Envision Healthcare Inactive 10-Q13 May 142014 Q1 Quarterly reportFinancial data

Company Profile

Document_and_Entity_Informatio

Document and Entity Information	3 Months Ended
Document and Entity Information	Mar. 31, 2014	1-May-14
Document and Entity Information	'	'
Entity Registrant Name	'Envision Healthcare Holdings, Inc.	'
Entity Central Index Key	'0001578318	'
Document Type	'10-Q	'
Document Period End Date	31-Mar-14	'
Amendment Flag	'false	'
Current Fiscal Year End Date	'--12-31	'
Entity Current Reporting Status	'Yes	'
Entity Filer Category	'Non-accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	181,131,273
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q1	'

CONSOLIDATED_STATEMENTS_OF_OPE

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (USD $)	3 Months Ended		12 Months Ended
In Thousands, except Share data, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Revenue, net of contractual discounts	$1,858,494	$1,605,248	'
Provision for uncompensated care	-844,283	-716,924	'
Net revenue	1,014,211	888,324	'
Compensation and benefits	743,661	641,789	'
Operating expenses	114,635	100,450	'
Insurance expense	30,981	25,833	'
Selling, general and administrative expenses	19,375	21,998	'
Depreciation and amortization expense	36,432	34,755	'
Restructuring charges	809	637	5,669
Income from operations	68,318	62,862	'
Interest income from restricted assets	86	366	'
Interest expense	-30,049	-51,752	'
Realized gains on investments	606	13	'
Other expense, net	-808	-12,721	'
Loss on early debt extinguishment	'	-122	'
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	38,153	-1,354	'
Income tax expense	-16,675	-2,568	'
Income (loss) before equity in earnings of unconsolidated subsidiary	21,478	-3,922	'
Equity in earnings of unconsolidated subsidiary	47	75	'
Net income (loss)	21,525	-3,847	'
Less: Net loss attributable to noncontrolling interest	3,300	'	'
Net income (loss)	24,825	-3,847	'
Basic net income (loss) per share attributable to Envision Healthcare Holdings, Inc. (in dollars per share)	$0.14	($0.03)	'
Diluted net income (loss) per share attributable to Envision Healthcare Holdings, Inc. (in dollars per share)	$0.13	($0.03)	'
Average common shares outstanding, basic (in shares)	180,782,025	130,696,421	'
Average common shares outstanding, diluted (in shares)	189,391,612	130,696,421	'
Comprehensive income:	'	'	'
Net income (loss)	21,525	-3,847	'
Other comprehensive loss, net of tax:	'	'	'
Unrealized holding losses during the period	-337	-436	'
Unrealized gains (losses) on derivative financial instruments	51	-298	'
Total other comprehensive loss, net of tax	-286	-734	-626
Comprehensive income (loss)	21,239	-4,581	'
Less: Comprehensive loss attributable to noncontrolling interest	3,300	'	'
Comprehensive income (loss)	$24,539	($4,581)	'

CONSOLIDATED_BALANCE_SHEETS

CONSOLIDATED BALANCE SHEETS (USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Current assets:	'	'
Cash and cash equivalents	$190,996	$204,712
Insurance collateral	19,442	29,619
Trade and other accounts receivable, net	840,940	801,146
Parts and supplies inventory	23,736	23,376
Prepaids and other current assets	26,661	23,430
Total current assets	1,101,775	1,082,283
Non-current assets:	'	'
Property, plant and equipment, net	190,935	194,715
Intangible assets, net	516,530	513,698
Insurance collateral	1,127	12,716
Goodwill	2,444,156	2,435,670
Other long-term assets	60,007	60,935
Total assets	4,314,530	4,300,017
Current liabilities:	'	'
Accounts payable	51,301	52,588
Accrued liabilities	371,570	350,936
Current deferred tax liabilities	35,639	35,487
Current portion of long-term debt	12,011	12,318
Total current liabilities	470,521	451,329
Long-term debt	1,892,272	1,895,381
Long-term deferred tax liabilities	151,225	151,130
Insurance reserves	151,792	175,427
Other long-term liabilities	16,721	16,997
Total liabilities	2,682,531	2,690,264
Commitments and contingencies	'	'
Equity:	'	'
Common stock ($0.01 par value; 2,000,000,000 shares authorized, 181,131,273 and 180,382,885 issued and outstanding as of March 31, 2014 and December 31, 2013, respectively)	1,804	1,804
Preferred stock ($0.01 par value; 200,000,000 shares authorized, none issued and outstanding as of March 31, 2014 and December 31, 2013)	'	'
Treasury stock at cost	-1,347	-1,347
Additional paid-in capital	1,577,521	1,576,764
Retained earnings	43,166	18,341
Accumulated other comprehensive loss	-1,125	-839
Total stockholders' equity	1,620,019	1,594,723
Noncontrolling interest	11,980	15,030
Total equity	1,631,999	1,609,753
Total liabilities and equity	$4,314,530	$4,300,017

CONSOLIDATED_BALANCE_SHEETS_Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Mar. 31, 2014	Dec. 31, 2013
CONSOLIDATED BALANCE SHEETS	'	'
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	181,131,273	180,382,885
Common stock, shares outstanding	181,131,273	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_CAS

CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2013
Cash Flows from Operating Activities	'
Net income (loss)	($3,847)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:	'
Depreciation and amortization	39,428
(Gain) loss on disposal of property, plant and equipment	39
Equity-based compensation expense	1,062
Excess tax benefits from equity-based compensation	-8
Loss on early debt extinguishment	122
Equity in earnings of unconsolidated subsidiary	-75
Dividends received	556
Deferred income taxes	-740
Changes in operating assets/liabilities, net of acquisitions:	'
Trade and other accounts receivable	-41,212
Parts and supplies inventory	-50
Prepaids and other current assets	-3,627
Accounts payable and accrued liabilities	19,212
Insurance accruals	-4,218
Net cash provided by operating activities	6,642
Cash Flows from Investing Activities	'
Purchases of available-for-sale securities	-159
Sales and maturities of available-for-sale securities	448
Purchases of property, plant and equipment	-10,493
Proceeds from sale of property, plant and equipment	197
Acquisition of businesses, net of cash received	-1,423
Net change in insurance collateral	7,362
Other investing activities	-702
Net cash used in investing activities	-4,770
Cash Flows from Financing Activities	'
Issuance of common stock	691
Borrowings under the Term Loan	150,000
Borrowings under the ABL Facility	56,940
Repayments of the Term Loan	-3,343
Repayments of the ABL Facility	-181,940
Dividend paid	-67
Debt issue costs	-4,415
Excess tax benefits from equity-based compensation	8
Net change in bank overdrafts	2,883
Other financing activities	-329
Net cash (used in) provided by financing activities	20,428
Change in cash and cash equivalents	22,300
Cash and cash equivalents, beginning of period	57,832
Cash and cash equivalents, end of period	$80,132

CONSOLIDATED_STATEMENTS_OF_OPE1

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (Envision Healthcare Corporation) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Revenue, net of contractual discounts	$1,858,494	$1,605,248
Provision for uncompensated care	-844,283	-716,924
Net revenue	1,014,211	888,324
Compensation and benefits	743,661	641,789
Operating expenses	114,635	100,450
Insurance expense	30,981	25,833
Selling, general and administrative expenses	19,375	21,998
Depreciation and amortization expense	36,432	34,755
Restructuring charges	809	637
Income from operations	68,318	62,862
Interest income from restricted assets	86	366
Interest expense	-30,049	-51,752
Realized gains on investments	606	13
Other income (expense), net	-808	-12,721
Loss on early debt extinguishment	'	-122
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	38,153	-1,354
Income tax expense	-16,675	-2,568
Income (loss) before equity in earnings of unconsolidated subsidiary	21,478	-3,922
Equity in earnings of unconsolidated subsidiary	47	75
Net income (loss)	21,525	-3,847
Less: Net loss attributable to noncontrolling interest	3,300	'
Net income (loss)	24,825	-3,847
Comprehensive income:	'	'
Net income	24,825	-3,847
Other comprehensive loss, net of tax:	'	'
Unrealized holding losses during the period	-337	-436
Unrealized gains (losses) on derivative financial instruments	51	-298
Total other comprehensive loss, net of tax	-286	-734
Comprehensive income (loss)	21,239	-4,581
Less: Comprehensive loss attributable to noncontrolling interest	3,300	'
Comprehensive income (loss)	24,539	-4,581
Corporation	'	'
Revenue, net of contractual discounts	1,858,494	1,605,248
Provision for uncompensated care	-844,283	-716,924
Net revenue	1,014,211	888,324
Compensation and benefits	743,661	641,789
Operating expenses	114,635	100,383
Insurance expense	30,981	25,833
Selling, general and administrative expenses	19,375	21,998
Depreciation and amortization expense	36,432	34,755
Restructuring charges	809	637
Income from operations	68,318	62,929
Interest income from restricted assets	86	366
Interest expense	-30,049	-40,290
Realized gains on investments	606	13
Other income (expense), net	334	-12,721
Loss on early debt extinguishment	'	-122
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	39,295	10,175
Income tax expense	-17,055	-7,134
Income (loss) before equity in earnings of unconsolidated subsidiary	22,240	3,041
Equity in earnings of unconsolidated subsidiary	47	75
Net income (loss)	22,287	3,116
Less: Net loss attributable to noncontrolling interest	3,300	'
Net income (loss)	25,587	3,116
Comprehensive income:	'	'
Net income	25,587	3,116
Other comprehensive loss, net of tax:	'	'
Unrealized holding losses during the period	-337	-436
Unrealized gains (losses) on derivative financial instruments	51	-298
Total other comprehensive loss, net of tax	-286	-734
Comprehensive income (loss)	22,001	2,382
Less: Comprehensive loss attributable to noncontrolling interest	3,300	'
Comprehensive income (loss)	$25,301	$2,382

CONSOLIDATED_BALANCE_SHEETS_En

CONSOLIDATED BALANCE SHEETS (Envision Healthcare Corporation) (USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Current assets:	'	'
Cash and cash equivalents	$190,996	$204,712
Insurance collateral	19,442	29,619
Trade and other accounts receivable, net	840,940	801,146
Parts and supplies inventory	23,736	23,376
Prepaids and other current assets	26,661	23,430
Total current assets	1,101,775	1,082,283
Non-current assets:	'	'
Property, plant and equipment, net	190,935	194,715
Intangible assets, net	516,530	513,698
Insurance collateral	1,127	12,716
Goodwill	2,444,156	2,435,670
Other long-term assets	60,007	60,935
Total assets	4,314,530	4,300,017
Current liabilities:	'	'
Accounts payable	51,301	52,588
Accrued liabilities	371,570	350,936
Current deferred tax liabilities	35,639	35,487
Current portion of long-term debt	12,011	12,318
Total current liabilities	470,521	451,329
Long-term debt	1,892,272	1,895,381
Long-term deferred tax liabilities	151,225	151,130
Insurance reserves	151,792	175,427
Other long-term liabilities	16,721	16,997
Total liabilities	2,682,531	2,690,264
Commitment and contingencies	'	'
Equity:	'	'
Common stock ($0.01 par value; 1,000 shares authorized, issued, and outstanding at March 31, 2014 and December 31, 2013)	1,804	1,804
Treasury stock at cost	-1,347	-1,347
Additional paid-in capital	1,577,521	1,576,764
Retained earnings	43,166	18,341
Accumulated other comprehensive loss	-1,125	-839
Total stockholders' equity	1,620,019	1,594,723
Noncontrolling interest	11,980	15,030
Total equity	1,631,999	1,609,753
Total liabilities and equity	4,314,530	4,300,017
Corporation	'	'
Current assets:	'	'
Cash and cash equivalents	109,274	122,990
Insurance collateral	19,442	29,619
Trade and other accounts receivable, net	840,940	801,146
Parts and supplies inventory	23,736	23,376
Prepaids and other current assets	28,956	23,925
Total current assets	1,022,348	1,001,056
Non-current assets:	'	'
Property, plant and equipment, net	190,935	194,715
Intangible assets, net	516,530	513,698
Insurance collateral	1,127	12,716
Goodwill	2,444,156	2,435,670
Other long-term assets	60,007	60,935
Total assets	4,235,103	4,218,790
Current liabilities:	'	'
Accounts payable	51,185	52,472
Accrued liabilities	379,879	357,979
Current deferred tax liabilities	55,951	55,799
Current portion of long-term debt	12,011	12,318
Total current liabilities	499,026	478,568
Long-term debt	1,892,272	1,895,381
Long-term deferred tax liabilities	151,353	151,258
Insurance reserves	151,792	175,427
Other long-term liabilities	16,721	16,997
Total liabilities	2,711,164	2,717,631
Commitment and contingencies	'	'
Equity:	'	'
Common stock ($0.01 par value; 1,000 shares authorized, issued, and outstanding at March 31, 2014 and December 31, 2013)	'	'
Treasury stock at cost	-1,347	-1,347
Additional paid-in capital	1,404,737	1,404,208
Retained earnings	109,694	84,107
Accumulated other comprehensive loss	-1,125	-839
Total stockholders' equity	1,511,959	1,486,129
Noncontrolling interest	11,980	15,030
Total equity	1,523,939	1,501,159
Total liabilities and equity	$4,235,103	$4,218,790

CONSOLIDATED_BALANCE_SHEETS_Pa1

CONSOLIDATED BALANCE SHEETS (Parenthetical) (Envision Healthcare Corporation) (USD $)	Mar. 31, 2014	Dec. 31, 2013
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	181,131,273	180,382,885
Common stock, shares outstanding	181,131,273	180,382,885
Corporation	'	'
Common stock, par value (in dollars per share)	$0.01	$0.01
Common stock, shares authorized	1,000	1,000
Common stock, shares issued	1,000	1,000
Common stock, shares outstanding	1,000	1,000

