Term Debt

Redemption price (as a percent)

100.00%

Senior Unsecured Notes due 2022 | Corporation

Long-Term Debt

Debt issued

$750,000,000

Interest rate (as a percent)

5.13%

Debt_Details_2

Debt (Details 2) (USD $)	12 Months Ended			0 Months Ended
Debt (Details 2) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Aug. 30, 2013	Oct. 01, 2012
Debt
Loss on early debt extinguishment	$66,397,000	$68,379,000	$8,307,000
Senior PIK Toggle Notes due 2017
Debt
Face amount of debt					450,000,000
Redemption price of debt instrument as a percentage of principal amount				102.75%
Repayments of debt and capital lease obligations				17,200,000
Loss on early debt extinguishment		$29,500,000

Debt_Details_3

Debt (Details 3) (USD $)	12 Months Ended
Debt (Details 3) (USD $)	Dec. 31, 2014	Dec. 31, 2013
Long-Term Debt
Total debt	$2,038,226,000	$1,907,699,000
Less current portion	-12,349,000	-12,318,000
Total long-term debt and capital lease obligations	2,025,877,000	1,895,381,000
Amount of certain fees paid by the entity	3,300,000
Aggregate amount of minimum payments required on long-term debt and capital lease obligations
2015	13,850,000
2016	13,883,000
2017	13,999,000
2018	1,249,539,000
2019	64,000
Thereafter	750,208,000
Total	2,041,543,000
Senior subordinated unsecured notes due 2019
Long-Term Debt
Total debt		607,750,000
Senior Unsecured Notes due 2022
Long-Term Debt
Total debt	750,000,000
Term Loan Facility
Long-Term Debt
Total debt	1,289,575,000	1,302,945,000
Discount on debt	-3,317,000	-4,217,000
Interest rate (as a percent)	4.00%	4.00%
Notes due at various dates from 2014 to 2022
Long-Term Debt
Total debt	482,000	852,000
Interest rate, minimum (as a percent)	6.00%
Interest rate, maximum (as a percent)	10.00%
Capital lease obligations due at various dates from 2014 to 2018
Long-Term Debt
Total debt	$1,486,000	$369,000

Derivative_Instruments_and_Hed1

Derivative Instruments and Hedging Activities (Details) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
	agreement	Dec. 31, 2013	Dec. 31, 2012
Derivative Instruments and Hedging Activities
Total gallons of diesel fuel	3,000,000
Fuel hedge
Derivative Instruments and Hedging Activities
Number of master agreements	1
Gallons of diesel fuel as a percentage of total estimated annual usage	11.10%
Fair value of derivative asset	$1.40	$0.70
Period over which deferred gain (loss) is expected to be reclassified from accumulated comprehensive income	12 months
Amount of deferred gain (loss) expected to be reclassified from accumulated comprehensive income	-0.7
Net payments to the counterparty	0.3
Net receipts from the counterparty		0.5	1
Fuel hedge \| Minimum
Derivative Instruments and Hedging Activities
Diesel fuel price (in dollars per gallon)	3.3
Fuel hedge \| Maximum
Derivative Instruments and Hedging Activities
Diesel fuel price (in dollars per gallon)	3.58
Interest rate swap agreements
Derivative Instruments and Hedging Activities
Notional amount of debt obligations	400
Effective rate of interest of debt (as a percent)	4.49%
Minimum variable interest rate of debt (as a percent)	1.00%
Fair value of derivative liability	1.5	3.1
Period over which deferred gain (loss) is expected to be reclassified from accumulated comprehensive income	12 months
Amount of deferred gain (loss) expected to be reclassified from accumulated comprehensive income	-1.5
Net payments to the counterparty	$2	$2	$0.50

Changes_in_Accumulated_Other_C2

Changes in Accumulated Other Comprehensive Income (Loss) by Component (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period	($839)	($213)
Other comprehensive income (loss) before reclassifications	-1,837	-1,330
Amounts reclassified from accumulated other comprehensive income (loss)	820	704
Total other comprehensive income (loss), net of tax	-1,017	-626	2,489
Balance at the end of the period	-1,856	-839	-213
Unrealized holding gains on available-for-sale securities
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period	699	1,591
Other comprehensive income (loss) before reclassifications	-491	-598
Amounts reclassified from accumulated other comprehensive income (loss)	-232	-294
Total other comprehensive income (loss), net of tax	-723	-892
Balance at the end of the period	-24	699
Fuel hedge \| Gains and losses on cash flow hedges
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period	420	1,057
Other comprehensive income (loss) before reclassifications	-1,130	-396
Amounts reclassified from accumulated other comprehensive income (loss)	-187	-241
Total other comprehensive income (loss), net of tax	-1,317	-637
Balance at the end of the period	-897	420
Interest rate swap agreements \| Gains and losses on cash flow hedges
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period	-1,958	-2,861
Other comprehensive income (loss) before reclassifications	-216	-336
Amounts reclassified from accumulated other comprehensive income (loss)	1,239	1,239
Total other comprehensive income (loss), net of tax	1,023	903
Balance at the end of the period	($935)	($1,958)

Changes_in_Accumulated_Other_C3

Changes in Accumulated Other Comprehensive Income (Loss) by Component (Details 2) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Amounts Reclassified from Accumulated Other Comprehensive Income
Operating expenses	$487,841	$424,865	$421,424
Interest expense, net	110,505	186,701	182,607
Realized gains (losses) on investments	371	471	394
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	209,110	10,178	68,269
Tax benefit (expense)	-89,498	994	-27,463
Net income	125,508	5,995	41,185
Gains and losses on cash flow hedges \| Amounts Reclassified from Accumulated Other Comprehensive Income
Amounts Reclassified from Accumulated Other Comprehensive Income
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-1,686	-1,600
Tax benefit (expense)	634	602
Net income	-1,052	-998
Gains and losses on cash flow hedges \| Fuel hedge \| Amounts Reclassified from Accumulated Other Comprehensive Income
Amounts Reclassified from Accumulated Other Comprehensive Income
Operating expenses	300,000	386,000
Gains and losses on cash flow hedges \| Interest rate swap agreements \| Amounts Reclassified from Accumulated Other Comprehensive Income
Amounts Reclassified from Accumulated Other Comprehensive Income
Interest expense, net	-1,986	-1,986
Unrealized holding gains on available-for-sale securities \| Amounts Reclassified from Accumulated Other Comprehensive Income
Amounts Reclassified from Accumulated Other Comprehensive Income
Realized gains (losses) on investments	371	471
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	371	471
Tax benefit (expense)	-139	-177
Net income	$232	$294

