Envision Healthcare 10-Q 6 May 16 2016 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2016	Apr. 29, 2016
Document and Entity Information
Entity Registrant Name	Envision Healthcare Holdings, Inc.
Entity Central Index Key	1,578,318
Document Type	10-Q
Document Period End Date	Mar. 31, 2016
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		187,126,554
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q1

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 191,657	$ 141,677
Insurance collateral	57,682	68,849
Trade and other accounts receivable, net	1,296,320	1,257,021
Parts and supplies inventory	33,675	34,023
Prepaids and other current assets	123,178	96,857
Total current assets	1,702,512	1,598,427
Non-current assets:
Property, plant and equipment, net	351,469	335,869
Intangible assets, net	1,020,105	1,051,631
Goodwill	3,299,231	3,271,933
Other long-term assets	95,421	95,712
Total assets	6,468,738	6,353,572
Current liabilities:
Accounts payable	63,442	68,985
Accrued liabilities	696,098	612,445
Current portion of long-term debt and capital lease obligations	24,453	24,550
Total current liabilities	783,993	705,980
Long-term debt and capital lease obligations	2,954,829	2,958,481
Long-term deferred tax liabilities	391,248	369,110
Insurance reserves	249,169	252,650
Other long-term liabilities	54,953	65,910
Total liabilities	$ 4,434,192	$ 4,352,131
Commitments and contingencies
Equity:
Common stock ($0.01 par value; 2,000,000,000 shares authorized, 187,121,179 and 186,924,004 issued and outstanding as of March 31, 2016 and December 31, 2015, respectively)	$ 1,871	$ 1,869
Preferred stock ($0.01 par value; 200,000,000 shares authorized, none issued and outstanding as of March 31, 2016 and December 31, 2015)
Additional paid-in capital	$ 1,681,680	$ 1,677,578
Retained earnings	315,591	288,741
Accumulated other comprehensive income (loss)	(3,114)	(1,649)
Total Envision Healthcare Holdings, Inc. equity	1,996,028	1,966,539
Noncontrolling interest	38,518	34,902
Total equity	2,034,546	2,001,441
Total liabilities and equity	$ 6,468,738	$ 6,353,572

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2016	Dec. 31, 2015
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	187,121,179	186,924,004
Common stock, shares outstanding	187,121,179	186,924,004
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 OPER

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS)
Revenue, net of contractual discounts	$ 2,863,914	$ 2,252,718
Provision for uncompensated care	(1,266,368)	(1,008,216)
Net revenue	1,597,546	1,244,502
Compensation and benefits	1,123,873	907,657
Operating expenses	253,215	151,726
Insurance expense	37,420	35,526
Selling, general and administrative expenses	37,990	26,449
Depreciation and amortization expense	57,433	39,881
Restructuring charges	106
Income from operations	87,509	83,263
Interest income from restricted assets	363	130
Interest expense, net	(38,883)	(26,687)
Realized gains (losses) on investments	15
Other income (expense), net	722	(332)
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	49,726	56,374
Income tax benefit (expense)	(19,392)	(22,516)
Income (loss) before equity in earnings of unconsolidated subsidiary	30,334	33,858
Equity in earnings of unconsolidated subsidiary	132	72
Net income (loss)	30,466	33,930
Less: Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$ 26,850	$ 33,375
Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:
Basic (in dollars per share)	$ 0.14	$ 0.18
Diluted (in dollars per share)	$ 0.14	$ 0.17
Weighted-average common shares outstanding:
Basic (in shares)	187,047,309	184,586,249
Diluted (in shares)	191,930,811	191,241,676
Comprehensive income (loss):
Net income (loss)	$ 30,466	$ 33,930
Other comprehensive income (loss), net of tax:
Unrealized holding gains (losses) during the period	(32)	(120)
Unrealized gains (losses) on derivative financial instruments	(1,433)	257
Total other comprehensive income (loss), net of tax	(1,465)	137
Comprehensive income (loss)	29,001	34,067
Less: Comprehensive (income) loss attributable to noncontrolling interest	(3,616)	(555)
Comprehensive income (loss) attributable to Envision Healthcare Holdings, Inc.	$ 25,385	$ 33,512

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Cash Flows from Operating Activities
Net income (loss)	$ 30,466	$ 33,930
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization expense	60,577	42,004
(Gain) loss on disposal of property, plant and equipment	72	27
Equity-based compensation expense	2,285	1,353
Excess tax benefits from equity-based compensation	(1,130)	(10,945)
Equity in earnings of unconsolidated subsidiary	(132)	(72)
Dividends received	386	370
Deferred income taxes	8,575	520
Changes in operating assets/liabilities, net of acquisitions:
Trade and other accounts receivable, net	(37,953)	(56,224)
Parts and supplies inventory	348	(122)
Prepaids and other current assets	(23,603)	6,837
Accounts payable and accrued liabilities	50,958	21,688
Insurance reserves	(1,698)	4,745
Other assets and liabilities, net	467	1,204
Net cash provided by (used in) operating activities	89,618	45,315
Cash Flows from Investing Activities
Purchases of available-for-sale securities	(8)	(472)
Sales and maturities of available-for-sale securities	1,448	200
Purchases of property, plant and equipment	(39,121)	(13,507)
Proceeds from sale of property, plant and equipment	28	44
Acquisition of businesses, net of cash received	(6,686)	(498,283)
Net change in insurance collateral	10,075	(4,508)
Other investing activities	(301)	(912)
Net cash provided by (used in) investing activities	(34,565)	(517,438)
Cash Flows from Financing Activities
Borrowings under the ABL Facility	70,000	285,000
Repayments of the ABL Facility	(70,000)	(50,000)
Repayments of the Term Loan	(5,843)	(3,343)
Debt issuance costs	(703)	(27)
Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan	689	3,548
Excess tax benefits from equity-based compensation	1,130	10,945
Contributions from (distributions to) noncontrolling interest, net		100
Other financing activities	(346)	(120)
Net cash provided by (used in) financing activities	(5,073)	246,103
Change in cash and cash equivalents	49,980	(226,020)
Cash and cash equivalents, beginning of period	141,677	318,895
Cash and cash equivalents, end of period	$ 191,657	$ 92,875

