Envision Healthcare 10-Q 14 Aug 14 2014 Q2 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	6 Months Ended
	Jun. 30, 2014	Aug. 01, 2014
Document and Entity Information	'	'
Entity Registrant Name	'Envision Healthcare Holdings, Inc.	'
Entity Central Index Key	'0001578318	'
Document Type	'10-Q	'
Document Period End Date	30-Jun-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	'	182,542,040
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q2	'

CONSOLIDATED_BALANCE_SHEETS

CONSOLIDATED BALANCE SHEETS (USD $)	Jun. 30, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Current assets:	'	'
Cash and cash equivalents	$162,603	$204,712
Insurance collateral	18,519	29,619
Trade and other accounts receivable, net	879,337	801,146
Parts and supplies inventory	23,832	23,376
Prepaids and other current assets	42,400	23,430
Total current assets	1,126,691	1,082,283
Non-current assets:	'	'
Property, plant and equipment, net	197,303	194,715
Intangible assets, net	551,706	513,698
Insurance collateral	'	12,716
Goodwill	2,544,477	2,435,670
Other long-term assets	39,200	60,935
Total assets	4,459,377	4,300,017
Current liabilities:	'	'
Accounts payable	48,905	52,588
Accrued liabilities	377,853	350,936
Current deferred tax liabilities	35,615	35,487
Current portion of long-term debt and capital lease obligations	12,306	12,318
Total current liabilities	474,679	451,329
Long-term debt and capital lease obligations	2,032,347	1,895,381
Long-term deferred tax liabilities	151,225	151,130
Insurance reserves	152,454	175,427
Other long-term liabilities	16,532	16,997
Total liabilities	2,827,237	2,690,264
Commitments and contingencies	'	'
Equity:	'	'
Common stock ($0.01 par value; 2,000,000,000 shares authorized, 181,205,468 and 180,382,885 issued and outstanding as of June 30, 2014 and December 31, 2013, respectively)	1,812	1,804
Preferred stock ($0.01 par value; 200,000,000 shares authorized, none issued and outstanding as of June 30, 2014 and December 31, 2013)	'	'
Treasury stock at cost	-1,347	-1,347
Additional paid-in capital	1,579,748	1,576,764
Retained earnings	41,174	18,341
Accumulated other comprehensive income	-1,227	-839
Total Envision Healthcare Holdings, Inc. equity	1,620,160	1,594,723
Noncontrolling interest	11,980	15,030
Total equity	1,632,140	1,609,753
Total liabilities and equity	$4,459,377	$4,300,017

CONSOLIDATED_BALANCE_SHEETS_Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Jun. 30, 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	181,205,468	180,382,885
Common stock, shares outstanding	181,205,468	180,382,885
Preferred stock, par value (in dollars per share)	$0.01	$0.01
Preferred stock, shares authorized	200,000,000	200,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0

CONSOLIDATED_STATEMENTS_OF_OPE

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS) (USD $)	3 Months Ended		6 Months Ended
In Thousands, except Share data, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Revenue, net of contractual discounts	$1,953,702	$1,689,805	$3,812,196	$3,295,053
Provision for uncompensated care	-878,375	-790,550	-1,722,658	-1,507,474
Net revenue	1,075,327	899,255	2,089,538	1,787,579
Compensation and benefits	767,007	643,960	1,510,668	1,285,749
Operating expenses	120,715	102,308	235,350	202,758
Insurance expense	31,583	25,840	62,564	51,673
Selling, general and administrative expenses	23,594	23,790	42,969	45,788
Depreciation and amortization expense	35,558	34,622	71,990	69,377
Restructuring charges	3,731	3,032	4,540	3,669
Income from operations	93,139	65,703	161,457	128,565
Interest income from restricted assets	246	266	332	632
Interest expense, net	-29,002	-50,002	-59,051	-101,754
Realized gains (losses) on investments	508	105	1,114	118
Other income (expense), net	-1,964	-249	-2,772	-12,970
Loss on early debt extinguishment	-66,397	'	-66,397	-122
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-3,470	15,823	34,683	14,469
Income tax benefit (expense)	1,412	-6,313	-15,263	-8,881
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	-2,058	9,510	19,420	5,588
Equity in earnings of unconsolidated subsidiary	66	87	113	162
Net income (loss)	-1,992	9,597	19,533	5,750
Less: Net (income) loss attributable to noncontrolling interest	'	'	3,300	'
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	-1,992	9,597	22,833	5,750
Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:	'	'	'	'
Basic (in dollars per share)	($0.01)	$0.07	$0.13	$0.04
Diluted (in dollars per share)	($0.01)	$0.07	$0.12	$0.04
Weighted-average common shares outstanding:	'	'	'	'
Basic (in shares)	181,140,242	131,672,134	180,962,123	131,187,567
Diluted (in shares)	181,140,242	137,271,357	189,460,445	135,990,366
Comprehensive income (loss):	'	'	'	'
Net income (loss)	-1,992	9,597	19,533	5,750
Other comprehensive income (loss), net of tax:	'	'	'	'
Unrealized holding gains (losses) during the period	-365	-13	-702	-449
Unrealized gains (losses) on derivative financial instruments	263	20	314	-278
Total other comprehensive income (loss), net of tax	-102	7	-388	-727
Comprehensive income (loss)	-2,094	9,604	19,145	5,023
Less: Comprehensive (income) loss attributable to noncontrolling interest	'	'	3,300	'
Comprehensive income (loss) attributable to Envision Healthcare Holdings, Inc.	($2,094)	$9,604	$22,445	$5,023

CONSOLIDATED_STATEMENTS_OF_CAS

CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013
Cash Flows from Operating Activities	'	'
Net income (loss)	$19,533	$5,750
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:	'	'
Depreciation and amortization	78,456	78,999
(Gain) loss on disposal of property, plant and equipment	-2,025	-10
Equity-based compensation expense	2,550	2,124
Excess tax benefits from equity-based compensation	-15,658	-3,168
Loss on early debt extinguishment	66,397	122
Equity in earnings of unconsolidated subsidiary	-113	-162
Dividends received	430	556
Deferred income taxes	486	4,231
Payment of dissenting shareholder settlement	'	-13,717
Changes in operating assets/liabilities, net of acquisitions:	'	'
Trade and other accounts receivable	-58,212	-54,963
Parts and supplies inventory	-423	-154
Prepaids and other current assets	-18,927	-12,305
Accounts payable and accrued liabilities	31,266	-9,948
Insurance accruals	-9,820	-3,452
Net cash provided by (used in) operating activities	93,940	-6,097
Cash Flows from Investing Activities	'	'
Purchases of available-for-sale securities	-3,372	-2,548
Sales and maturities of available-for-sale securities	10,527	4,170
Purchases of property, plant and equipment	-33,480	-26,198
Proceeds from sale of property, plant and equipment	2,216	328
Acquisition of businesses, net of cash received	-199,298	-1,423
Net change in insurance collateral	1,213	-2,024
Other investing activities	-2,363	-52
Net cash provided by (used in) investing activities	-224,557	-27,747
Cash Flows from Financing Activities	'	'
Issuance of common stock	'	1,117
Borrowings under the Term Loan	'	209,000
Borrowings under the ABL Facility	50,000	252,440
Proceeds from issuance of senior notes	740,625	'
Repayments of the Term Loan	-3,343	-65,685
Repayments of the ABL Facility	-50,000	-349,940
Repayments of senior notes	-607,750	'
Payment for debt extinguishment premiums	-37,630	'
Dividend paid	'	-67
Debt issuance costs	-1,374	-5,011
Equity issuance costs	'	-1,400
Excess tax benefits from equity-based compensation	15,658	3,168
Shares repurchased for tax withholdings	-14,430	'
Proceeds from noncontrolling interest	250	'
Payment of dissenting shareholder settlement	'	-38,336
Net change in bank overdrafts	'	8,117
Other financing activities	-3,498	-359
Net cash provided by (used in) financing activities	88,508	13,044
Change in cash and cash equivalents	-42,109	-20,800
Cash and cash equivalents, beginning of period	204,712	57,832
Cash and cash equivalents, end of period	$162,603	$37,032

General

General	6 Months Ended
	Jun. 30, 2014
General	'
General	'
	1.              General
	Basis of Presentation of Financial Statements
	Envision Healthcare Holdings, Inc., formerly known as CDRT Holding Corporation, is organized as a holding company that operates through various subsidiaries.  Envision Healthcare Corporation, formerly known as Emergency Medical Services Corporation, (“Corporation”) is a wholly-owned subsidiary of the Company.
	The accompanying interim consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) to reflect the consolidated financial position, results of operations and cash flows of the Company 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 the Company 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 the Company’s significant accounting policies and other information, see the Company’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 the Company’s Annual Report on Form 10-K for the year ended December 31, 2013.
	On July 29, 2013, the Company effected a 9.3 for 1.0 stock split of its common stock, resulting in 132,082,885 shares of common stock issued, 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, the Company’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, the Company 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 the Company at a public offering price of $30.50 per share. See Note 2 for further information on the Company’s public offerings and its equity.
	The Company’s business is conducted primarily through two operating subsidiaries, EmCare Holdings, Inc. (“EmCare”), its facility-based and post-acute care physician services segment, and American Medical Response, Inc. (“AMR”), its healthcare transportation services segment.

Summary_of_Significant_Account

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2014
Summary of Significant Accounting Policies	'
Summary of Significant Accounting Policies	'
	2.              Summary of Significant Accounting Policies
	Consolidation
	The consolidated financial statements of the Company include all of its wholly-owned subsidiaries, including Corporation, EmCare and AMR and their respective subsidiaries and affiliated physician groups. All significant intercompany transactions and balances have been eliminated in consolidation.
	Use of Estimates
	The preparation of financial statements requires management to make estimates and assumptions relating to the reporting of results of operations, financial condition and related disclosure of contingent assets and liabilities at the date of the financial statements including, but not limited to, estimates and assumptions for accounts receivable and insurance related reserves. Actual results may differ from those estimates under different assumptions or conditions.
	Insurance Collateral
	Insurance collateral is comprised of investments in U.S. Treasuries and marketable equity and debt securities held by the Company’s captive insurance subsidiary that supports the Company’s insurance program and reserves. 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 June 30, 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 June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30,			December 31,
		2014			2013
	Gross trade accounts receivable	$	4,511,437		$	3,841,672
	Allowance for contractual discounts	(2,402,789		)	(2,002,704		)
	Allowance for uncompensated care	(1,229,807		)	(1,038,833		)
	Trade accounts receivable, net	878,841			800,135
	Other receivables, net	496			1,011
	Trade and other accounts receivable, net	$	879,337		$	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 one million dollars to three million dollars 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 June 2014. As a result of this and previous actuarial valuations, the Company recorded increases in its provisions for insurance liabilities of $2.1 million and $7.3 million during the three and six months ended June 30, 2014, respectively, as compared to an increase of $0.8 million and a decrease of $0.4 million for the three and six months ended June 30, 2013, related to reserves for losses in prior years.
	The long-term portion of insurance reserves was $152.5 million and $175.4 million as of June 30, 2014 and December 31, 2013, respectively.
	Equity Structure and Public Offerings
	On August 13, 2013, the Company’s Registration Statement was declared effective by the Securities and Exchange Commission (the “SEC”) for an initial public offering of its Common Stock. The Company 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, the Company 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, the Company received net proceeds of approximately $1,025.9 million, after deducting the underwriters’ discounts and commissions paid and offering expenses of approximately $85.0 million, including a $20.0 million payment to Clayton, Dubilier & Rice, LLC (“CD&R”) in connection with the termination of a consulting agreement with the Company (“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 the 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 the 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, the Company registered the offering and sale of 27,500,000 shares of Common Stock by certain stockholders of the Company 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 the Company and certain non-executives were the selling stockholders in the offering. The Company 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, long-term debt and other long-term liabilities 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 June 30, 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 six months ended June 30, 2014 and 2013, the Company derived approximately 33% and 34%, respectively, of its revenue from Medicare and Medicaid, 64% and 62%, respectively, from insurance providers and contracted payors, and 3% and 4%, respectively, directly from patients.
	The Company estimates the fair value of its fixed rate senior notes based on an analysis in which the Company evaluates market conditions, related securities, various public and private offerings, and other publicly available information (Level 2, as defined below). The estimated fair value of the senior notes as of June 30, 2014 approximated the carrying value of $750.0 million.
	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 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 June 30, 2014 and December 31, 2013 (in thousands):
		June 30, 2014
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	6,130		$	—		$	—		$	6,130
	Fuel hedge	—			368			—			368
	Liabilities:
	Contingent consideration	—			—			1,734			1,734
	Interest rate swap	—			2,327			—			2,327
		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 six months ended June 30, 2014 and 2013, there were 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 services rendered. While the Company attempts to obtain all relevant billing information at the time the patient is within its 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.
The Company has historically reported Medicare and Medicaid managed care in the line Commercial insurance and managed care. Medicare managed care and Medicaid managed care have been reclassified into the Medicare and Medicaid lines in the current period and all prior periods have been conformed to current period presentation. Net revenue for the three and six months ended June 30, 2014 and 2013 consisted of the following (in thousands):
	Three months ended						Six months ended
	June 30,						June 30,
	2014			2013			2014			2013
Fee-for-service revenue, net of contractual discounts:
Medicare	$	300,428		$	266,762		$	550,740		$	500,636
Medicaid	110,625			93,649			166,441			144,863
Commercial insurance and managed care (excluding Medicare and Medicaid managed care)	607,567			497,136			1,252,750			1,057,327
Self-pay	752,221			687,772			1,476,728			1,317,029
Sub-total	1,770,841			1,545,319			3,446,659			3,019,855
Subsidies and fees	182,861			144,486			365,537			275,198
Revenue, net of contractual discounts	1,953,702			1,689,805			3,812,196			3,295,053
Provision for uncompensated care	(878,375		)	(790,550		)	(1,722,658		)	(1,507,474		)
Net revenue	$	1,075,327		$	899,255		$	2,089,538		$	1,787,579
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 $2.7 million and $3.8 million for the three and six months ended June 30, 2014, respectively, and increased the contractual discount and uncompensated care provisions (decreased net revenue) by approximately $1.3 million for the three months ended June 30, 2013 and decreased the contractual discount and uncompensated provisions (increased net revenue) by approximately $0.8 million for the six months ended June 30, 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.
Recent Accounting Pronouncements
In May 2014, the FASB issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers (“ASU 2014-09”) to clarify the principles for recognizing revenue and to develop a common revenue standard for GAAP and International Financial Reporting Standards.  ASU 2014-09 is effective for public companies for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period.  Early application is not permitted.  The Company has not yet determined the effects, if any, that adoption of ASU 2014-09 may have on its consolidated financial position or results of operations.

Basic_and_Diluted_Net_Income_L

Basic and Diluted Net Income (Loss) Per Share	6 Months Ended
	Jun. 30, 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
	The Company 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 the Company’s common stock. The following table presents EPS amounts for all periods and the basic and diluted weighted-average shares outstanding used in the calculation (in thousands, except share and per share amounts).
		Three months ended					Six months ended
		June 30,					June 30,
		2014			2013		2014		2013
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	(1,992	)	$	9,597	$	22,833	$	5,750
	Weighted-average common shares outstanding — common stock:
	Basic	181,140,242			131,672,134		180,962,123		131,187,567
	Dilutive impact of stock awards outstanding	—			5,599,223		8,498,322		4,802,799
	Diluted	181,140,242			137,271,357		189,460,445		135,990,366
	Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:
	Basic	$	(0.01	)	$	0.07	$	0.13	$	0.04
	Diluted	$	(0.01	)	$	0.07	$	0.12	$	0.04
	The Company had a net loss for the three months ended June 30, 2014; therefore, the effect of stock awards to purchase common stock of 8,362,994 is excluded from the computations of diluted loss per share since the effect is anti-dilutive. As of June 30, 2014 and 2013, there were no stock awards of common stock outstanding excluded from the weighted-average common shares outstanding above.

Acquisitions

Acquisitions	6 Months Ended
	Jun. 30, 2014
Acquisitions	'
Acquisitions	'
	4.              Acquisitions
	2014 Acquisitions
	Phoenix Physicians, LLC (“Phoenix Physicians”). On June 17, 2014, the Company acquired the stock of Phoenix Physicians for a total purchase price of $169.5 million paid in cash (the “Phoenix Physicians Acquisition.”)  Phoenix Physicians, in part through management services agreements with professional entities, is engaged in providing medical practices support and emergency department management and staffing services to hospitals, physicians and healthcare facilities in Florida. The Company has accounted for the acquisition of Phoenix Physicians using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. All of the goodwill is tax deductible and assigned to the EmCare segment.
	The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations (in thousands):
	Cash	$	7,052
	Accounts receivable	16,748
	Prepaid and other current assets	359
	Property, plant, and equipment	92
	Acquired intangible assets	56,000
	Goodwill	96,811
	Accounts payable	(1,073		)
	Accrued liabilities	(6,539		)
	Total purchase price	$	169,450
	The following unaudited pro forma operating results give effect to the Phoenix Physicians Acquisition, as if it had been completed as of January 1, 2013. These pro forma amounts are not necessarily indicative of the operating results that would have occurred if these transactions had occurred on such date. The pro forma adjustments are based on certain assumptions that the Company believes are reasonable.
		Three months ended					Six months ended
		June 30,					June 30,
		2014			2013		2014		2013
		(in thousands)
	Net revenue	$	35,572		$	28,224	$	64,270	$	55,929
	Net income	1,113			306		2,110		981
	The Company’s statements of operations for both the three months and six months ended June 30, 2014 include net revenue and net income of $3.5 million and $0.3 million, respectively, attributable to Phoenix Physicians.
	Other 2014 Acquisitions. The Company completed the acquisitions of Life Line Ambulance Service, Inc., an emergency medical transportation service provider with operations in Arizona, on February 6, 2014, MedStat EMS, Inc., an emergency and non-emergency medical ground transportation service provider with operations in Mississippi, on March 7, 2014, and Streamlined Medical Solutions, LLC, a healthcare technology company which has developed proprietary software to enhance patient direct admission and referral management processes, on May 21, 2014 for total aggregate purchase consideration of approximately $38.0 million paid in cash.
	The Company has accounted for these acquisitions using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. During the three months ended June 30, 2014, the Company made purchase price allocation adjustments. The total purchase price for these acquisitions was allocated to goodwill of $17.4 million, $11.4 million of which is tax deductible goodwill, other acquired intangible assets of $15.0 million, and net current assets of $5.6 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 six months ended June 30, 2014, the Company made purchase price allocation adjustments including a reclassification from goodwill to intangible assets of $5.4 million. The total purchase price for these acquisitions was allocated to goodwill of $20.8 million, all of which is tax deductible goodwill, other acquired intangible assets of $14.9 million, and net current liabilities of $1.5 million, which are subject to adjustment based upon the completion of purchase price allocations.