Equity_Details

Equity (Details) (USD $)	0 Months Ended	1 Months Ended	12 Months Ended		0 Months Ended		12 Months Ended	0 Months Ended
	Feb. 05, 2014	Sep. 30, 2014	Dec. 31, 2013	Dec. 31, 2012	Jul. 10, 2014	Aug. 19, 2013	Dec. 31, 2014	Sep. 30, 2014	Sep. 23, 2014
	Feb. 05, 2014	Sep. 30, 2014	Dec. 31, 2013	Dec. 31, 2012	Jul. 10, 2014	Aug. 19, 2013	item	Sep. 30, 2014	Sep. 23, 2014
Equity
Shares of common stock issued	27,500,000	17,500,000
Issue price (in dollars per share)	$30.50				34		33.32		$34.97
Aggregate offering price			$1,112,017,000	$334,000
Amount of debt held			1,907,699,000				2,038,226,000
Preferred stock, shares authorized			200,000,000				200,000,000
Senior subordinated unsecured notes due 2019
Equity
Amount used to redeem or repay the debt outstanding			332,500,000
Amount of debt held			607,750,000
Aggregate principal amount of notes redeemed			356,500,000
ABL Facility
Equity
Amount used to redeem or repay the debt outstanding			16,500,000
EVHC
Equity
Shares of common stock issued	27,500,000				27,500,000
Aggregate offering price			1,110,900,000			1,025,900,000
Number of votes for each share							1
Preferred stock, shares authorized			200,000,000				200,000,000
EVHC \| Senior PIK Toggle Notes due 2017
Equity
Amount used to redeem or repay the debt outstanding			479,600,000
EVHC \| ABL Facility
Equity
Amount used to redeem or repay the debt outstanding			16,500,000
Captive insurance subsidiary \| Senior subordinated unsecured notes due 2019
Equity
Amount of debt held			5,200,000
CD&R
Equity
Payment made in connection with the termination of a corporation consulting agreement			20,000,000			20,000,000
CD&R \| EVHC
Equity
Payment made in connection with the termination of a corporation consulting agreement			20,000,000			20,000,000
Initial public offering
Equity
Shares of common stock issued						42,000,000
Issue price (in dollars per share)						$23
Initial public offering \| EVHC
Equity
Shares of common stock issued						42,000,000
Aggregate offering price						1,110,900,000
Underwriter overallotment option
Equity
Shares of common stock issued					4,125,000	6,300,000
Aggregate offering price						1,110,900,000
Underwriters' discounts and commissions and offering expenses						85,000,000
Underwriter overallotment option \| EVHC
Equity
Shares of common stock issued	4,125,000				4,125,000	6,300,000		17,500,000
Issue price (in dollars per share)	$30.50	34.97			34	$23		$34.97
Aggregate offering price						1,025,900,000
Underwriters' discounts and commissions and offering expenses						$85,000,000

Restructuring_Charges_Details

Restructuring Charges (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Restructuring Charges
Incurred	$6,968	$5,669	$14,086
Paid	-4,274	-12,335
Accrued restructuring liability	8,376	5,682	12,318
EmCare
Restructuring Charges
Incurred	1,036	913
Paid	-1,330	-1,204
Accrued restructuring liability	188	482	773
Lease & Other Contract Termination Costs \| AMR
Restructuring Charges
Incurred	3,153	1,876
Paid	-615	-6,989
Accrued restructuring liability	5,547	3,009	8,122
Severance \| AMR
Restructuring Charges
Incurred	2,779	2,890
Paid	-2,278	-3,765
Accrued restructuring liability	2,641	2,140	3,015
Severance \| EVHC
Restructuring Charges
Incurred		20
Paid	-51	-377
Accrued restructuring liability		$51	$408

Retirement_Plans_and_Employee_1

Retirement Plans and Employee Benefits (Details) (USD $)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
	item	Dec. 31, 2013	Dec. 31, 2012
Retirement Plans and Employee Benefits
Number of 401(k) Plans	2
Maximum percentage of compensation which an employee may contribute under the 401(k) Plans	40.00%
Maximum annual employee contribution	$17,500,000
Employer matching contribution (as a percent)	50.00%
Maximum percentage of employee's eligible compensation for employer contribution match	6.00%
Employer contributions	12,900,000	9,300,000	12,300,000
Associated Physicians' Plan
Retirement Plans and Employee Benefits
Employer contributions	$2,900,000	$2,000,000	$2,500,000
Percentage reduction in employee's annual compensation in exchange for employer contribution made to their retirement account	20.00%
Minimum \| Associated Physicians' Plan
Retirement Plans and Employee Benefits
Maximum percentage of compensation which an employee may contribute under the 401(k) Plans	1.00%
Maximum \| Associated Physicians' Plan
Retirement Plans and Employee Benefits
Maximum percentage of compensation which an employee may contribute under the 401(k) Plans	25.00%

Equity_Based_Compensation_Deta

Equity Based Compensation (Details) (USD $)	12 Months Ended
Equity Based Compensation (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Sep. 23, 2014	Jul. 10, 2014	Feb. 05, 2014	Oct. 31, 2012	Aug. 19, 2013
Equity based compensation
Number of shares granted	45,370
Compensation charges	$5,109,000	$4,248,000	$4,248,000
Weighted Average Remaining Life
Market price (in dollars per share)	$33.32			$34.97	$34	$30.50
Minimum
Equity based compensation
Number of shares granted	2,500,000
Stock options
Equity based compensation
Tax benefits realized from stock awards exercised	46,200,000
Stock options \| Class A
Shares
Outstanding at beginning of year (in shares)	16,322,148
Granted (in shares)	34,304
Exercised (in shares)	-3,855,797
Forfeited (in shares)	-125,757
Outstanding at end of year (in shares)	12,374,898	16,322,148
Exercisable at end of year (in shares)	9,625,258
Weighted Average Exercise Price
Outstanding at beginning of year (in dollars per share)	$3.70
Granted (in dollars per share)	$33.25
Exercised (in dollars per share)	$2.64
Forfeited (in dollars per share)	$6.31
Outstanding at end of year (in dollars per share)	$4.10	$3.70
Exercisable at end of year (in dollars per share)	$3.93
Aggregate Intrinsic Value
Outstanding at beginning of year	519,325,000
Outstanding at end of year	378,574,000	519,325,000
Exercisable at end of year	296,038,000
Weighted Average Remaining Life
Outstanding at beginning of year	6 years 3 months 18 days	6 years 7 months 6 days
Outstanding at end of year	6 years 3 months 18 days	6 years 7 months 6 days
Exercisable at end of year	6 years 1 month 6 days
Stock options \| Key management employees
Equity based compensation
Number of shares granted			45,370
Stock options \| Maximum
Equity based compensation
Tax benefits realized from stock awards exercised		1,000,000	1,000,000
RSUs \| Non-employee directors
Equity based compensation
Number of shares granted		23,623	19,004
Weighted Average Remaining Life
Market price (in dollars per share)		$7.39	$6.64
Stock Compensation Plan
Equity based compensation
Compensation charges	5,100,000	4,200,000	4,200,000
Stock Compensation Plan \| Stock options \| Key management employees
Equity based compensation
Strike price (in dollars per share)							$3.69
Strike price before revision (in dollars per share)							$6.88
Stock Compensation Plan \| Stock options \| Maximum
Equity based compensation
Term of awards	10 years
Omnibus Incentive Plan
Equity based compensation
Shares of Common Stock available for grant	16,534,218							16,708,289
Number of participants, to whom awards granted in calendar year	0
Omnibus Incentive Plan \| Maximum
Equity based compensation
Fair market value of awards granted	$5,000,000
Omnibus Incentive Plan \| Performance based awards
Equity based compensation
Number of shares granted	0
Omnibus Incentive Plan \| Performance based awards \| Minimum
Equity based compensation
Number of shares granted	1,500,000
Omnibus Incentive Plan \| Stock options \| Maximum
Equity based compensation
Term of awards	10 years