CONSOLIDATED_STATEMENTS_OF_CAS1

CONSOLIDATED STATEMENTS OF CASH FLOWS (Envision Healthcare Corporation) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Cash Flows from Operating Activities	'	'
Net income	$21,525	($3,847)
Adjustments to reconcile net income to net cash provided by operating activities:	'	'
Depreciation and amortization	39,667	39,428
(Gain) loss on disposal of property, plant and equipment	-1,981	39
Equity-based compensation expense	1,062	1,062
Excess tax benefits from equity-based compensation	-14,790	-8
Loss on early debt extinguishment	'	122
Equity in earnings of unconsolidated subsidiary	-47	-75
Dividends received	430	556
Deferred income taxes	928	-740
Changes in operating assets/liabilities, net of acquisitions:	'	'
Trade and other accounts receivable	-35,429	-41,212
Parts and supplies inventory	-327	-50
Prepaids and other current assets	-3,468	-3,627
Accounts payable and accrued liabilities	34,183	19,212
Insurance accruals	-11,533	-4,218
Net cash provided by operating activities	30,220	6,642
Cash Flows from Investing Activities	'	'
Purchases of property, plant and equipment	-10,714	-10,493
Proceeds from sale of property, plant and equipment	2,156	197
Acquisition of businesses, net of cash received	-35,791	-1,423
Net change in insurance collateral	1,200	7,362
Other investing activities	-2,526	-702
Net cash used in investing activities	-39,973	-4,770
Cash Flows from Financing Activities	'	'
Issuance of common stock	'	691
Borrowings under the Term Loan	'	150,000
Borrowings under the ABL Facility	'	56,940
Repayments of the Term Loan	-3,343	-3,343
Repayments of the ABL Facility	'	-181,940
Debt issue costs	'	-4,415
Excess tax benefits from equity-based compensation	14,790	8
Shares repurchased for tax withholdings	-14,430	'
Proceeds from noncontrolling interest	250	'
Net change in bank overdrafts	'	2,883
Other financing activities	-1,230	-329
Net cash (used in) provided by financing activities	-3,963	20,428
Change in cash and cash equivalents	-13,716	22,300
Cash and cash equivalents, beginning of period	204,712	57,832
Cash and cash equivalents, end of period	190,996	80,132
Corporation	'	'
Cash Flows from Operating Activities	'	'
Net income	22,287	3,116
Adjustments to reconcile net income to net cash provided by operating activities:	'	'
Depreciation and amortization	39,667	38,372
(Gain) loss on disposal of property, plant and equipment	-1,981	39
Equity-based compensation expense	1,062	1,062
Excess tax benefits from equity-based compensation	-14,790	-8
Loss on early debt extinguishment	'	122
Equity in earnings of unconsolidated subsidiary	-47	-75
Dividends received	430	556
Deferred income taxes	928	-740
Changes in operating assets/liabilities, net of acquisitions:	'	'
Trade and other accounts receivable	-35,429	-41,351
Parts and supplies inventory	-327	-50
Prepaids and other current assets	-5,268	-2,548
Accounts payable and accrued liabilities	35,221	12,294
Insurance accruals	-11,533	-4,218
Net cash provided by operating activities	30,220	6,571
Cash Flows from Investing Activities	'	'
Purchases of marketable investment securities	-2,458	-159
Sales and maturities of marketable investment securities	8,160	448
Purchases of property, plant and equipment	-10,714	-10,493
Proceeds from sale of property, plant and equipment	2,156	197
Acquisition of businesses, net of cash received	-35,791	-1,423
Net change in insurance collateral	1,200	7,362
Other investing activities	-2,526	-702
Net cash used in investing activities	-39,973	-4,770
Cash Flows from Financing Activities	'	'
Issuance of common stock	'	691
Borrowings under the Term Loan	'	150,000
Borrowings under the ABL Facility	'	56,940
Repayments of the Term Loan	-3,343	-3,343
Repayments of the ABL Facility	'	-181,940
Debt issue costs	'	-4,411
Excess tax benefits from equity-based compensation	14,790	8
Shares repurchased for tax withholdings	-14,430	'
Proceeds from noncontrolling interest	250	'
Net change in bank overdrafts	'	2,883
Other financing activities	-1,230	-329
Net cash (used in) provided by financing activities	-3,963	20,499
Change in cash and cash equivalents	-13,716	22,300
Cash and cash equivalents, beginning of period	122,990	57,551
Cash and cash equivalents, end of period	$109,274	$79,851

General

General	3 Months Ended
General	Mar. 31, 2014
General	'
General	'
	1. General

	Basis of Presentation of Financial Statements

	Envision Healthcare Holdings, Inc. (“Holding”) indirectly owns all of the outstanding common stock of Envision Healthcare Corporation (“Corporation”). In June 2013, CDRT Holding Corporation’s name was changed to Envision Healthcare Holdings, Inc. and Emergency Medical Services Corporation’s name was changed to Envision Healthcare Corporation.

	The accompanying interim consolidated financial statements for Holding and Corporation have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim reporting, and accordingly, do not include all of the disclosures required for annual financial statements. In the opinion of management, the consolidated financial statements of Holding and Corporation (together the “Company” or “EVHC”) include all normal recurring adjustments necessary for a fair presentation of the periods presented. Operating results for interim periods are not necessarily indicative of the results that may be expected for the full year ending December 31, 2014. For further information on Holding’s and Corporation’s significant accounting policies and other information, see Holding’s and Corporation’s consolidated financial statements, including the accounting policies and notes thereto for the year ended December 31, 2013, which includes all disclosures required by GAAP, included in Holding’s and Corporation’s Annual Report on Form 10-K for the year ended December 31, 2013.

	On July 29, 2013, Holding effected a 9.3 for 1.0 stock split of Holding’s common stock, resulting in 132,082,885 shares of common stock issued, not including 504,197 treasury shares. The accompanying consolidated financial statements give retroactive effect to the stock split for all periods presented.

	On August 13, 2013, Holding’s registration statement (the “Registration Statement”) for an initial public offering of its common stock, par value $0.01 per share (“Common Stock”) was declared effective. On February 5, 2014, Holding registered the offering and sale of 31,625,000 shares of Common Stock (including shares sold pursuant to the underwriters’ option to purchase additional shares) by certain stockholders of Holding at a public offering price of $30.50 per share. See Note 2 for further information on Holding’s public offerings and its equity.

	The Company’s business is conducted primarily through two operating subsidiaries, EmCare Holdings, Inc. (“EmCare”), its facility-based physician services segment, and American Medical Response, Inc. (“AMR”), its medical transportation services segment.

Summary_of_Significant_Account

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2014
Summary of Significant Accounting Policies	'
Summary of Significant Accounting Policies	'
	2. Summary of Significant Accounting Policies

	Consolidation

	The consolidated financial statements of Holding include all of its wholly-owned subsidiaries, including Corporation and its respective subsidiaries and affiliated physician groups. The consolidated financial statements of Corporation, include all of its wholly-owned subsidiaries, including 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.

	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 support the Company’s insurance program and reserves. 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.

	Additionally, insurance collateral is comprised of cash deposits with third parties. Insurance collateral also includes a receivable from insurers of $1.8 million and $1.3 million as of March 31, 2014 and December 31, 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. The Company’s billing systems do not provide contractual allowances or uncompensated care reserves on outstanding patient accounts. The allowance for uncompensated care is related principally to receivables recorded for self-pay patients and is not recorded on specific accounts due to the volume and variability of individual patient receivable collections. While the billing systems do not specifically record the allowance for doubtful accounts to individual accounts owed or specific payor classifications, the portion of the allowance for uncompensated care associated with fee for service charges as of December 31, 2013 was equal to approximately 87% and 89% of outstanding self-pay receivables for EmCare and AMR, respectively, consistent with the Company’s collection history. Account balances are charged off against the uncompensated care allowance when it is probable the receivable will not be recovered and to the contractual allowance when payment is received. The Company’s accounts receivable and allowances as of March 31, 2014 and December 31, 2013 were as follows (in thousands):

			March 31,			December 31,
			2014			2013
	Gross trade accounts receivable		$	4,153,929		$	3,841,672
	Allowance for contractual discounts		(2,193,183		)	(2,002,704		)
	Allowance for uncompensated care		(1,121,079		)	(1,038,833		)
	Net trade accounts receivable		839,667			800,135
	Other receivables, net		1,273			1,011
	Net accounts receivable		$	840,940		$	801,146

	Other receivables primarily represent EmCare hospital subsidies and fees, and AMR fees for stand-by and special events and subsidies from community organizations.

	Accounts receivable allowances at EmCare are estimated based on cash collection and write-off experience at a facility level contract and facility specific payor mix. These allowances are reviewed and adjusted monthly through revenue provisions. In addition, a look-back analysis is done, typically after 15 months, to compare actual cash collected on a date of service basis to the revenue recorded for that period. Any adjustment necessary for an overage or deficit in these allowances based on actual collections is recorded through a revenue adjustment in the current period.

	AMR contractual allowances are determined primarily on payor reimbursement schedules that are included and regularly updated in the billing systems, and by historical collection experience. The billing systems calculate the difference between payor specific gross billings and contractually agreed to, or governmentally driven, reimbursement rates. The allowance for uncompensated care at AMR is related principally to receivables recorded for self-pay patients. AMR’s allowances on self-pay accounts receivable are estimated on claim level, historical write-off experience.

	Business Combinations

	Assets and liabilities of an acquired business are recorded at their fair values at the date of acquisition. The excess of the acquisition consideration over the estimated fair values is recorded as goodwill. All acquisition costs are expensed as incurred. While the Company uses its best estimates and assumptions as a part of the acquisition consideration allocation process to accurately value assets acquired and liabilities assumed at the acquisition date, the estimates are inherently uncertain and subject to refinement. As a result, during the measurement period the Company may record adjustments to the assets acquired and liabilities assumed, with the corresponding offset to goodwill. Upon the conclusion of the measurement period any subsequent adjustments are recorded as expense.

	Insurance Reserves

	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 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 the balance sheet date.

	The Company establishes reserves for claims based upon an assessment of actual claims and claims incurred but not reported. The reserves are established based on quarterly consultation with third-party independent actuaries using actuarial principles and assumptions that consider a number of factors, including historical claim payment patterns and legal costs, and changes in case reserves and the assumed rate of inflation in healthcare 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.

	The Company’s most recent actuarial valuation was completed in March 2014. As a result of this and previous actuarial valuations, the Company recorded increases in its provisions for insurance liabilities of $5.2 million during the three month period ended March 31, 2014 compared to decreases of $1.2 million for three month period ended March 31, 2013, related to reserves for losses in prior years.

	The long-term portion of insurance reserves was $151.8 million and $175.4 million as of March 31, 2014 and December 31, 2013, respectively.

	Equity Structure and Public Offerings — Holding

	On August 13, 2013, Holding’s Registration Statement was declared effective by the Securities and Exchange Commission (the “SEC”) for an initial public offering of its Common Stock. Holding registered the offering and sale of 42,000,000 shares of Common Stock and an additional 6,300,000 shares of Common Stock sold to the underwriters pursuant to their option to purchase additional shares at a price of $23 per share. On August 19, 2013, Holding completed the offering of 48,300,000 shares of Common Stock, at a price of $23 per share, for an aggregate offering price of $1,110.9 million, and the offering terminated. At the closing, Holding 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 Clayton, Dubilier & Rice, LLC (“CD&R”) in connection with the termination of a consulting agreement with Holding and Corporation (“Consulting Agreement”) which was recorded in the third quarter of 2013 to selling, general and administrative expenses in the statements of operations, see Note 13.

	Net proceeds from the initial public offering were used to (i) redeem in full Holding’s Senior PIK Toggle Notes due 2017 for a total of $479.6 million, which included a call premium pursuant to the indenture governing the Senior PIK Toggle Notes due 2017 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 Corporation’s senior unsecured notes due 2019 and all accrued but unpaid interest. The remaining proceeds were used for general corporate purposes which included, among other things, repayment of indebtedness and acquisitions.

	On February 5, 2014, Holding registered the offering and sale of 27,500,000 shares of Common Stock by certain stockholders of Holding and an additional 4,125,000 shares of Common Stock, which were sold by investment funds sponsored by, or affiliated with, CD&R (the “CD&R Affiliates”) to the underwriters pursuant to their option to purchase additional shares at $30.50 per share less the underwriting discount. The CD&R Affiliates, certain executive officers and directors of Holding and certain non-executives were the selling stockholders in the offering. Holding did not receive any of the proceeds from the sale of the shares being sold by the selling stockholders, including any shares sold pursuant to any exercise of the underwriters’ option to purchase additional shares.

	Financial Instruments and Concentration of Credit Risk

	The Company’s cash and cash equivalents, accounts receivable, accounts payable, accrued liabilities, insurance collateral, other than current portion of self-insurance estimates, 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 March 31, 2014 and December 31, 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 three months ended March 31, 2014 and 2013, the Company derived approximately 27% and 28%, respectively, of its revenue from Medicare and Medicaid, 70% and 68%, 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 quoted market prices (Level 1). The estimated fair value of the senior notes as of March 31, 2014 was approximately $650.7 million with a carrying value of $607.8 million. The Company’s captive insurance subsidiary holds $9.8 million of the senior notes as of March 31, 2014 which has been excluded from the carrying value stated above.

Fair Value Measurement

The Company classifies its financial instruments that are reported at fair value based on a hierarchal framework which 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 fixed income mortgage backed securities, 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 4.

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

		March 31, 2014
Description		Level 1			Level 2			Level 3		Total
Assets:
Available-for-sale securities (insurance collateral)		$	7,016		$	515		$	—	$	7,531
Fuel hedge		—			401			—		401
Liabilities:
Contingent consideration		—			—			1,734		1,734
Interest rate swap		—			2,735			—		2,735


		December 31, 2013
Description		Level 1			Level 2			Level 3		Total
Assets:
Available-for-sale securities (insurance collateral)		$	12,710		$	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 $6.0 million since December 31, 2013 primarily due to payments made.

During the three months ended March 31, 2014 and 2013, we had no transfers in and out of Level 1 and Level 2 fair value measurements.

Revenue Recognition

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. Provisions for estimated uncompensated care, or bad debt expense, are related principally to the number of self-pay patients treated in the period and are based primarily on historical collection experience to reduce revenues net of contractual discounts to the estimated amounts the Company expects to collect. Subsidy and fee revenue primarily represent hospital subsidies and fees at EmCare and fees for stand-by, special event and community subsidies at AMR.

The majority of the patients the Company treats are for the provision of emergency care in the pre-hospital and hospital settings. Due to federal government regulations governing the provision of such care, the Company is obligated to provide emergency care regardless of the patient’s ability to pay or whether or not the patient has insurance or other third-party coverage for the costs of the services rendered. While the Company attempts to obtain all relevant billing information at the time the patient is within our care, there are numerous patient encounters where such information is not available. In such cases, the Company’s billing operations will initially classify these patients as self-pay, with the applicable estimated allowance for uncompensated care, while they pursue collection of the account. Over the course of the first 30 to 60 days after these self-pay patients have been treated, the billing staff may identify the appropriate insurance or other third-party payor and re-assign the account from a self-pay payor classification to the appropriate payor. Depending on the final payor determination, the allowances for uncompensated care and contractual discounts will be adjusted accordingly. For accounts that remain classified as self-pay, the billing protocols and systems will generate bills and notifications generally for 90 to 120 days. If no collection or additional information is received from the patient, the account is written-off and sent to a collection agency. The Company’s revenue recognition models, which are reviewed and updated on a monthly basis, consider these events in determining the collectability of accounts receivable.

Net revenue for the three month periods ended March 31, 2014 and 2013 consisted of the following (in thousands):

		Quarter ended
		March 31,
		2014			2013
Fee-for-service revenue, net of contractuals:
Medicare		$	250,312		$	233,874
Medicaid		55,817			51,214
Commercial insurance and managed care		645,183			560,191
Self-pay		724,507			629,256
Sub-total		1,675,819			1,474,535
Subsidies and fees		182,675			130,713
Revenue, net of contractuals		1,858,494			1,605,248
Provision for uncompensated care		(844,283		)	(716,924		)
Net revenue		$	1,014,211		$	888,324

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 in 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 $1.1 million for the three months ended March 31, 2014 and decreased the contractual discount and uncompensated provisions (increased net revenue) by approximately $2.1 million for the three months ended March 31, 2013.

The Company 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.