Insurance_Collateral

Insurance Collateral	6 Months Ended
	Jun. 30, 2014
Insurance Collateral	'
Insurance Collateral	'
	5.              Insurance Collateral
	Insurance collateral consisted of the following as of June 30, 2014 and December 31, 2013 (in thousands):
		June 30,		December 31,
		2014		2013
	Available-for-sale securities:
	U.S. Treasuries	$	1,199	$	2,100
	Corporate bonds /Fixed income	2,702		6,372
	Corporate equity	2,229		4,755
	Total available-for-sale securities	6,130		13,227
	Insurance receivable	1,796		1,300
	Cash deposits and other	10,593		27,808
	Total insurance collateral	$	18,519	$	42,335
	Amortized cost basis and aggregate fair value of the Company’s available-for-sale securities as of June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30, 2014
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	1,182	$	19		$	(2	)	$	1,199
	Corporate bonds /Fixed income	2,693		10			(1		)	2,702
	Corporate equity	2,194		49			(14		)	2,229
	Total available-for-sale securities	$	6,069	$	78		$	(17	)	$	6,130
		December 31, 2013
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,064	$	37		$	(1	)	$	2,100
	Corporate bonds /Fixed income	6,384		26			(38		)	6,372
	Corporate equity	4,399		500			(144		)	4,755
	Total available-for-sale securities	$	12,847	$	563		$	(183	)	$	13,227
	As of June 30, 2014, available-for-sale securities included U.S. Treasuries and corporate bonds /fixed income securities of $0.6 million with contractual maturities within one year, $2.8 million with contractual maturities extending longer than one year through five years and $0.5 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 June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30, 2014					December 31, 2013
		Fair Value		Unrealized			Fair Value			Unrealized
				Loss						Loss
	U.S. Treasuries:
	Less than 12 months	$	132	$	(2	)	$	132		$	(1	)
	12 months or more	—		—			—			—
	Corporate bonds /Fixed income:
	Less than 12 months	552		(1		)	2,768			(18		)
	12 months or more	—		—			2,178			(20		)
	Corporate equity:
	Less than 12 months	1,225		(14		)	—			—
	12 months or more	—		—			2,553			(144		)
	Total	$	1,909	$	(17	)	$	7,631		$	(183	)
	The Company realized net gains of $0.5 million and $1.1 million on the sale and maturities of available-for-sale securities for the three and six months ended June 30, 2014, respectively, and net gains of $0.1 million on the sale and maturities of available-for-sale securities for both the three and six months ended June 30, 2013, respectively.

Accrued_Liabilities

Accrued Liabilities	6 Months Ended
	Jun. 30, 2014
Accrued Liabilities	'
Accrued Liabilities	'
	6.              Accrued Liabilities
	Accrued liabilities were as follows as of June 30, 2014 and December 31, 2013 (in thousands):
		June 30,		December 31,
		2014		2013
	Accrued wages and benefits	$	183,092	$	161,398
	Accrued paid time-off	29,732		25,713
	Current portion of self-insurance reserves	71,720		73,738
	Accrued restructuring	6,560		5,682
	Current portion of compliance and legal	4,262		2,000
	Accrued billing and collection fees	2,571		2,954
	Accrued incentive compensation	25,067		19,570
	Accrued interest	2,755		6,898
	Other	52,094		52,983
	Total accrued liabilities	$	377,853	$	350,936

LongTerm_Debt

Long-Term Debt	6 Months Ended
	Jun. 30, 2014
Debt and Capital Lease Obligations	'
Debt and Capital Lease Obligations	'
	7.              Debt and Capital Lease Obligations
	Senior Unsecured Notes due 2019
	On May 25, 2011, Corporation issued $950 million of senior unsecured notes due 2019 (“2019 Notes”). During the second quarter of 2012, the Company’s captive insurance subsidiary purchased $15.0 million of the 2019 Notes through an open market transaction and currently holds none of the 2019 Notes subsequent to the redemption of the 2019 Notes on December 30, 2013 and June 18, 2014.
	On December 30, 2013, the Company redeemed $332.5 million in aggregate principal amount of the 2019 Notes of which $5.2 million was held by the Company’s captive insurance subsidiary at a redemption price of 108.125%, plus accrued and unpaid interest of $2.2 million. During the fourth quarter of 2013, the Company recorded a loss on early debt extinguishment of $38.7 million related to premiums and unamortized debt issuance costs from the partial redemption of the 2019 Notes.
	On June 18, 2014, the Company redeemed $617.5 million in aggregate principal amount of the 2019 Notes of which $9.8 million was held by the Company’s captive insurance subsidiary at a redemption price of 106.094%, plus accrued and unpaid interest of $2.4 million. During the second quarter of 2014, the Company recorded a loss on early debt extinguishment of $66.4 million related to premiums, financing fees paid to the creditors of the unsecured senior notes due 2022, and unamortized debt issuance costs from the redemption of the 2019 Notes.
	Senior Secured Credit Facilities
	On May 25, 2011, Corporation entered into $1.8 billion of senior secured credit facilities (“Senior Secured Credit Facilities”) that consisted of a $1.44 billion senior secured term loan facility due 2018 (the “Term Loan Facility”) and a $350 million asset-backed revolving credit facility due 2016 (the “ABL Facility”). The Senior Secured Credit Facilities are secured by substantially all of the assets of the Company.
	Term Loan Facility
	Prior to February 7, 2013, loans under the Term Loan Facility bore interest at the Company’s election at a rate equal to (i) the highest of (x) the rate for deposits in U.S. dollars in the London interbank market (adjusted for maximum reserves) for the applicable interest period (“Term Loan LIBOR”) 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, the Company 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) the rate for deposits in U.S. dollars in the London Interbank Market (adjusted for maximum reserves) for the applicable interest period (“LIBOR”) and (y) 1.00%, plus, in each case, 3.00% (with a step-down to 2.75% in the event that the Company meets a consolidated first lien net leverage ratio of 2.50:1.00), or (ii) the alternate base rate, which will be the highest of (w) the corporate base rate established by the administrative agent from time to time, (x) 0.50% in excess of the overnight federal funds rate, (y) the one-month LIBOR (adjusted for maximum reserves) plus 1.00% and (z) 2.00%, plus, in each case, 2.00% (with a step-down to 1.75% in the event that the Company meets a consolidated first lien net leverage ratio of 2.50:1.00). The Company recorded a loss on early debt extinguishment of $0.1 million related to unamortized debt issuance costs as a result of this modification.
	The credit agreement governing the Term Loan Facility contains customary representations and warranties and customary affirmative and negative covenants. The negative covenants are limited to the following: limitations on the incurrence of debt, liens, fundamental changes, restrictions on subsidiary distributions, transactions with affiliates, further negative pledge, asset sales, restricted payments, investments and acquisitions, repayment of certain junior debt (including the senior notes) or amendments of junior debt documents related thereto and line of business. The negative covenants are subject to the customary exceptions.
	ABL Facility
	Prior to February 27, 2013, loans under the ABL Facility bore interest at the Company’s election at a rate equal to (i) the rate for deposits in U.S. dollars in the London interbank market (adjusted for maximum reserves) for the applicable interest period (“ABL LIBOR”), 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 (the “ABL Amendment”) to the credit agreement governing the ABL Facility (as amended, the “ABL Credit Agreement”), under which the Company 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 June 30, 2014, letters of credit outstanding which impact the available credit under the ABL Facility were $129.9 million and the maximum available under the ABL Facility was $320.1 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 second quarter of 2013, the Company recorded $5.0 million of debt issuance expense related to the Term Loan Amendment and ABL Amendment.
	Senior PIK Toggle Notes
	On October 1, 2012, the Company issued $450 million of Senior PIK Toggle Notes due 2017 (the “PIK Notes”) and used the proceeds from the offering to pay an extraordinary dividend to its stockholders, pay debt issuance costs and make certain payments to members of management with rollover options in the Company.
	On August 30, 2013, the Company redeemed all of the PIK Notes at a redemption price equal to 102.75% of the aggregate principal amount of the PIK Notes, plus accrued and unpaid interest of $17.2 million. During the third quarter of 2013, the Company recorded a loss on early debt extinguishment of $29.5 million related to premiums and unamortized debt issuance costs from the redemption of the PIK Notes.
	Senior Unsecured Notes due 2022
	On June 18, 2014, Corporation issued $750.0 million of senior unsecured notes due 2022 (“2022 Notes”) the proceeds of which were used to redeem the 2019 Notes and for other general corporate purposes. The Company paid $9.4 million in financing fees to the creditors of the 2022 Notes which was recorded to loss on early debt extinguishment for the three months ended June 30, 2014.
	The 2022 Notes have a fixed interest rate of 5.125%, payable semi-annually on January 1 and July 1 with the principal due at maturity on July 1, 2022. The 2022 Notes are general unsecured obligations of the Company and are guaranteed by each of the Company’s domestic subsidiaries, except for any of the Company’s subsidiaries subject to regulation as an insurance company, including the Company’s captive insurance subsidiary.
	The Company may redeem the 2022 Notes, in whole or in part, at any time prior to July 1, 2017, at a price equal to 100% of the principal amount thereof, plus accrued and unpaid interest, if any, to the redemption date, plus the applicable make-whole premium. The Company may redeem the 2022 Notes, in whole or in part, at any time (i) on and after July 1, 2017 and prior to July 1, 2018, at a price equal to 103.844% of the principal amount of the 2022 Notes, (ii) on or after July 1, 2018 and prior to July 1, 2019, at a price equal to 102.563% of the principal amount of the 2022 Notes, (iii) on or after July 1, 2019 and prior to July 1, 2020, at a price equal to 101.281% of the principal amount of the 2022 Notes, and (iv) on or after July 1, 2020, at a price equal to 100.000% of the principal amount of the 2022 Notes, in each case, plus accrued and unpaid interest, if any, to the redemption date. In addition, at any time prior to July 1, 2017, the Company at its option may redeem up to 40% of the aggregate principal amount of the 2022 Notes with the proceeds of certain equity offerings at a redemption price of 105.125%, plus accrued and unpaid interest, if any, to the applicable redemption date.
	The indenture governing the 2022 Notes contains covenants that, among other things, limit the Company’s ability and the ability of its restricted subsidiaries to: incur additional indebtedness or issue certain preferred shares; pay dividends on, redeem or repurchase stock or make other distributions in respect of its capital stock; repurchase, prepay or redeem subordinated indebtedness; make investments; create restrictions on the ability of the Company’s restricted subsidiaries to pay dividends to the Company or make other intercompany transfers; create liens; transfer or sell assets; consolidate, merge or sell or otherwise dispose of all or substantially all of its assets; enter into certain transactions with affiliates; and designate subsidiaries as unrestricted subsidiaries. Upon the occurrence of certain events constituting a change of control, the Company is required to make an offer to repurchase all of the 2022 Notes (unless otherwise redeemed) at a purchase price equal to 101% of their principal amount, plus accrued and unpaid interest, if any to the repurchase date. If the Company sells assets under certain circumstances, it must use the proceeds to make an offer to purchase the 2022 Notes at a price equal to 100% of their principal amount, plus accrued and unpaid interest, if any, to the date of purchase.
	Debt and capital lease obligations consisted of the following as of June 30, 2014 and December 31, 2013 (in thousands):
		June 30,			December 31,
		2014			2013
	Senior unsecured notes due 2019	$	—		$	607,750
	Senior unsecured notes due 2022	750,000			—
	Senior secured term loan due 2018 (4.00% at June 30, 2014 and December 31, 2013)	1,296,261			1,302,945
	Discount on senior secured term loan	(3,687		)	(4,217		)
	ABL Facility	—			—
	Notes due at various dates from 2014 to 2022 with interest rates from 6% to 10%	811			852
	Capital lease obligations due at various dates from 2014 to 2018	1,268			369
	Total	2,044,653			1,907,699
	Less current portion	(12,306		)	(12,318		)
	Total long-term debt and capital lease obligations	$	2,032,347		$	1,895,381

Derivative_Instruments_and_Hed

Derivative Instruments and Hedging Activities	6 Months Ended
	Jun. 30, 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 June 30, 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 $3.78 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 1.3 million gallons, which represents approximately 16.8% 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 June 30, 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 $0.1 million for each of the three months ended June 30, 2014 and 2013, respectively, and $0.3 million for each of the six months ended June 30, 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 $2.3 million and $3.1 million as of June 30, 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 for each of the three months ended June 30, 2014 and 2013, respectively, and $1.0 million for each of the six months ended June 30, 2014 and 2013, respectively.

Changes_in_Accumulated_Other_C

Changes in Accumulated Other Comprehensive Income by Component	6 Months Ended
	Jun. 30, 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 (AOCI) by component as of June 30, 2014 and December 31, 2013 (in thousands). 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	(18		)	(114		)	(8		)	(140		)
	Amounts reclassified from accumulated other comprehensive income	(172		)	618			(694		)	(248		)
	Net current-period other comprehensive income	(190		)	504			(702		)	(388		)
	Balance as of June 30, 2014	$	230		$	(1,454	)	$	(3	)	$	(1,227	)
	The following table shows the line item on the statements of operations affected by reclassifications out of AOCI (in thousands):
		Amount reclassified from AOCI
		Three months ended June 30,						Six months ended June 30,
	Details about AOCI components	2014			2013			2014			2013			Statements of Operations
	Gains and losses on cash flow hedges:
	Fuel Hedge	$	95		$	26		$	276		$	221		Operating expenses
	Interest rate swap	(497		)	(496		)	(993		)	(987		)	Interest expense, net
		(402		)	(470		)	(717		)	(766		)	Total before tax
		152			177			271			288			Tax benefit (expense)
		$	(250	)	$	(293	)	$	(446	)	$	(478	)	Net of tax
	Unrealized holding gains on available-for-sale securities	$	508		$	105		$	1,114		$	118		Realized gains (losses) on investments
		508			105			1,114			118			Total before tax
		(192		)	(39		)	(420		)	(44		)	Tax benefit (expense)
		$	316		$	66		$	694		$	74		Net of tax

Restructuring_Charges

Restructuring Charges	6 Months Ended
	Jun. 30, 2014
Restructuring Charges	'
Restructuring Charges	'
	10.       Restructuring Charges
	The Company recorded restructuring charges of $3.7 million and $4.5 million during the three and six months ended June 30, 2014, respectively, and $3.0 million and $3.7 million during the three and six months ended June 30, 2013, respectively, related primarily to continuing efforts to re-align AMR’s operations and billing functions.  Payments currently under this plan are expected to be complete by March 2015.
		AMR
		Lease and
		other contract
		termination						EmCare			EVHC
		costs			Severance			Severance			Severance			Total
		(in thousands)
	Balance as of January 1, 2013	$	8,122		$	3,015		$	773		$	408		$	12,318
	Incurred	1,876			2,890			913			20			5,699
	Paid	(6,989		)	(3,765		)	(1,204		)	(377		)	(12,335		)
	Balance as of December 31, 2013	$	3,009		$	2,140		$	482		$	51		$	5,682
	Incurred	2,899			512			728			401			4,540
	Paid	(878		)	(1,620		)	(719		)	(445		)	(3,662		)
	Balance as of June 30, 2014	$	5,030		$	1,032		$	491		$	7		$	6,560

Equity_Based_Compensation

Equity Based Compensation	6 Months Ended
	Jun. 30, 2014
Equity Based Compensation	'
Equity Based Compensation	'
	11.       Equity Based Compensation
	Upon completion of the Company’s initial public offering, the previous stock compensation plan (“Stock Compensation Plan”) terminated and the Envision Healthcare Holdings, Inc. 2013 Omnibus Incentive Plan (“Omnibus Incentive Plan”) was adopted pursuant to which options and awards with respect to a total of 16,708,289 shares of Common Stock are available for grant. As of June 30, 2014, a total of 16,539,986 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 June 30, 2014, no grants of performance based awards under the Omnibus Incentive Plan had been made. Options are granted with exercise prices equal to the fair value of the Company’s common stock at the date of grant. No participant may be granted in any calendar year awards covering more than 2.5 million shares of Common Stock or 1.5 million performance awards up to a maximum dollar value of $5.0 million. Non-performance based awards 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 $1.5 million and $1.1 million was recorded for the three months ended June 30, 2014 and 2013, respectively, and $2.5 million and $2.1 million was recorded for the six months ended June 30, 2014 and 2013, respectively.

Commitments_and_Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 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 $11.4 million and $11.2 million for the three months ended June 30, 2014 and 2013, respectively and $22.7 million and $22.3 million for the six months ended June 30, 2014 and 2013, respectively.
	The Company also records certain leasehold improvements and vehicles 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.
	In December 2006, AMR received a subpoena from the U.S. Department of Justice (“DOJ”). The subpoena requested copies of documents for the period from January 2000 through the present. The subpoena required AMR to produce a broad range of documents relating to the operations of certain AMR affiliates in New York. The Company produced documents responsive to the subpoena. The government identified claims for reimbursement that the government believes lack support for the level billed, and invited the Company to respond to the identified areas of concern. The Company reviewed the information provided by the government and provided its response. On May 20, 2011, AMR entered into a settlement agreement with the DOJ and a Corporate Integrity Agreement (“CIA”) with the Office of Inspector General of the Department of Health and Human Services (“OIG”) in connection with this matter. Under the terms of the settlement, AMR paid $2.7 million to the federal government. In connection with the settlement, the Company entered into a CIA with a five-year period beginning May 20, 2011. Pursuant to this CIA, the Company is required to maintain a compliance program, which includes, among other elements, the appointment of a compliance officer and committee, training of employees nationwide, safeguards for its billing operations as they relate to services provided in New York, including specific training for operations and billing personnel providing services in New York, review by an independent review organization and reporting of certain reportable events. The Company entered into the settlement in order to avoid the uncertainties of litigation, and has not admitted any wrongdoing. In May 2013, a subsidiary of the Company entered into an agreement to divest substantially all the assets underlying AMR’s services in New York, although the obligations of the Company’s compliance program will remain in effect following the expected divestiture. The divesture was completed on July 1, 2013.
	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 June 30, 2014 and December 31, 2013, the Company had $129.9 million in outstanding letters of credit.
	Other Legal Matters
	Four different putative class action lawsuits have been filed against AMR and certain subsidiaries in California alleging violations of California wage and hour laws.  On April 16, 2008, Laura Bartoni commenced a suit in the Superior Court for the State of California, County of Alameda; on July 8, 2008, Vaughn Banta filed suit in the Superior Court of the State of California, County of Los Angeles; on January 22, 2009, Laura Karapetian filed suit in the Superior Court of the State of California, County of Los Angeles: and on March 11, 2010, Melanie Aguilar filed suit in Superior Court of the State of California, County of Los Angeles.  The Banta, Aguilar and Karapetian cases have been coordinated in the Superior Court for the State of California, County of Los Angeles, and the Aguilar and Karapetian cases have subsequently been consolidated into a single action.  In these cases, the plaintiffs allege principally that the AMR entities failed to pay wages, including overtime wages, in compliance with California law, and failed to provide required meal breaks, rest breaks or pay premium compensation for missed breaks.  The plaintiffs are seeking to certify classes on these claims and are seeking lost wages, various penalties, and attorneys’ fees under California law.  The Court has certified classes in the consolidated Karapetian /Aguilar case on claims alleging that AMR has not provided meal periods in compliance with the law as to dispatchers and call takers, that AMR has an unlawful time round policy, and that AMR has an unlawful practice of setting rates for those employees; the Court denied certification of the rest period claims of these employees.  In Banta, the Court denied certification of the meal and rest period claims as to EMTs and paramedics, a decision that is being appealed; the Court indicated that it would certify a class on overtime claims, but plaintiff’s counsel have indicated that they intend to dismiss that claim as AMR’s policy complies with a recent Court of Appeal decision.  No rulings have been made as to class certification in Bartoni.  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 the Company (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	6 Months Ended
	Jun. 30, 2014
Related Party Transactions	'
Related Party Transactions	'
	13.       Related Party Transactions
	CD&R Affiliates
	Stockholders Agreement
	In connection with the Company’s initial public offering, the Company entered into a stockholders agreement (“Stockholders Agreement”) with CD&R Affiliates. Under the Stockholders Agreement, CD&R Affiliates were granted the right to designate for nomination for election a number of CD&R-designated directors equal to: (i) at least a majority of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 50% of the outstanding shares of Common Stock, (ii) at least 40% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 40% but less than 50% of the outstanding shares of Common Stock, (iii) at least 30% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 30% but less than 40% of the outstanding shares of Common Stock, (iv) at least 20% of the total number of directors comprising the board of directors at such time as long as the CD&R Affiliates own at least 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
	The Company was 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 and $2.5 million for the three months and six months ended June 30, 2013, respectively, for 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 the Company to terminate the Consulting Agreement.
	Registration Rights Agreement
	In connection with the closing of the Merger, the Company entered into a registration rights agreement (“Registration Rights Agreement”) with the CD&R Affiliates which grants the CD&R Affiliates specified demand and piggyback registration rights with respect to the Company’s Common Stock. Under the Registration Rights Agreement, if the Company registers Common Stock under the Securities Act of 1933, as amended the “Securities Act”), holders of the Common Stock, including CD&R Affiliates, have the right to require the Company’s to use reasonable best efforts to include in the Company’s registration statement shares of Common Stock held by them, subject to certain limitations and at the expense of the Company.
	Indemnification Agreements
	In connection with the closing of the Merger, the Company and the Company entered into separate indemnification agreements with CD&R and CD&R Affiliates (the “CD&R Entities”). Under the indemnification agreement with the CD&R Entities, Holding and the Company, subject to certain limitations, jointly and severally agreed to indemnify the CD&R Entities and certain of their affiliates against certain liabilities arising out of performance of the Consulting Agreement and certain other claims and liabilities.
	Other
	On November 25, 2008, the Company entered into a corporate account agreement with The Hertz Corporation pursuant to which it agreed to spend a minimum total amount of $460,000 per year for the rental of cars from The Hertz Corporation and its subsidiaries and licensees. For each of the three and six months ended June 30, 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.
	Other Transactions
	In connection with the closing of the Merger, Holding and Corporation entered into separate indemnification agreements with each of Richard J. Schnall, Ronald A. Williams, William A. Sanger, and Kenneth A. Giuriceo as the directors of Holding and Corporation. Under the indemnification agreements with the directors of Holding and Corporation, Holding and Corporation, subject to certain limitations, jointly and severally agreed to indemnify the directors against certain liabilities arising out of service as a director.
	The executive employment agreements include indemnification provisions whereby the Company agrees to indemnify each of these individuals against claims arising out of events or occurrences related to that individual’s service as the Company’s agent or the agent of any of its subsidiaries to the fullest extent legally permitted.
	In connection with the Company’s initial public offering, the Company entered into new indemnification agreements with each of its directors. On November 11, 2013, the Company entered into an indemnification agreement with Mark V. Mactas. Under these agreements, the Company agrees to indemnify each of these individuals against claims arising out of events or occurrences related to that individual’s service as the Company’s agent or the agent of any of its subsidiaries to the fullest extent legally permitted.