Equity_Based_Compensation_Deta1

Equity Based Compensation (Details 2) (USD $)	12 Months Ended
In Millions, except Per Share data, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Fair value assumptions
Weighted average fair value of the options granted (in dollars per share)	11.03	2.44
Total intrinsic value of awards exercised	115	9.4
Unrecognized compensation expense	5.1
Weighted average remaining vesting life	1 year 1 month 6 days
Stock options
Fair value assumptions
Volatility, minimum (as a percent)	30.00%	30.00%
Volatility, maximum (as a percent)	35.00%	35.00%
Volatility (as a percent)			30.00%
Risk free rate, minimum (as a percent)	0.33%	0.67%	0.20%
Risk free rate, maximum (as a percent)	2.17%	1.56%	0.82%
Expected dividend yield (as a percent)	0.00%	0.00%	0.00%
Expected term of options		5 years
Stock options \| Maximum
Fair value assumptions
Expected term of options	7 years		5 years
Stock options \| Minimum
Fair value assumptions
Expected term of options	6 years 3 months 18 days		2 years

Commitments_and_Contingencies_1

Commitments and Contingencies (Details) (USD $)	12 Months Ended
Commitments and Contingencies (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Commitments and Contingencies
Rental expense	$45,700,000	$44,800,000	$42,900,000
Capital Leases
2015	519,000
2016	519,000
2017	589,000
2018	19,000
Total	1,646,000
Less imputed interest	-160,000
Total capital lease obligations	1,486,000
Less current portion	-433,000
Long-term capital lease obligations	1,053,000
Operating Leases & Other
2015	63,676,000
2016	41,897,000
2017	38,385,000
2018	31,510,000
2019	21,155,000
Thereafter	40,716,000
Total	$237,339,000

Commitments_and_Contingencies_2

Commitments and Contingencies (Details 2) (USD $)	12 Months Ended	0 Months Ended	23 Months Ended	0 Months Ended
	Dec. 31, 2013	Apr. 15, 2013	Mar. 10, 2010	Sep. 12, 2006	20-May-11	Dec. 31, 2014	Nov. 30, 2013
	Dec. 31, 2013	Apr. 15, 2013	item	Sep. 12, 2006	20-May-11	Dec. 31, 2014	item
Commitments and Contingencies
Outstanding letters of credit	$132,500,000					$112,300,000
Payment of dissenting shareholder settlement	13,717,000
Payment of dissenting shareholder settlement	38,336,000
Merion Capital, L.P
Commitments and Contingencies
Settlement amount to resolve the claims		52,100,000
Payment of dissenting shareholder settlement	13,700,000
Payment of dissenting shareholder settlement	38,300,000
Legal settlement costs	8,400,000
Accrued interest included in reserve for unpaid merger consideration	1,900,000
AMR \| Predecessor
Commitments and Contingencies
Number of lawsuits purporting to be class actions filed			4
Violation of the federal anti-kickback statute \| AMR
Commitments and Contingencies
Term of CIA				5 years
Violation of the federal anti-kickback statute \| AMR \| Predecessor
Commitments and Contingencies
Amount paid for settlement				9,000,000
Subpoena from the DOJ \| AMR
Commitments and Contingencies
Term of CIA					5 years
Subpoena from the DOJ \| AMR \| Predecessor
Commitments and Contingencies
Settlement amount to resolve the claims					2,700,000
Subpoena from the OIG \| EmCare
Commitments and Contingencies
Number of lawsuits, in which the Company is defendant						2
Subpoena from New Hampshire Department of Insurance \| AMR
Commitments and Contingencies
Number of motor vehicle accident patients transported by AMR							150

Related_Party_Transactions_Det

Related Party Transactions (Details) (USD $)	12 Months Ended	0 Months Ended	12 Months Ended
Related Party Transactions (Details) (USD $)	Dec. 31, 2014	Nov. 15, 2008	Dec. 31, 2013
CD&R
Related party transactions
Percentage of outstanding shares of common stock owned	27.70%
The Hertz Corporation
Related party transactions
Minimum agreed amount per year to be spend for rental of cars		$460,000
Term of the corporate account agreement	1 year
The Hertz Corporation \| Maximum
Related party transactions
Amount spent under contract	1,000,000		$1,000,000
Condition one \| CD&R \| Minimum
Related party transactions
Percentage of outstanding shares of common stock owned	50.00%
Condition two \| CD&R \| Minimum
Related party transactions
Percentage of outstanding shares of common stock owned	40.00%
Percentage of total number of directors comprising the board of directors	40.00%
Condition two \| CD&R \| Maximum
Related party transactions
Percentage of outstanding shares of common stock owned	50.00%
Condition three \| CD&R \| Minimum
Related party transactions
Percentage of outstanding shares of common stock owned	30.00%
Percentage of total number of directors comprising the board of directors	30.00%
Condition three \| CD&R \| Maximum
Related party transactions
Percentage of outstanding shares of common stock owned	40.00%
Condition four \| CD&R
Related party transactions
Percentage of outstanding shares of common stock owned	30.00%
Condition four \| CD&R \| Minimum
Related party transactions
Percentage of outstanding shares of common stock owned	20.00%
Percentage of total number of directors comprising the board of directors	20.00%
Condition five \| CD&R \| Minimum
Related party transactions
Percentage of outstanding shares of common stock owned	5.00%
Percentage of total number of directors comprising the board of directors	5.00%
Condition five \| CD&R \| Maximum
Related party transactions
Percentage of outstanding shares of common stock owned	20.00%
Additional condition \| CD&R \| Minimum
Related party transactions
Percentage of outstanding shares of common stock owned	30.00%

Variable_Interest_Entities_Det

Variable Interest Entities (Details) (USD $)	12 Months Ended
Variable Interest Entities (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	$1,363,239,000	$1,082,283,000
Current liabilities	576,868,000	451,329,000
Income tax benefit included in net losses attributable to noncontrolling interest	2,300,000
UHS-EmCare JV
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	21,427,000
Current liabilities	6,748,000
Cash contributions for working capital requirements	300,000
UHS-EmCare JV \| EmCare
Variable Interest Entities
Voting control (as a percent)	50.00%
HCA-EmCare JV
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	155,041,000	88,479,000
Current liabilities	31,163,000	22,005,000
Cash contributions for working capital requirements	$1,000,000	$3,000,000	$6,500,000
HCA-EmCare JV \| EmCare
Variable Interest Entities
Voting control (as a percent)	50.00%