General

General	3 Months Ended
	Mar. 31, 2016
General
General	1. General Basis of Presentation of Financial Statements Envision Healthcare Holdings, Inc. is organized as a holding company that operates through various subsidiaries. Envision Healthcare 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, 2016. 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, 2015, which includes all disclosures required by GAAP, included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2015. 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., including its affiliates (“AMR”), its healthcare transportation services segment.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2016
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, insurance related reserves and acquired intangible assets. Actual results may differ from those estimates under different assumptions or conditions. Insurance Collateral Insurance collateral is comprised of investments in marketable equity and debt securities held by the Company’s captive insurance subsidiary that supports the Company’s insurance program and reserves, as well as cash deposits with third parties. Certain of these investments, if sold or otherwise liquidated, would have to be replaced by other suitable financial assurances and are, therefore, considered restricted. These investments are designated as available-for-sale and reported at fair value with the related temporary unrealized gains and losses reported as a separate component of accumulated other comprehensive income (loss), net of deferred income tax. Declines in the fair value of a marketable investment security which are determined to be other-than-temporary are recognized in the statements of operations, thus establishing a new cost basis for such investment. Investment income earned on these investments is reported as interest income from restricted assets in the statements of operations. Realized gains and losses are determined based on an average cost basis. Insurance collateral also includes a receivable from insurers of $1.1 million and $0.6 million as of March 31, 2016 and December 31, 2015, 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, 2015, was equal to approximately 94% and 86% of outstanding self-pay receivables for EmCare and AMR, respectively, consistent with the Company’s collection history. Account balances are charged off against the uncompensated care allowance when it is probable the receivable will not be recovered and to the contractual allowance when payment is received. The Company’s accounts receivable and allowances as of March 31, 2016, and December 31, 2015, were as follows (in thousands): March 31, December 31, 2016 2015 Gross trade accounts receivable $ $ Allowance for contractual discounts Allowance for uncompensated care Trade accounts receivable, net Other receivables, net Trade and other accounts receivable, net $ $ Other receivables primarily represent employee advances and other miscellaneous receivables. 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. The Company compares actual cash collected on a date of service basis to the revenue recorded for that period and records any adjustment necessary for an overage or deficit in these allowances based on actual collections and future estimated collections. 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 based on historical write-off experience and future estimated collections. Debt Issuance Costs Debt issuance costs related to the Company’s senior secured credit facilities and senior unsecured notes are included as a deduction from the carrying amount of long-term debt in the consolidated balance sheets, and are amortized to interest expense using the effective interest method over the term of the related debt. 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 income or expense. Insurance Reserves Insurance reserves are established for automobile, workers compensation, general liability and professional liability claims utilizing policies with both fully-insured and self-insured components. This includes the use of an off-shore captive insurance program through a wholly-owned subsidiary for certain liability programs for both EmCare and AMR. In those instances where the Company has obtained third-party insurance coverage, the Company normally retains liability for the first $1 to $3 million of the loss. Insurance reserves cover known claims and incidents within the level of Company retention that may result in the assertion of additional claims, as well as claims from unknown incidents that may be asserted arising from activities through the balance sheet date. The Company establishes reserves for claims based upon an assessment of actual claims and claims incurred but not reported. The reserves are established based on quarterly consultation with third-party independent actuaries using actuarial principles and assumptions that consider a number of factors, including historical claim payment patterns and legal costs, changes in case reserves and the assumed rate of inflation in healthcare costs and property damage repairs. Claims are discounted at a rate of 1.5 % which is commensurate with the risk free rate. The Company’s most recent actuarial valuation was completed in March 2016. As a result of this and previous actuarial valuations, the Company recorded increases in its provision for insurance liabilities of $0.9 million and $2.6 million for the three months ended March 31, 2016 and 2015, respectively, related to reserves for losses in prior years. 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, accrued liabilities and the senior secured credit facility approximates fair value as of March 31, 2016, and December 31, 2015. Concentration of credit risks in accounts receivable is limited, due to the large number of customers comprising the Company’s customer base throughout the United States. A significant component of the Company’s revenue is derived from Medicare and Medicaid. Given that these are government programs, the credit risk for these customers is considered low. The Company performs ongoing credit evaluations of its other customers, but does not require collateral to support customer accounts receivable. The Company establishes an allowance for uncompensated care based on the credit risk applicable to particular customers, historical trends and other relevant information. For the three months ended March 31, 2016, and 2015, the Company derived approximately 34% of its revenue from Medicare and Medicaid, 63% and 64% , respectively, from insurance providers and contracted payors, and 3% and 2% , 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 March 31, 2016, and December 31, 2015, was approximately $757.5 million and $735.0 million, respectively, with a carrying amount 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 derivatives and corporate bonds. Level 3—Pricing inputs are unobservable as of the reporting date and reflect the Company’s own assumptions about the fair value of the asset or liability. Balances in this category include the Company’s estimate, using a combination of internal and external fair value analyses, of contingent consideration for acquisitions described in Note 4. The following table summarizes the valuation of the Company’s financial instruments by the above fair value hierarchy levels as of March 31, 2016, and December 31, 2015 (in thousands): March 31, 2016 Description Level 1 Level 2 Level 3 Total Assets: Available-for-sale securities (insurance collateral) $ $ $ — $ Liabilities: Contingent consideration — — Fuel hedge — — December 31, 2015 Description Level 1 Level 2 Level 3 Total Assets: Available-for-sale securities (insurance collateral) $ $ $ — $ Liabilities: Contingent consideration — — Fuel hedge — — There has been no change in the contingent consideration balance classified as a Level 3 liability during the three months ended March 31, 2016. During the three months ended March 31, 2016, and 2015, the Company had no transfers between Level 1 and Level 2 fair value measurements. Revenue Recognition Fee-for-service revenue is recognized at the time of service and is recorded net of provisions for contractual discounts and estimated uncompensated care. Fee-for-service revenue represents billings for services provided to patients, for which the Company receives payment from the patient or their third-party payor. Provisions for contractual discounts are related to differences between gross charges and specific payor, including governmental, reimbursement schedules. The Company records fee-for-service revenue, net of the contractual discounts based on the information entered into the Company’s billing systems from received medical charts. An estimate for unprocessed medical charts for a given service period is made and adjusted in future periods based on actual medical charts processed. Information entered into the billing systems is subject to change, e.g. change in payor status, and may impact recorded fee-for-service revenue, net of the contractual discounts. Such changes are recognized in the period the change is known. Revenue from home health services, net of revenue adjustments and provisions for contractual discounts, is earned and billed either on an episode of care basis (“episodic-based revenue”), on a per visit basis, or on a daily basis depending upon the payment terms and conditions established with each payor for services provided. Revenue recognized on a non-episodic basis is recorded