Basic_and_Diluted_Net_Income_L

Basic and Diluted Net Income (Loss) Per Share	3 Months Ended
	Mar. 31, 2014
Basic and Diluted Net Income (Loss) Per Share	'
Basic and Diluted Net Income (Loss) Per Share	'
	3. Basic and Diluted Net Income (Loss) Per Share

	Holding presents both basic earnings per share (“EPS”) and diluted EPS. Basic EPS excludes potential dilution and is computed by dividing “Net income (loss) attributable to Envision Healthcare Holdings, Inc.” by the weighted-average number of 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 Holding’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 share and per share amounts).

		Quarter ended
		March 31,
		2014		2013
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	24,825	$	(3,847	)

	Weighted-average common shares outstanding — common stock:
	Basic	180,782,025		130,696,421
	Dilutive impact of stock awards outstanding	8,609,587		—
	Diluted	189,391,612		130,696,421

	Earnings per share — common stock:
	Basic net income (loss) per share attributable to Envision Healthcare Holdings, Inc.	$	0.14	$	(0.03	)
	Diluted net income (loss) per share attributable to Envision Healthcare Holdings, Inc.	$	0.13	$	(0.03	)

	Holding had a net loss for the three months ended March 31, 2013, therefore, the effect of stock awards to purchase common stock of 3,930,872 is excluded from the computations of diluted loss per share since the effect is anti-dilutive. As of March 31, 2014 and 2013, there were no stock awards of common stock outstanding excluded from the weighted-average common shares outstanding above.

Acquisitions

Acquisitions	3 Months Ended
Acquisitions	Mar. 31, 2014
Acquisitions	'
Acquisitions	'
	4. Acquisitions

	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 and MedStat EMS, Inc., an emergency and non-emergency medical ground transportation service provider with operations in Mississippi, on March 7, 2014 for total aggregate purchase consideration of approximately $36.2 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. The total purchase price for these acquisitions was allocated to goodwill of $15.9 million, $9.9 million of which is tax deductible goodwill, other acquired intangible assets of $15.0 million, and net current assets of $5.3 million, which are subject to adjustment based upon the completion of purchase price allocations.

	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 medical 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 the first quarter of 2014, the Company made purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $7.4 million. The total purchase price for these acquisitions was allocated to goodwill of $18.8 million, all of which is tax deductible goodwill, other acquired intangible assets of $16.9 million, and net current liabilities of $1.5 million, which are subject to adjustment based upon the completion of purchase price allocations.

Insurance_Collateral

Insurance Collateral	3 Months Ended
	Mar. 31, 2014
Insurance Collateral	'
Insurance Collateral	'
	5. Insurance Collateral

	Insurance collateral consisted of the following as of March 31, 2014 and December 31, 2013 (in thousands):

		March 31,		December 31,
		2014		2013
	Available-for-sale securities:
	U.S. Treasuries	$	2,113	$	2,100
	Corporate bonds / Fixed income	3,346		6,372
	Corporate equity	2,072		4,755
	Total available-for-sale securities	7,531		13,227
	Insurance receivable	1,796		1,300
	Cash deposits and other	11,242		27,808
	Total insurance collateral	$	20,569	$	42,335

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

		March 31, 2014
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,077	$	37		$	(1	)	$	2,113
	Corporate bonds / Fixed income	3,316		31			(1		)	3,346
	Corporate equity	2,095		15			(38		)	2,072
	Total available-for-sale securities	$	7,488	$	83		$	(40	)	$	7,531

		December 31, 2013
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,063	$	37		$	—		$	2,100
	Corporate bonds / Fixed income	6,385		26			(39		)	6,372
	Corporate equity	4,399		500			(144		)	4,755
	Total available-for-sale securities	$	12,847	$	563		$	(183	)	$	13,227

	As of March 31, 2014, available-for-sale securities included U.S. Treasuries and corporate bonds / fixed income securities of $0.9 million with contractual maturities within one year, $3.3 million with contractual maturities extending longer than one year through five years and $1.3 million with contractual maturities extending longer than five years through and including ten 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 March 31, 2014 and December 31, 2013 were as follows (in thousands):

		March 31, 2014					December 31, 2013
		Fair Value		Unrealized			Fair Value			Unrealized
				Loss						Loss
	U.S. Treasuries:
	Less than 12 months	$	133	$	(1	)	$	132		$	(1	)
	12 months or more	—		—			—			—
	Corporate bonds / Fixed income:
	Less than 12 months	853		(1		)	2,768			(18		)
	12 months or more	—		—			2,178			(20		)
	Corporate equity:
	Less than 12 months	1,104		(38		)	—			—
	12 months or more	—		—			2,553			(144		)
	Total	$	2,090	$	(40	)	$	7,631		$	(183	)

	The Company realized net gains of $0.6 million and $13 thousand on the sale and maturities of available-for-sale securities for the three months ended March 31, 2014 and 2013, respectively.

Accrued_Liabilities

Accrued Liabilities	3 Months Ended
	Mar. 31, 2014
Accrued Liabilities	'
Accrued Liabilities	'
	6. Accrued Liabilities

	Accrued liabilities were as follows as of March 31, 2014 and December 31, 2013 (in thousands):

		March 31,			December 31,
		2014			2013
	Accrued wages and benefits	$	173,823		$	161,398
	Accrued paid time-off	29,367			25,713
	Current portion of self-insurance reserves	71,499			73,738
	Accrued restructuring	4,972			5,682
	Current portion of compliance and legal	3,558			2,000
	Accrued billing and collection fees	2,929			2,954
	Accrued incentive compensation	23,083			19,570
	Accrued interest	17,921			6,898
	Accrued income taxes	7,982			7,043
	Other	44,745			52,983
	Total accrued liabilities — Corporation	$	379,879		$	357,979
	Accrued income taxes — adjustment for Holding	(8,309		)	(7,043		)
	Total accrued liabilities — Holding	$	371,570		$	350,936

LongTerm_Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2014
Long-Term Debt	'
Long-Term Debt	'
	7. Long-Term 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, Corporation’s captive insurance subsidiary purchased $15.0 million of the 2019 Notes through an open market transaction and currently holds $9.8 million of the 2019 Notes subsequent to the partial redemption of the 2019 Notes on December 30, 2013.

	On December 30, 2013, Corporation 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 fourth quarter of 2013, Corporation recorded a loss on early debt extinguishment of $38.7 million related to premiums and unamortized debt issuance costs from the redemption of the 2019 Notes.

	The 2019 Notes have a fixed interest rate of 8.125%, payable semi-annually with the principal due at maturity in 2019. The 2019 Notes are general unsecured obligations of Corporation and are guaranteed by each of Corporation’s domestic subsidiaries, except for any of Corporation’s subsidiaries subject to regulation as an insurance company, including Corporation’s captive insurance subsidiary.

	The Company may redeem the 2019 Notes, in whole or in part, at any time prior to June 1, 2014, 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 2019 Notes, in whole or in part, at any time (i) on and after June 1, 2014 and prior to June 1, 2015, at a price equal to 106.094% of the principal amount of the 2019 Notes, (ii) on or after June 1, 2015 and prior to June 1, 2016, at a price equal to 104.063% of the principal amount of the 2019 Notes, (iii) on or after June 1, 2016 and prior to June 1, 2017, at a price equal to 102.031% of the principal amount of the 2019 Notes, and (iv) on or after June 1, 2017, at a price equal to 100.000% of the principal amount of the 2019 Notes, in each case, plus accrued and unpaid interest, if any, to the redemption date. In addition, at any time prior to June 1, 2014, the Company may redeem up to 35% of the aggregate principal amount of the 2019 Notes with the proceeds of certain equity offerings at a redemption price of 108.125%, plus accrued and unpaid interest, which it exercised on December 30, 2013 by redeeming $332.5 million in principal amount.

	The indenture governing the 2019 Notes contains covenants that, among other things, limit Corporation’s ability and the ability of its restricted subsidiaries to: incur more indebtedness or issue certain preferred shares; pay dividends, redeem stock or make other distributions; make investments; create restrictions on the ability of its restricted subsidiaries to pay dividends to Corporation or make other intercompany transfers; create liens; transfer or sell assets; merge or consolidate; enter into certain transactions with affiliates; and designate subsidiaries as unrestricted subsidiaries. Upon the occurrence of certain events constituting a change of control, Corporation is required to make an offer to repurchase all of the 2019 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 Corporation sells assets under certain circumstances, it must use the proceeds to make an offer to purchase the 2019 Notes at a price equal to 100% of their principal amount, plus accrued and unpaid interest, if any, to the date of purchase.

	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 corporation.

	Term Loan Facility

	Prior to February 7, 2013, loans under the Term Loan Facility bore interest at Corporation’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”) 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 (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 Corporation 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 Corporation 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 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 Corporation’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”), 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 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 Corporation increased its commitments 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.

	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 March 31, 2014, letters of credit outstanding which impact the available credit under the ABL Facility were $132.5 million and the maximum available under the ABL Facility was $317.5 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 the first quarter of 2013, Corporation 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, Holding 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 Holding. Cash interest accrues on these notes at a rate of 9.25% payable semi-annually on April 1 and October 1 commencing on April 1, 2013. PIK interest accrues on these notes at a rate of 10.0%. The Holding PIK Notes are Holding’s senior unsecured indebtedness and are not guaranteed by any of its subsidiaries.

	On August 30, 2013, Holding 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 third quarter of 2013, Holding 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.

	Long-term debt and capital leases consisted of the following as of March 31, 2014 and December 31, 2013 (in thousands):

		March 31,			December 31,
		2014			2013
	Senior unsecured notes due 2019	$	607,750		$	607,750
	Senior secured term loan due 2018 (4.00% at March 31, 2014 and December 31, 2013)	1,299,603			1,302,945
	Discount on senior secured term loan	(3,951		)	(4,217		)
	ABL Facility	—			—
	Notes due at various dates from 2014 to 2022 with interest rates from 6% to 10%	511			852
	Capital lease obligations due at various dates from 2014 to 2018	370			369
	Total	1,904,283			1,907,699
	Less current portion	(12,011		)	(12,318		)
	Total long-term debt	$	1,892,272		$	1,895,381

Derivative_Instruments_and_Hed

Derivative Instruments and Hedging Activities	3 Months Ended
Derivative Instruments and Hedging Activities	Mar. 31, 2014
Derivative Instruments and Hedging Activities	'
Derivative Instruments and Hedging Activities	'
	8. Derivative Instruments and Hedging Activities

	The Company manages its exposure to changes in fuel prices and interest rates 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 March 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 $3.63 to $3.82 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 1.9 million gallons, which represents approximately 25.2% of the Company’s total estimated usage during the periods hedged, through December 2014. The Company recorded, as a component of other comprehensive income before applicable tax impacts, an asset associated with the fair value of the fuel hedge in the amount of $0.4 million and $0.7 million as of March 31, 2014 and December 31, 2013, respectively. Over the next 12 months, the Company expects to reclassify $0.4 million of deferred gain from accumulated other comprehensive income as the related fuel hedge transactions mature. Settlement of hedge agreements are included in operating expenses and resulted in net receipts from the counterparty of $0.2 million and $0.2 million for the three months ended March 31, 2014 and 2013, respectively.

	In October 2011, the Company entered into interest rate swap agreements which 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 will continue to make interest payments based on the variable rate associated with the debt (based on LIBOR, but not less than 1.0%) and will periodically settle with its counterparties for the difference between the rate paid and the fixed rate. The Company recorded, as a component of other comprehensive income before applicable tax impacts, a liability associated with the fair value of the interest rate swap in the amount of $2.7 million and $3.1 million as of March 31, 2014 and December 31, 2013, respectively. Over the next 12 months, the Company expects to reclassify $2.1 million of deferred loss from accumulated other comprehensive income 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 $0.5 million and $0.5 million for the three months ended March 31, 2014 and 2013, respectively.

Changes_in_Accumulated_Other_C

Changes in Accumulated Other Comprehensive Income by Component	3 Months Ended
	Mar. 31, 2014
Changes in Accumulated Other Comprehensive Income by Component	'
Changes in Accumulated Other Comprehensive Income by Component	'
	9. Changes in Accumulated Other Comprehensive Income by Component

	The following table summarizes the changes in the Company’s accumulated other comprehensive income by component as of March 31, 2014 and December 31, 2013. All amounts are after tax.

		Fuel hedge			Interest rate swap			Unrealized			Total
								holding gains on
								available-for-sale
								securities
	Balance as of January 1, 2013	$	1,057		$	(2,861	)	$	1,591		(213		)
	Other comprehensive income before reclassifications	(396		)	(336		)	(598		)	(1,330		)
	Amounts reclassified from accumulated other comprehensive income	(241		)	1,239			(294		)	704
	Net current-period other comprehensive income	(637		)	903			(892		)	(626		)
	Balance as of December 31, 2013	$	420		$	(1,958	)	$	699		$	(839	)
	Other comprehensive income before reclassifications	(86		)	(59		)	41			(104		)
	Amounts reclassified from accumulated other comprehensive income	(113		)	309			(378		)	(182		)
	Net current-period other comprehensive income	(199		)	250			(337		)	(286		)
	Balance as of March 31, 2014	$	221		$	(1,708	)	$	362		$	(1,125	)

	The following table shows the line item on the Consolidated Statements of Operations affected by reclassifications out of accumulated other comprehensive income.

		Amount reclassified from AOCI
		Quarter ended
		March 31,
	Details about AOCI components	2014			2013			Statements of Operations
	Gains and losses on cash flow hedges
	Fuel hedge	$	181		180			Operating expenses
	Interest rate swap	(496		)	(491		)	Interest expense
		(315		)	(311		)	Total before tax
		119			117			Tax benefit (expense)
		$	(196	)	$	(194	)	Net of tax

	Unrealized holding gains on available-for-sale securities	$	606		13			Realized gains (losses) on investments
		606			13			Total before tax
		(228		)	(5		)	Tax expense
		$	378		$	8		Net of tax

Restructuring_Charges

Restructuring Charges	3 Months Ended
	Mar. 31, 2014
Restructuring Charges	'
Restructuring Charges	'
	10. Restructuring Charges

	The Company recorded a restructuring charge of $0.8 million and $0.6 million for the three months ended March 31, 2014 and 2013, respectively, related to continuing efforts to re-align AMR’s operations and the reorganization of EmCare’s geographic regions. Payments currently under this plan are expected to be complete by March 2015.

		AMR						EmCare			Corporation
		Lease &			Severance			Severance			Severance			Total
		Other Contract
		Termination
		Costs
		(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	738			(26		)	97			—			809
	Paid	(582		)	(657		)	(234		)	(46		)	(1,519		)
	Balance as of March 31, 2014	$	3,165		$	1,457		$	345		$	5		$	4,972

Equity_Based_Compensation

Equity Based Compensation	3 Months Ended
Equity Based Compensation	Mar. 31, 2014
Equity Based Compensation	'
Equity Based Compensation	'
	11. Equity Based Compensation

	Upon completion of Holding’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 March 31, 2014, a total of 16,607,028 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 March 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 Holding’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 vest ratably over five years. Performance based awards vest upon achievement of certain company-wide objectives. All options have 10 year terms.

	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.