Insurance_Details

Insurance (Details) (USD $)	12 Months Ended
Insurance (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013
Schedule of Business Insurance Collateral and Reserve [Line Items]
Discount rate for claims other than general liability claims (as a percent)	1.50%
Non-health and welfare insurance reserves
Accrued Liabilities	$74,212,000	$73,738,000
Insurance reserves	180,639,000	175,427,000
Total Liabilities	254,851,000	249,165,000
Minimum
Schedule of Business Insurance Collateral and Reserve [Line Items]
Liability exposure in instances where third-party insurance coverage is obtained	1,000,000
Maximum
Schedule of Business Insurance Collateral and Reserve [Line Items]
Liability exposure in instances where third-party insurance coverage is obtained	3,000,000
Automobile
Non-health and welfare insurance reserves
Accrued Liabilities	7,469,000	7,034,000
Insurance reserves	6,230,000	5,779,000
Total Liabilities	13,699,000	12,813,000
Workers compensation
Non-health and welfare insurance reserves
Accrued Liabilities	18,299,000	21,876,000
Insurance reserves	30,826,000	32,097,000
Total Liabilities	49,125,000	53,973,000
General/Professional liability
Non-health and welfare insurance reserves
Accrued Liabilities	48,444,000	44,828,000
Insurance reserves	143,583,000	137,551,000
Total Liabilities	$192,027,000	$182,379,000

Insurance_Details_2

Insurance (Details 2) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Changes to the entity's estimated losses under self-insured programs
Balance at the beginning of the period	$249,165	$238,597	$247,872
Expense for current period reserves	62,836	74,501	77,003
Unfavorable (favorable) changes to prior reserves	7,539	9,141	-2,480
Changes in losses covered by commercial insurance programs	17,532		-9,185
Increase in reserves from acquisitions	18,217
Payments for claims	-100,438	-73,074	-74,613
Balance at the end of the period	254,851	249,165	238,597
Discount factor	7,045	8,418	8,485
Undiscounted reserve, end of period	261,896	257,583	247,082
Expected future claim payments relating to non-health and welfare insurance reserves
2015	74,212
2016	58,942
2017	41,294
2018	28,497
2019	16,915
Thereafter	34,991
Total	$254,851

Segment_Information_Details

Segment Information (Details) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	item	Dec. 31, 2013	Dec. 31, 2012
Segment Information
Number of separately managed business units									2
Segment Information
Net revenue	$1,157,777	$1,150,329	$1,075,327	$1,014,211	$984,845	$955,888	$899,255	$888,324	$4,397,644	$3,728,312	$3,300,121
Income from operations	113,128	113,901	93,139	68,318	84,687	63,503	65,703	62,862	388,486	276,755	256,742
Adjusted EBITDA									556,224	445,705	404,452
Goodwill	2,538,633				2,435,670				2,538,633	2,435,670	2,413,632
Intangible assets, net	524,482				513,698				524,482	513,698
Total identifiable assets	4,703,753				4,300,017				4,703,753	4,300,017
Capital expenditures									78,046	65,879	60,215
Segment
Segment Information
Net revenue									4,397,644	3,728,312	3,300,121
Income from operations									388,486	276,828	256,941
Adjusted EBITDA									556,224	445,778	404,651
Goodwill	2,538,633				2,435,670				2,538,633	2,435,670	2,413,632
Intangible assets, net	524,482				513,698				524,482	513,698	564,218
Total identifiable assets	4,500,450				4,139,323				4,500,450	4,139,323	4,013,513
Capital expenditures									71,940	59,664	54,917
Segment \| Facility-Based Physician Services
Segment Information
Net revenue									2,842,458	2,358,787	1,915,148
Income from operations									282,495	219,842	199,300
Adjusted EBITDA									363,333	294,033	260,657
Goodwill	1,679,495				1,574,882				1,679,495	1,574,882	1,555,924
Intangible assets, net	365,094				370,897				365,094	370,897	407,184
Total identifiable assets	2,884,250				2,624,161				2,884,250	2,624,161	2,468,605
Capital expenditures									15,480	8,215	12,229
Segment \| Healthcare Transportation Services
Segment Information
Net revenue									1,555,186	1,369,525	1,384,973
Income from operations									105,991	56,986	57,641
Adjusted EBITDA									192,891	151,745	143,994
Goodwill	859,138				860,788				859,138	860,788	857,708
Intangible assets, net	159,388				142,801				159,388	142,801	157,034
Total identifiable assets	1,616,200				1,515,162				1,616,200	1,515,162	1,544,908
Capital expenditures									$56,460	$51,449	$42,688

Segment_Information_Details_2

Segment Information (Details 2) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Reconciliation of net income (loss) to Adjusted EBITDA
Net income (loss)	$47,490	$52,843	($1,992)	$21,525	$13,408	($7,663)	$9,597	($3,847)	$119,866	$11,495	$41,185
Add-back of non-operating expense (income):
Interest expense, net									110,505	186,701	182,607
Income tax expense (benefit)									89,498	-994	27,463
Loss on early debt extinguishment									66,397	68,379	8,307
Realized (losses) gains on investments									-371	-471	-394
Equity in earnings of unconsolidated subsidiary									-254	-323	-379
Other expense (income), net									3,980	12,760	-1,422
Income from operations	113,128	113,901	93,139	68,318	84,687	63,503	65,703	62,862	388,486	276,755	256,742
Add-back of operating expense (income):
Depreciation and amortization expense									146,155	140,632	123,751
Restructuring charges									6,968	5,669	14,086
Net loss (income) attributable to noncontrolling interest									-5,642	5,500
Interest income from restricted assets									-1,135	-792	-625
Equity-based compensation expense									5,109	4,248	4,248
Adjusted EBITDA									556,224	445,705	404,452
Segment
Reconciliation of net income (loss) to Adjusted EBITDA
Net income (loss)									119,866	11,495	41,185
Add-back of non-operating expense (income):
Interest expense, net									110,505	186,701	182,607
Income tax expense (benefit)									89,498	-994	27,463
Loss on early debt extinguishment									66,397	68,379	8,307
Realized (losses) gains on investments									-371	-471	-394
Interest income from restricted assets									-1,135	-792	-625
Equity in earnings of unconsolidated subsidiary									-254	-323	-379
Other expense (income), net									3,980	12,760	-1,422
Income from operations									388,486	276,828	256,941
Add-back of operating expense (income):
Depreciation and amortization expense									146,155	140,632	123,751
Restructuring charges									6,968	5,669	14,086
Net loss (income) attributable to noncontrolling interest									5,642	-5,500
Adjustment to net (income) loss attributable to noncontrolling interest due to deferred taxes									2,259
Interest income from restricted assets									1,135	792	625
Equity-based compensation expense									5,109	4,248	4,248
Transaction costs	4,988								4,988
Related party management fees										23,109	5,000
Adjusted EBITDA									556,224	445,778	404,651
EVHC.
Add-back of operating expense (income):
Corporate operating expense										($73)	($199)

Segment_Information_Details_3

Segment Information (Details 3) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Reconciliation of segment assets to total assets and segment capital expenditures to total capital expenditures
Total identifiable assets	$4,703,753	$4,300,017
Capital expenditures	78,046	65,879	60,215
Segment
Reconciliation of segment assets to total assets and segment capital expenditures to total capital expenditures
Total identifiable assets	4,500,450	4,139,323	4,013,513
Capital expenditures	71,940	59,664	54,917
EVHC.
Reconciliation of segment assets to total assets and segment capital expenditures to total capital expenditures
Cash	167,345	133,792
Other assets	35,958	26,902
Capital expenditures	$6,106	$6,215	$5,298