in a similar manner to the Company’s fee-for-service revenue. Home health service revenue under the Medicare prospective payment system is based on a 60 -day episode payment rate that is subject to adjustment based on certain variables. Adjustments are estimated based on historical experience and are recorded in the period in which services are rendered. Revenue from contract staffing assignments, net of sales adjustments and discounts, are recognized when earned, based on the hours worked by the Company’s contract professionals. Conversion and direct hire fees are recognized when the employment candidate accepts permanent employment and all obligations are satisfied. The Company includes reimbursed expenses in revenue, net of contractual discounts and the associated amount of reimbursement expense in compensation and benefits. Revenue generated under fire protection service contracts is recognized over the life of the contract. Subscription fees, which are generally received in advance, are deferred and recognized on a straight-line basis over the term of the subscription agreement, which is generally one year. Subsidy and fee revenue primarily represent hospital subsidies and fees at EmCare and fees for stand-by, special event and community subsidies at AMR. Provisions for estimated uncompensated care, or bad debts, are related principally to the number of self-pay patients treated in the period. Net revenue for the three months ended March 31, 2016, and 2015 consisted of the following (in thousands): Three Months Ended March 31, 2016 2015 Revenue, net of contractual discounts, excluding subsidies and fees: Medicare $ $ Medicaid Commercial insurance and managed care (excluding Medicare and Medicaid managed care) Self-pay Sub-total Subsidies and fees Revenue, net of contractual discounts Provision for uncompensated care Net revenue $ $ Healthcare reimbursement is complex and may involve lengthy delays. Third-party payors are continuing 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 (and correspondingly decreased net revenue) by approximately $2.9 million and $3.6 million for the three months ended March 31, 2016, and 2015, respectively. 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. Reclassifications Certain prior period balances in the consolidated balance sheets have been reclassified to conform to the current year presentation. Such reclassifications had no impact on the results of operations or cash flows previously reported. Recent Accounting Pronouncements In May 2014, the Financial Accounting Standards Board (the (“FASB”) issued Accounting Standards Update (“ASU”) 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. The guidance will be effective for public companies for annual reporting periods beginning after December 15, 2017, including interim periods within that reporting period, with early adoption for annual reporting periods beginning after December 15, 2016, permitted. The Company is currently evaluating the impact and 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 or the method of adoption. In August 2014, the FASB issued Accounting Standards Update No. 2014-15, Presentation of Financial Statements—Going Concern (Subtopic 205-40), Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern (“ASU 2014-15”), which requires management to evaluate, in connection with preparing financial statements for each annual and interim reporting period, whether there are conditions or events, considered in the aggregate, that raise substantial doubt about an entity’s ability to continue as a going concern within one year after the date that the financial statements are issued (or within one year after the date that the financial statements are available to be issued when applicable) and provide related disclosures. ASU 2014-15 is effective for the annual period ending after December 15, 2016, and for annual and interim periods thereafter. The adoption of ASU 2014-15 is not expected to impact the Company's consolidated financial statements. In February 2015, the FASB issued ASU No. 2015-02, Amendments to the Consolidation Analysis (“ASU 2015-02”), which amends existing accounting standards for consolidation under the variable interest entity and voting interest entity models. The new guidance changes the analysis for determining whether a fee paid to a decision maker or service provider is a variable interest. ASU 2015-02 is effective for interim and annual periods beginning after December 15, 2015. Entities may choose to adopt the standard using either a full retrospective approach or a modified retrospective approach. The Company adopted ASU 2015-02 under the modified retrospective approach during the current period and determined that its adoption does not impact our consolidated financial position or results of operations. In April 2015, the FASB issued ASU No. 2015-03, Interest — Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs (“ASU 2015-03”), which requires debt issuance costs to be presented in the balance sheet as a direct deduction from the associated debt liability. ASU 2015-03 is effective for annual reporting periods beginning after December 15, 2015, including interim periods within that reporting period. The Company adopted ASU 2015-03 retrospectively during the current period and, as a result, $34.6 million of debt issuance costs related to the Company’s senior secured credit facilities and senior unsecured notes were reclassified from other long-term assets to long-term debt and capital lease obligations on the Company’s consolidated balance sheets as of December 31, 2015. In November 2015, the FASB issued ASU No. 2015-17, Balance Sheet Classification of Deferred Taxes (“ASU 2015-17”), which simplifies the presentation of deferred income taxes and requires that deferred tax liabilities and assets be classified as non-current in the consolidated balance sheets. ASU 2015-17 is effective for annual reporting periods beginning after December 15, 2016, with early adoption permitted. The Company adopted ASU 2015-17 retrospectively during the current period and, as a result, $85.8 million of current deferred tax liabilities were reclassified to long-term deferred tax liabilities on the Company’s consolidated balance sheets as of December 31, 2015. In February 2016, the FASB issued ASU No. 2016-02, Leases (“ASU 2016-02”), which amends the existing accounting standards for lease accounting, including requiring lessees to recognize most leases on the consolidated balance sheets and making targeted changes to lessor accounting. ASU 2016-02 will be effective for annual periods beginning after December 15, 2018, with early adoption permitted. The new leases standard requires a modified retrospective transition approach for all leases existing at, or entered into after, the date of initial application, with an option to use certain transition relief. The Company is currently evaluating the impact and has not yet determined the effects, if any, that adoption of ASU 2016-02 may have on its consolidated financial position or results of operations. In March 2016, the FASB issued ASU No. 2016-09, Compensation—Stock Compensation (Topic 718) (“ASU 2016-09”), which was issued as part of the FASB's simplification initiative and affects all entities that issue share-based payment awards to their employees. This ASU covers accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. ASU 2016-09 will be effective for annual periods beginning after December 15, 2016, with early adoption permitted. The Company is currently evaluating the impact and has not yet determined the effects, if any, that adoption of ASU 2016-09 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	3 Months Ended
	Mar. 31, 2016
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 Basic net income per common share attributable to the Company’s common stockholders is determined using the two-class method and is computed by dividing net income attributable to the Company’s common stockholders by the weighted-average of common shares outstanding during the period. The two-class method is an earnings allocation formula that determines income per share for each class of common stock and participating security according to participation rights in undistributed earnings. Diluted net income per common share attributable to the Company’s common shareholders reflects the more dilutive earnings per share amount calculated using the treasury stock method or the two-class method. The following table presents earnings per share 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 March 31, 2016 2015 Net income (loss) attributable to Envision Healthcare Holdings, Inc. stockholders $ $ Net income (loss) allocated to participating securities (a) — Net income (loss) attributable to Envision Healthcare Holdings, Inc. common stockholders Weighted-average common shares outstanding — common stock: Basic Dilutive impact of stock awards outstanding Diluted Net income (loss) per share attributable to Envision Healthcare Holdings, Inc. common stockholders: Basic $ $ Diluted $ $ (a) Restricted stock units and market-based performance share units granted to employees and non-employee directors are considered participating securities. For the three months ended March 31, 201 6, and 2015 , there were stock awards to acquire 1,153,129 shares and 36,957 shares of common stock outstanding, respectively, not included in the weighted-average common shares outstanding above, as their effect is anti-dilutive.