	A compensation charge of $1.1 million was recorded for shares vested for each of the three months ended March 31, 2014 and 2013.

Commitments_and_Contingencies

Commitments and Contingencies	3 Months Ended
Commitments and Contingencies	Mar. 31, 2014
Commitments and Contingencies	'
Commitments and Contingencies	'
	12. Commitments and Contingencies

	Lease Commitments

	The Company leases various facilities and equipment under operating lease agreements. Rental expense incurred under these leases was $11.3 million and $11.1 million for the three months ended March 31, 2014 and 2013, 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.

	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 December 2006, AMR received a subpoena from the 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 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.

	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 March 31, 2014 and December 31, 2013, the Company had $132.5 million in outstanding letters of credit.

	Other Legal Matters

	Four different lawsuits purporting to be class actions 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. Plaintiffs allege principally that the AMR entities failed to pay overtime wages pursuant to California law, and failed to provide required meal breaks, rest breaks or pay premium compensation for missed breaks. Plaintiffs are seeking to certify the classes and are seeking lost wages, penalties, attorneys’ fees and other sanctions permitted under California law for violations of wage hour laws. At the present time, the courts have not certified classes in any of these cases. In a hearing on February 25, 2014 in the Banta and Aguilar/Karapetian cases, the court indicated that it intends to certify classes on some issues, and deny certification on some issues, but is has not signed an order to such effect. The Company is unable at this time to estimate the amount of potential damages, if any in any of these actions.

	Merion Capital, L.P. (“Merion”), a former stockholder of Corporation, filed an action in the Delaware Court of Chancery on June 20, 2011 seeking to exercise its right to appraisal of its holdings in Corporation prior to the merger of Corporation with a wholly-owned subsidiary of Holding (the “Merger”) on May 25, 2011. During the first quarter of 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.

	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 seeking certain information from the Company relating to its operations as an indirect air carrier and its relationships with Part 135 direct air carriers. The Company responded to the subpoena in February 2013. The Federal Aviation Administration has made no further inquiries of the Company and the Company believes this matter is closed.

	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 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 is cooperating with the Department during its investigation and, as such, is in the process of gathering responsive documents, formulating a response to the subpoena, and is seeking to engage in a meaningful dialogue with the relevant New Hampshire Department of Insurance and Attorney General’s Office representatives. At this time, the Company is unable to determine the potential impact, if any, that will result from this investigation.

	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	3 Months Ended
Related Party Transactions	Mar. 31, 2014
Related Party Transactions	'
Related Party Transactions	'
	13. Related Party Transactions

	CD&R Affiliates

	Stockholders Agreement

	In connection with Holding’s initial public offering, Holding 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 40% but less than 50% 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.

	Consulting Agreement

	Holding and Corporation were party to the Consulting Agreement with CD&R dated May 25, 2011, pursuant to which CD&R provided the Company and its subsidiaries with financial, investment banking, management, advisory and other services in exchange for an annual fee of $5.0 million. The Company expensed $1.3 million for the three months ended March 31, 2013 in respect of this fee.

	During the third quarter of 2013, the Company made a $20.0 million payment to CD&R with proceeds received from the initial public offering of Common Stock of Holding to terminate the Consulting Agreement.

	Registration Rights Agreement

	In connection with the closing of the Merger, Holding 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 Holding’s Common Stock. Under the Registration Rights Agreement, if Holding registers Common Stock under the Securities Act, holders of the Common Stock, including CD&R Affiliates, have the right to require Holding’s to use reasonable best efforts to include in Holding’s registration statement shares of Common Stock held by them, subject to certain limitations and at the expense of Holding.

	Indemnification Agreements

	In connection with the closing of the Merger, Holding and Corporation 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 Corporation, 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 Hertz and its subsidiaries and licensees. For each of the three months ended March 31, 2014 and 2013, we 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.

	Transactions between Holding and Corporation

	On April 1, 2013, Corporation declared and paid a dividend to Holding in the amount of $20.8 million. These funds were used by Holding to pay interest due on Holding’s PIK Notes.

	During the third and fourth quarters of 2013, Holding made a $489.3 million contribution to Corporation with proceeds received from the initial public offering of Common Stock of Holding to pay off debt and for other general corporate purposes.

	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 Holding’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	3 Months Ended
	Mar. 31, 2014
Variable Interest Entities	'
Variable Interest Entities	'
	14. 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.

	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 March 31, 2014 and December 31, 2013, which are included in the Company’s consolidated financial statements (in thousands).

		March 31,		December 31,
		2014		2013
	Current assets	$	116,200	$	88,479
	Current liabilities	28,148		22,005

Segment_Information

Segment Information	3 Months Ended
	Mar. 31, 2014
Segment Information	'
Segment Information	'
	15. Segment Information

	The Company is organized around two separately managed business units: facility- based physician services and medical 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 medical transportation services reportable segment focuses on providing a full range of medical 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 taxes, loss on early debt extinguishment, other income (expense), net, realized gains (losses) on investments, interest expense, equity-based compensation expense, related party management fees, restructuring charges, and depreciation and amortization expense (“Adjusted EBITDA”) is the measure of profit and loss that the CODM uses to assess performance, measure liquidity 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 or liquidity. 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):

			Quarter ended
			March 31,
			2014			2013

	Facility-Based Physician Services
	Net revenue		$	644,566		$	554,936
	Income from operations		51,235			47,892
	Segment Adjusted EBITDA		71,374			66,160
	Medical Transportation Services
	Net revenue		$	369,645		$	333,388
	Income from operations		17,083			15,037
	Segment Adjusted EBITDA		38,633			34,839
	Segment Totals
	Net revenue		$	1,014,211		$	888,324
	Income from operations		68,318			62,929
	Segment Adjusted EBITDA		110,007			100,999

	A reconciliation of Segment Adjusted EBITDA to net income (loss) is as follows (in thousands):

			Quarter ended
			March 31,
			2014			2013
	Adjusted EBITDA—Holding		$	110,007		$	100,932
	Other operating income		—			67
	Segment Adjusted EBITDA / Adjusted EBITDA—Corporation		110,007			100,999
	Depreciation and amortization expense		(36,432		)	(34,755		)
	Restructuring charges		(809		)	(637		)
	Interest income from restricted assets		(86		)	(366		)
	Equity-based compensation expense		(1,062		)	(1,062		)
	Related party management fees		—			(1,250		)
	Net loss attributable to noncontrolling interest		(3,300		)	—
	Income from operations		68,318			62,929
	Interest income from restricted assets		86			366
	Interest expense		(30,049		)	(40,290		)
	Realized gains on investments		606			13
	Other income (expense), net		334			(12,721		)
	Loss on early debt extinguishment		—			(122		)
	Income tax expense		(17,055		)	(7,134		)
	Equity in earnings of unconsolidated subsidiary		47			75
	Net income—Corporation		$	22,287		$	3,116
	Adjustments for Holding:
	Other operating income		—			(67		)
	Interest expense		—			(11,462		)
	Other expense, net		(1,142		)	—
	Income tax benefit		380			4,566
	Net income (loss)—Holding		$	21,525		$	(3,847	)

	A reconciliation of Segment Adjusted EBITDA to cash flows provided by operating activities is as follows:

			Quarter ended
			March 31,
			2014			2013
	Adjusted EBITDA—Holding		$	110,007		$	100,932
	Other operating income		—			67
	Segment Adjusted EBITDA / Adjusted EBITDA—Corporation		110,007			100,999
Related party management fees		—			(1,250		)
Restructuring charges		(809		)	(637		)
Interest expense (less deferred loan fee amortization)		(26,812		)	(36,636		)
Change in accounts receivable		(35,429		)	(41,351		)
Change in other operating assets/liabilities		18,093			5,478
Excess tax benefits from equity-based compensation		(14,790		)	(8		)
Other income (expense), net		334			(12,721		)
Income tax expense, net of change in deferred taxes		(16,127		)	(7,874		)
Net loss attributable to noncontrolling interest		(3,300		)	—
Other		(947		)	571
Cash flows provided by operating activities—Corporation		$	30,220		$	6,571
Adjustments for Holding:
Other operating income		—			(67		)
Interest expense (less deferred loan fee amortization)		—			(10,406		)
Change in accounts receivable		—			139
Change in other operating assets/liabilities		762			5,839
Other (expense) income, net		(1,142		)	—
Income tax benefit, net of change in deferred taxes		380			4,566
Cash flows provided by operating activities—Holding		$	30,220		$	6,642

Guarantors_of_Debt

Guarantors of Debt	3 Months Ended
	Mar. 31, 2014
Guarantors of Debt	'
Guarantors of Debt	'
	16. Guarantors of Debt

	Corporation is the issuer of the 2019 Notes and the borrower under the Senior Secured Credit Facilities. The 2019 Notes and the Senior Secured Credit Facilities are guaranteed by each of Corporation’s domestic subsidiaries, except for any subsidiaries subject to regulation as an insurance company, including Corporation’s captive insurance subsidiary. All of the operating income and cash flow of Corporation is generated by EmCare, AMR and their subsidiaries. As a result, funds necessary to meet the debt service obligations under the 2019 Notes and the Senior Secured Credit Facilities are provided by the distributions or advances from the subsidiary companies, EmCare and AMR. Investments in subsidiary operating companies are accounted for on the equity method. Accordingly, entries necessary to consolidate Corporation and all of its subsidiaries are reflected in the Eliminations/Adjustments column. Separate complete financial statements of Corporation and subsidiary guarantors would not provide additional material information that would be useful in assessing the financial composition of Corporation or the subsidiary guarantors.

	Corporation’s payment obligations under the 2019 Notes are jointly and severally guaranteed on a senior unsecured basis by the guarantors. Each of the guarantors is wholly owned, directly or indirectly, by Corporation, and all guarantees are full and unconditional. A guarantor will be released from its obligations under its guarantee under certain customary circumstances, including (i) the sale or disposition of the guarantor, (ii) the release of the guarantor from all of its obligations under all guarantees related to any indebtedness of Corporation, (iii) the merger or consolidation of the guarantor as specified in the indenture governing the 2019 Notes, (iv) the guarantor becomes an unrestricted subsidiary, (v) the defeasance of Corporation’s obligations under the indenture governing the 2019 Notes or (vi) the payment in full of the principal amount of the 2019 Notes.

	The condensed consolidating financial statements for Corporation, the guarantors and the non-guarantors were as follows (in thousands):

	Consolidating Statements of Operations

			Quarter ended March 31, 2014
			Corporation			Subsidiary			Subsidiary			Eliminations /			Total
						Guarantors			Non-Guarantor			Adjustments
	Net revenue		$	—		$	1,013,733		$	18,994		$	(18,516	)	$	1,014,211
	Compensation and benefits		—			743,493			168			—			743,661
	Operating expenses		—			114,628			7			—			114,635
	Insurance expense		—			30,962			18,535			(18,516		)	30,981
	Selling, general and administrative expenses		—			19,318			57			—			19,375
	Depreciation and amortization expense		—			36,427			5			—			36,432
	Restructuring charges		—			809			—			—			809
	Income from operations		—			68,096			222			—			68,318
	Interest (loss) income from restricted assets		—			(1,267		)	1,353			—			86
	Interest expense		—			(30,049		)	—			—			(30,049		)
	Realized gains on investments		—			228			378			—			606
	Other income (expense), net		—			376			(42		)	—			334
	Income before taxes and equity in earnings of unconsolidated subsidiary		—			37,384			1,911			—			39,295
	Income tax expense		—			(17,051		)	(4		)	—			(17,055		)
	Income before equity in earnings of unconsolidated subsidiary		—			20,333			1,907			—			22,240
	Equity in earnings of unconsolidated subsidiary		25,587			—			47			(25,587		)	47
	Net income		25,587			20,333			1,954			(25,587		)	22,287
	Less: Net loss attributable to noncontrolling interest		—			3,300			—			—			3,300
	Net income attributable to Corporation		$	25,587		$	23,633		$	1,954		$	(25,587	)	$	25,587

			Quarter ended March 31, 2013
			Corporation			Subsidiary			Subsidiary			Eliminations /			Total
						Guarantors			Non-Guarantor			Adjustments
	Net revenue		$	—		$	887,846		$	18,399		$	(17,921	)	$	888,324
	Compensation and benefits		—			641,625			164			—			641,789
	Operating expenses		—			100,377			6			—			100,383
	Insurance expense		—			23,909			19,845			(17,921		)	25,833
	Selling, general and administrative expenses		—			21,994			4			—			21,998
	Depreciation and amortization expense		—			34,750			5			—			34,755
	Restructuring charges		—			637			—			—			637
	Income (loss) from operations		—			64,554			(1,625		)	—			62,929
	Interest (loss) income from restricted assets		—			(1,492		)	1,858			—			366
	Interest expense		—			(40,290		)	—			—			(40,290		)
	Realized (losses) gains on investments		—			(45		)	58			—			13
	Other expense, net		—			(12,701		)	(20		)	—			(12,721		)
	Loss on early debt extinguishment		—			(122		)	—			—			(122		)
	Income before taxes and equity in earnings of unconsolidated subsidiary		—			9,904			271			—			10,175
	Income tax expense		—			(7,130		)	(4		)	—			(7,134		)
	Income before equity in earnings of unconsolidated subsidiary		—			2,774			267			—			3,041
	Equity in earnings of unconsolidated subsidiary		3,116			—			75			(3,116		)	75
	Net income		3,116			2,774			342			(3,116		)	3,116
	Less: Net loss attributable to noncontrolling interest		—			—			—			—			—
	Net income attributable to Corporation		$	3,116		$	2,774		$	342		$	(3,116	)	$	3,116

	Consolidating Balance Sheet
	As of March 31, 2014

						Subsidiary			Subsidiary			Eliminations /
			Corporation			Guarantors			Non-Guarantor			Adjustments			Total
	Assets
Current assets:
Cash and cash equivalents		$	—		$	52,298		$	66,726		$	(9,750	)	$	109,274
Insurance collateral		—			4,245			33,161			(17,964		)	19,442
Trade and other accounts receivable, net		—			838,796			7,483			(5,339		)	840,940
Parts and supplies inventory		—			23,729			7			—			23,736
Prepaids and other current assets		—			28,008			948			—			28,956
Current deferred tax assets		—			—			3,277			(3,277		)	—
Total current assets		—			947,076			111,602			(36,330		)	1,022,348
Property, plant, and equipment, net		—			190,935			—			—			190,935
Intercompany receivable		1,925,392			—			58,490			(1,983,882		)	—
Intangible assets, net		—			516,530			—			—			516,530
Long-term deferred tax assets		—			—			1,995			(1,995		)	—
Insurance collateral		—			93,640			1,127			(93,640		)	1,127
Goodwill		—			2,447,012			—			(2,856		)	2,444,156
Other long-term assets		48,833			—			1,461			9,713			60,007
Investment and advances in subsidiaries		1,477,581			3,553			—			(1,481,134		)	—
Total assets		$	3,451,806		$	4,198,746		$	174,675		$	(3,590,124	)	$	4,235,103
Liabilities and Equity
Current liabilities:
Accounts payable		$	—		$	51,102		$	83		$	—		$	51,185
Accrued liabilities		26,961			316,635			39,528			(3,245		)	379,879
Current deferred tax liabilities		—			59,228			—			(3,277		)	55,951
Current portion of long-term debt		11,871			140			—			—			12,011
Total current liabilities		38,832			427,105			39,611			(6,522		)	499,026
Long-term debt		1,901,015			1,007			—			(9,750		)	1,892,272
Long-term deferred tax liabilities		—			155,343			—			(3,990		)	151,353
Insurance reserves		—			125,127			131,511			(104,846		)	151,792
Other long-term liabilities		—			16,721			—			—			16,721
Intercompany payable		—			1,983,882			—			(1,983,882		)	—
Total liabilities		1,939,847			2,709,185			171,122			(2,108,990		)	2,711,164
Equity:
Common stock		—			—			30			(30		)	—
Treasury stock		(1,347		)	—			—			—			(1,347		)
Additional paid-in capital		1,404,737			1,372,563			—			(1,372,563		)	1,404,737
Retained earnings		109,694			106,374			3,292			(109,666		)	109,694
Accumulated other comprehensive loss		(1,125		)	(1,356		)	231			1,125			(1,125		)
Total Corporation equity		1,511,959			1,477,581			3,553			(1,481,134		)	1,511,959
Noncontrolling interest		—			11,980			—			—			11,980
Total equity		1,511,959			1,489,561			3,553			(1,481,134		)	1,523,939
Total liabilities and equity		$	3,451,806		$	4,198,746		$	174,675		$	(3,590,124	)	$	4,235,103