Segment_Information_Details_4

Segment Information (Details 4)	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
	item	Dec. 31, 2013	Dec. 31, 2012
Employees currently in the process of negotiations or who will be subject to negotiation in 2015 \| Collective Bargaining Agreements \| AMR
Collective Bargaining Agreements
Percentage of concentration risk	43.00%
Number of collective bargaining agreements	42
Number of operational locations	23
Number of employees subject to collective bargaining agreements	3,150
Employees who will be subject to negotiations in 2016 \| Collective Bargaining Agreements \| AMR
Collective Bargaining Agreements
Number of collective bargaining agreements	9
Number of employees subject to collective bargaining agreements	1,800
Total net revenue \| Customer concentration risk \| Hospital Corporation of America
Collective Bargaining Agreements
Percentage of concentration risk	27.50%	21.70%	14.90%
Numberof customers that represent a concentration risk	1

Valuation_and_Qualifying_Accou2

Valuation and Qualifying Accounts (Details) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Allowance for Contractual Discounts
Changes in valuation and qualifying accounts
Balance at the beginning of the period	$2,002,704	$1,619,488	$1,254,452
Additions	11,255,851	8,607,966	7,169,942
Reductions	-10,457,703	-8,224,750	-6,804,906
Balance at the end of the period	2,800,852	2,002,704	1,619,488
Allowance for Uncompensated Care
Changes in valuation and qualifying accounts
Balance at the beginning of the period	1,038,833	841,754	655,419
Additions	3,487,309	3,043,210	2,534,511
Reductions	-3,298,343	-2,846,131	-2,348,176
Balance at the end of the period	1,227,799	1,038,833	841,754
Total Accounts Receivable Allowances
Changes in valuation and qualifying accounts
Balance at the beginning of the period	3,041,537	2,461,242	1,909,871
Additions	14,743,160	11,651,176	9,704,453
Reductions	-13,756,046	-11,070,881	-9,153,082
Balance at the end of the period	$4,028,651	$3,041,537	$2,461,242

Consolidating_Financial_Inform2

Consolidating Financial Information (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Current assets:
Cash and cash equivalents	$318,895	$204,712	$57,832	$134,023
Insurance collateral	32,828	29,619
Trade and other accounts receivable, net	950,115	801,146
Parts and supplies inventory	24,484	23,376
Prepaids and other current assets	36,917	23,430
Total current assets	1,363,239	1,082,283
Property, plant, and equipment, net	211,276	194,715
Intangible assets, net	524,482	513,698
Insurance collateral	10,568	12,716
Goodwill	2,538,633	2,435,670	2,413,632
Other long-term assets	55,555	60,935
Total assets	4,703,753	4,300,017
Current liabilities:
Accounts payable	47,584	52,588
Accrued liabilities	412,657	350,936
Current deferred tax liabilities	104,278	35,487
Current portion of long-term debt and capital lease obligations	12,349	12,318
Total current liabilities	576,868	451,329
Long-term debt and capital lease obligations	2,025,877	1,895,381
Long-term deferred tax liabilities	130,963	151,130
Insurance reserves	180,639	175,427
Other long-term liabilities	20,365	16,997
Total liabilities	2,934,712	2,690,264
Equity:
Common stock	1,837	1,804
Preferred stock
Additional paid-in capital	1,616,747	1,575,417
Retained earnings	143,849	18,341
Accumulated other comprehensive income (loss)	-1,856	-839	-213
Total Envision Healthcare Holdings, Inc. equity	1,760,577	1,594,723
Noncontrolling interest	8,464	15,030
Total equity	1,769,041	1,609,753	544,687	913,490
Total liabilities and equity	4,703,753	4,300,017
Consolidating Adjustments
Current assets:
Prepaids and other current assets	-5,019	-27,355
Total current assets	-5,019	-27,355
Long-term deferred tax assets	-145	-128
Investment in wholly owned subsidiary	-1,756,407	-1,486,129
Total assets	-1,761,571	-1,513,612
Current liabilities:
Accrued liabilities	-3,650	-7,043
Current deferred tax liabilities	-1,369	-20,312
Total current liabilities	-5,019	-27,355
Long-term deferred tax liabilities	-145	-128
Total liabilities	-5,164	-27,483
Equity:
Additional paid-in capital	-1,544,222	-1,402,861
Retained earnings	-214,041	-84,107
Accumulated other comprehensive income (loss)	1,856	839
Total Envision Healthcare Holdings, Inc. equity	-1,756,407	-1,486,129
Total equity	-1,756,407	-1,486,129
Total liabilities and equity	-1,761,571	-1,513,612
EVHC (excluding Corporation)
Current assets:
Cash and cash equivalents	5	81,722	281
EVHC (excluding Corporation) \| Reportable legal entity
Current assets:
Cash and cash equivalents	5	81,722
Prepaids and other current assets	5,019	26,860
Total current assets	5,024	108,582
Long-term deferred tax assets	145	128
Investment in wholly owned subsidiary	1,756,407	1,486,129
Total assets	1,761,576	1,594,839
Current liabilities:
Accounts payable	999	116
Total current liabilities	999	116
Total liabilities	999	116
Equity:
Common stock	1,837	1,804
Additional paid-in capital	1,616,747	1,575,417
Retained earnings	143,849	18,341
Accumulated other comprehensive income (loss)	-1,856	-839
Total Envision Healthcare Holdings, Inc. equity	1,760,577	1,594,723
Total equity	1,760,577	1,594,723
Total liabilities and equity	1,761,576	1,594,839
Corporation and Subsidiaries
Current assets:
Cash and cash equivalents	318,890	122,990	57,551	134,023
Corporation and Subsidiaries \| Reportable legal entity
Current assets:
Cash and cash equivalents	318,890	122,990
Insurance collateral	32,828	29,619
Trade and other accounts receivable, net	950,115	801,146
Parts and supplies inventory	24,484	23,376
Prepaids and other current assets	36,917	23,925
Total current assets	1,363,234	1,001,056
Property, plant, and equipment, net	211,276	194,715
Intangible assets, net	524,482	513,698
Insurance collateral	10,568	12,716
Goodwill	2,538,633	2,435,670
Other long-term assets	55,555	60,935
Total assets	4,703,748	4,218,790
Current liabilities:
Accounts payable	46,585	52,472
Accrued liabilities	416,307	357,979
Current deferred tax liabilities	105,647	55,799
Current portion of long-term debt and capital lease obligations	12,349	12,318
Total current liabilities	580,888	478,568
Long-term debt and capital lease obligations	2,025,877	1,895,381
Long-term deferred tax liabilities	131,108	151,258
Insurance reserves	180,639	175,427
Other long-term liabilities	20,365	16,997
Total liabilities	2,938,877	2,717,631
Equity:
Additional paid-in capital	1,544,222	1,402,861
Retained earnings	214,041	84,107
Accumulated other comprehensive income (loss)	-1,856	-839
Total Envision Healthcare Holdings, Inc. equity	1,756,407	1,486,129
Noncontrolling interest	8,464	15,030
Total equity	1,764,871	1,501,159
Total liabilities and equity	$4,703,748	$4,218,790