Acquisitions

Acquisitions	3 Months Ended
	Mar. 31, 2016
Acquisitions
Acquisitions	4. Acquisitions 2015 Acquisitions Scottsdale Emergency Associates, LTD (“SEA”). On January 30, 2015, the Company acquired the stock of SEA for total purchase consideration of $104.8 million paid in cash. SEA is an emergency physician group serving the greater Phoenix market, with 40 physicians and more than a dozen mid-level providers. The Company acquired SEA to achieve certain operational and strategic benefits. The goodwill recognized in connection with the SEA acquisition is assigned to the EmCare segment and is primarily attributable to synergies that are expected to be achieved through the integration of SEA into the existing operations of EmCare. Of the goodwill recorded, none is tax deductible. Prior to the acquisition, SEA had a pension plan and is currently in the process of terminating and liquidating the plan. As the assets and liabilities of the pension plan of $10.1 million are offsetting , they are presented net in the consolidated balance sheets. The final allocation of the purchase price is in the table below (in thousands): Cash and cash equivalents $ Accounts receivable Prepaid and other current assets Acquired intangible assets Goodwill Accounts payable Accrued liabilities Long-term deferred tax liabilities Total purchase price $ During the three months ended March 31, 2016, the Company made purchase price allocation adjustments including a decrease of deferred tax liabilities of $0.4 million. VISTA Staffing Solutions (“VISTA”). On February 1, 2015, the Company acquired the stock of VISTA, a leading provider of locum tenens staffing and permanent placement services for physicians, nurse practitioners and physician assistants for total purchase consideration of $123.8 million, subject to a working capital adjustment of $0.5 million, paid in cash. VISTA operates throughout the United States. The Company acquired VISTA to expand into locum tenens staffing. The goodwill recognized in connection with the VISTA acquisition is assigned to the EmCare segment and is primarily attributable to synergies that are expected to be achieved through the integration of VISTA into the existing operations of EmCare. Of the goodwill recorded, $15.4 million is tax deductible. The final allocation of the purchase price is in the table below (in thousands): Cash and cash equivalents $ Accounts receivable Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Accrued liabilities Long-term deferred tax liabilities Insurance reserves Other long-term liabilities Total purchase price $ During the three months ended March 31, 2016, the Company made purchase price allocation adjustments including a reclassification from goodwill to accounts receivable of $0.3 million and a decrease to long-term deferred tax liabilities of $0.4 million. Emergency Medical Associates. On February 27, 2015, the Company acquired the stock of Emergency Medical Associates of New Jersey, P.A. and assets of Alpha Physician Resources, LLC (collectively “EMA”) for total purchase consideration of $282.3 million, subject to working capital adjustments, paid in cash. During the three months ended March 31, 2016, the Company executed a purchase agreement amendment that increased the total consideration by $10.5 million (the “EMA Amendment”). The Company acquired EMA to achieve certain operational and strategic benefits. EMA provides emergency department, hospitalist and urgent care services at 47 facilities in New Jersey, New York, Rhode Island, and North Carolina. The goodwill recognized in connection with the EMA acquisition is assigned to the EmCare segment and is primarily attributable to synergies that are expected to be achieved through the integration of EMA into the existing operations of EmCare. Of the goodwill recorded, $117.8 million is tax deductible. The final allocation of the purchase price is in the table below (in thousands): Cash and cash equivalents $ Accounts receivable Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Accrued liabilities Long-term deferred tax liabilities Insurance reserves Total purchase price $ During the three months ended March 31, 2016, goodwill recognized in connection with the EMA acquisition increased by $10.5 million due to the EMA Amendment. Additionally, the Company made purchase price allocation adjustments including an increase to other current assets of $1.1 million, an increase to accrued liabilities of $0.9 million to record an adjustment to accrued benefits, and other adjustments to opening balances for assets and liabilities. Rural/ Metro Corporation. On October 28, 2015, the Company completed the acquisition of Rural/ Metro Corporation (“Rural/ Metro”) for total purchase consideration of approximately $620.0 million, subject to working capital adjustments of $54.1 million paid in cash, of which $6.1 million was paid during the three months ended March 31, 2016. Rural/ Metro provides ambulance and fire protection services in 19 states and approximately 700 communities throughout the United States. The Company acquired Rural/ Metro to achieve certain operational and strategic benefits. The goodwill recognized in connection with the Rural/ Metro acquisition is assigned to the AMR segment and is primarily attributable to synergies that are expected to be achieved through the integration of Rural/ Metro into the existing operations of AMR. Of the goodwill recorded, $4.2 million is tax deductible. The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations and working capital adjustments (in thousands): Cash and cash equivalents $ Insurance collateral Accounts receivable Parts and supplies inventory Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Other current liabilities Accrued liabilities Capital lease obligations Insurance reserves Long-term deferred tax liabilities Other long-term liabilities Total purchase price $ During the three months ended March 31, 2016, the Company made purchase price allocation adjustments including an increase to goodwill of $6.1 million related to the working capital adjustment paid during the three months ended March 31, 2016, offset by an increase in other current assets of $1.7 million, a decrease in accrued liabilities of $1.0 million, an increase in other long-term liabilities of $1.0 million, and other adjustments to opening balances for assets and liabilities. Questcare Medical Services, P.A and QRx Medical Management, LLC. On December 3, 2015, the Company completed the acquisition of Questcare Medical Services, P.A. and QRx Medical Management, LLC (collectively “Questcare”) for total purchase consideration of $136.3 million in cash, subject to working capital adjustments. Questcare has more than 800 clinical providers staffing more than 50 facilities in Texas, Oklahoma and Colorado. Questcare clinicians manage patient care across multiple hospital-based clinical specialties including emergency department, hospitalist, critical care unit and pediatric and obstetric hospitalist care services. In addition, Questcare provides post-acute facility-based care as well as primary care, urgent care and tele-medicine services. The Company acquired Questcare to achieve certain operational and strategic benefits. The goodwill recognized in connection with the Questcare acquisition is assigned to the EmCare segment and is primarily attributable to synergies that are expected to be achieved through the integration of Questcare into the existing operations of EmCare. Of the goodwill recorded, $22.6 million is tax deductible. The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations and working capital adjustments (in thousands): Cash and cash equivalents $ Insurance collateral Accounts receivable Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Accrued liabilities Insurance reserves Long-term deferred tax liabilities Other long-term liabilities Total purchase price $ During the three months ended March 31, 2016, the Company made a purchase price allocation adjustment to increase long-term deferred tax liabilities by $3.7 million. The Company has accounted for these acquisitions using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. The Company’s statements of operations for the three months ended March 31, 2016, include net revenue of $313.8 million for SEA, VISTA, EMA, Rural/ Metro and Questcare. Other 2015 Acquisitions. On February 23, 2015, the Company acquired the stock of CareFirst, Inc., a provider of home health services in Birmingham, Alabama and surrounding areas for total purchase consideration of $7.3 million, subject to a working capital adjustment of $0.7 million, paid in cash. On July 10, 2015, the Company completed the acquisition of Vital Enterprises, Inc., Emergency Medical Transportation, Inc., and Marlboro Hudson Ambulance & Wheelchair Service, Inc. (together the “Vital/ Marlboro Entities”), providers of ambulance service operations located in the northeastern United States for total purchase consideration of $42.5 million, subject to working capital adjustments, paid in cash. The goodwill recognized in connection with the Vital/ Marlboro Entities is assigned to the AMR segment and is primarily attributable to synergies that are expected to be achieved through the integration of Vital/ Marlboro Entities into the existing operations of AMR. Of the goodwill recorded, $9.3 million is tax deductible. On September 30, 2015, the Company completed the acquisition of Northwest Tucson Emergency Physicians (“NTEP”), an emergency physician group serving the greater Tucson market, with 27 physicians and five mid-level providers for total purchase consideration of $25.0 million, subject to working capital adjustments, paid in cash. Prior to the acquisition, NTEP had a pension plan and is currently in the process of terminating and liquidating the plan. As the assets and liabilities of the pension plan of $2.8 million are offsetting , they are presented net in the consolidated balance sheets. The goodwill recognized in connection with the NTEP acquisition is assigned to the EmCare segment and is primarily attributable to synergies that are expected to be achieved through the integration of NTEP into the existing operations of EmCare. Of the goodwill recorded, none is tax deductible. On December 24, 2015, the Company completed the acquisition of MetroCare Services-Abilene GP, LLC (“MetroCare”), a provider of ambulance service operations located in Texas for total purchase consideration of $5.0 million, subject to working capital adjustments. The goodwill recognized in connection with the MetroCare acquisition is assigned to the AMR segment and is primarily attributable to synergies that are expected to be achieved through the integration of MetroCare into the existing operations of AMR. Of the goodwill recorded, $1.1 million is tax deductible. The Company has accounted for these acquisitions using the acquisition method of accounting, whereby the total purchase price was allocated to the acquired identifiable net assets based on assessments of their respective fair values, and the excess of the purchase price over the fair values of these identifiable net assets was allocated to goodwill. The total purchase price for these acquisitions was allocated to goodwill of $24.3 million, other acquired intangible assets of $53.1 million, net assets of $6.7 million and long-term deferred tax liabilities of $11.5 million. These allocations are subject to adjustment based upon the completion of purchase price allocations, except for the allocation of the CareFirst, Inc. acquisition, which was complete as of March 31, 2016. Pro Forma Information The following unaudited pro forma operating results give effect to the SEA, VISTA, EMA and Rural/ Metro acquisitions, as if they had been completed as of January 1, 2015. 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 (in thousands) March 31, 2015 Net revenue $ Net income (loss)