Consolidating Balance Sheet
As of December 31, 2013

		Corporation			Subsidiary			Subsidiary			Eliminations/			Total
					Guarantors			Non-			Adjustments
								Guarantor
Assets
Current assets:
Cash and cash equivalents		$	—		$	65,516		$	67,224		$	(9,750	)	$	122,990
Insurance collateral		—			11,960			53,587			(35,928		)	29,619
Trade and other accounts receivable, net		—			799,021			3,561			(1,436		)	801,146
Parts and supplies inventory		—			23,367			9			—			23,376
Prepaids and other current assets		—			23,692			233			—			23,925
Current deferred tax assets		—			—			3,515			(3,515		)	—
Total current assets		—			923,556			128,129			(50,629		)	1,001,056
Property, plant, and equipment, net		—			194,715			—			—			194,715
Intercompany receivable		1,914,158			—			2,370			(1,916,528		)	—
Intangible assets, net		—			513,698			—			—			513,698
Long-term deferred tax assets		—			—			3,125			(3,125		)	—
Insurance collateral		—			82,766			12,716			(82,766		)	12,716
Goodwill		—			2,438,526			125			(2,981		)	2,435,670
Other long-term assets		51,803			—			1,845			7,287			60,935
Investment and advances in subsidiaries		1,450,081			4,199			4,617			(1,458,897		)	—
Total assets		$	3,416,042		$	4,157,460		$	152,927		$	(3,507,639	)	$	4,218,790
Liabilities and Equity
Current liabilities:
Accounts payable		$	—		$	52,354		$	118		$	—		$	52,472
Accrued liabilities		13,683			352,816			14,940			(23,460		)	357,979
Current deferred tax liabilities		—			39,002			—			16,797			55,799
Current portion of long-term debt		11,872			446			—			—			12,318
Total current liabilities		25,555			444,618			15,058			(6,663		)	478,568
Long-term debt		1,904,358			773			—			(9,750		)	1,895,381
Long-term deferred tax liabilities		—			156,378			—			(5,120		)	151,258
Insurance reserves		—			157,055			133,670			(115,298		)	175,427
Other long-term liabilities		—			16,997			—			—			16,997
Intercompany payable		—			1,916,528			—			(1,916,528		)	—
Total liabilities		1,929,913			2,692,349			148,728			(2,053,359		)	2,717,631
Equity:
Common stock		—			—			30			(30		)	—
Treasury stock		(1,347		)	—			—			—			(1,347		)
Additional paid-in capital		1,404,208			1,366,151			—			(1,366,151		)	1,404,208
Retained earnings		84,107			85,524			3,414			(88,938		)	84,107
Accumulated other comprehensive loss		(839		)	(1,594		)	755			839			(839		)
Total Corporation equity		1,486,129			1,450,081			4,199			(1,454,280		)	1,486,129
Noncontrolling interest		—			15,030			—			—			15,030
Total equity		1,486,129			1,465,111			4,199			(1,454,280		)	1,501,159
Total liabilities and equity		$	3,416,042		$	4,157,460		$	152,927		$	(3,507,639	)	$	4,218,790

Condensed Consolidating Statement of Cash Flows

		Quarter ended March 31, 2014
		Corporation			Subsidiary			Subsidiary			Total
					Guarantors			Non-guarantors
Cash Flows from Operating Activities
Net cash provided by operating activities		$	—		$	62,815		$	(32,595	)	$	30,220
Cash Flows from Investing Activities
Purchases of available-for-sale securities		—			—			(2,458		)	(2,458		)
Sales and maturities of available-for-sale securities		—			—			8,160			8,160
Purchase of property, plant and equipment		—			(10,714		)	—			(10,714		)
Proceeds from sale of property, plant and equipment		—			2,156			—			2,156
Acquisition of businesses, net of cash received		—			(35,791		)	—			(35,791		)
Net change in insurance collateral		—			(12,710		)	13,910			1,200
Other investing activities		—			(2,526		)	—			(2,526		)
Net cash (used in) provided by investing activities		—			(59,585		)	19,612			(39,973		)
Cash Flows from Financing Activities
Issuance of common stock		—			—			—			—
Borrowings under the Term Loan		—			—			—			—
Borrowings under the ABL Facility		—			—			—			—
Repayments of the Term Loan		(3,343		)	—			—			(3,343		)
Repayments of the ABL Facility		—			—			—			—
Debt issue costs		—			—			—			—
Excess tax benefits from equity-based compensation		—			14,790			—			14,790
Shares repurchased for tax withholdings		—			(14,430		)	—			(14,430		)
Proceeds from noncontrolling interest		—			250			—			250
Net change in bank overdrafts		—			—			—			—
Other financing activities		—			(1,230		)	—			(1,230		)
Net intercompany borrowings (payments)		3,343			(15,828		)	12,485			—
Net cash (used in) provided by financing activities		—			(16,448		)	12,485			(3,963		)
Change in cash and cash equivalents		—			(13,218		)	(498		)	(13,716		)
Cash and cash equivalents, beginning of period		—			65,516			57,474			122,990
Cash and cash equivalents, end of period		$	—		$	52,298		$	56,976		$	109,274

		Quarter ended March 31, 2013
		Corporation			Subsidiary			Subsidiary			Total
					Guarantors			Non-guarantors
Cash Flows from Operating Activities
Net cash provided by operating activities		$	—		$	16,531		$	(9,960	)	$	6,571
Cash Flows from Investing Activities
Purchases of available-for-sale securities		—			—			(159		)	(159		)
Sales and maturities of available-for-sale securities		—			—			448			448
Purchase of property, plant and equipment		—			(10,493		)	—			(10,493		)
Proceeds from sale of property, plant and equipment		—			197			—			197
Acquisition of businesses, net of cash received		—			(1,423		)	—			(1,423		)
Net change in insurance collateral		—			(3,841		)	11,203			7,362
Other investing activities		—			(702		)	—			(702		)
Net cash (used in) provided by investing activities		—			(16,262		)	11,492			(4,770		)
Cash Flows from Financing Activities
Issuance of common stock		691			—			—			691
Borrowings under the Term Loan		150,000			—			—			150,000
Borrowings under the ABL Facility		56,940			—			—			56,940
Repayments of the Term Loan		(3,343		)	—			—			(3,343		)
Repayments of the ABL Facility		(181,940		)	—			—			(181,940		)
Debt issue costs		(4,411		)	—			—			(4,411		)
Excess tax benefits from equity-based compensation		—			8			—			8
Shares repurchased for tax withholdings		—			—			—			—
Net change in bank overdrafts		—			2,883			—			2,883
Other financing activities		(329		)	—			—			(329		)
Net intercompany borrowings (payments)		(17,608		)	12,510			5,098			—
Net cash (used in) provided by financing activities		—			15,401			5,098			20,499
Change in cash and cash equivalents		—			15,670			6,630			22,300
Cash and cash equivalents, beginning of period		—			6,925			50,626			57,551
Cash and cash equivalents, end of period		$	—		$	22,595		$	57,256		$	79,851

Summary_of_Significant_Account1

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2014
Summary of Significant Accounting Policies	'
Consolidation	'
	Consolidation

	The consolidated financial statements of Holding include all of its wholly-owned subsidiaries, including Corporation and its respective subsidiaries and affiliated physician groups. The consolidated financial statements of Corporation, include all of its wholly-owned subsidiaries, including 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.
Insurance Reserves	'
	Insurance Reserves

	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 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 the balance sheet date.

	The Company establishes reserves for claims based upon an assessment of actual claims and claims incurred but not reported. The reserves are established based on quarterly consultation with third-party independent actuaries using actuarial principles and assumptions that consider a number of factors, including historical claim payment patterns and legal costs, and changes in case reserves and the assumed rate of inflation in healthcare 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.

	The Company’s most recent actuarial valuation was completed in March 2014. As a result of this and previous actuarial valuations, the Company recorded increases in its provisions for insurance liabilities of $5.2 million during the three month period ended March 31, 2014 compared to decreases of $1.2 million for three month period ended March 31, 2013, related to reserves for losses in prior years.

	The long-term portion of insurance reserves was $151.8 million and $175.4 million as of March 31, 2014 and December 31, 2013, respectively.
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. The Company’s billing systems do not provide contractual allowances or uncompensated care reserves on outstanding patient accounts. The allowance for uncompensated care is related principally to receivables recorded for self-pay patients and is not recorded on specific accounts due to the volume and variability of individual patient receivable collections. While the billing systems do not specifically record the allowance for doubtful accounts to individual accounts owed or specific payor classifications, the portion of the allowance for uncompensated care associated with fee for service charges as of December 31, 2013 was equal to approximately 87% and 89% of outstanding self-pay receivables for EmCare and AMR, respectively, consistent with the Company’s collection history. Account balances are charged off against the uncompensated care allowance when it is probable the receivable will not be recovered and to the contractual allowance when payment is received. The Company’s accounts receivable and allowances as of March 31, 2014 and December 31, 2013 were as follows (in thousands):

		March 31,			December 31,
		2014			2013
	Gross trade accounts receivable	$	4,153,929		$	3,841,672
	Allowance for contractual discounts	(2,193,183		)	(2,002,704		)
	Allowance for uncompensated care	(1,121,079		)	(1,038,833		)
	Net trade accounts receivable	839,667			800,135
	Other receivables, net	1,273			1,011
	Net accounts receivable	$	840,940		$	801,146

	Other receivables primarily represent EmCare hospital subsidies and fees, and AMR fees for stand-by and special events and subsidies from community organizations.

	Accounts receivable allowances at EmCare are estimated based on cash collection and write-off experience at a facility level contract and facility specific payor mix. These allowances are reviewed and adjusted monthly through revenue provisions. In addition, a look-back analysis is done, typically after 15 months, to compare actual cash collected on a date of service basis to the revenue recorded for that period. Any adjustment necessary for an overage or deficit in these allowances based on actual collections is recorded through a revenue adjustment in the current period.

	AMR contractual allowances are determined primarily on payor reimbursement schedules that are included and regularly updated in the billing systems, and by historical collection experience. The billing systems calculate the difference between payor specific gross billings and contractually agreed to, or governmentally driven, reimbursement rates. The allowance for uncompensated care at AMR is related principally to receivables recorded for self-pay patients. AMR’s allowances on self-pay accounts receivable are estimated on claim level, historical write-off experience.
Business Combinations	'
	Business Combinations

	Assets and liabilities of an acquired business are recorded at their fair values at the date of acquisition. The excess of the acquisition consideration over the estimated fair values is recorded as goodwill. All acquisition costs are expensed as incurred. While the Company uses its best estimates and assumptions as a part of the acquisition consideration allocation process to accurately value assets acquired and liabilities assumed at the acquisition date, the estimates are inherently uncertain and subject to refinement. As a result, during the measurement period the Company may record adjustments to the assets acquired and liabilities assumed, with the corresponding offset to goodwill. Upon the conclusion of the measurement period any subsequent adjustments are recorded as expense.
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 support the Company’s insurance program and reserves. 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.

	Additionally, insurance collateral is comprised of cash deposits with third parties. Insurance collateral also includes a receivable from insurers of $1.8 million and $1.3 million as of March 31, 2014 and December 31, 2013, respectively, for liabilities in excess of the Company’s self-insured retention.
Equity Structure and Public Offerings	'
	Equity Structure and Public Offerings — Holding

	On August 13, 2013, Holding’s Registration Statement was declared effective by the Securities and Exchange Commission (the “SEC”) for an initial public offering of its Common Stock. Holding registered the offering and sale of 42,000,000 shares of Common Stock and an additional 6,300,000 shares of Common Stock sold to the underwriters pursuant to their option to purchase additional shares at a price of $23 per share. On August 19, 2013, Holding completed the offering of 48,300,000 shares of Common Stock, at a price of $23 per share, for an aggregate offering price of $1,110.9 million, and the offering terminated. At the closing, Holding 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 Clayton, Dubilier & Rice, LLC (“CD&R”) in connection with the termination of a consulting agreement with Holding and Corporation (“Consulting Agreement”) which was recorded in the third quarter of 2013 to selling, general and administrative expenses in the statements of operations, see Note 13.

	Net proceeds from the initial public offering were used to (i) redeem in full Holding’s Senior PIK Toggle Notes due 2017 for a total of $479.6 million, which included a call premium pursuant to the indenture governing the Senior PIK Toggle Notes due 2017 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 Corporation’s senior unsecured notes due 2019 and all accrued but unpaid interest. The remaining proceeds were used for general corporate purposes which included, among other things, repayment of indebtedness and acquisitions.

	On February 5, 2014, Holding registered the offering and sale of 27,500,000 shares of Common Stock by certain stockholders of Holding and an additional 4,125,000 shares of Common Stock, which were sold by investment funds sponsored by, or affiliated with, CD&R (the “CD&R Affiliates”) to the underwriters pursuant to their option to purchase additional shares at $30.50 per share less the underwriting discount. The CD&R Affiliates, certain executive officers and directors of Holding and certain non-executives were the selling stockholders in the offering. Holding did not receive any of the proceeds from the sale of the shares being sold by the selling stockholders, including any shares sold pursuant to any exercise of the underwriters’ option to purchase additional shares.
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, other than current portion of self-insurance estimates, 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 March 31, 2014 and December 31, 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 three months ended March 31, 2014 and 2013, the Company derived approximately 27% and 28%, respectively, of its revenue from Medicare and Medicaid, 70% and 68%, 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 quoted market prices (Level 1). The estimated fair value of the senior notes as of March 31, 2014 was approximately $650.7 million with a carrying value of $607.8 million. The Company’s captive insurance subsidiary holds $9.8 million of the senior notes as of March 31, 2014 which has been excluded from the carrying value stated above.
Fair Value Measurement	'
	Fair Value Measurement

	The Company classifies its financial instruments that are reported at fair value based on a hierarchal framework which 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 fixed income mortgage backed securities, 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 4.