Consolidating_Financial_Inform3

Consolidating Financial Information (Details 2) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Condensed Consolidating Statements of Operations
Net revenue	$1,157,777	$1,150,329	$1,075,327	$1,014,211	$984,845	$955,888	$899,255	$888,324	$4,397,644	$3,728,312	$3,300,121
Compensation and benefits									3,156,480	2,667,439	2,307,628
Operating expenses									487,841	424,865	421,424
Insurance expense									120,983	106,293	97,950
Selling, general and administrative expenses									90,731	106,659	78,540
Depreciation and amortization expense									146,155	140,632	123,751
Restructuring charges									6,968	5,669	14,086
Income from operations	113,128	113,901	93,139	68,318	84,687	63,503	65,703	62,862	388,486	276,755	256,742
Interest income from restricted assets									1,135	792	625
Interest expense, net									-110,505	-186,701	-182,607
Realized gains (losses) on investments									371	471	394
Other income (expense), net									-3,980	-12,760	1,422
Loss on early debt extinguishment									-66,397	-68,379	-8,307
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary									209,110	10,178	68,269
Income tax benefit (expense)									-89,498	994	-27,463
Income (loss) before equity in earnings of unconsolidated subsidiary									119,612	11,172	40,806
Equity in earnings of unconsolidated subsidiary									254	323	379
Net income (loss)	47,490	52,843	-1,992	21,525	13,408	-7,663	9,597	-3,847	119,866	11,495	41,185
Less: Net (income) loss attributable to noncontrolling interest									5,642	-5,500
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	49,899	52,776	-1,992	24,825	7,908	-7,663	9,597	-3,847	125,508	5,995	41,185
Consolidating Adjustments
Condensed Consolidating Statements of Operations
Equity in earnings of unconsolidated subsidiary									-129,934	-48,273	-48,459
Net income (loss)									-129,934	-48,273	-48,459
Net income (loss) attributable to Envision Healthcare Holdings, Inc.									-129,934	-48,273	-48,459
EVHC (excluding Corporation) \| Reportable legal entity
Condensed Consolidating Statements of Operations
Operating expenses										70
Selling, general and administrative expenses										3	199
Income from operations										-73	-199
Interest expense, net										-30,567	-11,462
Other income (expense), net									-4,153
Loss on early debt extinguishment										-29,519
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary									-4,153	-60,159	-11,661
Income tax benefit (expense)									-273	17,881	4,387
Income (loss) before equity in earnings of unconsolidated subsidiary									-4,426	-42,278	-7,274
Equity in earnings of unconsolidated subsidiary									129,934	48,273	48,459
Net income (loss)									125,508	5,995	41,185
Net income (loss) attributable to Envision Healthcare Holdings, Inc.									125,508	5,995	41,185
Corporation and Subsidiaries \| Reportable legal entity
Condensed Consolidating Statements of Operations
Net revenue									4,397,644	3,728,312	3,300,121
Compensation and benefits									3,156,480	2,667,439	2,307,628
Operating expenses									487,841	424,795	421,424
Insurance expense									120,983	106,293	97,950
Selling, general and administrative expenses									90,731	106,656	78,341
Depreciation and amortization expense									146,155	140,632	123,751
Restructuring charges									6,968	5,669	14,086
Income from operations									388,486	276,828	256,941
Interest income from restricted assets									1,135	792	625
Interest expense, net									-110,505	-156,134	-171,145
Realized gains (losses) on investments									371	471	394
Other income (expense), net									173	-12,760	1,422
Loss on early debt extinguishment									-66,397	-38,860	-8,307
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary									213,263	70,337	79,930
Income tax benefit (expense)									-89,225	-16,887	-31,850
Income (loss) before equity in earnings of unconsolidated subsidiary									124,038	53,450	48,080
Equity in earnings of unconsolidated subsidiary									254	323	379
Net income (loss)									124,292	53,773	48,459
Less: Net (income) loss attributable to noncontrolling interest									5,642	-5,500
Net income (loss) attributable to Envision Healthcare Holdings, Inc.									$129,934	$48,273	$48,459

Consolidating_Financial_Inform4

Consolidating Financial Information (Details 3) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	$274,048	$54,115	$216,435
Cash Flows from Investing Activities
Purchases of available-for-sale securities	-79,751	-3,156	-39,035
Sales and maturities of available-for-sale securities	62,673	14,096	96,643
Purchase of property, plant and equipment	-78,046	-65,879	-60,215
Proceeds from sale of property, plant and equipment	2,444	744	7,220
Acquisition of businesses, net of cash received	-181,642	-35,098	-193,002
Net change in insurance collateral	481	-7,235	34,332
Other investing activities	-2,977	-2,069	14
Net cash provided by (used in) investing activities	-276,818	-98,597	-154,043
Cash Flows from Financing Activities
Issuance of common stock		1,112,017	334
Borrowings under the Term Loan		150,000
Borrowings under the ABL Facility	50,000	345,440	130,000
Proceeds from issuance of senior notes	740,625		450,000
Repayments of the Term Loan	-13,372	-13,371	-262,884
Repayments of the ABL Facility	-50,000	-470,440	-5,000
Repayments of PIK Notes and senior notes	-607,750	-777,250	-15,000
Payment for debt extinguishment premiums	-37,630	-39,402
Dividend paid			-428,782
Debt issuance costs	-2,224	-5,011	-21,219
Proceeds from stock options exercised	7,730
Equity issuance costs		-65,131
Excess tax benefits from equity-based compensation	44,550	62	873
Class A common stock repurchased as treasury stock			-511
Shares repurchased for tax withholdings	-14,430
Contributions from (Distributions to) noncontrolling interest, net	-924	3,000	6,530
Payment of dissenting shareholder settlement		-38,336
Net change in bank overdrafts		-10,146	7,808
Other financing activities	378	-70	-732
Net cash provided by (used in) financing activities	116,953	191,362	-138,583
Change in cash and cash equivalents	114,183	146,880	-76,191
Cash and cash equivalents, beginning of period	204,712	57,832	134,023
Cash and cash equivalents, end of period	318,895	204,712	57,832
EVHC (excluding Corporation)
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	17,057	-33,425	187
Cash Flows from Financing Activities
Issuance of common stock		1,110,900
Proceeds from issuance of senior notes			450,000
Repayments of PIK Notes and senior notes		-450,000
Payment for debt extinguishment premiums		-12,386
Dividend paid		20,813	-428,782
Debt issuance costs		-4	-21,124
Equity issuance costs		-65,131
Net intercompany borrowings (payments)	-98,774	-489,326
Net cash provided by (used in) financing activities	-98,774	114,866	94
Change in cash and cash equivalents	-81,717	81,441	281
Cash and cash equivalents, beginning of period	81,722	281
Cash and cash equivalents, end of period	5	81,722	281
Corporation and Subsidiaries
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	256,991	87,540	216,248
Cash Flows from Investing Activities
Purchases of available-for-sale securities	-79,751	-3,156	-39,035
Sales and maturities of available-for-sale securities	62,673	14,096	96,643
Purchase of property, plant and equipment	-78,046	-65,879	-60,215
Proceeds from sale of property, plant and equipment	2,444	744	7,220
Acquisition of businesses, net of cash received	-181,642	-35,098	-193,002
Net change in insurance collateral	481	-7,235	34,332
Other investing activities	-2,977	-2,069	14
Net cash provided by (used in) investing activities	-276,818	-98,597	-154,043
Cash Flows from Financing Activities
Issuance of common stock		1,117	334
Borrowings under the Term Loan		150,000
Borrowings under the ABL Facility	50,000	345,440	130,000
Proceeds from issuance of senior notes	740,625
Repayments of the Term Loan	-13,372	-13,371	-262,884
Repayments of the ABL Facility	-50,000	-470,440	-5,000
Repayments of PIK Notes and senior notes	-607,750	-327,250	-15,000
Payment for debt extinguishment premiums	-37,630	-27,016
Dividend paid		-20,813
Debt issuance costs	-2,224	-5,007	-95
Proceeds from stock options exercised	7,730
Excess tax benefits from equity-based compensation	44,550	62	873
Class A common stock repurchased as treasury stock			-511
Shares repurchased for tax withholdings	-14,430
Contributions from (Distributions to) noncontrolling interest, net	-924	3,000	6,530
Payment of dissenting shareholder settlement		-38,336
Net change in bank overdrafts		-10,146	7,808
Other financing activities	378	-70	-732
Net intercompany borrowings (payments)	98,774	489,326
Net cash provided by (used in) financing activities	215,727	76,496	-138,677
Change in cash and cash equivalents	195,900	65,439	-76,472
Cash and cash equivalents, beginning of period	122,990	57,551	134,023
Cash and cash equivalents, end of period	$318,890	$122,990	$57,551