Variable_Interest_Entities

Variable Interest Entities	6 Months Ended
	Jun. 30, 2014
Variable Interest Entities	'
Variable Interest Entities	'
	14.       Variable Interest Entities
	GAAP requires the assets, liabilities, noncontrolling interests and activities of Variable Interest Entities (“VIE”) to be consolidated if an entity’s interest in the VIE has specific characteristics including: voting rights not proportional to ownership and the right to receive a majority of expected income or absorb a majority of expected losses. In addition, the entity exposed to the majority of the risks and rewards associated with the VIE is deemed its primary beneficiary and must consolidate the entity.
	UHS-EmCare JV
	EmCare entered into an agreement in 2014 with Universal Health Services, Inc. to form an entity which would provide physician services to various healthcare facilities (“UHS-EmCare JV”).  UHS-EmCare JV began providing services to healthcare facilities during the second quarter of 2014 and meets the definition of a VIE.  The Company determined that, although EmCare holds 50% voting control, EmCare is the primary beneficiary and must consolidate this VIE because:
	·         EmCare provides management services to UHS-EmCare JV including recruiting, credentialing, scheduling, billing, payroll, accounting and other various administrative services and therefore substantially all of UHS-EmCare JV’s activities involve EmCare; and
	·         as payment for management services, EmCare is entitled to receive a base management fee from UHS-EmCare JV.
	The following table summarizes the UHS-EmCare JV assets and liabilities as of June 30, 2014, which are included in the Company’s consolidated financial statements (in thousands):
		June 30,
		2014
	Current assets	$	14,798
	Current liabilities	7,373
	HCA-EmCare JV
	EmCare entered into an agreement in 2011 with an indirect wholly-owned subsidiary of HCA Holdings Inc. to form an entity which would provide physician services to various healthcare facilities (“HCA-EmCare JV”). HCA-EmCare JV began providing services to healthcare facilities during the first quarter of 2012 and meets the definition of a VIE. The Company determined that, although EmCare only holds 50% voting control, EmCare is the primary beneficiary and must consolidate this VIE because:
	·         EmCare provides management services to HCA-EmCare JV including recruiting, credentialing, scheduling, billing, payroll, accounting and other various administrative services and therefore substantially all of HCA-EmCare JV’s activities involve EmCare; and
	·         as payment for management services, EmCare is entitled to receive a base management fee from HCA-EmCare JV as well as a bonus management fee.
	The following table summarizes the HCA-EmCare JV assets and liabilities as of June 30, 2014 and December 31, 2013, which are included in the Company’s consolidated financial statements (in thousands):
		June 30,		December 31,
		2014		2013
	Current assets	$	107,353	$	88,479
	Current liabilities	30,650		22,005

Segment_Information

Segment Information	6 Months Ended
	Jun. 30, 2014
Segment Information	'
Segment Information	'
	15.       Segment Information
	The Company is organized around two separately managed business units: facility-based and post-acute care physician services and healthcare transportation services, which have been identified as operating segments. The facility-based and post-acute care physician services reportable segment provides physician services to hospitals primarily for emergency department, anesthesiology, hospitalist/inpatient, radiology, teleradiology and surgery services. It also offers physician-led care management solutions outside the hospital. The healthcare transportation services reportable segment focuses on providing a full range of 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 (the “CODM”) as he assesses the performance of the business units and decides how to allocate resources to the business units.
	Net income (loss) before equity in earnings of unconsolidated subsidiary, income tax benefit (expense), loss on early debt extinguishment, other income (expense), net, realized gains (losses) on investments, interest expense, net, equity-based compensation expense, 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 and make decisions. Adjusted EBITDA is not considered a measure of financial performance under GAAP and the items excluded from Adjusted EBITDA are significant components in understanding and assessing the Company’s financial performance. Adjusted EBITDA should not be considered in isolation or as an alternative to such GAAP measures as net income, cash flows provided by or used in operating, investing or financing activities or other financial statement data presented in the Company’s financial statements as an indicator of financial performance. Since Adjusted EBITDA is not a measure determined to be in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. Pre-tax income from continuing operations represents net revenue less direct operating expenses incurred within the operating segments. The accounting policies for reported segments are the same as for the Company as a whole (see Note 2).
	The Company’s operating segment results were as follows (in thousands):
		Three months ended						Six months ended
		June 30,						June 30,
		2014			2013			2014			2013
	Facility-Based Physician Services
	Net revenue	$	690,015		$	569,117		$	1,334,581		$	1,124,053
	Income from operations	68,844			53,204			120,079			101,096
	Adjusted EBITDA	87,079			70,575			158,453			136,735
	Healthcare Transportation Services
	Net revenue	$	385,312		$	330,138		$	754,957		$	663,526
	Income from operations	24,295			12,520			41,378			27,557
	Adjusted EBITDA	47,083			35,381			85,716			70,220
	Segment Totals
	Net revenue	$	1,075,327		$	899,255		$	2,089,538		$	1,787,579
	Income from operations	93,139			65,724			161,457			128,653
	Adjusted EBITDA	134,162			105,956			244,169			206,955
	A reconciliation of net income (loss) to Adjusted EBITDA (in thousands):
		Three months ended						Six months ended
		June 30,						June 30,
		2014			2013			2014			2013
	Net income (loss)	$	(1,992	)	$	9,597		$	19,533		$	5,750
	Add-back of non-operating expense (income):
	Interest expense, net	29,002			50,002			59,051			101,754
	Income tax expense (benefit)	(1,412		)	6,313			15,263			8,881
	Loss on early debt extinguishment	66,397			—			66,397			122
	Realized losses (gains) on investments	(508		)	(105		)	(1,114		)	(118		)
	Interest income from restricted assets	(246		)	(266		)	(332		)	(632		)
	Equity in earnings of unconsolidated subsidiary	(66		)	(87		)	(113		)	(162		)
	Other expense (income), net	1,964			249			2,772			12,970
	Corporate operating expense	—			21			—			88
	Income from operations — segment totals	93,139			65,724			161,457			128,653
	Add-back of operating expense (income):
	Depreciation and amortization expense	35,558			34,622			71,990			69,377
	Restructuring charges	3,731			3,032			4,540			3,669
	Net loss (income) attributable to noncontrolling interest	—			—			3,300			—
	Interest income from restricted assets	246			266			332			632
	Equity-based compensation expense	1,488			1,062			2,550			2,124
	Related party management fees	—			1,250			—			2,500
	Adjusted EBITDA — segment totals	134,162			105,956			244,169			206,955
	Corporate operating expense	—			(21		)	—			(88		)
	Adjusted EBITDA	$	134,162		$	105,935		$	244,169		$	206,867

Consolidating_Financial_Inform

Consolidating Financial Information	6 Months Ended
	Jun. 30, 2014
Consolidating Financial Information	'
Consolidating Financial Information	'
	16.       Consolidating Financial Information
	Pursuant to the indenture governing the 2022 Notes, so long as any of the 2022 Notes are outstanding, the Company is required to provide condensed consolidating financial information with a separate column for (i) the Company and its subsidiaries (other than Corporation and its subsidiaries) on a combined basis, (ii) Corporation and its subsidiaries, (iii) consolidating adjustments on a combined basis, and (iv) the total consolidated amount. The consolidating adjustments column represents the elimination of any intercompany activity between EVHC (excluding Corporation and its subsidiaries) and Corporation.
	Consolidating Balance Sheet
	As of June 30, 2014
	(in thousands, unaudited)
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
	Assets
	Current assets:
	Cash and cash equivalents	$	5		$	162,598		$	—		$	162,603
	Insurance collateral	—			18,519			—			18,519
	Trade and other accounts receivable, net	—			879,337			—			879,337
	Parts and supplies inventory	—			23,832			—			23,832
	Prepaids and other current assets	26,575			39,787			(23,962		)	42,400
	Total current assets	26,580			1,124,073			(23,962		)	1,126,691
	Property, plant, and equipment, net	—			197,303			—			197,303
	Intangible assets, net	—			551,706			—			551,706
	Long-term deferred tax assets	128			—			(128		)	—
	Insurance collateral	—			—			—			—
	Goodwill	—			2,544,477			—			2,544,477
	Other long-term assets	—			39,200			—			39,200
	Investment in wholly owned subsidiary	1,594,568			—			(1,594,568		)	—
	Total assets	$	1,621,276		$	4,456,759		$	(1,618,658	)	$	4,459,377
	Liabilities and Equity
	Current liabilities:
	Accounts payable	$	1,116		$	47,789		$	—		$	48,905
	Accrued liabilities	—			381,503			(3,650		)	377,853
	Current deferred tax liabilities	—			55,927			(20,312		)	35,615
	Current portion of long-term debt and capital lease obligations	—			12,306						12,306
	Total current liabilities	1,116			497,525			(23,962		)	474,679
	Long-term debt and capital lease obligations	—			2,032,347			—			2,032,347
	Long-term deferred tax liabilities	—			151,353			(128		)	151,225
	Insurance reserves	—			152,454			—			152,454
	Other long-term liabilities	—			16,532			—			16,532
	Total liabilities	1,116			2,850,211			(24,090		)	2,827,237
	Equity:
	Common stock	1,812			—			—			1,812
	Preferred stock	—			—			—			—
	Treasury stock	(1,347		)	(1,347		)	1,347			(1,347		)
	Additional paid-in capital	1,579,748			1,488,298			(1,488,298		)	1,579,748
	Retained earnings	41,174			108,844			(108,844		)	41,174
	Accumulated other comprehensive loss	(1,227		)	(1,227		)	1,227			(1,227		)
	Total Envision Healthcare Holdings, Inc. equity	1,620,160			1,594,568			(1,594,568		)	1,620,160
	Noncontrolling interest	—			11,980			—			11,980
	Total equity	1,620,160			1,606,548			(1,594,568		)	1,632,140
	Total liabilities and equity	$	1,621,276		$	4,456,759		$	(1,618,658	)	$	4,459,377
	Consolidating Balance Sheet
	As of December 31, 2013
	(in thousands)
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
	Assets
	Current assets:
	Cash and cash equivalents	$	81,722		$	122,990		—			$	204,712
	Insurance collateral	—			29,619			—			29,619
	Trade and other accounts receivable, net	—			801,146			—			801,146
	Parts and supplies inventory	—			23,376			—			23,376
	Prepaids and other current assets	26,860			23,925			(27,355		)	23,430
	Total current assets	108,582			1,001,056			(27,355		)	1,082,283
	Property, plant, and equipment, net	—			194,715			—			194,715
	Intangible assets, net	—			513,698			—			513,698
Long-term deferred tax assets	128			—			(128		)	—
Insurance collateral	—			12,716			—			12,716
Goodwill	—			2,435,670			—			2,435,670
Other long-term assets	—			60,935			—			60,935
Investment in wholly owned subsidiary	1,486,129			—			(1,486,129		)	—
Total assets	$	1,594,839		$	4,218,790		(1,513,612		)	$	4,300,017
Liabilities and Equity
Current liabilities:
Accounts payable	$	116		$	52,472		—			$	52,588
Accrued liabilities	—			357,979			(7,043		)	350,936
Current deferred tax liabilities	—			55,799			(20,312		)	35,487
Current portion of long-term debt and capital lease obligations	—			12,318			—			12,318
Total current liabilities	116			478,568			(27,355		)	451,329
Long-term debt and capital lease obligations	—			1,895,381			—			1,895,381
Long-term deferred tax liabilities	—			151,258			(128		)	151,130
Insurance reserves	—			175,427			—			175,427
Other long-term liabilities	—			16,997			—			16,997
Total liabilities	116			2,717,631			(27,483		)	2,690,264
Equity:
Common stock	1,804			—			—			1,804
Preferred stock	—			—			—			—
Treasury stock	(1,347		)	(1,347		)	1,347			(1,347		)
Additional paid-in capital	1,576,764			1,404,208			(1,404,208		)	1,576,764
Retained earnings	18,341			84,107			(84,107		)	18,341
Accumulated other comprehensive loss	(839		)	(839		)	839			(839		)
Total Envision Healthcare Holdings, Inc. equity	1,594,723			1,486,129			(1,486,129		)	1,594,723
Noncontrolling interest	—			15,030			—			15,030
Total equity	1,594,723			1,501,159			(1,486,129		)	1,609,753
Total liabilities and equity	$	1,594,839		$	4,218,790		$	(1,513,612	)	$	4,300,017
Condensed Consolidating Statements of Operations
(in thousands, unaudited)
	Three months ended June 30, 2014
	EVHC			Corporation			Consolidating			Total
	(excluding			and			Adjustments
	Corporation)			Subsidiaries
Net revenue	$	—		$	1,075,327		$	—		$	1,075,327
Compensation and benefits	—			767,007			—			767,007
Operating expenses	—			120,715			—			120,715
Insurance expense	—			31,583			—			31,583
Selling, general and administrative expenses	—			23,594			—			23,594
Depreciation and amortization expense	—			35,558			—			35,558
Restructuring charges	—			3,731			—			3,731
Income (loss) from operations	—			93,139			—			93,139
Interest income from restricted assets	—			246			—			246
Interest expense, net	—			(29,002		)	—			(29,002		)
Realized gains (losses) on investments	—			508			—			508
Other income (expense), net	(1,657		)	(307		)	—			(1,964		)
Loss on early debt extinguishment	—			(66,397		)	—			(66,397		)
Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(1,657		)	(1,813		)	—			(3,470		)
Income tax benefit (expense)	515			897			—			1,412
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(1,142		)	(916		)	—			(2,058		)
Equity in net income (loss) of subsidiary	(850		)	—			850			—
Equity in earnings of unconsolidated subsidiary	—			66			—			66
Net income (loss)	(1,992		)	(850		)	850			(1,992		)
Less: Net (income) loss attributable to noncontrolling interest	—			—			—			—
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	(1,992	)	$	(850	)	$	850		$	(1,992	)
Condensed Consolidating Statements of Operations
(in thousands, unaudited)
	Three months ended June 30, 2013
	EVHC			Corporation			Consolidating			Total
	(excluding			and			Adjustments
	Corporation)			Subsidiaries
Net revenue	$	—		$	899,255		$	—		$	899,255
Compensation and benefits	—			643,960			—			643,960
Operating expenses	20			102,288			—			102,308
Insurance expense	—			25,840			—			25,840
Selling, general and administrative expenses	1			23,789			—			23,790
Depreciation and amortization expense	—			34,622			—			34,622
Restructuring charges	—			3,032			—			3,032
Income from operations	(21		)	65,724			—			65,703
Interest income from restricted assets	—			266			—			266
Interest expense, net	(11,464		)	(38,538		)	—			(50,002		)
Realized gains (losses) on investments	—			105			—			105
Other income (expense), net	—			(249		)	—			(249		)
Loss on early debt extinguishment	—			—			—			—
Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(11,485		)	27,308			—			15,823
Income tax benefit (expense)	4,519			(10,832		)	—			(6,313		)
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(6,966		)	16,476			—			9,510
Equity in net income (loss) of subsidiary	16,563			—			(16,563		)	—
Equity in earnings of unconsolidated subsidiary	—			87			—			87
Net income (loss)	9,597			16,563			(16,563		)	9,597
Less: Net (income) loss attributable to noncontrolling interest	—			—			—			—
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	9,597		$	16,563		$	(16,563	)	$	9,597
Condensed Consolidating Statements of Operations
(in thousands, unaudited)
	Six months ended June 30, 2014
	EVHC			Corporation and			Consolidating			Total
	(excluding			Subsidiaries			Adjustments
	Corporation)
Net revenue	$	—		$	2,089,538		$	—		$	2,089,538
Compensation and benefits	—			1,510,668			—			1,510,668
Operating expenses	—			235,350			—			235,350
Insurance expense	—			62,564			—			62,564
Selling, general and administrative expenses	—			42,969			—			42,969
Depreciation and amortization expense	—			71,990			—			71,990
Restructuring charges	—			4,540			—			4,540
Income from operations	—			161,457			—			161,457
Interest income from restricted assets	—			332			—			332
Interest expense, net	—			(59,051		)	—			(59,051		)
Realized gains (losses) on investments	—			1,114			—			1,114
Other income (expense), net	(2,799		)	27			—			(2,772		)
Loss on early debt extinguishment	—			(66,397		)	—			(66,397		)
Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(2,799		)	37,482			—			34,683
Income tax benefit (expense)	895			(16,158		)	—			(15,263		)
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(1,904		)	21,324			—			19,420
Equity in net income (loss) of subsidiary	21,437			—			(21,437		)	—
Equity in earnings of unconsolidated subsidiary	—			113			—			113
Net income (loss)	19,533			21,437			(21,437		)	19,533
Less: Net (income) loss attributable to noncontrolling interest	—			3,300			—			3,300
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	19,533		$	24,737		$	(21,437	)	$	22,833
Condensed Consolidating Statements of Operations
(in thousands, unaudited)
	Six months ended June 30, 2013
	EVHC			Corporation and			Consolidating			Total
	(excluding			Subsidiaries			Adjustments
	Corporation)
Net revenue	$	—		$	1,787,579		$	—		$	1,787,579
Compensation and benefits	—			1,285,749			—			1,285,749
Operating expenses	87			202,671			—			202,758
Insurance expense	—			51,673			—			51,673
Selling, general and administrative expenses	1			45,787			—			45,788
Depreciation and amortization expense	—			69,377			—			69,377
Restructuring charges	—			3,669			—			3,669
Income from operations	(88		)	128,653			—			128,565
Interest income from restricted assets	—			632			—			632
Interest expense, net	(22,926		)	(78,828		)	—			(101,754		)
Realized gains (losses) on investments	—			118			—			118
Other income (expense), net	—			(12,970		)	—			(12,970		)
Loss on early debt extinguishment	—			(122		)	—			(122		)
Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(23.014		)	37,483			—			14,469
Income tax benefit (expense)	9,085			(17,966		)	—			(8,881		)
Income before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(13,929		)	19,517			—			5,588
Equity in net income (loss) of subsidiary	19,679			—			(19,679		)	—
Equity in earnings of unconsolidated subsidiary	—			162			—			162
Net income (loss)	5,750			19,679			(19,679		)	5,750
Less: Net (income) loss attributable to noncontrolling interest	—			—			—			—
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	5,750		$	19,679		$	(19,679	)	$	5,750
Condensed Consolidating Statement of Cash Flows
(in thousands, unaudited)
	Six months ended June 30, 2014
	EVHC			Corporation and			Total
	(excluding			Subsidiaries
	Corporation)
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	$	(391	)	$	94,331		$	93,940
Cash Flows from Investing Activities
Purchases of available-for-sale securities	—			(3,372		)	(3,372		)
Sales and maturities of available-for-sale securities	—			10,527			10,527
Purchase of property, plant and equipment	—			(33,480		)	(33,480		)
Proceeds from sale of property, plant and equipment	—			2,216			2,216
Acquisition of businesses, net of cash received	—			(199,298		)	(199,298		)
Net change in insurance collateral	—			1,213			1,213
Other investing activities	—			(2,363		)	(2,363		)
Net cash provided by (used in) investing activities	—			(224,557		)	(224,557		)
Cash Flows from Financing Activities
Borrowings under the ABL Facility	—			50,000			50,000
Proceeds from issuance of senior notes	—			740,625			740,625
Repayments of the Term Loan	—			(3,343		)	(3,343		)
Repayments of the ABL Facility	—			(50,000		)	(50,000		)
Repayments of senior notes	—			(607,750		)	(607,750		)
Payment for debt extinguishment premiums	—			(37,630		)	(37,630		)
Debt issuance costs	—			(1,374		)	(1,374		)
Excess tax benefits from equity-based compensation	—			15,658			15,658
Shares repurchased for tax withholdings	—			(14,430		)	(14,430		)
Proceeds from noncontrolling interest	—			250			250
Other financing activities	391			(3,889		)	(3,498		)
Net intercompany borrowings (payments)	(81,717		)	81,717			—
Net cash provided by (used in) financing activities	(81,326		)	169,834			88,508
Change in cash and cash equivalents	(81,717		)	39,608			(42,109		)
Cash and cash equivalents, beginning of period	81,722			122,990			204,712
Cash and cash equivalents, end of period	$	5		$	162,598		$	162,603
Condensed Consolidating Statement of Cash Flows
(in thousands, unaudited)
	Six months ended June 30, 2013
	EVHC			Corporation and			Total
	(excluding			Subsidiaries
	Corporation)
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	$	(19,343	)	$	13,246		$	(6,097	)
Cash Flows from Investing Activities
Purchases of available-for-sale securities	—			(2,548		)	(2,548		)
Sales and maturities of available-for-sale securities	—			4,170			4,170
Purchase of property, plant and equipment	—			(26,198		)	(26,198		)
Proceeds from sale of property, plant and equipment	—			328			328
Acquisition of businesses, net of cash received	—			(1,423		)	(1,423		)
Net change in insurance collateral	—			(2,024		)	(2,024		)
Other investing activities	—			(52		)	(52		)
Net cash provided by (used in) investing activities	—			(27,747		)	(27,747		)
Cash Flows from Financing Activities
Issuance of common stock	—			1,117			1,117
Borrowings under the Term Loan	—			209,000			209,000
Borrowings under the ABL Facility	—			252,440			252,440
Repayments of the Term Loan	—			(65,685		)	(65,685		)
Repayments of the ABL Facility	—			(349,940		)	(349,940		)
Dividend paid	(67		)	—			(67		)
Debt issuance costs	(4		)	(5,007		)	(5,011		)
Equity issuance costs	(1,400		)	—			(1,400		)
Excess tax benefits from equity-based compensation	—			3,168			3,168
Payment of dissenting shareholder settlement	—			(38,336		)	(38,336		)
Net change in bank overdrafts	—			8,117			8,117
Other financing activities	—			(359		)	(359		)
Net intercompany borrowings (payments)	20,813			(20,813		)	—
Net cash provided by (used in) financing activities	19,342			(6,298		)	13,044
Change in cash and cash equivalents	(1		)	(20,799		)	(20,800		)
Cash and cash equivalents, beginning of period	281			57,551			57,832
Cash and cash equivalents, end of period	$	280		$	36,752		$	37,032