Insurance Collateral

Insurance Collateral	3 Months Ended
	Mar. 31, 2016
Insurance Collateral
Insurance Collateral	5. Insurance Collateral Insurance collateral consisted of the following as of March 31, 2016 and December 31, 2015 (in thousands): March 31, December 31, 2016 2015 Available-for-sale securities: Corporate bonds/ Fixed income $ $ Corporate equity Total available-for-sale securities Insurance receivable Cash deposits and other Total insurance collateral $ $ As of March 31, 2016 and December 31, 2015, approximately $8.7 million and $9.1 million, respectively, of insurance collateral is included in other long-term assets on the consolidated balance sheets. Amortized cost basis and aggregate fair value of the Company’s available-for-sale securities as of March 31, 2016 and December 31, 2015 were as follows (in thousands): March 31, 2016 Gross Gross Unrealized Unrealized Fair Description Cost Basis Gains Losses Value Corporate bonds/ Fixed income $ $ $ — $ Corporate equity — Total available-for-sale securities $ $ $ $ December 31, 2015 Gross Gross Unrealized Unrealized Fair Description Cost Basis Gains Losses Value Corporate bonds/ Fixed income $ $ $ $ Corporate equity — Total available-for-sale securities $ $ $ $ As of March 31, 2016, available-for-sale securities included corporate bonds/ fixed income securities of $3.4 million with contractual maturities within one year and $9.1 million with contractual maturities extending longer than one year through five years. Actual maturities may differ from contractual maturities as a result of the Company’s ability to sell these securities prior to maturity. The Company’s temporarily impaired investment securities available-for-sale as of March 31, 2016 and December 31, 2015 were as follows (in thousands): March 31, 2016 December 31, 2015 Unrealized Unrealized Fair Value Loss Fair Value Loss Corporate bonds/ Fixed income: Less than 12 months $ $ — $ $ 12 months or more — — Corporate equity: Less than 12 months — — 12 months or more Total $ $ $ $ The Company evaluates the investment securities available-for-sale on a quarterly basis to determine whether declines in the fair value of these securities are other-than-temporary. This quarterly evaluation consists of reviewing the fair value of the security compared to the carrying amount, the historical volatility of the price of each security, and any industry and company specific factors related to each security. The Company is not aware of any specific factors indicating that the underlying issuers of the corporate bonds/ fixed income securities would not be able to pay interest as it becomes due or repay the principal amount at maturity. Therefore, the Company believes that the changes in the estimated fair values of these debt securities are related to temporary market fluctuations. Additionally, the Company is not aware of any specific factors which indicate the unrealized losses on the investments in corporate equity securities are due to anything other than temporary market fluctuations. The Company realized net gains of less than $0.1 million and zero on the sale and maturities of available-for-sale securities for the three months ended March 31, 2016 and 2015, respectively.

Accrued Liabilities

Accrued Liabilities	3 Months Ended
	Mar. 31, 2016
Accrued Liabilities
Accrued Liabilities	6. Accrued Liabilities Accrued liabilities were as follows as of March 31, 2016 and December 31, 2015 (in thousands): March 31, December 31, 2016 2015 Accrued wages and benefits $ $ Current portion of self-insurance reserve Current portion of compliance and legal Accrued incentive compensation Accrued income taxes Accrued medical claim liabilities Deferred revenue Other Total accrued liabilities $ $

Debt and Capital Lease Obligati

Debt and Capital Lease Obligations	3 Months Ended
	Mar. 31, 2016
Debt and Capital Lease Obligations
Debt and Capital Lease Obligations	7. Debt and Capital Lease Obligations Debt and capital lease obligations consisted of the following as of March 31, 2016 and December 31, 2015 (in thousands): March 31, December 31, 2016 2015 Senior unsecured notes due 2022 $ $ Senior secured term loans due 2018 (4.25% to 4.50% as of March 31, 2016 and December 31, 2015) ABL Facility — — Notes due at various dates from 2016 to 2022 with interest rates from 6% to 10% Capital lease obligations due at various dates from 2016 to 2018 Total Less current portion Discount on senior secured term loan Debt issuance costs on senior unsecured notes, senior secured term loan and ABL Facility Total long-term debt and capital lease obligations $ $ As of March 31, 2016, letters of credit outstanding, which impact the available credit under the ABL Facility were $149.8 million and the maximum amount available under the ABL Facility was $400.2 million. These letters of credit primarily secure the Company’s obligations under its captive insurance program.

Derivative Instruments and Hedg

Derivative Instruments and Hedging Activities	3 Months Ended
	Mar. 31, 2016
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, from time to time, uses highly effective derivative instruments to manage well-defined risk exposures. The Company monitors its positions and the credit ratings of its counterparties and does not anticipate non-performance by the counterparties. The Company does not use derivative instruments for speculative purposes. At March 31, 2016, the Company was party to a series of fuel hedge transactions with a major financial institution under one master agreement executed in December 2014. Each of the transactions effectively fixes the cost of diesel fuel at prices ranging from $3.16 to $3.58 per gallon. The Company purchases the diesel fuel at the market rate and periodically settles with its counterparty for the difference between the national average price for the period published by the Department of Energy and the agreed upon fixed price. The transactions fix the price for a total of 1.9 million gallons, which represents approximately 18% of the Company’s total estimated usage during the periods hedged, through December 2016. The Company recorded, as a component of other comprehensive income (loss) before applicable tax impacts, a liability associated with the fair value of the fuel hedge in the amount $2.3 million and $2.8 million, respectively, as of March 31, 2016 and December 31, 2015, respectively. Over the next 12 months, the Company expects to reclassify $2.3 million of deferred loss from accumulated other comprehensive income (loss) as the related fuel hedge transactions mature. Settlement of hedge agreements are included in operating expenses and resulted in net payments to the counterparty of $0.8 million and $0.2 million for the three months ended March 31, 2016 and 2015, respectively.

Changes in Accumulated Other Co

Changes in Accumulated Other Comprehensive Income (Loss) by Component	3 Months Ended
	Mar. 31, 2016
Changes in Accumulated Other Comprehensive Income (Loss) by Component
Changes in Accumulated Other Comprehensive Income (Loss) by Component	9. Changes in Accumulated Other Comprehensive Income (Loss) by Component The following table summarizes the changes in the Company’s accumulated other comprehensive income (loss) (“AOCI”) by component as of March 31, 2016 and December 31, 2015 (in thousands). All amounts are after tax. Unrealized holding gains (losses) on Interest rate available-for-sale Fuel hedge swap securities Other Total Balance as of January 1, 2015 $ $ $ $ — $ Other comprehensive income (loss) before reclassifications Amounts reclassified from accumulated other comprehensive income (loss) — Net current-period other comprehensive income (loss) Balance as of December 31, 2015 — Other comprehensive income (loss) before reclassifications — Amounts reclassified from accumulated other comprehensive income (loss) — — Net current-period other comprehensive income (loss) — Balance as of March 31, 2016 $ $ — $ $ $ The following table shows the line on the statements of operations affected by reclassifications out of AOCI (in thousands): Amount reclassified from AOCI Three Months Ended March 31, Details about AOCI components 2016 2015 Statements of Operations Gains and losses on cash flow hedges: Fuel hedge $ $ Operating expenses Interest rate swap — Interest expense, net Total before tax Tax benefit (expense) $ $ Net of tax Unrealized holding gains (losses) on available-for-sale securities $ $ — Realized gains (losses) on investments — Total before tax — Tax benefit (expense) $ $ — Net of tax