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

		March 31, 2014
	Description	Level 1			Level 2			Level 3		Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	7,016		$	515		$	—	$	7,531
	Fuel hedge	—			401			—		401
	Liabilities:
	Contingent consideration	—			—			1,734		1,734
	Interest rate swap	—			2,735			—		2,735


		December 31, 2013
	Description	Level 1			Level 2			Level 3		Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	12,710		$	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 $6.0 million since December 31, 2013 primarily due to payments made.

	During the three months ended March 31, 2014 and 2013, we had no transfers in and out of Level 1 and Level 2 fair value measurements.
Revenue Recognition	'
	Revenue Recognition

	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. Provisions for estimated uncompensated care, or bad debt expense, are related principally to the number of self-pay patients treated in the period and are based primarily on historical collection experience to reduce revenues net of contractual discounts to the estimated amounts the Company expects to collect. Subsidy and fee revenue primarily represent hospital subsidies and fees at EmCare and fees for stand-by, special event and community subsidies at AMR.

	The majority of the patients the Company treats are for the provision of emergency care in the pre-hospital and hospital settings. Due to federal government regulations governing the provision of such care, the Company is obligated to provide emergency care regardless of the patient’s ability to pay or whether or not the patient has insurance or other third-party coverage for the costs of the services rendered. While the Company attempts to obtain all relevant billing information at the time the patient is within our care, there are numerous patient encounters where such information is not available. In such cases, the Company’s billing operations will initially classify these patients as self-pay, with the applicable estimated allowance for uncompensated care, while they pursue collection of the account. Over the course of the first 30 to 60 days after these self-pay patients have been treated, the billing staff may identify the appropriate insurance or other third-party payor and re-assign the account from a self-pay payor classification to the appropriate payor. Depending on the final payor determination, the allowances for uncompensated care and contractual discounts will be adjusted accordingly. For accounts that remain classified as self-pay, the billing protocols and systems will generate bills and notifications generally for 90 to 120 days. If no collection or additional information is received from the patient, the account is written-off and sent to a collection agency. The Company’s revenue recognition models, which are reviewed and updated on a monthly basis, consider these events in determining the collectability of accounts receivable.

	Net revenue for the three month periods ended March 31, 2014 and 2013 consisted of the following (in thousands):

		Quarter ended
		March 31,
		2014			2013
	Fee-for-service revenue, net of contractuals:
	Medicare	$	250,312		$	233,874
	Medicaid	55,817			51,214
	Commercial insurance and managed care	645,183			560,191
	Self-pay	724,507			629,256
	Sub-total	1,675,819			1,474,535
	Subsidies and fees	182,675			130,713
	Revenue, net of contractuals	1,858,494			1,605,248
	Provision for uncompensated care	(844,283		)	(716,924		)
	Net revenue	$	1,014,211		$	888,324

	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 in 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 $1.1 million for the three months ended March 31, 2014 and decreased the contractual discount and uncompensated provisions (increased net revenue) by approximately $2.1 million for the three months ended March 31, 2013.

	The Company 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.

Summary_of_Significant_Account2

Summary of Significant Accounting Policies (Tables)	3 Months Ended
Summary of Significant Accounting Policies (Tables)	Mar. 31, 2014
Summary of Significant Accounting Policies	'
Schedule of accounts receivable and allowances	'
	The Company’s accounts receivable and allowances as of March 31, 2014 and December 31, 2013 were as follows (in thousands):

		March 31,			December 31,
		2014			2013
	Gross trade accounts receivable	$	4,153,929		$	3,841,672
	Allowance for contractual discounts	(2,193,183		)	(2,002,704		)
	Allowance for uncompensated care	(1,121,079		)	(1,038,833		)
	Net trade accounts receivable	839,667			800,135
	Other receivables, net	1,273			1,011
	Net accounts receivable	$	840,940		$	801,146
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 March 31, 2014 and December 31, 2013 (in thousands):

		March 31, 2014
	Description	Level 1			Level 2			Level 3		Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	7,016		$	515		$	—	$	7,531
	Fuel hedge	—			401			—		401
	Liabilities:
	Contingent consideration	—			—			1,734		1,734
	Interest rate swap	—			2,735			—		2,735


		December 31, 2013
	Description	Level 1			Level 2			Level 3		Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	12,710		$	517		$	—	$	13,227
	Fuel hedge	—			672			—		672
	Liabilities:
	Contingent consideration	—			—			7,734		7,734
	Interest rate swap	—			3,135			—		3,135

Schedule of net revenue	'
	Net revenue for the three month periods ended March 31, 2014 and 2013 consisted of the following (in thousands):

		Quarter ended
		March 31,
		2014			2013
	Fee-for-service revenue, net of contractuals:
	Medicare	$	250,312		$	233,874
	Medicaid	55,817			51,214
	Commercial insurance and managed care	645,183			560,191
	Self-pay	724,507			629,256
	Sub-total	1,675,819			1,474,535
	Subsidies and fees	182,675			130,713
	Revenue, net of contractuals	1,858,494			1,605,248
	Provision for uncompensated care	(844,283		)	(716,924		)
	Net revenue	$	1,014,211		$	888,324

Basic_and_Diluted_Net_Income_L1

Basic and Diluted Net Income (Loss) Per Share (Tables)	3 Months Ended
	Mar. 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 share and per share amounts).

		Quarter ended
		March 31,
		2014		2013
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	24,825	$	(3,847	)

	Weighted-average common shares outstanding — common stock:
	Basic	180,782,025		130,696,421
	Dilutive impact of stock awards outstanding	8,609,587		—
	Diluted	189,391,612		130,696,421

	Earnings per share — common stock:
	Basic net income (loss) per share attributable to Envision Healthcare Holdings, Inc.	$	0.14	$	(0.03	)
	Diluted net income (loss) per share attributable to Envision Healthcare Holdings, Inc.	$	0.13	$	(0.03	)

Insurance_Collateral_Tables

Insurance Collateral (Tables)	3 Months Ended
	Mar. 31, 2014
Insurance Collateral	'
Schedule of insurance collateral	'
	Insurance collateral consisted of the following as of March 31, 2014 and December 31, 2013 (in thousands):

		March 31,		December 31,
		2014		2013
	Available-for-sale securities:
	U.S. Treasuries	$	2,113	$	2,100
	Corporate bonds / Fixed income	3,346		6,372
	Corporate equity	2,072		4,755
	Total available-for-sale securities	7,531		13,227
	Insurance receivable	1,796		1,300
	Cash deposits and other	11,242		27,808
	Total insurance collateral	$	20,569	$	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 March 31, 2014 and December 31, 2013 were as follows (in thousands):

		March 31, 2014
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,077	$	37		$	(1	)	$	2,113
	Corporate bonds / Fixed income	3,316		31			(1		)	3,346
	Corporate equity	2,095		15			(38		)	2,072
	Total available-for-sale securities	$	7,488	$	83		$	(40	)	$	7,531

		December 31, 2013
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,063	$	37		$	—		$	2,100
	Corporate bonds / Fixed income	6,385		26			(39		)	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 March 31, 2014 and December 31, 2013 were as follows (in thousands):

		March 31, 2014					December 31, 2013
		Fair Value		Unrealized			Fair Value			Unrealized
				Loss						Loss
	U.S. Treasuries:
	Less than 12 months	$	133	$	(1	)	$	132		$	(1	)
	12 months or more	—		—			—			—
	Corporate bonds / Fixed income:
	Less than 12 months	853		(1		)	2,768			(18		)
	12 months or more	—		—			2,178			(20		)
	Corporate equity:
	Less than 12 months	1,104		(38		)	—			—
	12 months or more	—		—			2,553			(144		)
	Total	$	2,090	$	(40	)	$	7,631		$	(183	)

Accrued_Liabilities_Tables

Accrued Liabilities (Tables)	3 Months Ended
	Mar. 31, 2014
Accrued Liabilities	'
Schedule of accrued liabilities	'
	Accrued liabilities were as follows as of March 31, 2014 and December 31, 2013 (in thousands):

		March 31,			December 31,
		2014			2013
	Accrued wages and benefits	$	173,823		$	161,398
	Accrued paid time-off	29,367			25,713
	Current portion of self-insurance reserves	71,499			73,738
	Accrued restructuring	4,972			5,682
	Current portion of compliance and legal	3,558			2,000
	Accrued billing and collection fees	2,929			2,954
	Accrued incentive compensation	23,083			19,570
	Accrued interest	17,921			6,898
	Accrued income taxes	7,982			7,043
	Other	44,745			52,983
	Total accrued liabilities — Corporation	$	379,879		$	357,979
	Accrued income taxes — adjustment for Holding	(8,309		)	(7,043		)
	Total accrued liabilities — Holding	$	371,570		$	350,936

LongTerm_Debt_Tables

Long-Term Debt (Tables)	3 Months Ended
	Mar. 31, 2014
Long-Term Debt	'
Schedule of long-term debt and capital leases	'
	Long-term debt and capital leases consisted of the following as of March 31, 2014 and December 31, 2013 (in thousands):

		March 31,			December 31,
		2014			2013
	Senior unsecured notes due 2019	$	607,750		$	607,750
	Senior secured term loan due 2018 (4.00% at March 31, 2014 and December 31, 2013)	1,299,603			1,302,945
	Discount on senior secured term loan	(3,951		)	(4,217		)
	ABL Facility	—			—
	Notes due at various dates from 2014 to 2022 with interest rates from 6% to 10%	511			852
	Capital lease obligations due at various dates from 2014 to 2018	370			369
	Total	1,904,283			1,907,699
	Less current portion	(12,011		)	(12,318		)
	Total long-term debt	$	1,892,272		$	1,895,381

Changes_in_Accumulated_Other_C1

Changes in Accumulated Other Comprehensive Income by Component (Tables)	3 Months Ended
	Mar. 31, 2014
Changes in Accumulated Other Comprehensive Income by Component	'
Summary of changes in the Company's accumulated other comprehensive income by component, after tax	'


		Fuel hedge			Interest rate swap			Unrealized			Total
								holding gains on
								available-for-sale
								securities
	Balance as of January 1, 2013	$	1,057		$	(2,861	)	$	1,591		(213		)
	Other comprehensive income before reclassifications	(396		)	(336		)	(598		)	(1,330		)
	Amounts reclassified from accumulated other comprehensive income	(241		)	1,239			(294		)	704
	Net current-period other comprehensive income	(637		)	903			(892		)	(626		)
	Balance as of December 31, 2013	$	420		$	(1,958	)	$	699		$	(839	)
	Other comprehensive income before reclassifications	(86		)	(59		)	41			(104		)
	Amounts reclassified from accumulated other comprehensive income	(113		)	309			(378		)	(182		)
	Net current-period other comprehensive income	(199		)	250			(337		)	(286		)
	Balance as of March 31, 2014	$	221		$	(1,708	)	$	362		$	(1,125	)
Schedule of Consolidated Statement of Operations affected by reclassifications out of accumulated other comprehensive income	'


		Amount reclassified from AOCI
		Quarter ended
		March 31,
	Details about AOCI components	2014			2013			Statements of Operations
	Gains and losses on cash flow hedges
	Fuel hedge	$	181		180			Operating expenses
	Interest rate swap	(496		)	(491		)	Interest expense
		(315		)	(311		)	Total before tax
		119			117			Tax benefit (expense)
		$	(196	)	$	(194	)	Net of tax

	Unrealized holding gains on available-for-sale securities	$	606		13			Realized gains (losses) on investments
		606			13			Total before tax
		(228		)	(5		)	Tax expense
		$	378		$	8		Net of tax

Restructuring_Charges_Tables

Restructuring Charges (Tables)	3 Months Ended
	Mar. 31, 2014
Restructuring Charges	'
Schedule of restructuring charges	'


		AMR						EmCare			Corporation
		Lease &			Severance			Severance			Severance			Total
		Other Contract
		Termination
		Costs
		(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	738			(26		)	97			—			809
	Paid	(582		)	(657		)	(234		)	(46		)	(1,519		)
	Balance as of March 31, 2014	$	3,165		$	1,457		$	345		$	5		$	4,972

Variable_Interest_Entities_Tab

Variable Interest Entities (Tables)	3 Months Ended
	Mar. 31, 2014
Variable Interest Entities	'
Summary of the HCA-EmCare JV assets and liabilities which are included in the consolidated financial statements	'
	The following is a summary of the HCA-EmCare JV assets and liabilities as of March 31, 2014 and December 31, 2013, which are included in the Company’s consolidated financial statements (in thousands).

		March 31,		December 31,
		2014		2013
	Current assets	$	116,200	$	88,479
	Current liabilities	28,148		22,005

Segment_Information_Tables

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2014
Segment Information	'
Schedule of the Company's operating segment results	'
	The Company’s operating segment results were as follows (in thousands):

		Quarter ended
		March 31,
		2014			2013

	Facility-Based Physician Services
	Net revenue	$	644,566		$	554,936
	Income from operations	51,235			47,892
	Segment Adjusted EBITDA	71,374			66,160
	Medical Transportation Services
	Net revenue	$	369,645		$	333,388
	Income from operations	17,083			15,037
	Segment Adjusted EBITDA	38,633			34,839
	Segment Totals
	Net revenue	$	1,014,211		$	888,324
	Income from operations	68,318			62,929
	Segment Adjusted EBITDA	110,007			100,999
Schedule of reconciliation of Segment Adjusted EBITDA to net income (loss)	'
	A reconciliation of Segment Adjusted EBITDA to net income (loss) is as follows (in thousands):

		Quarter ended
		March 31,
		2014			2013
	Adjusted EBITDA—Holding	$	110,007		$	100,932
	Other operating income	—			67
	Segment Adjusted EBITDA / Adjusted EBITDA—Corporation	110,007			100,999
	Depreciation and amortization expense	(36,432		)	(34,755		)
	Restructuring charges	(809		)	(637		)
	Interest income from restricted assets	(86		)	(366		)
	Equity-based compensation expense	(1,062		)	(1,062		)
	Related party management fees	—			(1,250		)
	Net loss attributable to noncontrolling interest	(3,300		)	—
	Income from operations	68,318			62,929
	Interest income from restricted assets	86			366
	Interest expense	(30,049		)	(40,290		)
	Realized gains on investments	606			13
	Other income (expense), net	334			(12,721		)
	Loss on early debt extinguishment	—			(122		)
	Income tax expense	(17,055		)	(7,134		)
	Equity in earnings of unconsolidated subsidiary	47			75
	Net income—Corporation	$	22,287		$	3,116
	Adjustments for Holding:
	Other operating income	—			(67		)
	Interest expense	—			(11,462		)
	Other expense, net	(1,142		)	—
	Income tax benefit	380			4,566
	Net income (loss)—Holding	$	21,525		$	(3,847	)
Schedule of reconciliation of Segment Adjusted EBITDA to cash flows provided by operating activities	'