Subsequent_Events

Subsequent Events	6 Months Ended
	Jun. 30, 2014
Subsequent Events	'
Subsequent Events	'
	17.       Subsequent Events
	On July 10, 2014, the Company registered the offering and sale of 27,500,000 shares of Common Stock by certain stockholders of the Company and an additional 4,125,000 shares of Common Stock, which were sold by the CD&R Affiliates to the underwriters pursuant to their option to purchase additional shares at $34.00 per share less the underwriting discount. The CD&R Affiliates, certain executive officers and directors of the Company and certain non-executives were the selling stockholders in the offering. The Company 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.

Summary_of_Significant_Account1

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2014
Summary of Significant Accounting Policies	'
Consolidation	'
	Consolidation
	The consolidated financial statements of the Company include all of its wholly-owned subsidiaries, including Corporation, EmCare and AMR and their respective subsidiaries and affiliated physician groups. All significant intercompany transactions and balances have been eliminated in consolidation.
Use of Estimates	'
	Use of Estimates
	The preparation of financial statements requires management to make estimates and assumptions relating to the reporting of results of operations, financial condition and related disclosure of contingent assets and liabilities at the date of the financial statements including, but not limited to, estimates and assumptions for accounts receivable and insurance related reserves. Actual results may differ from those estimates under different assumptions or conditions.
Insurance Collateral	'
	Insurance Collateral
	Insurance collateral is comprised of investments in U.S. Treasuries and marketable equity and debt securities held by the Company’s captive insurance subsidiary that supports the Company’s insurance program and reserves. 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 June 30, 2014 and December 31, 2013, respectively, for liabilities in excess of the Company’s self-insured retention.
Trade and Other Accounts Receivable, net	'
	Trade and Other Accounts Receivable, net
	The Company estimates its allowances based on payor reimbursement schedules, historical collections and write-off experience and other economic data. 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 June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30,			December 31,
		2014			2013
	Gross trade accounts receivable	$	4,511,437		$	3,841,672
	Allowance for contractual discounts	(2,402,789		)	(2,002,704		)
	Allowance for uncompensated care	(1,229,807		)	(1,038,833		)
	Trade accounts receivable, net	878,841			800,135
	Other receivables, net	496			1,011
	Trade and other accounts receivable, net	$	879,337		$	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 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 one million dollars to three million dollars 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 June 2014. As a result of this and previous actuarial valuations, the Company recorded increases in its provisions for insurance liabilities of $2.1 million and $7.3 million during the three and six months ended June 30, 2014, respectively, as compared to an increase of $0.8 million and a decrease of $0.4 million for the three and six months ended June 30, 2013, related to reserves for losses in prior years.
	The long-term portion of insurance reserves was $152.5 million and $175.4 million as of June 30, 2014 and December 31, 2013, respectively.
Equity Structure and Public Offerings	'
	Equity Structure and Public Offerings
	On August 13, 2013, the Company’s Registration Statement was declared effective by the Securities and Exchange Commission (the “SEC”) for an initial public offering of its Common Stock. The Company 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, the Company 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, the Company received net proceeds of approximately $1,025.9 million, after deducting the underwriters’ discounts and commissions paid and offering expenses of approximately $85.0 million, including a $20.0 million payment to Clayton, Dubilier & Rice, LLC (“CD&R”) in connection with the termination of a consulting agreement with the Company (“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 the 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 the 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, the Company registered the offering and sale of 27,500,000 shares of Common Stock by certain stockholders of the Company 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 the Company and certain non-executives were the selling stockholders in the offering. The Company 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, long-term debt and other long-term liabilities 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 June 30, 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 six months ended June 30, 2014 and 2013, the Company derived approximately 33% and 34%, respectively, of its revenue from Medicare and Medicaid, 64% and 62%, respectively, from insurance providers and contracted payors, and 3% and 4%, respectively, directly from patients.
	The Company estimates the fair value of its fixed rate senior notes based on an analysis in which the Company evaluates market conditions, related securities, various public and private offerings, and other publicly available information (Level 2, as defined below). The estimated fair value of the senior notes as of June 30, 2014 approximated the carrying value of $750.0 million.
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 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 June 30, 2014 and December 31, 2013 (in thousands):
		June 30, 2014
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	6,130		$	—		$	—		$	6,130
	Fuel hedge	—			368			—			368
	Liabilities:
	Contingent consideration	—			—			1,734			1,734
	Interest rate swap	—			2,327			—			2,327
		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 six months ended June 30, 2014 and 2013, there were 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 services rendered. While the Company attempts to obtain all relevant billing information at the time the patient is within its 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.
	The Company has historically reported Medicare and Medicaid managed care in the line Commercial insurance and managed care. Medicare managed care and Medicaid managed care have been reclassified into the Medicare and Medicaid lines in the current period and all prior periods have been conformed to current period presentation. Net revenue for the three and six months ended June 30, 2014 and 2013 consisted of the following (in thousands):
		Three months ended						Six months ended
		June 30,						June 30,
		2014			2013			2014			2013
	Fee-for-service revenue, net of contractual discounts:
	Medicare	$	300,428		$	266,762		$	550,740		$	500,636
	Medicaid	110,625			93,649			166,441			144,863
	Commercial insurance and managed care (excluding Medicare and Medicaid managed care)	607,567			497,136			1,252,750			1,057,327
	Self-pay	752,221			687,772			1,476,728			1,317,029
	Sub-total	1,770,841			1,545,319			3,446,659			3,019,855
	Subsidies and fees	182,861			144,486			365,537			275,198
	Revenue, net of contractual discounts	1,953,702			1,689,805			3,812,196			3,295,053
	Provision for uncompensated care	(878,375		)	(790,550		)	(1,722,658		)	(1,507,474		)
	Net revenue	$	1,075,327		$	899,255		$	2,089,538		$	1,787,579
	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 $2.7 million and $3.8 million for the three and six months ended June 30, 2014, respectively, and increased the contractual discount and uncompensated care provisions (decreased net revenue) by approximately $1.3 million for the three months ended June 30, 2013 and decreased the contractual discount and uncompensated provisions (increased net revenue) by approximately $0.8 million for the six months ended June 30, 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.
Recent Accounting Pronouncements	'
	Recent Accounting Pronouncements
	In May 2014, the FASB issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers (“ASU 2014-09”) to clarify the principles for recognizing revenue and to develop a common revenue standard for GAAP and International Financial Reporting Standards.  ASU 2014-09 is effective for public companies for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period.  Early application is not permitted.  The Company has not yet determined the effects, if any, that adoption of ASU 2014-09 may have on its consolidated financial position or results of operations.

Summary_of_Significant_Account2

Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2014
Summary of Significant Accounting Policies	'
Schedule of accounts receivable and allowances	'
	The Company’s accounts receivable and allowances as of June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30,			December 31,
		2014			2013
	Gross trade accounts receivable	$	4,511,437		$	3,841,672
	Allowance for contractual discounts	(2,402,789		)	(2,002,704		)
	Allowance for uncompensated care	(1,229,807		)	(1,038,833		)
	Trade accounts receivable, net	878,841			800,135
	Other receivables, net	496			1,011
	Trade and other accounts receivable, net	$	879,337		$	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 June 30, 2014 and December 31, 2013 (in thousands):
		June 30, 2014
	Description	Level 1			Level 2			Level 3			Total
	Assets:
	Available-for-sale securities (insurance collateral)	$	6,130		$	—		$	—		$	6,130
	Fuel hedge	—			368			—			368
	Liabilities:
	Contingent consideration	—			—			1,734			1,734
	Interest rate swap	—			2,327			—			2,327
		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 and six months ended June 30, 2014 and 2013 consisted of the following (in thousands):
		Three months ended						Six months ended
		June 30,						June 30,
		2014			2013			2014			2013
	Fee-for-service revenue, net of contractual discounts:
	Medicare	$	300,428		$	266,762		$	550,740		$	500,636
	Medicaid	110,625			93,649			166,441			144,863
	Commercial insurance and managed care (excluding Medicare and Medicaid managed care)	607,567			497,136			1,252,750			1,057,327
	Self-pay	752,221			687,772			1,476,728			1,317,029
	Sub-total	1,770,841			1,545,319			3,446,659			3,019,855
	Subsidies and fees	182,861			144,486			365,537			275,198
	Revenue, net of contractual discounts	1,953,702			1,689,805			3,812,196			3,295,053
	Provision for uncompensated care	(878,375		)	(790,550		)	(1,722,658		)	(1,507,474		)
	Net revenue	$	1,075,327		$	899,255		$	2,089,538		$	1,787,579

Basic_and_Diluted_Net_Income_L1

Basic and Diluted Net Income (Loss) Per Share (Tables)	6 Months Ended
	Jun. 30, 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).
		Three months ended					Six months ended
		June 30,					June 30,
		2014			2013		2014		2013
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	(1,992	)	$	9,597	$	22,833	$	5,750
	Weighted-average common shares outstanding — common stock:
	Basic	181,140,242			131,672,134		180,962,123		131,187,567
	Dilutive impact of stock awards outstanding	—			5,599,223		8,498,322		4,802,799
	Diluted	181,140,242			137,271,357		189,460,445		135,990,366
	Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:
	Basic	$	(0.01	)	$	0.07	$	0.13	$	0.04
	Diluted	$	(0.01	)	$	0.07	$	0.12	$	0.04

Acquisitions_Tables

Acquisitions (Tables)	6 Months Ended
	Jun. 30, 2014
Acquisitions	'
Schedule of allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations	'
	The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations (in thousands):
	Cash	$	7,052
	Accounts receivable	16,748
	Prepaid and other current assets	359
	Property, plant, and equipment	92
	Acquired intangible assets	56,000
	Goodwill	96,811
	Accounts payable	(1,073		)
	Accrued liabilities	(6,539		)
	Total purchase price	$	169,450
Schedule of unaudited pro forma operating results	'
		Three months ended					Six months ended
		June 30,					June 30,
		2014			2013		2014		2013
		(in thousands)
	Net revenue	$	35,572		$	28,224	$	64,270	$	55,929
	Net income	1,113			306		2,110		981

Insurance_Collateral_Tables

Insurance Collateral (Tables)	6 Months Ended
	Jun. 30, 2014
Insurance Collateral	'
Schedule of insurance collateral	'
	Insurance collateral consisted of the following as of June 30, 2014 and December 31, 2013 (in thousands):
		June 30,		December 31,
		2014		2013
	Available-for-sale securities:
	U.S. Treasuries	$	1,199	$	2,100
	Corporate bonds /Fixed income	2,702		6,372
	Corporate equity	2,229		4,755
	Total available-for-sale securities	6,130		13,227
	Insurance receivable	1,796		1,300
	Cash deposits and other	10,593		27,808
	Total insurance collateral	$	18,519	$	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 June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30, 2014
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	1,182	$	19		$	(2	)	$	1,199
	Corporate bonds /Fixed income	2,693		10			(1		)	2,702
	Corporate equity	2,194		49			(14		)	2,229
	Total available-for-sale securities	$	6,069	$	78		$	(17	)	$	6,130
		December 31, 2013
	Description	Cost Basis		Gross			Gross			Fair
				Unrealized			Unrealized			Value
				Gains			Losses
	U.S. Treasuries	$	2,064	$	37		$	(1	)	$	2,100
	Corporate bonds /Fixed income	6,384		26			(38		)	6,372
	Corporate equity	4,399		500			(144		)	4,755
	Total available-for-sale securities	$	12,847	$	563		$	(183	)	$	13,227
Schedule of the entity's temporarily impaired investment securities available-for-sale	'
	The Company’s temporarily impaired investment securities available-for-sale as of June 30, 2014 and December 31, 2013 were as follows (in thousands):
		June 30, 2014					December 31, 2013
		Fair Value		Unrealized			Fair Value			Unrealized
				Loss						Loss
	U.S. Treasuries:
	Less than 12 months	$	132	$	(2	)	$	132		$	(1	)
	12 months or more	—		—			—			—
	Corporate bonds /Fixed income:
	Less than 12 months	552		(1		)	2,768			(18		)
	12 months or more	—		—			2,178			(20		)
	Corporate equity:
	Less than 12 months	1,225		(14		)	—			—
	12 months or more	—		—			2,553			(144		)
	Total	$	1,909	$	(17	)	$	7,631		$	(183	)

Accrued_Liabilities_Tables

Accrued Liabilities (Tables)	6 Months Ended
	Jun. 30, 2014
Accrued Liabilities	'
Schedule of accrued liabilities	'
	Accrued liabilities were as follows as of June 30, 2014 and December 31, 2013 (in thousands):
		June 30,		December 31,
		2014		2013
	Accrued wages and benefits	$	183,092	$	161,398
	Accrued paid time-off	29,732		25,713
	Current portion of self-insurance reserves	71,720		73,738
	Accrued restructuring	6,560		5,682
	Current portion of compliance and legal	4,262		2,000
	Accrued billing and collection fees	2,571		2,954
	Accrued incentive compensation	25,067		19,570
	Accrued interest	2,755		6,898
	Other	52,094		52,983
	Total accrued liabilities	$	377,853	$	350,936