Equity Based Compensation

Equity Based Compensation	3 Months Ended
	Mar. 31, 2016
Equity Based Compensation
Equity Based Compensation	11. Equity-Based Compensation Omnibus Incentive Plan Upon completion of the Company’s initial public offering in August 2013, the then-existing stock compensation plan terminated and the Envision Healthcare Holdings, Inc. 2013 Omnibus Incentive Plan (“Omnibus Incentive Plan”) was adopted, pursuant to which options and awards with respect to a total of 16,708,289 shares of common stock are available for grant. As of March 31, 2016, a total of 13,953,321 shares remained available for grant under the Omnibus Incentive Plan. Awards under the Omnibus Incentive Plan include both performance and non-performance based awards. Awards are granted with exercise prices equal to the fair value of the Company’s com mon stock at the date of grant. No participant may be granted in any calendar year awards covering more than 2.5 million shares of common stock or 1.5 million performance awards up to a maximum dollar value of $5.0 million. Non-performance based awards have time-based vesting and performance-based awards vest upon achievement of certain market-based objectives. All options have 10 -year terms. During February 2016, the Company adopted a long-term incentive plan (the “2016 LTIP”) which provides stock options, restricted stock units (“RSUs”), and market-based performance share units (“PSUs”) in combination. The stock options and RSUs vest ratably over three years. The PSUs vest based on achievement of both the three -year service condition and market condition. The holders of the RSUs and PSUs are entitled to receive cash dividend equivalents related to regular cash dividends paid by the Company. As of March 31, 2016, the Company had issued awards under the 2016 LTIP including 1,573,288 stock options with a grant date fair value of $8.38 per option using the Black-Scholes valuation model, 278,904 RSUs with a grant date fair value of $21.99 per RSU using the market price on the date of grant, and 585,587 PSUs with a grant date fair value of $22.41 per PSU using a Monte Carlo simulation model. The Monte Carlo simulation used to calculate the fair value of the PSUs simulates the present value of the potential outcomes of future stock prices of the Company and the companies included in the defined performance index over the performance cycle. The projection of stock prices are based on the risk-free rate of return, the volatilities of the stock price of the Company and the companies included in the defined performance index, and the correlation of the stock price of the Company with these companies. Total equity-based compensation charges of $2.3 million and $1.4 million were recorded for the three months ended March 31, 2016 and 2015, respectively. As of March 31, 2016, total unrecognized compensation cost related to unvested awards was $34.8 million, which will be recognized over the weighted average remaining vesting life of 2.1 years.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2016
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 $19.0 million and $12.8 million for the three months ended March 31, 2016 and 2015, 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. Letters of Credit As of March 31, 2016 and December 31, 2015, the Company had $172.9 million and $140.8 million, respectively, in outstanding letters of credit. 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. Other Legal Matters In December 2006, AMR received a subpoena from the U.S. Department of Justice (“DOJ”). The subpoena requested copies of documents for the period from January 2000 through the present. The subpoena required AMR to produce a broad range of documents relating to the operations of certain AMR affiliates in New York. The Company produced documents responsive to the subpoena. The government identified claims for reimbursement that the government believes lack support for the level billed, and invited the Company to respond to the identified areas of concern. The Company reviewed the information provided by the government and provided its response. On May 20, 2011, AMR entered into a settlement agreement with the DOJ and a Corporate Integrity Agreement (“CIA”) with the Office of Inspector General of the Department of Health and Human Services (“OIG”) in connection with this matter. Under the terms of the settlement, AMR paid $2.7 million to the federal government. In connection with the settlement, the Company entered into a CIA with a five -year period beginning May 20, 2011. Pursuant to this CIA, the Company is required to maintain a compliance program, which includes, among other elements, the appointment of a compliance officer and committee, training of employees nationwide, safeguards for its billing operations as they relate to services provided in New York, including specific training for operations and billing personnel providing services in New York, review by an independent review organization and reporting of certain reportable events. The Company entered into the settlement in order to avoid the uncertainties of litigation, and has not admitted any wrongdoing. In May 2013 a subsidiary of the Company entered into an agreement to divest substantially all the assets underlying AMR’s services in New York, although the obligations of the Company’s compliance program will remain in effect following the expected divestiture. The divesture was completed on July 1, 2013. Four different putative class action lawsuits were 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. While certification of the rest period claims in the consolidated Karapetian/ Aguilar case was denied, the Court certified classes 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 rounding policy, and that AMR has an unlawful practice of setting rates for those employees. On October 13, 2015, the Court decertified all classes in the Karapetian/ Aguilar case, a decision that is being appealed. In the Banta case, the Court denied certification of the meal and rest period claims as to EMTs and paramedics, a decision that plaintiff’s counsel appealed. The appeal was denied because of the pendency of other class and representative claims in the case. The Court indicated that it would certify a class on overtime claims and plaintiff’s counsel indicated an intention to dismiss that claim as AMR’s policy complies with a recent Court of Appeals decision. To date, these claims have not been dismissed. In the Bartoni case, the Court denied certification on the meal and rest period claims of all unionized employees in Northern California, a decision that is being appealed; while the Court certified a class on the overtime claims, plaintiffs’ counsel stipulated to decertify and dismiss those claims as AMR’s policy complies with a recent Court of Appeals decision. The Company is unable at this time to estimate the amount of potential damages, if any. In September 2009 a qui tam action was filed against Rural/Metro in the U. S. District Court for the Northern District of Alabama. The complaint alleged that Rural/Metro had falsified Medicare required documents and billed Medicare and Medicaid improperly for ambulance services. The federal government intervened in the lawsuit on March 14, 2011, and on June 14, 2012, Rural/Metro entered into a settlement agreement with the DOJ and plaintiff, agreeing to pay $5.5 million to the federal government. In connection with this settlement, Rural/Metro entered into a CIA with the OIG (the “Rural/Metro CIA”), which requires it to maintain a compliance program. This program includes, among other elements, the appointment of a compliance officer and committee, training of employees nationwide, safeguards for Rural/Metro’s billing operations, review by an independent review organization and reporting of certain reportable events. The term of the Rural/Metro CIA is five years and is set to expire in June 2017. On October 28, 2015, the Company completed its acquisition of Rural/Metro. On December 10, 2012, an OIG subpoena was served on Mercy Hospital in Buffalo, New York, requesting documents related to interfacility specialty care transports provided by Rural/Metro’s Buffalo division. Rural/Metro provided responsive documents. On April 14, 2014, Rural/Metro received a second subpoena from the DOJ, Western District of New York, requesting additional information. The investigation was subsequently expanded to include Rural/Metro’s Kentucky market. Rural/Metro is cooperating with the government and is in the process of providing additional responsive documents. The Company is unable to determine the potential impact, if any, that will result from this investigation. 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 be primarily focused on EmCare’s contracts for services at hospitals that are affiliated with Health Management Associates, Inc. (“HMA”). 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 were unsealed; the Company is a named defendant in two of these lawsuits (the “HMA 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, intervened in these matters as they relate to the Company. The Company has been engaged in dialogue with the relevant federal government representatives in an effort to reach a resolution of this matter. As the Company and these government representatives have made significant progress towards resolution of these matters, the Company recorded a reserve of $30.0 million as of December 31, 2015, based on the Company’s estimates of probable exposure resulting from the HMA Lawsuits. On January 8, 2015, the U.S. Attorney’s Office for the District of Arizona issued a Civil Investigative Demand (“CID”) for copies of documents pertaining to ambulance transports provided by Rural/ Metro in its San Diego and Arizona markets. The CID does not provide any information regarding specific allegations or claims made by the government. Rural/ Metro is cooperating with the government during its investigation and has provided responsive documents. The Company is unable to determine the potential impact, if any, that will result from this investigation. On March 27, 2015, OIG issued a Request for Information or Assistance to Rural/ Metro relating to its Arvada, Colorado location. The request does not indicate any specific allegation against Rural/ Metro. Rural/ Metro is cooperating with the government during its investigation and has provided responsive documents. 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.