		Quarter ended
		March 31,
		2014			2013
	Adjusted EBITDA—Holding	$	110,007		$	100,932
	Other operating income	—			67
	Segment Adjusted EBITDA / Adjusted EBITDA—Corporation	110,007			100,999
	Related party management fees	—			(1,250		)
	Restructuring charges	(809		)	(637		)
	Interest expense (less deferred loan fee amortization)	(26,812		)	(36,636		)
	Change in accounts receivable	(35,429		)	(41,351		)
	Change in other operating assets/liabilities	18,093			5,478
	Excess tax benefits from equity-based compensation	(14,790		)	(8		)
	Other income (expense), net	334			(12,721		)
	Income tax expense, net of change in deferred taxes	(16,127		)	(7,874		)
	Net loss attributable to noncontrolling interest	(3,300		)	—
	Other	(947		)	571
	Cash flows provided by operating activities—Corporation	$	30,220		$	6,571
	Adjustments for Holding:
	Other operating income	—			(67		)
	Interest expense (less deferred loan fee amortization)	—			(10,406		)
	Change in accounts receivable	—			139
	Change in other operating assets/liabilities	762			5,839
	Other (expense) income, net	(1,142		)	—
	Income tax benefit, net of change in deferred taxes	380			4,566
	Cash flows provided by operating activities—Holding	$	30,220		$	6,642

Guarantors_of_Debt_Tables

Guarantors of Debt (Tables)	3 Months Ended
	Mar. 31, 2014
Guarantors of Debt	'
Schedule of Consolidating Statements of Operations	'
	The condensed consolidating financial statements for Corporation, the guarantors and the non-guarantors were as follows (in thousands):

	Consolidating Statements of Operations

			Quarter ended March 31, 2014
			Corporation			Subsidiary			Subsidiary			Eliminations /			Total
						Guarantors			Non-Guarantor			Adjustments
	Net revenue		$	—		$	1,013,733		$	18,994		$	(18,516	)	$	1,014,211
	Compensation and benefits		—			743,493			168			—			743,661
	Operating expenses		—			114,628			7			—			114,635
	Insurance expense		—			30,962			18,535			(18,516		)	30,981
	Selling, general and administrative expenses		—			19,318			57			—			19,375
	Depreciation and amortization expense		—			36,427			5			—			36,432
	Restructuring charges		—			809			—			—			809
	Income from operations		—			68,096			222			—			68,318
	Interest (loss) income from restricted assets		—			(1,267		)	1,353			—			86
	Interest expense		—			(30,049		)	—			—			(30,049		)
	Realized gains on investments		—			228			378			—			606
	Other income (expense), net		—			376			(42		)	—			334
	Income before taxes and equity in earnings of unconsolidated subsidiary		—			37,384			1,911			—			39,295
	Income tax expense		—			(17,051		)	(4		)	—			(17,055		)
	Income before equity in earnings of unconsolidated subsidiary		—			20,333			1,907			—			22,240
	Equity in earnings of unconsolidated subsidiary		25,587			—			47			(25,587		)	47
	Net income		25,587			20,333			1,954			(25,587		)	22,287
	Less: Net loss attributable to noncontrolling interest		—			3,300			—			—			3,300
	Net income attributable to Corporation		$	25,587		$	23,633		$	1,954		$	(25,587	)	$	25,587

			Quarter ended March 31, 2013
			Corporation			Subsidiary			Subsidiary			Eliminations /			Total
						Guarantors			Non-Guarantor			Adjustments
	Net revenue		$	—		$	887,846		$	18,399		$	(17,921	)	$	888,324
	Compensation and benefits		—			641,625			164			—			641,789
	Operating expenses		—			100,377			6			—			100,383
	Insurance expense		—			23,909			19,845			(17,921		)	25,833
	Selling, general and administrative expenses		—			21,994			4			—			21,998
	Depreciation and amortization expense		—			34,750			5			—			34,755
	Restructuring charges		—			637			—			—			637
	Income (loss) from operations		—			64,554			(1,625		)	—			62,929
	Interest (loss) income from restricted assets		—			(1,492		)	1,858			—			366
	Interest expense		—			(40,290		)	—			—			(40,290		)
	Realized (losses) gains on investments		—			(45		)	58			—			13
	Other expense, net		—			(12,701		)	(20		)	—			(12,721		)
	Loss on early debt extinguishment		—			(122		)	—			—			(122		)
	Income before taxes and equity in earnings of unconsolidated subsidiary		—			9,904			271			—			10,175
	Income tax expense		—			(7,130		)	(4		)	—			(7,134		)
	Income before equity in earnings of unconsolidated subsidiary		—			2,774			267			—			3,041
	Equity in earnings of unconsolidated subsidiary		3,116			—			75			(3,116		)	75
	Net income		3,116			2,774			342			(3,116		)	3,116
	Less: Net loss attributable to noncontrolling interest		—			—			—			—			—
	Net income attributable to Corporation		$	3,116		$	2,774		$	342		$	(3,116	)	$	3,116
Schedule of Consolidating Balance Sheet	'
	The condensed consolidating financial statements for Corporation, the guarantors and the non-guarantors were as follows (in thousands):

	Consolidating Balance Sheet
	As of March 31, 2014

						Subsidiary			Subsidiary			Eliminations /
			Corporation			Guarantors			Non-Guarantor			Adjustments			Total
	Assets
	Current assets:
	Cash and cash equivalents		$	—		$	52,298		$	66,726		$	(9,750	)	$	109,274
	Insurance collateral		—			4,245			33,161			(17,964		)	19,442
	Trade and other accounts receivable, net		—			838,796			7,483			(5,339		)	840,940
	Parts and supplies inventory		—			23,729			7			—			23,736
	Prepaids and other current assets		—			28,008			948			—			28,956
	Current deferred tax assets		—			—			3,277			(3,277		)	—
	Total current assets		—			947,076			111,602			(36,330		)	1,022,348
	Property, plant, and equipment, net		—			190,935			—			—			190,935
	Intercompany receivable		1,925,392			—			58,490			(1,983,882		)	—
	Intangible assets, net		—			516,530			—			—			516,530
	Long-term deferred tax assets		—			—			1,995			(1,995		)	—
	Insurance collateral		—			93,640			1,127			(93,640		)	1,127
	Goodwill		—			2,447,012			—			(2,856		)	2,444,156
	Other long-term assets		48,833			—			1,461			9,713			60,007
	Investment and advances in subsidiaries		1,477,581			3,553			—			(1,481,134		)	—
	Total assets		$	3,451,806		$	4,198,746		$	174,675		$	(3,590,124	)	$	4,235,103
	Liabilities and Equity
	Current liabilities:
	Accounts payable		$	—		$	51,102		$	83		$	—		$	51,185
	Accrued liabilities		26,961			316,635			39,528			(3,245		)	379,879
	Current deferred tax liabilities		—			59,228			—			(3,277		)	55,951
	Current portion of long-term debt		11,871			140			—			—			12,011
	Total current liabilities		38,832			427,105			39,611			(6,522		)	499,026
	Long-term debt		1,901,015			1,007			—			(9,750		)	1,892,272
	Long-term deferred tax liabilities		—			155,343			—			(3,990		)	151,353
	Insurance reserves		—			125,127			131,511			(104,846		)	151,792
	Other long-term liabilities		—			16,721			—			—			16,721
	Intercompany payable		—			1,983,882			—			(1,983,882		)	—
	Total liabilities		1,939,847			2,709,185			171,122			(2,108,990		)	2,711,164
	Equity:
	Common stock		—			—			30			(30		)	—
	Treasury stock		(1,347		)	—			—			—			(1,347		)
	Additional paid-in capital		1,404,737			1,372,563			—			(1,372,563		)	1,404,737
	Retained earnings		109,694			106,374			3,292			(109,666		)	109,694
	Accumulated other comprehensive loss		(1,125		)	(1,356		)	231			1,125			(1,125		)
	Total Corporation equity		1,511,959			1,477,581			3,553			(1,481,134		)	1,511,959
	Noncontrolling interest		—			11,980			—			—			11,980
	Total equity		1,511,959			1,489,561			3,553			(1,481,134		)	1,523,939
	Total liabilities and equity		$	3,451,806		$	4,198,746		$	174,675		$	(3,590,124	)	$	4,235,103

	Consolidating Balance Sheet
	As of December 31, 2013

			Corporation			Subsidiary			Subsidiary			Eliminations/			Total
						Guarantors			Non-			Adjustments
									Guarantor
	Assets
	Current assets:
	Cash and cash equivalents		$	—		$	65,516		$	67,224		$	(9,750	)	$	122,990
	Insurance collateral		—			11,960			53,587			(35,928		)	29,619
	Trade and other accounts receivable, net		—			799,021			3,561			(1,436		)	801,146
	Parts and supplies inventory		—			23,367			9			—			23,376
	Prepaids and other current assets		—			23,692			233			—			23,925
	Current deferred tax assets		—			—			3,515			(3,515		)	—
Total current assets		—			923,556			128,129			(50,629		)	1,001,056
Property, plant, and equipment, net		—			194,715			—			—			194,715
Intercompany receivable		1,914,158			—			2,370			(1,916,528		)	—
Intangible assets, net		—			513,698			—			—			513,698
Long-term deferred tax assets		—			—			3,125			(3,125		)	—
Insurance collateral		—			82,766			12,716			(82,766		)	12,716
Goodwill		—			2,438,526			125			(2,981		)	2,435,670
Other long-term assets		51,803			—			1,845			7,287			60,935
Investment and advances in subsidiaries		1,450,081			4,199			4,617			(1,458,897		)	—
Total assets		$	3,416,042		$	4,157,460		$	152,927		$	(3,507,639	)	$	4,218,790
Liabilities and Equity
Current liabilities:
Accounts payable		$	—		$	52,354		$	118		$	—		$	52,472
Accrued liabilities		13,683			352,816			14,940			(23,460		)	357,979
Current deferred tax liabilities		—			39,002			—			16,797			55,799
Current portion of long-term debt		11,872			446			—			—			12,318
Total current liabilities		25,555			444,618			15,058			(6,663		)	478,568
Long-term debt		1,904,358			773			—			(9,750		)	1,895,381
Long-term deferred tax liabilities		—			156,378			—			(5,120		)	151,258
Insurance reserves		—			157,055			133,670			(115,298		)	175,427
Other long-term liabilities		—			16,997			—			—			16,997
Intercompany payable		—			1,916,528			—			(1,916,528		)	—
Total liabilities		1,929,913			2,692,349			148,728			(2,053,359		)	2,717,631
Equity:
Common stock		—			—			30			(30		)	—
Treasury stock		(1,347		)	—			—			—			(1,347		)
Additional paid-in capital		1,404,208			1,366,151			—			(1,366,151		)	1,404,208
Retained earnings		84,107			85,524			3,414			(88,938		)	84,107
Accumulated other comprehensive loss		(839		)	(1,594		)	755			839			(839		)
Total Corporation equity		1,486,129			1,450,081			4,199			(1,454,280		)	1,486,129
Noncontrolling interest		—			15,030			—			—			15,030
Total equity		1,486,129			1,465,111			4,199			(1,454,280		)	1,501,159
Total liabilities and equity		$	3,416,042		$	4,157,460		$	152,927		$	(3,507,639	)	$	4,218,790
Schedule of Condensed Consolidating Statement of Cash Flows	'
	The condensed consolidating financial statements for Corporation, the guarantors and the non-guarantors were as follows (in thousands):

	Condensed Consolidating Statement of Cash Flows

			Quarter ended March 31, 2014
			Corporation			Subsidiary			Subsidiary			Total
						Guarantors			Non-guarantors
	Cash Flows from Operating Activities
	Net cash provided by operating activities		$	—		$	62,815		$	(32,595	)	$	30,220
	Cash Flows from Investing Activities
	Purchases of available-for-sale securities		—			—			(2,458		)	(2,458		)
	Sales and maturities of available-for-sale securities		—			—			8,160			8,160
	Purchase of property, plant and equipment		—			(10,714		)	—			(10,714		)
	Proceeds from sale of property, plant and equipment		—			2,156			—			2,156
	Acquisition of businesses, net of cash received		—			(35,791		)	—			(35,791		)
	Net change in insurance collateral		—			(12,710		)	13,910			1,200
	Other investing activities		—			(2,526		)	—			(2,526		)
	Net cash (used in) provided by investing activities		—			(59,585		)	19,612			(39,973		)
	Cash Flows from Financing Activities
	Issuance of common stock		—			—			—			—
	Borrowings under the Term Loan		—			—			—			—
	Borrowings under the ABL Facility		—			—			—			—
	Repayments of the Term Loan		(3,343		)	—			—			(3,343		)
	Repayments of the ABL Facility		—			—			—			—
	Debt issue costs		—			—			—			—
	Excess tax benefits from equity-based compensation		—			14,790			—			14,790
	Shares repurchased for tax withholdings		—			(14,430		)	—			(14,430		)
	Proceeds from noncontrolling interest		—			250			—			250
	Net change in bank overdrafts		—			—			—			—
	Other financing activities		—			(1,230		)	—			(1,230		)
	Net intercompany borrowings (payments)		3,343			(15,828		)	12,485			—
	Net cash (used in) provided by financing activities		—			(16,448		)	12,485			(3,963		)
	Change in cash and cash equivalents		—			(13,218		)	(498		)	(13,716		)
	Cash and cash equivalents, beginning of period		—			65,516			57,474			122,990
	Cash and cash equivalents, end of period		$	—		$	52,298		$	56,976		$	109,274

			Quarter ended March 31, 2013
			Corporation			Subsidiary			Subsidiary			Total
						Guarantors			Non-guarantors
	Cash Flows from Operating Activities
	Net cash provided by operating activities		$	—		$	16,531		$	(9,960	)	$	6,571
	Cash Flows from Investing Activities
	Purchases of available-for-sale securities		—			—			(159		)	(159		)
	Sales and maturities of available-for-sale securities		—			—			448			448
	Purchase of property, plant and equipment		—			(10,493		)	—			(10,493		)
	Proceeds from sale of property, plant and equipment		—			197			—			197
	Acquisition of businesses, net of cash received		—			(1,423		)	—			(1,423		)
	Net change in insurance collateral		—			(3,841		)	11,203			7,362
	Other investing activities		—			(702		)	—			(702		)
	Net cash (used in) provided by investing activities		—			(16,262		)	11,492			(4,770		)
	Cash Flows from Financing Activities
	Issuance of common stock		691			—			—			691
	Borrowings under the Term Loan		150,000			—			—			150,000
	Borrowings under the ABL Facility		56,940			—			—			56,940
	Repayments of the Term Loan		(3,343		)	—			—			(3,343		)
	Repayments of the ABL Facility		(181,940		)	—			—			(181,940		)
	Debt issue costs		(4,411		)	—			—			(4,411		)
	Excess tax benefits from equity-based compensation		—			8			—			8
	Shares repurchased for tax withholdings		—			—			—			—
	Net change in bank overdrafts		—			2,883			—			2,883
	Other financing activities		(329		)	—			—			(329		)
	Net intercompany borrowings (payments)		(17,608		)	12,510			5,098			—
	Net cash (used in) provided by financing activities		—			15,401			5,098			20,499
Change in cash and cash equivalents		—			15,670			6,630			22,300
Cash and cash equivalents, beginning of period		—			6,925			50,626			57,551
Cash and cash equivalents, end of period		$	—		$	22,595		$	57,256		$	79,851