LongTerm_Debt_Tables

Long-Term Debt (Tables)	6 Months Ended
	Jun. 30, 2014
Debt and Capital Lease Obligations	'
Schedule of long-term debt and capital lease obligations	'
	Debt and capital lease obligations consisted of the following as of June 30, 2014 and December 31, 2013 (in thousands):
		June 30,			December 31,
		2014			2013
	Senior unsecured notes due 2019	$	—		$	607,750
	Senior unsecured notes due 2022	750,000			—
	Senior secured term loan due 2018 (4.00% at June 30, 2014 and December 31, 2013)	1,296,261			1,302,945
	Discount on senior secured term loan	(3,687		)	(4,217		)
	ABL Facility	—			—
	Notes due at various dates from 2014 to 2022 with interest rates from 6% to 10%	811			852
	Capital lease obligations due at various dates from 2014 to 2018	1,268			369
	Total	2,044,653			1,907,699
	Less current portion	(12,306		)	(12,318		)
	Total long-term debt and capital lease obligations	$	2,032,347		$	1,895,381

Changes_in_Accumulated_Other_C1

Changes in Accumulated Other Comprehensive Income by Component (Tables)	6 Months Ended
	Jun. 30, 2014
Changes in Accumulated Other Comprehensive Income by Component	'
Summary of changes in the Company's accumulated other comprehensive income (AOCI) by component, after tax	'
	The following table summarizes the changes in the Company’s accumulated other comprehensive income (AOCI) by component as of June 30, 2014 and December 31, 2013 (in thousands). 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	(18		)	(114		)	(8		)	(140		)
	Amounts reclassified from accumulated other comprehensive income	(172		)	618			(694		)	(248		)
	Net current-period other comprehensive income	(190		)	504			(702		)	(388		)
	Balance as of June 30, 2014	$	230		$	(1,454	)	$	(3	)	$	(1,227	)
Schedule of statements of operations affected by reclassifications out of AOCI	'
	The following table shows the line item on the statements of operations affected by reclassifications out of AOCI (in thousands):
		Amount reclassified from AOCI
		Three months ended June 30,						Six months ended June 30,
	Details about AOCI components	2014			2013			2014			2013			Statements of Operations
	Gains and losses on cash flow hedges:
	Fuel Hedge	$	95		$	26		$	276		$	221		Operating expenses
	Interest rate swap	(497		)	(496		)	(993		)	(987		)	Interest expense, net
		(402		)	(470		)	(717		)	(766		)	Total before tax
		152			177			271			288			Tax benefit (expense)
		$	(250	)	$	(293	)	$	(446	)	$	(478	)	Net of tax
	Unrealized holding gains on available-for-sale securities	$	508		$	105		$	1,114		$	118		Realized gains (losses) on investments
		508			105			1,114			118			Total before tax
		(192		)	(39		)	(420		)	(44		)	Tax benefit (expense)
		$	316		$	66		$	694		$	74		Net of tax

Restructuring_Charges_Tables

Restructuring Charges (Tables)	6 Months Ended
	Jun. 30, 2014
Restructuring Charges	'
Schedule of restructuring charges	'
		AMR
		Lease and
		other contract
		termination						EmCare			EVHC
		costs			Severance			Severance			Severance			Total
		(in thousands)
	Balance as of January 1, 2013	$	8,122		$	3,015		$	773		$	408		$	12,318
	Incurred	1,876			2,890			913			20			5,699
	Paid	(6,989		)	(3,765		)	(1,204		)	(377		)	(12,335		)
	Balance as of December 31, 2013	$	3,009		$	2,140		$	482		$	51		$	5,682
	Incurred	2,899			512			728			401			4,540
	Paid	(878		)	(1,620		)	(719		)	(445		)	(3,662		)
	Balance as of June 30, 2014	$	5,030		$	1,032		$	491		$	7		$	6,560

Variable_Interest_Entities_Tab

Variable Interest Entities (Tables)	6 Months Ended
	Jun. 30, 2014
UHS-EmCare JV	'
Variable Interest Entities	'
Summary of the variable interest entity assets and liabilities which are included in the Company's consolidated financial statements	'
	The following table summarizes the UHS-EmCare JV assets and liabilities as of June 30, 2014, which are included in the Company’s consolidated financial statements (in thousands):
		June 30,
		2014
	Current assets	$	14,798
	Current liabilities	7,373
HCA-EmCare JV	'
Variable Interest Entities	'
Summary of the variable interest entity assets and liabilities which are included in the Company's consolidated financial statements	'
	The following table summarizes the HCA-EmCare JV assets and liabilities as of June 30, 2014 and December 31, 2013, which are included in the Company’s consolidated financial statements (in thousands):
		June 30,		December 31,
		2014		2013
	Current assets	$	107,353	$	88,479
	Current liabilities	30,650		22,005

Segment_Information_Tables

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2014
Segment Information	'
Schedule of the Company's operating segment results	'
	The Company’s operating segment results were as follows (in thousands):
		Three months ended						Six months ended
		June 30,						June 30,
		2014			2013			2014			2013
	Facility-Based Physician Services
	Net revenue	$	690,015		$	569,117		$	1,334,581		$	1,124,053
	Income from operations	68,844			53,204			120,079			101,096
	Adjusted EBITDA	87,079			70,575			158,453			136,735
	Healthcare Transportation Services
	Net revenue	$	385,312		$	330,138		$	754,957		$	663,526
	Income from operations	24,295			12,520			41,378			27,557
	Adjusted EBITDA	47,083			35,381			85,716			70,220
	Segment Totals
	Net revenue	$	1,075,327		$	899,255		$	2,089,538		$	1,787,579
	Income from operations	93,139			65,724			161,457			128,653
	Adjusted EBITDA	134,162			105,956			244,169			206,955
Schedule of reconciliation of net income (loss) to Adjusted EBITDA	'
	A reconciliation of net income (loss) to Adjusted EBITDA (in thousands):
		Three months ended						Six months ended
		June 30,						June 30,
		2014			2013			2014			2013
	Net income (loss)	$	(1,992	)	$	9,597		$	19,533		$	5,750
	Add-back of non-operating expense (income):
	Interest expense, net	29,002			50,002			59,051			101,754
	Income tax expense (benefit)	(1,412		)	6,313			15,263			8,881
	Loss on early debt extinguishment	66,397			—			66,397			122
	Realized losses (gains) on investments	(508		)	(105		)	(1,114		)	(118		)
	Interest income from restricted assets	(246		)	(266		)	(332		)	(632		)
	Equity in earnings of unconsolidated subsidiary	(66		)	(87		)	(113		)	(162		)
	Other expense (income), net	1,964			249			2,772			12,970
	Corporate operating expense	—			21			—			88
	Income from operations — segment totals	93,139			65,724			161,457			128,653
	Add-back of operating expense (income):
	Depreciation and amortization expense	35,558			34,622			71,990			69,377
	Restructuring charges	3,731			3,032			4,540			3,669
	Net loss (income) attributable to noncontrolling interest	—			—			3,300			—
	Interest income from restricted assets	246			266			332			632
	Equity-based compensation expense	1,488			1,062			2,550			2,124
	Related party management fees	—			1,250			—			2,500
	Adjusted EBITDA — segment totals	134,162			105,956			244,169			206,955
	Corporate operating expense	—			(21		)	—			(88		)
	Adjusted EBITDA	$	134,162		$	105,935		$	244,169		$	206,867

Consolidating_Financial_Inform1

Consolidating Financial Information (Tables)	6 Months Ended
	Jun. 30, 2014
Guarantors of Debt	'
Schedule of Consolidating Balance Sheet	'
	Consolidating Balance Sheet
	As of June 30, 2014
	(in thousands, unaudited)
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
	Assets
	Current assets:
	Cash and cash equivalents	$	5		$	162,598		$	—		$	162,603
	Insurance collateral	—			18,519			—			18,519
	Trade and other accounts receivable, net	—			879,337			—			879,337
	Parts and supplies inventory	—			23,832			—			23,832
	Prepaids and other current assets	26,575			39,787			(23,962		)	42,400
	Total current assets	26,580			1,124,073			(23,962		)	1,126,691
	Property, plant, and equipment, net	—			197,303			—			197,303
	Intangible assets, net	—			551,706			—			551,706
	Long-term deferred tax assets	128			—			(128		)	—
	Insurance collateral	—			—			—			—
	Goodwill	—			2,544,477			—			2,544,477
	Other long-term assets	—			39,200			—			39,200
	Investment in wholly owned subsidiary	1,594,568			—			(1,594,568		)	—
	Total assets	$	1,621,276		$	4,456,759		$	(1,618,658	)	$	4,459,377
	Liabilities and Equity
	Current liabilities:
	Accounts payable	$	1,116		$	47,789		$	—		$	48,905
	Accrued liabilities	—			381,503			(3,650		)	377,853
	Current deferred tax liabilities	—			55,927			(20,312		)	35,615
	Current portion of long-term debt and capital lease obligations	—			12,306						12,306
	Total current liabilities	1,116			497,525			(23,962		)	474,679
	Long-term debt and capital lease obligations	—			2,032,347			—			2,032,347
	Long-term deferred tax liabilities	—			151,353			(128		)	151,225
	Insurance reserves	—			152,454			—			152,454
	Other long-term liabilities	—			16,532			—			16,532
	Total liabilities	1,116			2,850,211			(24,090		)	2,827,237
	Equity:
	Common stock	1,812			—			—			1,812
	Preferred stock	—			—			—			—
	Treasury stock	(1,347		)	(1,347		)	1,347			(1,347		)
	Additional paid-in capital	1,579,748			1,488,298			(1,488,298		)	1,579,748
	Retained earnings	41,174			108,844			(108,844		)	41,174
	Accumulated other comprehensive loss	(1,227		)	(1,227		)	1,227			(1,227		)
	Total Envision Healthcare Holdings, Inc. equity	1,620,160			1,594,568			(1,594,568		)	1,620,160
	Noncontrolling interest	—			11,980			—			11,980
	Total equity	1,620,160			1,606,548			(1,594,568		)	1,632,140
	Total liabilities and equity	$	1,621,276		$	4,456,759		$	(1,618,658	)	$	4,459,377
	Consolidating Balance Sheet
	As of December 31, 2013
	(in thousands)
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
	Assets
	Current assets:
	Cash and cash equivalents	$	81,722		$	122,990		—			$	204,712
	Insurance collateral	—			29,619			—			29,619
	Trade and other accounts receivable, net	—			801,146			—			801,146
	Parts and supplies inventory	—			23,376			—			23,376
	Prepaids and other current assets	26,860			23,925			(27,355		)	23,430
	Total current assets	108,582			1,001,056			(27,355		)	1,082,283
	Property, plant, and equipment, net	—			194,715			—			194,715
	Intangible assets, net	—			513,698			—			513,698
	Long-term deferred tax assets	128			—			(128		)	—
	Insurance collateral	—			12,716			—			12,716
Goodwill	—			2,435,670			—			2,435,670
Other long-term assets	—			60,935			—			60,935
Investment in wholly owned subsidiary	1,486,129			—			(1,486,129		)	—
Total assets	$	1,594,839		$	4,218,790		(1,513,612		)	$	4,300,017
Liabilities and Equity
Current liabilities:
Accounts payable	$	116		$	52,472		—			$	52,588
Accrued liabilities	—			357,979			(7,043		)	350,936
Current deferred tax liabilities	—			55,799			(20,312		)	35,487
Current portion of long-term debt and capital lease obligations	—			12,318			—			12,318
Total current liabilities	116			478,568			(27,355		)	451,329
Long-term debt and capital lease obligations	—			1,895,381			—			1,895,381
Long-term deferred tax liabilities	—			151,258			(128		)	151,130
Insurance reserves	—			175,427			—			175,427
Other long-term liabilities	—			16,997			—			16,997
Total liabilities	116			2,717,631			(27,483		)	2,690,264
Equity:
Common stock	1,804			—			—			1,804
Preferred stock	—			—			—			—
Treasury stock	(1,347		)	(1,347		)	1,347			(1,347		)
Additional paid-in capital	1,576,764			1,404,208			(1,404,208		)	1,576,764
Retained earnings	18,341			84,107			(84,107		)	18,341
Accumulated other comprehensive loss	(839		)	(839		)	839			(839		)
Total Envision Healthcare Holdings, Inc. equity	1,594,723			1,486,129			(1,486,129		)	1,594,723
Noncontrolling interest	—			15,030			—			15,030
Total equity	1,594,723			1,501,159			(1,486,129		)	1,609,753
Total liabilities and equity	$	1,594,839		$	4,218,790		$	(1,513,612	)	$	4,300,017
Schedule of Consolidating Statements of Operations	'
	Condensed Consolidating Statements of Operations
	(in thousands, unaudited)
		Three months ended June 30, 2014
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
	Net revenue	$	—		$	1,075,327		$	—		$	1,075,327
	Compensation and benefits	—			767,007			—			767,007
	Operating expenses	—			120,715			—			120,715
	Insurance expense	—			31,583			—			31,583
	Selling, general and administrative expenses	—			23,594			—			23,594
	Depreciation and amortization expense	—			35,558			—			35,558
	Restructuring charges	—			3,731			—			3,731
	Income (loss) from operations	—			93,139			—			93,139
	Interest income from restricted assets	—			246			—			246
	Interest expense, net	—			(29,002		)	—			(29,002		)
	Realized gains (losses) on investments	—			508			—			508
	Other income (expense), net	(1,657		)	(307		)	—			(1,964		)
	Loss on early debt extinguishment	—			(66,397		)	—			(66,397		)
	Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(1,657		)	(1,813		)	—			(3,470		)
	Income tax benefit (expense)	515			897			—			1,412
	Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(1,142		)	(916		)	—			(2,058		)
	Equity in net income (loss) of subsidiary	(850		)	—			850			—
	Equity in earnings of unconsolidated subsidiary	—			66			—			66
	Net income (loss)	(1,992		)	(850		)	850			(1,992		)
	Less: Net (income) loss attributable to noncontrolling interest	—			—			—			—
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	(1,992	)	$	(850	)	$	850		$	(1,992	)
	Condensed Consolidating Statements of Operations
	(in thousands, unaudited)
		Three months ended June 30, 2013
		EVHC			Corporation			Consolidating			Total
		(excluding			and			Adjustments
		Corporation)			Subsidiaries
	Net revenue	$	—		$	899,255		$	—		$	899,255
	Compensation and benefits	—			643,960			—			643,960
	Operating expenses	20			102,288			—			102,308
	Insurance expense	—			25,840			—			25,840
	Selling, general and administrative expenses	1			23,789			—			23,790
	Depreciation and amortization expense	—			34,622			—			34,622
	Restructuring charges	—			3,032			—			3,032
	Income from operations	(21		)	65,724			—			65,703
	Interest income from restricted assets	—			266			—			266
	Interest expense, net	(11,464		)	(38,538		)	—			(50,002		)
	Realized gains (losses) on investments	—			105			—			105
	Other income (expense), net	—			(249		)	—			(249		)
	Loss on early debt extinguishment	—			—			—			—
	Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(11,485		)	27,308			—			15,823
	Income tax benefit (expense)	4,519			(10,832		)	—			(6,313		)
	Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(6,966		)	16,476			—			9,510
	Equity in net income (loss) of subsidiary	16,563			—			(16,563		)	—
	Equity in earnings of unconsolidated subsidiary	—			87			—			87
	Net income (loss)	9,597			16,563			(16,563		)	9,597
	Less: Net (income) loss attributable to noncontrolling interest	—			—			—			—
	Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	9,597		$	16,563		$	(16,563	)	$	9,597
	Condensed Consolidating Statements of Operations
	(in thousands, unaudited)
		Six months ended June 30, 2014
		EVHC			Corporation and			Consolidating			Total
		(excluding			Subsidiaries			Adjustments
		Corporation)
	Net revenue	$	—		$	2,089,538		$	—		$	2,089,538
	Compensation and benefits	—			1,510,668			—			1,510,668
	Operating expenses	—			235,350			—			235,350
Insurance expense	—			62,564			—			62,564
Selling, general and administrative expenses	—			42,969			—			42,969
Depreciation and amortization expense	—			71,990			—			71,990
Restructuring charges	—			4,540			—			4,540
Income from operations	—			161,457			—			161,457
Interest income from restricted assets	—			332			—			332
Interest expense, net	—			(59,051		)	—			(59,051		)
Realized gains (losses) on investments	—			1,114			—			1,114
Other income (expense), net	(2,799		)	27			—			(2,772		)
Loss on early debt extinguishment	—			(66,397		)	—			(66,397		)
Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(2,799		)	37,482			—			34,683
Income tax benefit (expense)	895			(16,158		)	—			(15,263		)
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(1,904		)	21,324			—			19,420
Equity in net income (loss) of subsidiary	21,437			—			(21,437		)	—
Equity in earnings of unconsolidated subsidiary	—			113			—			113
Net income (loss)	19,533			21,437			(21,437		)	19,533
Less: Net (income) loss attributable to noncontrolling interest	—			3,300			—			3,300
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	19,533		$	24,737		$	(21,437	)	$	22,833
Condensed Consolidating Statements of Operations
(in thousands, unaudited)
	Six months ended June 30, 2013
	EVHC			Corporation and			Consolidating			Total
	(excluding			Subsidiaries			Adjustments
	Corporation)
Net revenue	$	—		$	1,787,579		$	—		$	1,787,579
Compensation and benefits	—			1,285,749			—			1,285,749
Operating expenses	87			202,671			—			202,758
Insurance expense	—			51,673			—			51,673
Selling, general and administrative expenses	1			45,787			—			45,788
Depreciation and amortization expense	—			69,377			—			69,377
Restructuring charges	—			3,669			—			3,669
Income from operations	(88		)	128,653			—			128,565
Interest income from restricted assets	—			632			—			632
Interest expense, net	(22,926		)	(78,828		)	—			(101,754		)
Realized gains (losses) on investments	—			118			—			118
Other income (expense), net	—			(12,970		)	—			(12,970		)
Loss on early debt extinguishment	—			(122		)	—			(122		)
Income (loss) before taxes and equity in earnings of unconsolidated subsidiary	(23.014		)	37,483			—			14,469
Income tax benefit (expense)	9,085			(17,966		)	—			(8,881		)
Income before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	(13,929		)	19,517			—			5,588
Equity in net income (loss) of subsidiary	19,679			—			(19,679		)	—
Equity in earnings of unconsolidated subsidiary	—			162			—			162
Net income (loss)	5,750			19,679			(19,679		)	5,750
Less: Net (income) loss attributable to noncontrolling interest	—			—			—			—
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$	5,750		$	19,679		$	(19,679	)	$	5,750
Schedule of Consolidating Statement of Cash Flows	'
	Condensed Consolidating Statement of Cash Flows
	(in thousands, unaudited)
		Six months ended June 30, 2014
		EVHC			Corporation and			Total
		(excluding			Subsidiaries
		Corporation)
	Cash Flows from Operating Activities
	Net cash provided by (used in) operating activities	$	(391	)	$	94,331		$	93,940
	Cash Flows from Investing Activities
	Purchases of available-for-sale securities	—			(3,372		)	(3,372		)
	Sales and maturities of available-for-sale securities	—			10,527			10,527
	Purchase of property, plant and equipment	—			(33,480		)	(33,480		)
	Proceeds from sale of property, plant and equipment	—			2,216			2,216
	Acquisition of businesses, net of cash received	—			(199,298		)	(199,298		)
	Net change in insurance collateral	—			1,213			1,213
	Other investing activities	—			(2,363		)	(2,363		)
	Net cash provided by (used in) investing activities	—			(224,557		)	(224,557		)
	Cash Flows from Financing Activities
	Borrowings under the ABL Facility	—			50,000			50,000
	Proceeds from issuance of senior notes	—			740,625			740,625
	Repayments of the Term Loan	—			(3,343		)	(3,343		)
	Repayments of the ABL Facility	—			(50,000		)	(50,000		)
	Repayments of senior notes	—			(607,750		)	(607,750		)
	Payment for debt extinguishment premiums	—			(37,630		)	(37,630		)
	Debt issuance costs	—			(1,374		)	(1,374		)
	Excess tax benefits from equity-based compensation	—			15,658			15,658
	Shares repurchased for tax withholdings	—			(14,430		)	(14,430		)
	Proceeds from noncontrolling interest	—			250			250
	Other financing activities	391			(3,889		)	(3,498		)
	Net intercompany borrowings (payments)	(81,717		)	81,717			—
	Net cash provided by (used in) financing activities	(81,326		)	169,834			88,508
	Change in cash and cash equivalents	(81,717		)	39,608			(42,109		)
	Cash and cash equivalents, beginning of period	81,722			122,990			204,712
	Cash and cash equivalents, end of period	$	5		$	162,598		$	162,603
	Condensed Consolidating Statement of Cash Flows
	(in thousands, unaudited)
		Six months ended June 30, 2013
		EVHC			Corporation and			Total
		(excluding			Subsidiaries
		Corporation)
	Cash Flows from Operating Activities
	Net cash provided by (used in) operating activities	$	(19,343	)	$	13,246		$	(6,097	)
	Cash Flows from Investing Activities
	Purchases of available-for-sale securities	—			(2,548		)	(2,548		)
	Sales and maturities of available-for-sale securities	—			4,170			4,170
	Purchase of property, plant and equipment	—			(26,198		)	(26,198		)
	Proceeds from sale of property, plant and equipment	—			328			328
	Acquisition of businesses, net of cash received	—			(1,423		)	(1,423		)
	Net change in insurance collateral	—			(2,024		)	(2,024		)
	Other investing activities	—			(52		)	(52		)
	Net cash provided by (used in) investing activities	—			(27,747		)	(27,747		)
	Cash Flows from Financing Activities
	Issuance of common stock	—			1,117			1,117
	Borrowings under the Term Loan	—			209,000			209,000
	Borrowings under the ABL Facility	—			252,440			252,440
	Repayments of the Term Loan	—			(65,685		)	(65,685		)
	Repayments of the ABL Facility	—			(349,940		)	(349,940		)
	Dividend paid	(67		)	—			(67		)
	Debt issuance costs	(4		)	(5,007		)	(5,011		)
	Equity issuance costs	(1,400		)	—			(1,400		)
	Excess tax benefits from equity-based compensation	—			3,168			3,168
	Payment of dissenting shareholder settlement	—			(38,336		)	(38,336		)
	Net change in bank overdrafts	—			8,117			8,117
Other financing activities	—			(359		)	(359		)
Net intercompany borrowings (payments)	20,813			(20,813		)	—
Net cash provided by (used in) financing activities	19,342			(6,298		)	13,044
Change in cash and cash equivalents	(1		)	(20,799		)	(20,800		)
Cash and cash equivalents, beginning of period	281			57,551			57,832
Cash and cash equivalents, end of period	$	280		$	36,752		$	37,032