Quarterly_Financial_Informatio2

Quarterly Financial Information (unaudited) (Details) (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Quarterly Financial Information (unaudited)
Net revenue	$1,157,777	$1,150,329	$1,075,327	$1,014,211	$984,845	$955,888	$899,255	$888,324	$4,397,644	$3,728,312	$3,300,121
Income from operations	113,128	113,901	93,139	68,318	84,687	63,503	65,703	62,862	388,486	276,755	256,742
Net income (loss)	47,490	52,843	-1,992	21,525	13,408	-7,663	9,597	-3,847	119,866	11,495	41,185
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$49,899	$52,776	($1,992)	$24,825	$7,908	($7,663)	$9,597	($3,847)	$125,508	$5,995	$41,185
Earnings (loss) per share attributable to Envision Healthcare Holdings, Inc.:
Basic (in dollars per share)	$0.27	$0.29	($0.01)	$0.14	$0.04	($0.05)	$0.07	($0.03)	$0.69	$0.04	$0.32
Diluted (in dollars per share)	$0.26	$0.28	($0.01)	$0.13	$0.04	($0.05)	$0.07	($0.03)	$0.66	$0.04	$0.31

Subsequent_Events_Details

Subsequent Events (Details) (USD $)	1 Months Ended	0 Months Ended
In Millions, unless otherwise specified	Feb. 28, 2015	Feb. 01, 2015	Dec. 31, 2014
ABL Facility
Subsequent events
Available borrowing capacity			$337.70
Subsequent Event \| ABL Facility
Subsequent events
Available borrowing capacity	144.4
Subsequent Event \| ABL Facility \| Letter of Credit
Subsequent events
Available borrowing capacity	120.6
Subsequent Event \| EMA and SEA
Subsequent events
Total consideration of acquisitions paid in cash	380
Subsequent Event \| EMA
Subsequent events
Number of Health Care Facilities			47
Subsequent Event \| SEA
Subsequent events
Number of Physicians Employed			40
Subsequent Event \| VISTA Staffing Solutions
Subsequent events
Total consideration of acquisitions paid in cash		$123

Schedule_II_Registrants_Conden1

Schedule II - Registrant's Condensed Financial Statements (Details) (USD $)	Dec. 31, 2014	Dec. 31, 2013	Aug. 19, 2013	Dec. 31, 2012	Dec. 31, 2011
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Aug. 19, 2013	Dec. 31, 2012	Dec. 31, 2011
Current assets:
Cash and cash equivalents	$318,895	$204,712		$57,832	$134,023
Prepaids and other current assets	36,917	23,430
Total current assets	1,363,239	1,082,283
Non-current assets:
Other long-term assets	55,555	60,935
Total assets	4,703,753	4,300,017
Current liabilities:
Accounts payable	47,584	52,588
Accrued liabilities	412,657	350,936
Total current liabilities	576,868	451,329
Long-term debt	2,025,877	1,895,381
Total liabilities	2,934,712	2,690,264
Equity:
Common stock ($0.01 par value; 2,000,000,000 shares authorized, 183,679,113 and 180,382,885 issued and outstanding at December 31, 2014 and 2013, respectively)	1,837	1,804
Preferred stock ($0.01 par value; 200,000,000 shares authorized, none issued and outstanding at December 31, 2014 and 2013)
Additional paid-in capital	1,616,747	1,575,417
Retained earnings	143,849	18,341
Accumulated other comprehensive income	-1,856	-839		-213
Total Envision Healthcare Holdings, Inc. equity	1,760,577	1,594,723
Total liabilities and equity	4,703,753	4,300,017
Common stock, par value (in dollars per share)	($0.01)	($0.01)	$0.01
Common stock, shares authorized	2,000,000,000	2,000,000,000
Common stock, shares issued	183,679,113	180,382,885
Common stock, shares outstanding	183,679,113	180,382,885
Preferred stock, par value (in dollars per share)	$0.01	$0.01
Preferred stock, shares authorized	200,000,000	200,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
EVHC
Current assets:
Cash and cash equivalents	5	81,722		281
Prepaids and other current assets	5,019	26,860
Total current assets	5,024	108,582
Non-current assets:
Investment in wholly owned subsidiary	1,756,407	1,486,129
Long-term deferred tax asset	145	128
Total assets	1,761,576	1,594,839
Current liabilities:
Accounts payable	999	116
Total current liabilities	999	116
Total liabilities	999	116
Equity:
Common stock ($0.01 par value; 2,000,000,000 shares authorized, 183,679,113 and 180,382,885 issued and outstanding at December 31, 2014 and 2013, respectively)	1,837	1,804
Additional paid-in capital	1,616,747	1,575,417
Retained earnings	143,849	18,341
Accumulated other comprehensive income	-1,856	-839
Total Envision Healthcare Holdings, Inc. equity	1,760,577	1,594,723
Total liabilities and equity	$1,761,576	$1,594,839
Common stock, par value (in dollars per share)	($0.01)	($0.01)
Common stock, shares authorized	2,000,000,000	2,000,000,000
Common stock, shares issued	183,679,113	180,382,885
Common stock, shares outstanding	183,679,113	180,382,885
Preferred stock, par value (in dollars per share)	($0.01)	($0.01)
Preferred stock, shares authorized	200,000,000	200,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0