Variable Interest Entities

Variable Interest Entities	3 Months Ended
	Mar. 31, 2016
Variable Interest Entities
Variable Interest Entities	13. Variable Interest Entities GAAP requires the assets, liabilities, noncontrolling interests and activities of Variable Interest Entities (“VIEs”) to be consolidated if an entity’s interest in the VIE has a controlling financial interest. Under the Variable Interest Model, a controlling financial interest is determined based on which entity, if any, has: i) the power to direct the activities of the VIE that most significantly impacts the VIE’s economic performance and ii) the obligations to absorb the losses that could potentially be significant to the VIE or the right to receive benefits from the VIE that could potentially be significant to the VIE. For all consolidated VIEs, the Company is not contractually obligated to fund losses, if any, in excess of its investment. AHAH-Evolution JV Evolution Health, LLC (“Evolution”), included within the EmCare segment, entered into an agreement in 2014 with Ascension Health to form an entity which would provide home health, hospice, and home infusion therapy pharmacy services to patients (“AHAH-Evolution JV”). AHAH-Evolution JV began providing services to patients during the first quarter of 2015 and meets the definition of a VIE. The Company determined that, although Evolution holds 50% voting control, Evolution is the primary beneficiary and must consolidate this VIE because: · Evolution provides management services to AHAH-Evolution JV including providing comprehensive management oversight, operational reporting guidelines, recruiting, credentialing, billing, payroll, accounting, and other various administrative services and therefore substantially all of AHAH-Evolution JV’s activities involve Evolution; and · as payment for management services, Evolution is entitled to receive a variable management fee from AHAH-Evolution. The following table summarizes the AHAH-Evolution JV assets and liabilities as of March 31, 2016, which are included in the Company’s consolidated financial statements (in thousands): March 31, December 31, 2016 2015 Current assets $ $ Current liabilities UHS-EmCare JV EmCare entered into an agreement in 2014 with Universal Health Services, Inc. to form an entity to provide physician services to various healthcare facilities (“UHS-EmCare JV”). UHS-EmCare JV began providing services to healthcare facilities during the second quarter of 2014 and meets the definition of a VIE. The Company determined that, although EmCare holds 50% voting control, EmCare is the primary beneficiary and must consolidate this VIE because: · EmCare provides management services to UHS-EmCare JV including recruiting, credentialing, scheduling, billing, payroll, accounting and other various administrative services and therefore substantially all of UHS-EmCare JV’s activities involve EmCare; and · as payment for management services, EmCare is entitled to receive a variable management fee from UHS-EmCare JV. The following table summarizes the UHS-EmCare JV assets and liabilities as of March 31, 2016 and December 31, 2015, which are included in the Company’s consolidated financial statements (in thousands): March 31, December 31, 2016 2015 Current assets $ $ Current liabilities HCA-EmCare JV EmCare entered into an agreement in 2011 with an indirect wholly-owned subsidiary of HCA Holdings Inc. to form an entity to 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 March 31, 2016 and December 31, 2015, which are included in the Company’s consolidated financial statements (in thousands): March 31, December 31, 2016 2015 Current assets $ $ Current liabilities

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2016
Segment Information
Segment Information	14. 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 reportable 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, tele-radiology 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, transaction costs related to acquisition activity, related party management fees, restructuring and other charges, severance and related costs, adjustment to net (income) loss attributable to noncontrolling interest due to deferred taxes, and depreciation and amortization expense (“Adjusted EBITDA”) is the measure of profit and loss that the CODM uses to assess performance and make decisions. Adjusted EBITDA is not considered a measure of financial performance under GAAP and the items excluded from Adjusted EBITDA are significant components in understanding and assessing the Company’s financial performance. Adjusted EBITDA should not be considered in isolation or as an alternative to such GAAP measures as net income, cash flows provided by or used in operating, investing or financing activities or other financial statement data presented in the Company’s financial statements as an indicator of financial performance. Since Adjusted EBITDA is not a measure determined to be in accordance with GAAP and is susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. Pre-tax income from continuing operations represents net revenue less direct operating expenses incurred within the operating segments. The accounting policies for reported segments are the same as for the Company as a whole (see Note 2). The Company’s operating segment results were as follows (in thousands): Three Months Ended March 31, 2016 2015 Facility-Based and Post-Acute Care Physician Services Net revenue $ $ Income from operations Adjusted EBITDA Healthcare Transportation Services Net revenue $ $ Income from operations Adjusted EBITDA Segment Totals Net revenue $ $ Income from operations Adjusted EBITDA A reconciliation of net income (loss) to Adjusted EBITDA (in thousands): Three Months Ended March 31, 2016 2015 Net income (loss) $ $ Add-back of non-operating expense (income): Interest expense, net Income tax expense (benefit) Realized losses (gains) on investments — Interest income from restricted assets Equity in earnings of unconsolidated subsidiary Other expense (income), net Income from operations — segment totals Add-back of operating expense (income): Depreciation and amortization expense Restructuring and other charges — Severance and related costs Net (income) loss attributable to noncontrolling interest Interest income from restricted assets Equity-based compensation expense Transaction costs Adjusted EBITDA $ $ Three Months Ended March 31, Facility-Based and Post-Acute Care Physician Services 2016 2015 Adjusted EBITDA $ $ Depreciation and amortization expense Restructuring and other charges — Severance and related costs Net (income) loss attributable to noncontrolling interest Interest income from restricted assets Equity-based compensation expense Transaction costs Income from operations $ $ Three Months Ended March 31, Healthcare Transportation Services 2016 2015 Adjusted EBITDA $ $ Depreciation and amortization expense Severance and related costs Interest income from restricted assets Equity-based compensation expense Transaction costs Income from operations $ $

Consolidating Financial Informa

Consolidating Financial Information	3 Months Ended
	Mar. 31, 2016
Consolidating Financial Information
Consolidating Financial Information	15. 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 March 31, 2016 (in thousands, unaudited) EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Assets Current assets: Cash and cash equivalents $ $ $ — $ Insurance collateral — — Trade and other accounts receivable, net — — Parts and supplies inventory — — Prepaids and other current assets — — Total current assets — Property, plant, and equipment, net — — Intangible assets, net — — Goodwill — — Other long-term assets Investment in wholly owned subsidiary — — Total assets $ $ $ $ Liabilities and Equity Current liabilities: Accounts payable $ — $ $ — $ Accrued liabilities — — Current portion of long-term debt and capital lease obligations — — Total current liabilities — — Long-term debt and capital lease obligations — — Long-term deferred tax liabilities — Insurance reserves — — Other long-term liabilities — — Total liabilities — Equity: Common stock — — Preferred stock — — — — Additional paid-in capital Retained earnings Accumulated other comprehensive income (loss) Total Envision Healthcare Holdings, Inc. equity Noncontrolling interest — — Total equity Total liabilities and equity $ $ $ $ Consolidating Balance Sheet As of December 31, 2015 (in thousands) EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Assets Current assets: Cash and cash equivalents $ $ $ — $ Insurance collateral — — Trade and other accounts receivable, net — — Parts and supplies inventory — — Prepaids and other current assets Total current assets Property, plant, and equipment, net — — Intangible assets, net — — Goodwill — — Other long-term assets Investment in wholly owned subsidiary — — Total assets $ $ $ $ Liabilities and Equity Current liabilities: Accounts payable $ $ $ — $ Accrued liabilities — Current portion of long-term debt and capital lease obligations — — Total current liabilities Long-term debt and capital lease obligations — — Long-term deferred tax liabilities — Insurance reserves — — Other long-term liabilities — — Total liabilities Equity: Common stock — — Preferred stock — — — — Additional paid-in capital Retained earnings Accumulated other comprehensive income (loss) Total Envision Healthcare Holdings, Inc. equity Noncontrolling interest — — Total equity Total liabilities and equity $ $ $ $ Condensed Consolidating Statement of Operations (in thousands, unaudited) Three Months Ended March 31, 2016 EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Net revenue $ — $ $ — $ Compensation and benefits — — Operating expenses — — Insurance expense — — Selling, general and administrative expenses — — Depreciation and amortization expense — — Restructuring and other charges — — Income (loss) from operations — — Interest income from restricted assets — — Interest expense, net — — Realized gains (losses) on investments — — Other income (expense), net — Income (loss) before taxes and equity in earnings of unconsolidated subsidiary — Income tax benefit (expense) — Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary — Equity in net income (loss) of subsidiary — — Equity in earnings of unconsolidated subsidiary — — Net income (loss) Less: Net (income) loss attributable to noncontrolling interest — — Net income (loss) attributable to Envision Healthcare Holdings, Inc. $ $ $ $ Condensed Consolidating Statement of Operations (in thousands, unaudited) Three Months Ended March 31, 2015 EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Net revenue $ — $ $ — $ Compensation and benefits — — Operating expenses — — Insurance expense — — Selling, general and administrative expenses — — Depreciation and amortization expense — — Income from operations — — Interest income from restricted assets — — Interest expense, net — — Other income (expense), net — — Income (loss) before taxes and equity in earnings of unconsolidated subsidiary — Income tax benefit (expense) — Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary — Equity in net income (loss) of subsidiary — — Equity in earnings of unconsolidated subsidiary — — Net income (loss) Less: Net (income) loss attributable to noncontrolling interest — — Net income (loss) attributable to Envision Healthcare Holdings, Inc. $ $ $ $ Condensed Consolidating Statement of Cash Flows (in thousands, unaudited) Three Months Ended March 31, 2016 EVHC (excluding Corporation and Corporation) Subsidiaries Total Cash Flows from Operating Activities Net cash provided by (used in) operating activities $ $ $ Cash Flows from Investing Activities Purchases of available-for-sale securities — Sales and maturities of available-for-sale securities — Purchase of property, plant and equipment — Proceeds from sale of property, plant and equipment — Acquisition of businesses, net of cash received — Net change in insurance collateral — Other investing activities — Net cash provided by (used in) investing activities — Cash Flows from Financing Activities Borrowings under the ABL Facility — Repayments of the ABL Facility — Repayments of the Term Loan — Debt issuance costs — Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan — Excess tax benefits from equity-based compensation — Other financing activities — Net intercompany borrowings (payments) — Net cash provided by (used in) financing activities Change in cash and cash equivalents — Cash and cash equivalents, beginning of period Cash and cash equivalents, end of period $ $ $ Condensed Consolidating Statement of Cash Flows (in thousands, unaudited) Three Months Ended March 31, 2015 EVHC (excluding Corporation and Corporation) Subsidiaries Total Cash Flows from Operating Activities Net cash provided by (used in) operating activities $ $ $ Cash Flows from Investing Activities Purchases of available-for-sale securities — Sales and maturities of available-for-sale securities — Purchase of property, plant and equipment — Proceeds from sale of property, plant and equipment — Acquisition of businesses, net of cash received — Net change in insurance collateral — Other investing activities — Net cash provided by (used in) investing activities — Cash Flows from Financing Activities Borrowings under the ABL Facility — Repayments of the Term Loan — Repayments of the ABL Facility — Debt issuance costs — Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan — Excess tax benefits from equity-based compensation — Contributions from noncontrolling interest, net — Other financing activities — Net intercompany borrowings (payments) — Net cash provided by (used in) financing activities Change in cash and cash equivalents — Cash and cash equivalents, beginning of period Cash and cash equivalents, end of period $ $ $