General_Details

General (Details) (USD $)	0 Months Ended		6 Months Ended			0 Months Ended
	Feb. 05, 2014	Jul. 29, 2013	Jun. 30, 2014	Dec. 31, 2013	Aug. 13, 2013	Jul. 10, 2014
			item			Subsequent events
Basis of Presentation of Financial Statements	'	'	'	'	'	'
Stock split ratio	'	9.3	'	'	'	'
Shares of common stock issued	'	132,082,885	'	'	'	'
Treasury shares issued	'	504,197	'	'	'	'
Common stock, par value (in dollars per share)	'	'	$0.01	$0.01	$0.01	'
Shares of common stock issued	31,625,000	'	'	'	'	27,500,000
Public offering price (in dollars per share)	$30.50	'	'	'	'	$34
Number of operating subsidiaries	'	'	2	'	'	'

Summary_of_Significant_Account3

Summary of Significant Accounting Policies (Details) (USD $)	6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Insurance Collateral	'	'
Reinsurance receivable	$1,796	$1,300
Trade and Other Accounts Receivable, net	'	'
Gross trade accounts receivable	4,511,437	3,841,672
Allowance for contractual discounts	-2,402,789	-2,002,704
Allowance for uncompensated care	-1,229,807	-1,038,833
Trade accounts receivable, net	878,841	800,135
Other receivables, net	496	1,011
Trade and other accounts receivable, net	$879,337	$801,146
Period after which look-back analysis is performed to review and adjust overage or deficit in accounts receivable allowances	'15 months	'
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		6 Months Ended
	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 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	$2,100,000	$800,000	$7,300,000	($400,000)	'
Long-term portion of insurance reserves	152,454,000	'	152,454,000	'	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

6 Months Ended

0 Months Ended

6 Months Ended

0 Months Ended

Feb. 05, 2014

Aug. 19, 2013

Jun. 30, 2013

Jul. 10, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Aug. 19, 2013

Aug. 19, 2013

Aug. 13, 2013

Feb. 05, 2014

Aug. 19, 2013

Aug. 13, 2013

Jul. 10, 2014

Subsequent events

Senior PIK Toggle Notes due 2017

Revolving credit facility

Senior subordinated unsecured notes due 2019

CD&R

Initial public offering

Initial public offering

Underwriters overallotment option

Underwriters overallotment option

Underwriters overallotment option

Underwriters overallotment option

Subsequent events

Equity Structure and Public Offerings

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Shares of common stock issued

31,625,000

'

'

27,500,000

'

'

'

'

48,300,000

42,000,000

4,125,000

'

6,300,000

4,125,000

Issue price (in dollars per share)

$30.50

'

'

$34

'

'

'

'

$23

'

'

'

$23

'

Aggregate offering price

'

'

$1,117,000

'

'

'

'

'

'

'

'

$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)	6 Months Ended
	Jun. 30, 2014	Jun. 30, 2013
Medicare and Medicaid	'	'
Concentration of credit risk	'	'
Percentage of concentration risk	33.00%	34.00%
Insurance providers and contracted payors	'	'
Concentration of credit risk	'	'
Percentage of concentration risk	64.00%	62.00%
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 $)	Jun. 30, 2014
In Millions, unless otherwise specified
Senior subordinated unsecured notes purchased by EVHC subsidiary	'
Financial Instruments	'
Estimated fair value of the senior subordinate notes	$750
Carrying value of the senior subordinate notes	$750

Summary_of_Significant_Account8

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

Jun. 30, 2014

Jun. 30, 2013

Jun. 30, 2014

Dec. 31, 2013

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 30, 2014

Dec. 31, 2013

Level 1

Level 1

Level 2

Level 2

Level 2

Level 2

Level 2

Level 3

Level 3

Total

Total

Total

Total

Total

Total

Total

Total

Available-for-sale securities (insurance collateral)

Available-for-sale securities (insurance collateral)

Available-for-sale securities (insurance collateral)

Fuel hedge

Fuel hedge

Interest rate swap

Interest rate swap

Contingent consideration

Contingent consideration

Available-for-sale securities (insurance collateral)

Available-for-sale securities (insurance collateral)

Fuel hedge

Fuel hedge

Contingent consideration

Contingent consideration

Interest rate swap

Interest rate swap

Fair value measurement

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Assets

'

'

$6,130,000

$12,710,000

$517,000

$368,000

$672,000

'

'

'

'

$6,130,000

$13,227,000

$368,000

$672,000

'

'

'

'

Liabilities

'

'

'

'

'

'

'

2,327,000

3,135,000

1,734,000

7,734,000

'

'

'

'

1,734,000

7,734,000

2,327,000

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

0

0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

0

0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

0

0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

$0

$0

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Summary_of_Significant_Account9

Summary of Significant Accounting Policies (Details 7) (USD $)	3 Months Ended		6 Months Ended
	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Revenue Recognition	'	'	'	'
Fee-for-service revenue, net of contractual discounts:	$1,770,841,000	$1,545,319,000	$3,446,659,000	$3,019,855,000
Subsidies and fees	182,861,000	144,486,000	365,537,000	275,198,000
Revenue, net of contractual discounts	1,953,702,000	1,689,805,000	3,812,196,000	3,295,053,000
Provision for uncompensated care	-878,375,000	-790,550,000	-1,722,658,000	-1,507,474,000
Net revenue	1,075,327,000	899,255,000	2,089,538,000	1,787,579,000
Revenue Recognition	'	'	'	'
(Increase) decrease in contractual discount or uncompensated care provisions	2,700,000	1,300,000	3,800,000	-800,000
Medicare	'	'	'	'
Revenue Recognition	'	'	'	'
Fee-for-service revenue, net of contractual discounts:	300,428,000	266,762,000	550,740,000	500,636,000
Medicaid	'	'	'	'
Revenue Recognition	'	'	'	'
Fee-for-service revenue, net of contractual discounts:	110,625,000	93,649,000	166,441,000	144,863,000
Commercial insurance and managed care (excluding Medicare and Medicaid managed care)	'	'	'	'
Revenue Recognition	'	'	'	'
Fee-for-service revenue, net of contractual discounts:	607,567,000	497,136,000	1,252,750,000	1,057,327,000
Self-pay	'	'	'	'
Revenue Recognition	'	'	'	'
Fee-for-service revenue, net of contractual discounts:	$752,221,000	$687,772,000	$1,476,728,000	$1,317,029,000
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		6 Months Ended		12 Months Ended
In Thousands, except Share data, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
Basic and diluted net income (loss) per share	'	'	'	'	'
Net income (loss)	($1,992)	$9,597	$22,833	$5,750	'
Weighted-average common shares outstanding - common stock:	'	'	'	'	'
Basic (in shares)	181,140,242	131,672,134	180,962,123	131,187,567	'
Dilutive impact of stock awards outstanding (in shares)	'	5,599,223	8,498,322	4,802,799	'
Diluted (in shares)	181,140,242	137,271,357	189,460,445	135,990,366	'
Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:	'	'	'	'	'
Basic (in dollars per share)	($0.01)	$0.07	$0.13	$0.04	'
Diluted (in dollars per share)	($0.01)	$0.07	$0.12	$0.04	'
Stock awards of common stock outstanding excluded from the computations of diluted loss per share and weighted-average common shares outstanding	8,362,994	'	0	'	0

Acquisitions_Details

Acquisitions (Details) (USD $)	3 Months Ended		6 Months Ended			0 Months Ended		12 Months Ended		3 Months Ended
	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013	Jun. 17, 2014	Mar. 07, 2014	Dec. 31, 2013	Jun. 30, 2014	21-May-14
						Phoenix Physicians	Life Line Ambulance Service, Inc. and MedStat EMS, Inc.	CMORx, LLC and Loya Medical Services, PLLC	CMORx, LLC and Loya Medical Services, PLLC	Other 2014 Acquisition
								item
Acquisitions	'	'	'	'	'	'	'	'	'	'
Number of related corporations which leverage the provision of non-emergency medical transportation services	'	'	'	'	'	'	'	2	'	'
Total consideration of acquisitions paid in cash	'	'	'	'	'	$169,500,000	'	$34,200,000	'	$38,000,000
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations	'	'	'	'	'	'	'	'	'	'
Cash	'	'	'	'	'	7,052,000	'	'	'	'
Accounts receivable	'	'	'	'	'	16,748,000	'	'	'	'
Prepaid and other current assets	'	'	'	'	'	359,000	'	'	'	'
Property, plant and equipment	'	'	'	'	'	92,000	'	'	'	'
Acquired intangible assets	'	'	'	'	'	56,000,000	15,000,000	14,900,000	5,400,000	'
Goodwill	2,544,477,000	'	2,544,477,000	'	2,435,670,000	96,811,000	17,400,000	20,800,000	'	'
Accounts payable	'	'	'	'	'	-1,073,000	'	'	'	'
Accrued liabilities	'	'	'	'	'	-6,539,000	'	'	'	'
Total purchase price	'	'	'	'	'	169,450,000	'	'	'	'
Unaudited pro forma operating results	'	'	'	'	'	'	'	'	'	'
Net revenue	35,572,000	28,224,000	64,270,000	55,929,000	'	'	'	'	'	'
Net income	1,113,000	306,000	2,110,000	981,000	'	'	'	'	'	'
Net revenue	3,500,000	'	3,500,000	'	'	'	'	'	'	'
Net income	300,000	'	300,000	'	'	'	'	'	'	'
Tax deductible goodwill	'	'	'	'	'	'	11,400,000	'	'	'
Net current assets	'	'	'	'	'	'	5,600,000	'	'	'
Net current liabilities	'	'	'	'	'	'	'	$1,500,000	'	'

Insurance_Collateral_Details

Insurance Collateral (Details) (USD $)	Jun. 30, 2014	Dec. 31, 2013
Insurance collateral	'	'
Available-for-sale securities	$6,130,000	$13,227,000
Insurance receivable	1,796,000	1,300,000
Cash deposits and other	10,593,000	27,808,000
Total insurance collateral	18,519,000	42,335,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	6,069,000	12,847,000
Gross Unrealized Gains	78,000	563,000
Gross Unrealized Losses	-17,000	-183,000
Fair Value	6,130,000	13,227,000
U.S. Treasuries	'	'
Insurance collateral	'	'
Available-for-sale securities	1,199,000	2,100,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	1,182,000	2,064,000
Gross Unrealized Gains	19,000	37,000
Gross Unrealized Losses	-2,000	-1,000
Fair Value	1,199,000	2,100,000
Corporate bonds / Fixed income	'	'
Insurance collateral	'	'
Available-for-sale securities	2,702,000	6,372,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	2,693,000	6,384,000
Gross Unrealized Gains	10,000	26,000
Gross Unrealized Losses	-1,000	-38,000
Fair Value	2,702,000	6,372,000
Contractual maturities of available-for-sale securities	'	'
Within one year	600,000	'
Longer than one year through five years	2,800,000	'
Longer than five years through ten years	500,000	'
Corporate equity	'	'
Insurance collateral	'	'
Available-for-sale securities	2,229,000	4,755,000
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities	'	'
Cost Basis	2,194,000	4,399,000
Gross Unrealized Gains	49,000	500,000
Gross Unrealized Losses	-14,000	-144,000
Fair Value	$2,229,000	$4,755,000

Insurance_Collateral_Details_2

Insurance Collateral (Details 2) (USD $)	3 Months Ended		6 Months Ended
	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
Insurance collateral	'	'	'	'	'
Securities available-for-sale, Fair Value, Total	$1,909,000	'	$1,909,000	'	$7,631,000
Securities available-for-sale, Unrealized Loss, Total	-17,000	'	-17,000	'	-183,000
Realized net gains on the sale and maturities of available-for-sale securities	500,000	100,000	1,100,000	100,000	'
U.S. Treasuries	'	'	'	'	'
Insurance collateral	'	'	'	'	'
Securities available-for-sale, Less than 12 months, Fair Value	132,000	'	132,000	'	132,000
Securities available-for-sale, Less than 12 months, Unrealized Loss	-2,000	'	-2,000	'	-1,000
Corporate bonds / Fixed income	'	'	'	'	'
Insurance collateral	'	'	'	'	'
Securities available-for-sale, Less than 12 months, Fair Value	552,000	'	552,000	'	2,768,000
Securities available-for-sale, 12 months or more, Fair Value	'	'	'	'	2,178,000
Securities available-for-sale, Less than 12 months, Unrealized Loss	-1,000	'	-1,000	'	-18,000
Securities available-for-sale, 12 months or more, Unrealized Loss	'	'	'	'	-20,000
Corporate equity	'	'	'	'	'
Insurance collateral	'	'	'	'	'
Securities available-for-sale, Less than 12 months, Fair Value	1,225,000	'	1,225,000	'	'
Securities available-for-sale, 12 months or more, Fair Value	'	'	'	'	2,553,000
Securities available-for-sale, Less than 12 months, Unrealized Loss	-14,000	'	-14,000	'	'
Securities available-for-sale, 12 months or more, Unrealized Loss	'	'	'	'	($144,000)

Accrued_Liabilities_Details

Accrued Liabilities (Details) (USD $)	Jun. 30, 2014	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Accrued liabilities	'	'	'
Accrued wages and benefits	$183,092	$161,398	'
Accrued paid time-off	29,732	25,713	'
Current portion of self-insurance reserve	71,720	73,738	'
Accrued restructuring	6,560	5,682	12,318
Current portion of compliance and legal	4,262	2,000	'
Accrued billing and collection fees	2,571	2,954	'
Accrued incentive compensation	25,067	19,570	'
Accrued interest	2,755	6,898	'
Other	52,094	52,983	'
Total accrued liabilities	$377,853	$350,936	'

LongTerm_Debt_Details

Long-Term Debt (Details) (USD $)

3 Months Ended

6 Months Ended

3 Months Ended

6 Months Ended

0 Months Ended

6 Months Ended

0 Months Ended

3 Months Ended

0 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

6 Months Ended

6 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

Jun. 30, 2014

Jun. 30, 2013

Jun. 30, 2014

Jun. 30, 2013

Dec. 31, 2013

Jun. 30, 2014

Jun. 30, 2014

Jun. 18, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 18, 2014

Dec. 30, 2013

Jun. 30, 2014

Dec. 31, 2013

Jun. 18, 2014

Dec. 30, 2013

25-May-11

Jun. 18, 2014

Dec. 30, 2013

Jun. 30, 2012

25-May-11

Feb. 07, 2013

Jun. 30, 2014

Dec. 31, 2013

25-May-11

Feb. 06, 2013

Feb. 07, 2013

Feb. 07, 2013

Feb. 07, 2013

Feb. 06, 2013

Feb. 07, 2013

Feb. 07, 2013

Feb. 06, 2013

Feb. 07, 2013

Feb. 06, 2013

Jun. 30, 2014

Feb. 27, 2013

25-May-11

Jun. 30, 2014

Jun. 30, 2014

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 26, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 26, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 26, 2013

Feb. 26, 2013

Feb. 26, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 27, 2013

Feb. 06, 2013

Feb. 26, 2013

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior Unsecured Notes due 2022

Senior unsecured notes due 2019

Senior unsecured notes due 2019

Senior unsecured notes due 2019

Senior unsecured notes due 2019

Senior unsecured notes due 2019

Senior unsecured notes due 2019

Senior unsecured notes due 2019

Senior unsecured notes purchased by captive insurance subsidiary

Senior unsecured notes purchased by captive insurance subsidiary

Senior unsecured notes purchased by captive insurance subsidiary

Credit Facilities

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

Term Loan Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

ABL Facility

Corporation

Corporation

Period prior to July 1, 2017

Period on and after July 1, 2017 and prior to July 1, 2018

Period on or after July 1, 2018 and prior to July 1, 2019

Period on or after July 1, 2019 and prior to July 1, 2020

Period on or after July 1, 2020

Captive insurance subsidiary

Captive insurance subsidiary

Corporation

Corporation

Corporation

Option one

Option one

Option one

Option one

Option two

Option two

Option two

Option two

Option two

Option two

Corporation

Minimum

Maximum

Option one

Option one

Option one

Option one

Option one

Option one

Option one

Option one

Option one

Option one

Option one

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Option two

Corporation

Overnight federal funds rate

Adjusted LIBOR rate

Corporation

Overnight federal funds rate

Overnight federal funds rate

Adjusted LIBOR rate

LIBOR rate

Overnight federal funds rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Minimum