Schedule_II_Registrants_Conden2

Schedule II - Registrant's Condensed Financial Statements (Details 2) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Registrant's Condensed Financial Statements
Equity in net income of subsidiary	($254)	($323)	($379)
Operating expenses	487,841	424,865	421,424
Selling, general and administrative expenses	90,731	106,659	78,540
Interest expense	110,505	186,701	182,607
Other income (expense), net	-3,980	-12,760	1,422
Loss on early debt extinguishment	-66,397	-68,379	-8,307
Tax benefit (expense)	-89,498	994	-27,463
Net income	125,508	5,995	41,185
Other comprehensive income, net of tax	-1,017	-626	2,489
Comprehensive income (loss)	118,849	10,869	43,674
EVHC
Registrant's Condensed Financial Statements
Equity in net income of subsidiary	124,292	48,942
Operating expenses		70
Selling, general and administrative expenses		3
Interest expense		30,567
Other income (expense), net	4,153
Loss on early debt extinguishment		29,519
(Loss) Income before income taxes	120,139	-11,217
Tax benefit (expense)	-273	22,712
Net income	119,866	11,495
Other comprehensive income, net of tax	-1,017	-626
Comprehensive income (loss)	$118,849	$10,869

Schedule_II_Registrants_Conden3

Schedule II - Registrant's Condensed Financial Statements (Details 3) (USD $)	12 Months Ended			0 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Aug. 19, 2013
Cash Flows from Operating Activities
Net income (loss)	$125,508	$5,995	$41,185
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in net income of subsidiary	-254	-323	-379
Depreciation and amortization	155,629	158,588	141,015
Loss on early debt extinguishment	-66,397	-68,379	-8,307
Deferred income taxes	44,651	2,416	31,932
Net cash provided by (used in) operating activities	274,048	54,115	216,435
Cash Flows from Investing Activities
Net cash provided by (used in) investing activities	-276,818	-98,597	-154,043
Cash Flows from Financing Activities
Issuance of common stock		1,112,017	334
Repayments of PIK Notes and senior notes	-607,750	-777,250	-15,000
Payment for debt extinguishment premiums	-37,630	-39,402
Equity issuance costs		-65,131
Debt issue costs	-2,224	-5,011	-21,219
Net cash provided by (used in) financing activities	116,953	191,362	-138,583
Change in cash and cash equivalents	114,183	146,880	-76,191
Cash and cash equivalents, beginning of period	204,712	57,832	134,023
Cash and cash equivalents, end of period	318,895	204,712	57,832
EVHC
Cash Flows from Operating Activities
Net income (loss)	119,866	11,495
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Equity in net income of subsidiary	124,292	48,942
Depreciation and amortization		2,817
Loss on early debt extinguishment		29,519
Deferred income taxes	18,926	-25,184
Changes in operating assets/liabilities	2,557	-3,130
Net cash provided by (used in) operating activities	17,057	-33,425
Cash Flows from Financing Activities
Issuance of common stock		1,110,900		1,025,900
Repayments of PIK Notes and senior notes		-450,000
Payment for debt extinguishment premiums		-12,386
Distribution to Corporation	-98,774	-489,326
Dividend received		20,813
Equity issuance costs		-65,131
Debt issue costs		-4
Net cash provided by (used in) financing activities	-98,774	114,866
Change in cash and cash equivalents	-81,717	81,441
Cash and cash equivalents, beginning of period	81,722	281
Cash and cash equivalents, end of period	$5	$81,722

Schedule_II_Registrants_Conden4

Schedule II - Registrant's Condensed Financial Statements (Details 4) (USD $)	12 Months Ended			0 Months Ended
	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012	Aug. 30, 2013	Oct. 01, 2012
Registrant's Condensed Financial Statements
Loss on early debt extinguishment	($66,397,000)	($68,379,000)	($8,307,000)
Senior PIK Toggle Notes due 2017
Registrant's Condensed Financial Statements
Face amount of debt					450,000,000
Repayments of debt and capital lease obligations				17,200,000
Loss on early debt extinguishment		-29,500,000
EVHC
Registrant's Condensed Financial Statements
Loss on early debt extinguishment		29,519,000
EVHC \| Senior PIK Toggle Notes due 2017
Registrant's Condensed Financial Statements
Face amount of debt					450,000,000
Redemption price (as a percent)				102.75%
Repayments of debt and capital lease obligations				17,200,000
Loss on early debt extinguishment		$29,500,000

Schedule_II_Registrants_Conden5

Schedule II - Registrant's Condensed Financial Statements (Details 5) (USD $)	0 Months Ended	1 Months Ended	12 Months Ended		0 Months Ended			12 Months Ended	0 Months Ended
	Feb. 05, 2014	Sep. 30, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 30, 2013	Aug. 19, 2013	Jul. 10, 2014	Dec. 31, 2014	Sep. 30, 2014	Sep. 23, 2014	Jun. 18, 2014
	Feb. 05, 2014	Sep. 30, 2014	Dec. 31, 2013	Dec. 31, 2012	Dec. 30, 2013	Aug. 19, 2013	Jul. 10, 2014	item	Sep. 30, 2014	Sep. 23, 2014	Jun. 18, 2014
Consolidating Statements
Shares of common stock issued	27,500,000	17,500,000
Issue price (in dollars per share)	$30.50						34	33.32		$34.97
Aggregate offering price			$1,112,017,000	$334,000
Amount of debt held			1,907,699,000					2,038,226,000
Preferred stock, shares authorized			200,000,000					200,000,000
ABL Facility
Consolidating Statements
Amount used to redeem or repay the debt outstanding			16,500,000
Senior unsecured notes due 2019
Consolidating Statements
Principal amount of debt redeemed					332,500,000
CD&R
Consolidating Statements
Payment made in connection with the termination of a corporation consulting agreement			20,000,000			20,000,000
Initial public offering
Consolidating Statements
Shares of common stock issued						42,000,000
Issue price (in dollars per share)						$23
Underwriter overallotment option
Consolidating Statements
Shares of common stock issued						6,300,000	4,125,000
Aggregate offering price						1,110,900,000
Underwriters' discounts and commissions and offering expenses						85,000,000
EVHC
Consolidating Statements
Shares of common stock issued	27,500,000						27,500,000
Aggregate offering price			1,110,900,000			1,025,900,000
Number of votes for each share								1
Preferred stock, shares authorized			200,000,000					200,000,000
EVHC \| Senior PIK Toggle Notes due 2017
Consolidating Statements
Amount used to redeem or repay the debt outstanding			479,600,000
EVHC \| ABL Facility
Consolidating Statements
Amount used to redeem or repay the debt outstanding			16,500,000
EVHC \| Senior unsecured notes due 2019
Consolidating Statements
Amount used to redeem or repay the debt outstanding			356,500,000
Principal amount of debt redeemed			332,500,000
EVHC \| CD&R
Consolidating Statements
Payment made in connection with the termination of a corporation consulting agreement			20,000,000			20,000,000
EVHC \| Initial public offering
Consolidating Statements
Shares of common stock issued						42,000,000
Aggregate offering price						1,110,900,000
EVHC \| Underwriter overallotment option
Consolidating Statements
Shares of common stock issued	4,125,000					6,300,000	4,125,000		17,500,000
Issue price (in dollars per share)	$30.50	34.97				$23	34		$34.97
Aggregate offering price						1,025,900,000
Underwriters' discounts and commissions and offering expenses						85,000,000
Captive insurance subsidiary \| Senior unsecured notes due 2019
Consolidating Statements
Amount of debt held			$5,200,000		$5,200,000						$9,800,000