General_Details

General (Details) (USD $)	0 Months Ended	3 Months Ended		0 Months Ended
	Feb. 05, 2014	Mar. 31, 2014	Dec. 31, 2013	Jul. 29, 2013	Aug. 13, 2013
	Feb. 05, 2014	item	Dec. 31, 2013	Holding	Holding
Basis of Presentation of Financial Statements	'	'	'	'	'
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	'
Treasury shares issued	'	'	'	504,197	'
Shares of common stock issued	31,625,000	'	'	'	'
Public offering price (in dollars per share)	$30.50	'	'	'	'
Number of operating subsidiaries	'	2	'	'	'

Summary_of_Significant_Account3

Summary of Significant Accounting Policies (Details) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Insurance Collateral	'	'
Reinsurance receivable	$1,796	$1,300
Trade and Other Accounts Receivable, net	'	'
Net accounts receivable	840,940	801,146
Period after which look-back analysis is performed to review and adjust overage or deficit in accounts receivable allowances	'15 months	'
Corporation	'	'
Trade and Other Accounts Receivable, net	'	'
Gross trade accounts receivable	4,153,929	3,841,672
Allowance for contractual discounts	-2,193,183	-2,002,704
Allowance for uncompensated care	-1,121,079	-1,038,833
Net trade accounts receivable	839,667	800,135
Other receivables, net	1,273	1,011
Net accounts receivable	840,940	801,146
Holding	'	'
Trade and Other Accounts Receivable, net	'	'
Other receivables, net	$0	'
EmCare	'	'
Trade and Other Accounts Receivable, net	'	'
Provision for uncompensated care associated with fee for service charges as a percentage of outstanding self-pay receivables	'	87.00%
AMR	'	'
Trade and Other Accounts Receivable, net	'	'
Provision for uncompensated care associated with fee for service charges as a percentage of outstanding self-pay receivables	'	89.00%

Summary_of_Significant_Account4

Summary of Significant Accounting Policies (Details 2) (USD $)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Insurance Reserves	'	'	'
Discount rate for claims other than general liability claims (as a percent)	1.50%	'	'
Increases (decreases) in provisions for insurance liabilities for prior year losses	$5,200,000	($1,200,000)	'
Long-term portion of insurance reserves	151,792,000	0	175,427,000
Minimum	'	'	'
Insurance Reserves	'	'	'
Liability exposure in instances where third-party insurance coverage is obtained	1,000,000	'	'
Maximum	'	'	'
Insurance Reserves	'	'	'
Liability exposure in instances where third-party insurance coverage is obtained	$3,000,000	'	'

Summary_of_Significant_Account5

Summary of Significant Accounting Policies (Details 3) (USD $)

0 Months Ended

3 Months Ended

0 Months Ended

Feb. 05, 2014

Aug. 19, 2013

Mar. 31, 2013

Mar. 31, 2014

Mar. 31, 2013

Aug. 19, 2013

Aug. 13, 2013

Feb. 05, 2014

Aug. 19, 2013

Aug. 13, 2013

Senior PIK Toggle Notes due 2017

Revolving credit facility

Senior subordinated unsecured notes due 2019

EVHC

CD&R

Initial public offering

Underwriters overallotment option

Equity Structure and Public Offerings

Shares of common stock issued

31,625,000

48,300,000

42,000,000

4,125,000

6,300,000

Issue price (in dollars per share)

$30.50

$23

Aggregate offering price

$691,000

$1,110,900,000

Net proceeds, initial public offering

1,025,900,000

Underwriters' discounts and commissions and offering expenses

85,000,000

Payment made in connection with the termination of a corporation consulting agreement

20,000,000

Amount used to redeem or repay the debt outstanding

$479,600,000

$16,500,000

$332,500,000

Summary_of_Significant_Account6

Summary of Significant Accounting Policies (Details 4) (Net revenue, Customer concentration risk)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Medicare and Medicaid	'	'
Concentration of credit risk	'	'
Percentage of concentration risk	27.00%	28.00%
Insurance providers and contracted payors	'	'
Concentration of credit risk	'	'
Percentage of concentration risk	70.00%	68.00%
Patients	'	'
Concentration of credit risk	'	'
Percentage of concentration risk	3.00%	4.00%

Summary_of_Significant_Account7

Summary of Significant Accounting Policies (Details 5) (Senior subordinated unsecured notes purchased by EVHC subsidiary, USD $)	Mar. 31, 2014
In Millions, unless otherwise specified	Mar. 31, 2014
Financial Instruments	'
Estimated fair value of the senior subordinate notes	$650.70
Carrying value of the senior subordinate notes	607.8
Captive insurance subsidiary	'
Financial Instruments	'
Carrying value of the senior subordinate notes	$9.80

Summary_of_Significant_Account8

Summary of Significant Accounting Policies (Details 6) (USD $)

Mar. 31, 2014

Mar. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Level 1

Level 2

Level 3

Total

Available-for-sale securities (insurance collateral)

Fuel hedge

Interest rate swap

Contingent consideration

Available-for-sale securities (insurance collateral)

Fuel hedge

Contingent consideration

Interest rate swap

Fair value measurement

Assets

$7,016,000

$12,710,000

$515,000

$517,000

$401,000

$672,000

$7,531,000

$13,227,000

$401,000

$672,000

Liabilities

2,735,000

3,135,000

1,734,000

7,734,000

1,734,000

7,734,000

2,735,000

3,135,000

Decrease in a level 3 liability of the contingent consideration

6,000,000

Transfers in assets from Level 1 to level 2 fair value measurements

Transfers in assets from Level 2 to level 1 fair value measurements

Transfers in liabilities from Level 1 to level 2 fair value measurements

Transfers in liabilities from Level 2 to level 1 fair value measurements

Summary_of_Significant_Account9

Summary of Significant Accounting Policies (Details 7) (USD $)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Revenue Recognition	'	'
Fee-for-service revenue, net of contractuals	$1,675,819,000	$1,474,535,000
Subsidies and fees	182,675,000	130,713,000
Revenue, net of contractuals	1,858,494,000	1,605,248,000
Provision for uncompensated care	-844,283,000	-716,924,000
Net revenue	1,014,211,000	888,324,000
Revenue Recognition	'	'
(Increase) decrease in contractual discount or uncompensated care provisions	-1,100,000	2,100,000
Medicare	'	'
Revenue Recognition	'	'
Fee-for-service revenue, net of contractuals	250,312,000	233,874,000
Medicaid	'	'
Revenue Recognition	'	'
Fee-for-service revenue, net of contractuals	55,817,000	51,214,000
Commercial insurance and managed care	'	'
Revenue Recognition	'	'
Fee-for-service revenue, net of contractuals	645,183,000	560,191,000
Self-pay	'	'
Revenue Recognition	'	'
Fee-for-service revenue, net of contractuals	$724,507,000	$629,256,000
Minimum \| Self-pay	'	'
Revenue Recognition	'	'
Treatment period	'30 days	'
Bills and notifications period	'90 days	'
Maximum \| Self-pay	'	'
Revenue Recognition	'	'
Treatment period	'60 days	'
Bills and notifications period	'120 days	'

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	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Basic and diluted net income per share	'	'	'
Net income (loss)	24,825	-3,847	'
Weighted-average common shares outstanding - common stock:	'	'	'
Basic (in shares)	180,782,025	130,696,421	'
Dilutive impact of stock awards outstanding (in shares)	8,609,587	'	'
Diluted (in shares)	189,391,612	130,696,421	'
Earnings per share - common stock:	'	'	'
Basic net income (loss) per share (in dollars per share)	0.14	-0.03	'
Diluted net income (loss) per share (in dollars per share)	0.13	-0.03	'
Holding	'	'	'
Earnings per share - common stock:	'	'	'
Stock awards of common stock outstanding excluded from the computations of diluted loss per share and weighted-average common shares outstanding	0	3,930,872	0

Acquisitions_Details

Acquisitions (Details) (USD $)	Mar. 31, 2014	Dec. 31, 2013	Mar. 07, 2014	Dec. 31, 2013	Mar. 31, 2014
			Life Line Ambulance Service, Inc. and MedStat EMS, Inc.	CMORx, LLC and Loya Medical Services, PLLC	CMORx, LLC and Loya Medical Services, PLLC
				item
Acquisitions	'	'	'	'	'
Total consideration of acquisitions paid in cash	'	'	$36,200,000	$34,200,000	'
Goodwill	2,444,156,000	2,435,670,000	15,900,000	18,800,000	'
Tax deductible goodwill	'	'	9,900,000	'	'
Number of related corporations which leverage the provision of non-emergency medical transportation services	'	'	'	2	'
Intangible assets	'	'	15,000,000	16,900,000	7,400,000
Net current assets	'	'	5,300,000	'	'
Net current liabilities	'	'	'	$1,500,000	'

Insurance_Collateral_Details

Insurance Collateral (Details) (USD $)	Mar. 31, 2014	Dec. 31, 2013
Insurance collateral	'	'
Available-for-sale securities	$7,531,000	$13,227,000
Insurance receivable	1,796,000	1,300,000
Cash deposits and other	11,242,000	27,808,000
Total insurance collateral	20,569,000	42,335,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	7,488,000	12,847,000
Gross Unrealized Gains	83,000	563,000
Gross Unrealized Losses	-40,000	-183,000
Fair Value	7,531,000	13,227,000
U.S. Treasuries	'	'
Insurance collateral	'	'
Available-for-sale securities	2,113,000	2,100,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	2,077,000	2,063,000
Gross Unrealized Gains	37,000	37,000
Gross Unrealized Losses	-1,000	'
Fair Value	2,113,000	2,100,000
Corporate bonds / Fixed income	'	'
Insurance collateral	'	'
Available-for-sale securities	3,346,000	6,372,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	3,316,000	6,385,000
Gross Unrealized Gains	31,000	26,000
Gross Unrealized Losses	-1,000	-39,000
Fair Value	3,346,000	6,372,000
Contractual maturities of available-for-sale securities	'	'
Within one year	900,000	'
Longer than one year through five years	3,300,000	'
Longer than five years through ten years	1,300,000	'
Corporate equity	'	'
Insurance collateral	'	'
Available-for-sale securities	2,072,000	4,755,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	2,095,000	4,399,000
Gross Unrealized Gains	15,000	500,000
Gross Unrealized Losses	-38,000	-144,000
Fair Value	$2,072,000	$4,755,000

Insurance_Collateral_Details_2

Insurance Collateral (Details 2) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Insurance collateral	'	'	'
Securities available-for-sale, Fair Value, Total	$2,090	'	$7,631
Securities available-for-sale, Unrealized Loss, Total	-40	'	-183
Realized net gains on the sale and maturities of available-for-sale securities	600	13	'
U.S. Treasuries	'	'	'
Insurance collateral	'	'	'
Securities available-for-sale, Less than 12 months, Fair Value	133	'	132
Securities available-for-sale, Less than 12 months, Unrealized Loss	-1	'	-1
Corporate bonds / Fixed income	'	'	'
Insurance collateral	'	'	'
Securities available-for-sale, Less than 12 months, Fair Value	853	'	2,768
Securities available-for-sale, 12 months or more, Fair Value	'	'	2,178
Securities available-for-sale, Less than 12 months, Unrealized Loss	-1	'	-18
Securities available-for-sale, 12 months or more, Unrealized Loss	'	'	-20
Corporate equity	'	'	'
Insurance collateral	'	'	'
Securities available-for-sale, Less than 12 months, Fair Value	1,104	'	'
Securities available-for-sale, 12 months or more, Fair Value	'	'	2,553
Securities available-for-sale, Less than 12 months, Unrealized Loss	-38	'	'
Securities available-for-sale, 12 months or more, Unrealized Loss	'	'	($144)

Accrued_Liabilities_Details

Accrued Liabilities (Details) (USD $)	Mar. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Accrued liabilities	'	'	'
Accrued restructuring	$4,972	$5,682	$12,318
Total accrued liabilities	371,570	350,936	'
Corporation	'	'	'
Accrued liabilities	'	'	'
Accrued wages and benefits	173,823	161,398	'
Accrued paid time-off	29,367	25,713	'
Current portion of self-insurance reserve	71,499	73,738	'
Accrued restructuring	4,972	5,682	'
Current portion of compliance and legal	3,558	2,000	'
Accrued billing and collection fees	2,929	2,954	'
Accrued incentive compensation	23,083	19,570	'
Accrued interest	17,921	6,898	'
Accrued income taxes	7,982	7,043	'
Other	44,745	52,983	'
Total accrued liabilities	379,879	357,979	'
Holding	'	'	'
Accrued liabilities	'	'	'
Accrued income taxes	($8,309)	($7,043)	'

LongTerm_Debt_Details

Long-Term Debt (Details) (USD $)

3 Months Ended

0 Months Ended

3 Months Ended

0 Months Ended

3 Months Ended

0 Months Ended

1 Months Ended

0 Months Ended

1 Months Ended

0 Months Ended

1 Months Ended

0 Months Ended

1 Months Ended

3 Months Ended

0 Months Ended

2 Months Ended

0 Months Ended

2 Months Ended

0 Months Ended

2 Months Ended

0 Months Ended

1 Months Ended

2 Months Ended

Mar. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

25-May-11

Mar. 31, 2014

Dec. 30, 2013

Dec. 31, 2013

Dec. 30, 2013

Mar. 31, 2014

Dec. 30, 2013

Jun. 30, 2012

25-May-11

Mar. 31, 2014

Dec. 31, 2013

25-May-11

Feb. 07, 2013

Mar. 31, 2014

Dec. 31, 2013

Feb. 07, 2013

Feb. 06, 2013

Feb. 07, 2013

Feb. 06, 2013

Feb. 07, 2013

Feb. 06, 2013

Feb. 07, 2013

Feb. 06, 2013

Mar. 31, 2014

25-May-11

Feb. 27, 2013

Mar. 31, 2014

Feb. 27, 2013

Feb. 26, 2013

Feb. 27, 2013

Feb. 26, 2013

Feb. 27, 2013

Feb. 26, 2013

Feb. 27, 2013

Feb. 06, 2013

Feb. 26, 2013

Corporation

Senior unsecured notes due 2019

Senior unsecured notes purchased by captive insurance subsidiary

Credit Facilities

Term Loan Facility

ABL Facility

Corporation

Captive insurance subsidiary

Period prior to June 1, 2014

Period on and after June 1, 2014 and prior to June 1, 2015

Period on or after June 1, 2015 and prior to June 1, 2016

Period on or after June 1, 2016 and prior to June 1, 2017

Period on or after June 1, 2017

Corporation

Option one

Option two

Corporation

Minimum

Maximum

Option one

Option two

Corporation

Adjusted LIBOR rate

Corporation

Overnight federal funds rate

Adjusted LIBOR rate

LIBOR rate

Corporation

Overnight federal funds rate

Adjusted LIBOR rate

Minimum

Maximum

Overnight federal funds rate

Adjusted LIBOR rate

LIBOR rate

Corporation

Minimum

Maximum

Corporation

Minimum

Maximum

Corporation

Average daily excess availability less than or equal to 33% of availability