Maximum

Overnight federal funds rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

Adjusted LIBOR rate

LIBOR rate

LIBOR rate

Corporation

Corporation

Corporation

Corporation

Corporation

Corporation

Corporation

Corporation

Minimum

Minimum

Minimum

Maximum

Maximum

Maximum

Corporation

Corporation

Corporation

Corporation

Minimum

Minimum

Maximum

Maximum

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

Average daily excess availability greater than 33% but less than or equal to 66% of availability

Average daily excess availability greater than 66% of availability

Average daily excess availability greater than 33% but less than or equal to 66% of availability

Average daily excess availability greater than 66% of availability

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

Average daily excess availability greater than 33% but less than or equal to 66% of availability

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

Average daily excess availability greater than 33% but less than or equal to 66% of availability

Average daily excess availability greater than 66% of availability

Average daily excess availability greater than 33% but less than or equal to 66% of availability

Average daily excess availability greater than 66% of availability

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

Average daily excess availability greater than 33% but less than or equal to 66% of availability

Long-Term Debt

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt issued

'

'

'

'

'

'

'

$750,000,000

'

'

'

'

'

'

'

'

'

'

'

'

$950,000,000

'

'

'

'

$150,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Amount of debt held

2,044,653,000

'

2,044,653,000

'

1,907,699,000

750,000,000

750,000,000

'

'

'

'

'

'

'

'

'

'

'

9,800,000

5,200,000

'

0

0

15,000,000

'

'

1,296,261,000

1,302,945,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Principal amount of debt redeemed

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

332,500,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Redemption price (as a percent)

'

'

'

'

'

'

'

'

'

100.00%

103.84%

102.56%

101.28%

100.00%

106.09%

108.13%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

'

'

'

'

'

'

'

'

'

40.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

'

'

'

'

'

'

'

'

'

105.13%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

'

'

'

'

'

'

101.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

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

'

'

'

'

'

'

100.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Repayments of debt and capital lease obligations

'

'

'

'

'

'

'

'

'

'

'

'

'

'

2,400,000

2,200,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Loss on early debt extinguishment

-66,397,000

'

-66,397,000

-122,000

'

9,400,000

'

'

'

'

'

'

'

'

617,500,000

'

66,400,000

38,700,000

'

'

'

'

'

'

'

100,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Interest rate (as a percent)

'

'

'

'

'

'

'

'

5.13%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

4.00%

4.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Maximum borrowing capacity

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

1,800,000,000

'

'

'

1,440,000,000

'

'

'

'

'

'

'

'

'

'

'

450,000,000

350,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Reference rate (as a percent)

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

1.50%

1.00%

'

'

2.50%

2.00%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Interest rate margin (as a percent)

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

3.75%

3.00%

0.50%

'

2.75%

2.00%

0.50%

0.50%

1.00%

1.00%

'

'

'

'

'

0.50%

'

2.00%

1.75%

1.50%

2.25%

'

'

2.75%

'

'

1.25%

1.75%

0.50%

1.00%

1.00%

0.75%

0.50%

'

'

'

'

'

1.00%

Variable interest rate basis

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'LIBOR

'

'

'

'

'one-month LIBOR rate

'one-month Term Loan LIBOR rate

'

'

'

'

'

'

'LIBOR

'

'

'

'

'

'

'

'

'

'

'

'

'one-month LIBOR rate

'

'

'

'

'

'

'

'one-month ABL LIBOR

'

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

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

2.75%

'

'

'

1.75%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Consolidated first lien net leverage ratio

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

2.5

'

'

'

2.5

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Average daily excess availability as a percentage of availability

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

33.00%

66.00%

'

33.00%

66.00%

'

'

'

'

'

'

'

33.00%

66.00%

33.00%

66.00%

'

'

Commitment fee (as a percent)

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

0.38%

0.50%

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Outstanding debt

129,900,000

'

129,900,000

'

129,900,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

129,900,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Available borrowing capacity

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

320,100,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Period of average excess availability exceeding agreed upon thresholds

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'30 days

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Fixed charge coverage ratio

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

1

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Debt issuance expense related to amendments

'

$5,000,000

$1,374,000

$5,011,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

LongTerm_Debt_Details_2

Long-Term Debt (Details 2) (USD $)	3 Months Ended	6 Months Ended		0 Months Ended	3 Months Ended
	Jun. 30, 2014	Jun. 30, 2014	Jun. 30, 2013	Aug. 30, 2013	Sep. 30, 2013	Oct. 01, 2012
				PIK Notes	PIK Notes	PIK Notes
Debt	'	'	'	'	'	'
Face amount of debt	'	'	'	'	'	$450,000,000
Redemption price of debt instrument as a percentage of principal amount	'	'	'	102.75%	'	'
Repayments of debt and capital lease obligations	'	'	'	17,200,000	'	'
Loss on early debt extinguishment	($66,397,000)	($66,397,000)	($122,000)	'	$29,500,000	'

LongTerm_Debt_Details_3

Long-Term Debt (Details 3) (USD $)	6 Months Ended	12 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Dec. 31, 2013
Long-Term Debt	'	'
Total debt	$2,044,653	$1,907,699
Less current portion	-12,306	-12,318
Total long-term debt and capital lease obligations	2,032,347	1,895,381
Senior subordinated unsecured notes due 2019	'	'
Long-Term Debt	'	'
Total debt	'	607,750
Senior Unsecured Notes due 2022	'	'
Long-Term Debt	'	'
Total debt	750,000	'
Senior Unsecured Notes due 2022 | Corporation	'	'
Long-Term Debt	'	'
Interest rate (as a percent)	5.13%	'
Senior secured term loan due 2018	'	'
Long-Term Debt	'	'
Discount on debt	-3,687	-4,217
Total debt	1,296,261	1,302,945
Interest rate (as a percent)	4.00%	4.00%
Notes due at various dates from 2014 to 2022	'	'
Long-Term Debt	'	'
Total debt	811	852
Interest rate, minimum (as a percent)	6.00%	6.00%
Interest rate, maximum (as a percent)	10.00%	10.00%
Capital lease obligations due at various dates from 2014 to 2018	'	'
Long-Term Debt	'	'
Total debt	$1,268	$369

Derivative_Instruments_and_Hed1

Derivative Instruments and Hedging Activities (Details) (USD $)	3 Months Ended		6 Months Ended
In Millions, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
	gal		agreement
			gal
Fuel hedge	'	'	'	'	'
Derivative Instruments and Hedging Activities	'	'	'	'	'
Number of master agreements	'	'	1	'	'
Total gallons of diesel fuel	1,300,000	'	1,300,000	'	'
Gallons of diesel fuel as a percentage of total estimated annual usage	16.80%	'	16.80%	'	'
Fair value of derivative asset	$0.40	'	$0.40	'	$0.70
Net receipts from the counterparty	0.1	0.1	0.3	0.3	'
Period over which deferred gain (loss) is expected to be reclassified from accumulated comprehensive income	'	'	'12 months	'	'
Amount of deferred gain (loss) expected to be reclassified from accumulated comprehensive income	'	'	0.4	'	'
Fuel hedge | Minimum	'	'	'	'	'
Derivative Instruments and Hedging Activities	'	'	'	'	'
Diesel fuel price (in dollars per gallon)	'	'	3.63	'	'
Fuel hedge | Maximum	'	'	'	'	'
Derivative Instruments and Hedging Activities	'	'	'	'	'
Diesel fuel price (in dollars per gallon)	'	'	3.78	'	'
Interest rate swap agreements	'	'	'	'	'
Derivative Instruments and Hedging Activities	'	'	'	'	'
Notional amount of debt obligations	400	'	400	'	'
Effective rate of interest of debt (as a percent)	4.49%	'	4.49%	'	'
Minimum variable interest rate of debt (as a percent)	1.00%	'	1.00%	'	'
Fair value of derivative liability	2.3	'	2.3	'	3.1
Net payments to the counterparty	0.5	0.5	1	1	'
Period over which deferred gain (loss) is expected to be reclassified from accumulated comprehensive income	'	'	'12 months	'	'
Amount of deferred gain (loss) expected to be reclassified from accumulated comprehensive income	'	'	($2.10)	'	'

Changes_in_Accumulated_Other_C2

Changes in Accumulated Other Comprehensive Income by Component (Details) (USD $)	3 Months Ended		6 Months Ended		12 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
Changes in the company's AOCI by component, after tax	'	'	'	'	'
Balance at the beginning of the period	'	'	($839)	($213)	($213)
Other comprehensive income before reclassifications	'	'	-140	'	-1,330
Amounts reclassified from accumulated other comprehensive income	'	'	-248	'	704
Total other comprehensive income (loss), net of tax	-102	7	-388	-727	-626
Balance at the end of the period	-1,227	'	-1,227	'	-839
Unrealized holding gains on available-for-sale securities	'	'	'	'	'
Changes in the company's AOCI by component, after tax	'	'	'	'	'
Balance at the beginning of the period	'	'	699	1,591	1,591
Other comprehensive income before reclassifications	'	'	-8	'	-598
Amounts reclassified from accumulated other comprehensive income	'	'	-694	'	-294
Total other comprehensive income (loss), net of tax	'	'	-702	'	-892
Balance at the end of the period	-3	'	-3	'	699
Fuel hedge | Gains and losses on cash flow hedges	'	'	'	'	'
Changes in the company's AOCI by component, after tax	'	'	'	'	'
Balance at the beginning of the period	'	'	420	1,057	1,057
Other comprehensive income before reclassifications	'	'	-18	'	-396
Amounts reclassified from accumulated other comprehensive income	'	'	-172	'	-241
Total other comprehensive income (loss), net of tax	'	'	-190	'	-637
Balance at the end of the period	230	'	230	'	420
Interest rate swap | Gains and losses on cash flow hedges	'	'	'	'	'
Changes in the company's AOCI by component, after tax	'	'	'	'	'
Balance at the beginning of the period	'	'	-1,958	-2,861	-2,861
Other comprehensive income before reclassifications	'	'	-114	'	-336
Amounts reclassified from accumulated other comprehensive income	'	'	618	'	1,239
Total other comprehensive income (loss), net of tax	'	'	504	'	903
Balance at the end of the period	($1,454)	'	($1,454)	'	($1,958)

Changes_in_Accumulated_Other_C3

Changes in Accumulated Other Comprehensive Income by Component (Details 2) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Operating expenses	$120,715	$102,308	$235,350	$202,758
Interest expense, net	29,002	50,002	59,051	101,754
Realized (loss) gain on investments	508	105	1,114	118
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-3,470	15,823	34,683	14,469
Tax benefit (expense)	1,412	-6,313	-15,263	-8,881
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	-1,992	9,597	22,833	5,750
Gains and losses on cash flow hedges | Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-402	-470	-717	-766
Tax benefit (expense)	152	177	271	288
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	-250	-293	-446	-478
Gains and losses on cash flow hedges | Fuel hedge | Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Operating expenses	95	26	276	221
Gains and losses on cash flow hedges | Interest rate swap | Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Interest expense, net	-497	-496	-993	-987
Unrealized holding gains on available-for-sale securities | Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Amounts Reclassified from Accumulated Other Comprehensive Income	'	'	'	'
Realized (loss) gain on investments	508	105	1,114	118
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	508	105	1,114	118
Tax benefit (expense)	-192	-39	-420	-44
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$316	$66	$694	$74

Restructuring_Charges_Details

Restructuring Charges (Details) (USD $)	3 Months Ended		6 Months Ended		12 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013	Dec. 31, 2012
Restructuring Charges	'	'	'	'	'	'
Incurred	$3,731	$3,032	$4,540	$3,669	$5,699	'
Paid	'	'	-3,662	'	-12,335	'
Accrued restructuring liability	6,560	'	6,560	'	5,682	12,318
Lease & Other Contract Termination Costs | AMR	'	'	'	'	'	'
Restructuring Charges	'	'	'	'	'	'
Incurred	'	'	2,899	'	1,876	'
Paid	'	'	-878	'	-6,989	'
Accrued restructuring liability	5,030	'	5,030	'	3,009	8,122
Severance	'	'	'	'	'	'
Restructuring Charges	'	'	'	'	'	'
Incurred	'	'	401	'	20	'
Paid	'	'	-445	'	-377	'
Accrued restructuring liability	7	'	7	'	51	408
Severance | AMR	'	'	'	'	'	'
Restructuring Charges	'	'	'	'	'	'
Incurred	'	'	512	'	2,890	'
Paid	'	'	-1,620	'	-3,765	'
Accrued restructuring liability	1,032	'	1,032	'	2,140	3,015
Severance | EmCare	'	'	'	'	'	'
Restructuring Charges	'	'	'	'	'	'
Incurred	'	'	728	'	913	'
Paid	'	'	-719	'	-1,204	'
Accrued restructuring liability	$491	'	$491	'	$482	$773

Equity_Based_Compensation_Deta

Equity Based Compensation (Details) (USD $)

3 Months Ended

6 Months Ended

6 Months Ended

Jun. 30, 2014

Jun. 30, 2013

Jun. 30, 2014

Jun. 30, 2013

Jun. 30, 2014

Aug. 19, 2013

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Omnibus Incentive Plan

Omnibus Incentive Plan

Omnibus Incentive Plan

Omnibus Incentive Plan

Omnibus Incentive Plan

Omnibus Incentive Plan

Omnibus Incentive Plan

Omnibus Incentive Plan

item

Minimum

Maximum

Performance based awards

Performance based awards

Non-performance based awards

Stock options

Minimum

Maximum

Equity based compensation

'

'

'

'

'

'

'

'

'

'

'

'

Shares of Common Stock available for grant

'

'

'

'

16,539,986

16,708,289

'

'

'

'

'

'

Number of shares granted

'

'

'

'

'

'

2,500,000

'

0

1,500,000

'

'

Number of participants, to whom awards granted in calendar year

'

'

'

'

0

'

'

'

'

'

'

'

Fair market value of awards granted

'

'

'

'

'

'

'

$5,000,000

'

'

'

'

Vesting period of awards

'

'

'

'

'

'

'

'

'

'

'5 years

'

Term of awards

'

'

'

'

'

'

'

'

'

'

'

'10 years

Compensation charges

$1,488,000

$1,062,000

$2,550,000

$2,124,000

'

'

'

'

'

'

'

'

Commitments_and_Contingencies_

Commitments and Contingencies (Details) (USD $)	3 Months Ended		6 Months Ended			0 Months Ended	3 Months Ended	23 Months Ended	1 Months Ended	0 Months Ended
In Millions, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013	Apr. 15, 2013	Mar. 31, 2013	Mar. 10, 2010	31-May-11	20-May-11	Jun. 30, 2014
						Merion Capital, L.P	Merion Capital, L.P	AMR	Subpoena from the DOJ	Subpoena from the DOJ	Subpoena from the OIG
								Predecessor	AMR	AMR	EmCare
								item		Predecessor	item
Commitments and Contingencies	'	'	'	'	'	'	'	'	'	'	'
Rental expense	$11.40	$11.20	$22.70	$22.30	'	'	'	'	'	'	'
Term of CIA	'	'	'	'	'	'	'	'	'5 years	'	'
Settlement amount to resolve the claims	'	'	'	'	'	52.1	'	'	'	2.7	'
Outstanding letters of credit	129.9	'	129.9	'	129.9	'	'	'	'	'	'
Number of lawsuits purporting to be class actions filed	'	'	'	'	'	'	'	4	'	'	'
Legal settlement costs	'	'	'	'	'	'	8.4	'	'	'	'
Accrued interest included in reserve for unpaid merger consideration	'	'	'	'	'	'	$1.90	'	'	'	'
Number of lawsuits, in which the Company is defendant	'	'	'	'	'	'	'	'	'	'	2

Related_Party_Transactions_Det

Related Party Transactions (Details) (USD $)

3 Months Ended

6 Months Ended

3 Months Ended

6 Months Ended

0 Months Ended

6 Months Ended

3 Months Ended

6 Months Ended

Jun. 30, 2013

Jun. 30, 2013

Sep. 30, 2013

Jun. 30, 2013

Jun. 30, 2014

Jun. 30, 2013

Nov. 25, 2008

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2013

Jun. 30, 2014

Jun. 30, 2013

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

Jun. 30, 2014

CD&R

CD&R

CD&R

CD&R

The Hertz Corporation

The Hertz Corporation

Maximum

Maximum

Maximum

Maximum

Condition one

Condition two

Condition two

Condition three

Condition three

Condition four

Condition four

Condition five

Condition five

Additional condition

The Hertz Corporation

The Hertz Corporation

The Hertz Corporation

The Hertz Corporation

Minimum

Minimum

Maximum

Minimum

Maximum

Minimum

Maximum

Minimum

Maximum

Minimum

CD&R

CD&R

CD&R

CD&R

CD&R

CD&R

CD&R

CD&R

CD&R

CD&R

Related party transactions

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Percentage of outstanding shares of common stock owned

'

'

'

'

'

'

'

'

'

'

'

'

50.00%

40.00%

50.00%

30.00%

40.00%

40.00%

50.00%

5.00%

20.00%

30.00%

Percentage of total number of directors comprising the board of directors

'

'

'

'

'

'

'

'

'

'

'

'

'

40.00%

'

30.00%

'

20.00%

'

5.00%

'

'

Annual fee

'

'

'

'

$5,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Annual management fee

1,250,000

2,500,000

'

1,300,000

'

2,500,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Payment made in connection with the termination of a consulting agreement

'

'

20,000,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Minimum agreed amount per year to be spend for rental of cars

'

'

'

'

'

'

460,000

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Amount spent under contract

'

'

'

'

'

'

'

'

$1,000,000

$1,000,000

$1,000,000

$1,000,000

'

'

'

'

'

'

'

'

'

'

Term of the corporate account agreement

'

'

'

'

'

'

'

'1 year

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Variable_Interest_Entities_Det

Variable Interest Entities (Details) (USD $)	Jun. 30, 2014	Dec. 31, 2013	Jun. 30, 2014	Jun. 30, 2014	Jun. 30, 2014	Dec. 31, 2013	Jun. 30, 2014
In Thousands, unless otherwise specified			UHS-EmCare JV	UHS-EmCare JV	HCA-EmCare JV	HCA-EmCare JV	HCA-EmCare JV
				EmCare			EmCare
Variable Interest Entities	'	'	'	'	'	'	'
Voting control (as a percent)	'	'	'	50.00%	'	'	50.00%
Summary of the assets and liabilities which are included in the Company's consolidated financial statements	'	'	'	'	'	'	'
Current assets	$1,126,691	$1,082,283	$14,798	'	$107,353	$88,479	'
Current liabilities	$474,679	$451,329	$7,373	'	$30,650	$22,005	'

Segment_Information_Details

Segment Information (Details) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
			item
Segment Information	'	'	'	'
Number of separately managed business units	'	'	2	'
Segment Information	'	'	'	'
Net revenue	$1,075,327	$899,255	$2,089,538	$1,787,579
Income from operations	93,139	65,703	161,457	128,565
Adjusted EBITDA	134,162	105,935	244,169	206,867
Segment	'	'	'	'
Segment Information	'	'	'	'
Net revenue	1,075,327	899,255	2,089,538	1,787,579
Income from operations	93,139	65,724	161,457	128,653
Adjusted EBITDA	134,162	105,956	244,169	206,955
Segment | Facility Based Physician Services	'	'	'	'
Segment Information	'	'	'	'
Net revenue	690,015	569,117	1,334,581	1,124,053
Income from operations	68,844	53,204	120,079	101,096
Adjusted EBITDA	87,079	70,575	158,453	136,735
Segment | Healthcare Transportation Services	'	'	'	'
Segment Information	'	'	'	'
Net revenue	385,312	330,138	754,957	663,526
Income from operations	24,295	12,520	41,378	27,557
Adjusted EBITDA	$47,083	$35,381	$85,716	$70,220

Segment_Information_Details_2

Segment Information (Details 2) (USD $)	3 Months Ended		6 Months Ended		12 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
Reconciliation of net income (loss) to Adjusted EBITDA	'	'	'	'	'
Net income (loss)	($1,992)	$9,597	$19,533	$5,750	'
Add-back of non-operating expense (income):	'	'	'	'	'
Interest expense, net	29,002	50,002	59,051	101,754	'
Tax benefit (expense)	-1,412	6,313	15,263	8,881	'
Loss on early debt extinguishment	66,397	'	66,397	122	'
Realized (losses) gains on investments	-508	-105	-1,114	-118	'
Interest income from restricted assets	-246	-266	-332	-632	'
Equity in earnings of unconsolidated subsidiary	-66	-87	-113	-162	'
Other expense (income), net	1,964	249	2,772	12,970	'
Income from operations	93,139	65,703	161,457	128,565	'
Add-back of operating expense (income):	'	'	'	'	'
Depreciation and amortization expense	35,558	34,622	71,990	69,377	'
Restructuring charges	3,731	3,032	4,540	3,669	5,699
Net loss (income) attributable to noncontrolling interest	'	'	-3,300	'	'
Interest income from restricted assets	246	266	332	632	'
Equity-based compensation expense	1,488	1,062	2,550	2,124	'
Related party management fees	'	1,250	'	2,500	'
Adjusted EBITDA	134,162	105,935	244,169	206,867	'
Operating Segments [Member]	'	'	'	'	'
Reconciliation of net income (loss) to Adjusted EBITDA	'	'	'	'	'
Net income (loss)	-1,992	9,597	19,533	5,750	'
Add-back of non-operating expense (income):	'	'	'	'	'
Interest expense, net	29,002	50,002	59,051	101,754	'
Tax benefit (expense)	-1,412	6,313	15,263	8,881	'
Loss on early debt extinguishment	66,397	'	66,397	122	'
Realized (losses) gains on investments	-508	-105	-1,114	-118	'
Interest income from restricted assets	-246	-266	-332	-632	'
Equity in earnings of unconsolidated subsidiary	-66	-87	-113	-162	'
Other expense (income), net	-1,964	-249	2,772	12,970	'
Income from operations	93,139	65,724	161,457	128,653	'
Add-back of operating expense (income):	'	'	'	'	'
Depreciation and amortization expense	35,558	34,622	71,990	69,377	'
Restructuring charges	3,731	3,032	4,540	3,669	'
Net loss (income) attributable to noncontrolling interest	'	'	3,300	'	'
Interest income from restricted assets	246	266	332	632	'
Equity-based compensation expense	1,488	1,062	2,550	2,124	'
Related party management fees	'	1,250	'	2,500	'
Adjusted EBITDA	134,162	105,956	244,169	206,955	'
Corporate, Non-Segment [Member]	'	'	'	'	'
Add-back of operating expense (income):	'	'	'	'	'
Corporate operating expense	'	($21)	'	($88)	'

Consolidating_Financial_Inform2

Consolidating Financial Information (Details) (USD $)	Jun. 30, 2014	Dec. 31, 2013	Jun. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:	'	'	'	'
Cash and cash equivalents	$162,603	$204,712	$37,032	$57,832
Insurance collateral	18,519	29,619	'	'
Trade and other accounts receivable, net	879,337	801,146	'	'
Parts and supplies inventory	23,832	23,376	'	'
Prepaids and other current assets	42,400	23,430	'	'
Total current assets	1,126,691	1,082,283	'	'
Property, plant, and equipment, net	197,303	194,715	'	'
Intangible assets, net	551,706	513,698	'	'
Insurance collateral	'	12,716	'	'
Goodwill	2,544,477	2,435,670	'	'
Other long-term assets	39,200	60,935	'	'
Total assets	4,459,377	4,300,017	'	'
Current liabilities:	'	'	'	'
Accounts payable	48,905	52,588	'	'
Accrued liabilities	377,853	350,936	'	'
Current deferred tax liabilities	35,615	35,487	'	'
Current portion of long-term debt and capital lease obligations	12,306	12,318	'	'
Total current liabilities	474,679	451,329	'	'
Long-term debt and capital lease obligations	2,032,347	1,895,381	'	'
Long-term deferred tax liabilities	151,225	151,130	'	'
Insurance reserves	152,454	175,427	'	'
Other long-term liabilities	16,532	16,997	'	'
Total liabilities	2,827,237	2,690,264	'	'
Equity:	'	'	'	'
Common stock	1,812	1,804	'	'
Treasury stock	-1,347	-1,347	'	'
Additional paid-in capital	1,579,748	1,576,764	'	'
Retained earnings	41,174	18,341	'	'
Accumulated other comprehensive loss	-1,227	-839	'	-213
Total Envision Healthcare Holdings, Inc. equity	1,620,160	1,594,723	'	'
Noncontrolling interest	11,980	15,030	'	'
Total equity	1,632,140	1,609,753	'	'
Total liabilities and equity	4,459,377	4,300,017	'	'
Consolidating Adjustments	'	'	'	'
Current assets:	'	'	'	'
Prepaids and other current assets	-23,962	-27,355	'	'
Total current assets	-23,962	-27,355	'	'
Long-term deferred tax assets	-128	-128	'	'
Investment in wholly owned subsidiary	-1,594,568	-1,486,129	'	'
Total assets	-1,618,658	-1,513,612	'	'
Current liabilities:	'	'	'	'
Accrued liabilities	-3,650	-7,043	'	'
Current deferred tax liabilities	-20,312	-20,312	'	'
Total current liabilities	-23,962	-27,355	'	'
Long-term deferred tax liabilities	-128	-128	'	'
Total liabilities	-24,090	-27,483	'	'
Equity:	'	'	'	'
Treasury stock	1,347	1,347	'	'
Additional paid-in capital	-1,488,298	-1,404,208	'	'
Retained earnings	-108,844	-84,107	'	'
Accumulated other comprehensive loss	1,227	839	'	'
Total Envision Healthcare Holdings, Inc. equity	-1,594,568	-1,486,129	'	'
Total equity	-1,594,568	-1,486,129	'	'
Total liabilities and equity	-1,618,658	-1,513,612	'	'
EVHC (excluding Corporation)	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	5	81,722	280	281
EVHC (excluding Corporation) | Reportable legal entity	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	5	81,722	'	'
Prepaids and other current assets	26,575	26,860	'	'
Total current assets	26,580	108,582	'	'
Long-term deferred tax assets	128	128	'	'
Investment in wholly owned subsidiary	1,594,568	1,486,129	'	'
Total assets	1,621,276	1,594,839	'	'
Current liabilities:	'	'	'	'
Accounts payable	1,116	116	'	'
Total current liabilities	1,116	116	'	'
Total liabilities	1,116	116	'	'
Equity:	'	'	'	'
Common stock	1,812	1,804	'	'
Treasury stock	-1,347	-1,347	'	'
Additional paid-in capital	1,579,748	1,576,764	'	'
Retained earnings	41,174	18,341	'	'
Accumulated other comprehensive loss	-1,227	-839	'	'
Total Envision Healthcare Holdings, Inc. equity	1,620,160	1,594,723	'	'
Total equity	1,620,160	1,594,723	'	'
Total liabilities and equity	1,621,276	1,594,839	'	'
Corporation and Subsidiaries	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	162,598	122,990	36,752	57,551
Corporation and Subsidiaries | Reportable legal entity	'	'	'	'
Current assets:	'	'	'	'
Cash and cash equivalents	162,598	122,990	'	'
Insurance collateral	18,519	29,619	'	'
Trade and other accounts receivable, net	879,337	801,146	'	'
Parts and supplies inventory	23,832	23,376	'	'
Prepaids and other current assets	39,787	23,925	'	'
Total current assets	1,124,073	1,001,056	'	'
Property, plant, and equipment, net	197,303	194,715	'	'
Intangible assets, net	551,706	513,698	'	'
Insurance collateral	'	12,716	'	'
Goodwill	2,544,477	2,435,670	'	'
Other long-term assets	39,200	60,935	'	'
Total assets	4,456,759	4,218,790	'	'
Current liabilities:	'	'	'	'
Accounts payable	47,789	52,472	'	'
Accrued liabilities	381,503	357,979	'	'
Current deferred tax liabilities	55,927	55,799	'	'
Current portion of long-term debt and capital lease obligations	12,306	12,318	'	'
Total current liabilities	497,525	478,568	'	'
Long-term debt and capital lease obligations	2,032,347	1,895,381	'	'
Long-term deferred tax liabilities	151,353	151,258	'	'
Insurance reserves	152,454	175,427	'	'
Other long-term liabilities	16,532	16,997	'	'
Total liabilities	2,850,211	2,717,631	'	'
Equity:	'	'	'	'
Treasury stock	-1,347	-1,347	'	'
Additional paid-in capital	1,488,298	1,404,208	'	'
Retained earnings	108,844	84,107	'	'
Accumulated other comprehensive loss	-1,227	-839	'	'
Total Envision Healthcare Holdings, Inc. equity	1,594,568	1,486,129	'	'
Noncontrolling interest	11,980	15,030	'	'
Total equity	1,606,548	1,501,159	'	'
Total liabilities and equity	$4,456,759	$4,218,790	'	'

Consolidating_Financial_Inform3

Consolidating Financial Information (Details 2) (USD $)	3 Months Ended		6 Months Ended		12 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013	Dec. 31, 2013
Condensed Consolidating Statements of Operations	'	'	'	'	'
Net revenue	$1,075,327	$899,255	$2,089,538	$1,787,579	'
Compensation and benefits	767,007	643,960	1,510,668	1,285,749	'
Operating expenses	120,715	102,308	235,350	202,758	'
Insurance expense	31,583	25,840	62,564	51,673	'
Selling, general and administrative expenses	23,594	23,790	42,969	45,788	'
Depreciation and amortization expense	35,558	34,622	71,990	69,377	'
Restructuring charges	3,731	3,032	4,540	3,669	5,699
Income from operations	93,139	65,703	161,457	128,565	'
Interest income from restricted assets	246	266	332	632	'
Interest expense, net	-29,002	-50,002	-59,051	-101,754	'
Realized gains (losses) on investments	508	105	1,114	118	'
Other income (expense), net	-1,964	-249	-2,772	-12,970	'
Loss on early debt extinguishment	-66,397	'	-66,397	-122	'
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-3,470	15,823	34,683	14,469	'
Income tax benefit (expense)	1,412	-6,313	-15,263	-8,881	'
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	-2,058	9,510	19,420	5,588	'
Equity in earnings of unconsolidated subsidiary	66	87	113	162	'
Net income (loss)	-1,992	9,597	19,533	5,750	'
Less: Net (income) loss attributable to noncontrolling interest	'	'	3,300	'	'
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	-1,992	9,597	22,833	5,750	'
Consolidating Adjustments	'	'	'	'	'
Condensed Consolidating Statements of Operations	'	'	'	'	'
Equity in earnings of unconsolidated subsidiary	850	-16,563	-21,437	-19,679	'
Net income (loss)	850	-16,563	-21,437	-19,679	'
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	850	-16,563	-21,437	-19,679	'
EVHC (excluding Corporation) | Reportable legal entity	'	'	'	'	'
Condensed Consolidating Statements of Operations	'	'	'	'	'
Operating expenses	'	20	'	87	'
Selling, general and administrative expenses	'	1	'	1	'
Income from operations	'	-21	'	-88	'
Interest expense, net	'	-11,464	'	-22,926	'
Other income (expense), net	-1,657	'	-2,799	'	'
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-1,657	-11,485	-2,799	-23,014	'
Income tax benefit (expense)	515	4,519	895	9,085	'
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	-1,142	-6,966	-1,904	-13,929	'
Equity in earnings of unconsolidated subsidiary	-850	16,563	21,437	19,679	'
Net income (loss)	-1,992	9,597	19,533	5,750	'
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	-1,992	9,597	19,533	5,750	'
Corporation and Subsidiaries | Reportable legal entity	'	'	'	'	'
Condensed Consolidating Statements of Operations	'	'	'	'	'
Net revenue	1,075,327	899,255	2,089,538	1,787,579	'
Compensation and benefits	767,007	643,960	1,510,668	1,285,749	'
Operating expenses	120,715	102,288	235,350	202,671	'
Insurance expense	31,583	25,840	62,564	51,673	'
Selling, general and administrative expenses	23,594	23,789	42,969	45,787	'
Depreciation and amortization expense	35,558	34,622	71,990	69,377	'
Restructuring charges	3,731	3,032	4,540	3,669	'
Income from operations	93,139	65,724	161,457	128,653	'
Interest income from restricted assets	246	266	332	632	'
Interest expense, net	-29,002	-38,538	-59,051	-78,828	'
Realized gains (losses) on investments	508	105	1,114	118	'
Other income (expense), net	-307	-249	27	-12,970	'
Loss on early debt extinguishment	-66,397	'	-66,397	-122	'
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	-1,813	27,308	37,482	37,483	'
Income tax benefit (expense)	897	-10,832	-16,158	-17,966	'
Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary	-916	16,476	21,324	19,517	'
Equity in earnings of unconsolidated subsidiary	66	87	113	162	'
Net income (loss)	-850	16,563	21,437	19,679	'
Less: Net (income) loss attributable to noncontrolling interest	'	'	3,300	'	'
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	($850)	$16,563	$24,737	$19,679	'

Consolidating_Financial_Inform4

Consolidating Financial Information (Details 3) (USD $)	3 Months Ended		6 Months Ended
In Thousands, unless otherwise specified	Jun. 30, 2014	Jun. 30, 2013	Jun. 30, 2014	Jun. 30, 2013
Cash Flows from Operating Activities	'	'	'	'
Net cash provided by (used in) operating activities	$63,720	($12,739)	$93,940	($6,097)
Cash Flows from Investing Activities	'	'	'	'
Purchases of available-for-sale securities	'	'	-3,372	-2,548
Sales and maturities of available-for-sale securities	'	'	10,527	4,170
Purchase of property, plant and equipment	'	'	-33,480	-26,198
Proceeds from sale of property, plant and equipment	'	'	2,216	328
Acquisition of businesses, net of cash received	'	'	-199,298	-1,423
Net change in insurance collateral	'	'	1,213	-2,024
Other investing activities	'	'	-2,363	-52
Net cash provided by (used in) investing activities	'	'	-224,557	-27,747
Cash Flows from Financing Activities	'	'	'	'
Issuance of common stock	'	'	'	1,117
Borrowings under the Term Loan	'	'	'	209,000
Borrowings under the ABL Facility	'	'	50,000	252,440
Proceeds from issuance of senior notes	'	'	740,625	'
Repayments of the Term Loan	'	'	-3,343	-65,685
Repayments of the ABL Facility	'	'	-50,000	-349,940
Repayments of senior notes	'	'	-607,750	'
Payment for debt extinguishment premiums	'	'	-37,630	'
Dividend paid	'	'	'	-67
Debt issuance costs	'	-5,000	-1,374	-5,011
Equity issuance costs	'	'	'	-1,400
Excess tax benefits from equity-based compensation	'	'	15,658	3,168
Shares repurchased for tax withholdings	'	'	-14,430	'
Proceeds from noncontrolling interest	'	'	250	'
Payment of dissenting shareholder settlement	'	'	'	-38,336
Net change in bank overdrafts	'	'	'	8,117
Other financing activities	'	'	-3,498	-359
Net cash provided by (used in) financing activities	'	'	88,508	13,044
Change in cash and cash equivalents	'	'	-42,109	-20,800
Cash and cash equivalents, beginning of period	'	'	204,712	57,832
Cash and cash equivalents, end of period	162,603	37,032	162,603	37,032
EVHC (excluding Corporation)	'	'	'	'
Cash Flows from Operating Activities	'	'	'	'
Net cash provided by (used in) operating activities	'	'	-391	-19,343
Cash Flows from Financing Activities	'	'	'	'
Dividend paid	'	'	'	-67
Debt issuance costs	'	'	'	-4
Equity issuance costs	'	'	'	-1,400
Other financing activities	'	'	391	'
Net intercompany borrowings (payments)	'	'	-81,717	20,813
Net cash provided by (used in) financing activities	'	'	-81,326	19,342
Change in cash and cash equivalents	'	'	-81,717	-1
Cash and cash equivalents, beginning of period	'	'	81,722	281
Cash and cash equivalents, end of period	5	280	5	280
Corporation and Subsidiaries	'	'	'	'
Cash Flows from Operating Activities	'	'	'	'
Net cash provided by (used in) operating activities	'	'	94,331	13,246
Cash Flows from Investing Activities	'	'	'	'
Purchases of available-for-sale securities	'	'	-3,372	-2,548
Sales and maturities of available-for-sale securities	'	'	10,527	4,170
Purchase of property, plant and equipment	'	'	-33,480	-26,198
Proceeds from sale of property, plant and equipment	'	'	2,216	328
Acquisition of businesses, net of cash received	'	'	-199,298	-1,423
Net change in insurance collateral	'	'	1,213	-2,024
Other investing activities	'	'	-2,363	-52
Net cash provided by (used in) investing activities	'	'	-224,557	-27,747
Cash Flows from Financing Activities	'	'	'	'
Issuance of common stock	'	'	'	1,117
Borrowings under the Term Loan	'	'	'	209,000
Borrowings under the ABL Facility	'	'	50,000	252,440
Proceeds from issuance of senior notes	'	'	740,625	'
Repayments of the Term Loan	'	'	-3,343	-65,685
Repayments of the ABL Facility	'	'	-50,000	-349,940
Repayments of senior notes	'	'	-607,750	'
Payment for debt extinguishment premiums	'	'	-37,630	'
Debt issuance costs	'	'	-1,374	-5,007
Excess tax benefits from equity-based compensation	'	'	15,658	3,168
Shares repurchased for tax withholdings	'	'	-14,430	'
Proceeds from noncontrolling interest	'	'	250	'
Payment of dissenting shareholder settlement	'	'	'	-38,336
Net change in bank overdrafts	'	'	'	8,117
Other financing activities	'	'	-3,889	-359
Net intercompany borrowings (payments)	'	'	81,717	-20,813
Net cash provided by (used in) financing activities	'	'	169,834	-6,298
Change in cash and cash equivalents	'	'	39,608	-20,799
Cash and cash equivalents, beginning of period	'	'	122,990	57,551
Cash and cash equivalents, end of period	$162,598	$36,752	$162,598	$36,752

Subsequent_Events_Details

Subsequent Events (Details) (USD $)	0 Months Ended
	Feb. 05, 2014	Feb. 05, 2014	Aug. 13, 2013	Jul. 10, 2014	Jul. 10, 2014
		Underwriters overallotment option	Underwriters overallotment option	Subsequent events	Subsequent events
					Underwriters overallotment option
Subsequent events	'	'	'	'	'
Shares of common stock issued	31,625,000	4,125,000	6,300,000	27,500,000	4,125,000
Issue price (in dollars per share)	$30.50	'	$23	$34	'