Summary of Significant Accoun20

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2016
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, insurance related reserves and acquired intangible assets. Actual results may differ from those estimates under different assumptions or conditions.
Insurance Collateral	Insurance Collateral Insurance collateral is comprised of investments in marketable equity and debt securities held by the Company’s captive insurance subsidiary that supports the Company’s insurance program and reserves, as well as cash deposits with third parties. Certain of these investments, if sold or otherwise liquidated, would have to be replaced by other suitable financial assurances and are, therefore, considered restricted. These investments are designated as available-for-sale and reported at fair value with the related temporary unrealized gains and losses reported as a separate component of accumulated other comprehensive income (loss), net of deferred income tax. Declines in the fair value of a marketable investment security which are determined to be other-than-temporary are recognized in the statements of operations, thus establishing a new cost basis for such investment. Investment income earned on these investments is reported as interest income from restricted assets in the statements of operations. Realized gains and losses are determined based on an average cost basis. Insurance collateral also includes a receivable from insurers of $1.1 million and $0.6 million as of March 31, 2016 and December 31, 2015, 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, 2015, was equal to approximately 94% and 86% of outstanding self-pay receivables for EmCare and AMR, respectively, consistent with the Company’s collection history. Account balances are charged off against the uncompensated care allowance when it is probable the receivable will not be recovered and to the contractual allowance when payment is received. The Company’s accounts receivable and allowances as of March 31, 2016, and December 31, 2015, were as follows (in thousands): March 31, December 31, 2016 2015 Gross trade accounts receivable $ $ Allowance for contractual discounts Allowance for uncompensated care Trade accounts receivable, net Other receivables, net Trade and other accounts receivable, net $ $ Other receivables primarily represent employee advances and other miscellaneous receivables. 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. The Company compares actual cash collected on a date of service basis to the revenue recorded for that period and records any adjustment necessary for an overage or deficit in these allowances based on actual collections and future estimated collections. 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 based on historical write-off experience and future estimated collections.
Debt Issuance Costs	Debt Issuance Costs Debt issuance costs related to the Company’s senior secured credit facilities and senior unsecured notes are included as a deduction from the carrying amount of long-term debt in the consolidated balance sheets, and are amortized to interest expense using the effective interest method over the term of the related debt.
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 income or 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 $1 to $3 million of the loss. Insurance reserves cover known claims and incidents within the level of Company retention that may result in the assertion of additional claims, as well as claims from unknown incidents that may be asserted arising from activities through the balance sheet date. The Company establishes reserves for claims based upon an assessment of actual claims and claims incurred but not reported. The reserves are established based on quarterly consultation with third-party independent actuaries using actuarial principles and assumptions that consider a number of factors, including historical claim payment patterns and legal costs, changes in case reserves and the assumed rate of inflation in healthcare costs and property damage repairs. Claims are discounted at a rate of 1.5 % which is commensurate with the risk free rate. The Company’s most recent actuarial valuation was completed in March 2016. As a result of this and previous actuarial valuations, the Company recorded increases in its provision for insurance liabilities of $0.9 million and $2.6 million for the three months ended March 31, 2016 and 2015, respectively, related to reserves for losses in prior years.
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, accrued liabilities and the senior secured credit facility approximates fair value as of March 31, 2016, and December 31, 2015. Concentration of credit risks in accounts receivable is limited, due to the large number of customers comprising the Company’s customer base throughout the United States. A significant component of the Company’s revenue is derived from Medicare and Medicaid. Given that these are government programs, the credit risk for these customers is considered low. The Company performs ongoing credit evaluations of its other customers, but does not require collateral to support customer accounts receivable. The Company establishes an allowance for uncompensated care based on the credit risk applicable to particular customers, historical trends and other relevant information. For the three months ended March 31, 2016, and 2015, the Company derived approximately 34% of its revenue from Medicare and Medicaid, 63% and 64% , respectively, from insurance providers and contracted payors, and 3% and 2% , 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 March 31, 2016, and December 31, 2015, was approximately $757.5 million and $735.0 million, respectively, with a carrying amount 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 derivatives and corporate bonds. Level 3—Pricing inputs are unobservable as of the reporting date and reflect the Company’s own assumptions about the fair value of the asset or liability. Balances in this category include the Company’s estimate, using a combination of internal and external fair value analyses, of contingent consideration for acquisitions described in Note 4. The following table summarizes the valuation of the Company’s financial instruments by the above fair value hierarchy levels as of March 31, 2016, and December 31, 2015 (in thousands): March 31, 2016 Description Level 1 Level 2 Level 3 Total Assets: Available-for-sale securities (insurance collateral) $ $ $ — $ Liabilities: Contingent consideration — — Fuel hedge — — December 31, 2015 Description Level 1 Level 2 Level 3 Total Assets: Available-for-sale securities (insurance collateral) $ $ $ — $ Liabilities: Contingent consideration — — Fuel hedge — — There has been no change in the contingent consideration balance classified as a Level 3 liability during the three months ended March 31, 2016. During the three months ended March 31, 2016, and 2015, the Company had no transfers between Level 1 and Level 2 fair value measurements.
Revenue Recognition	Revenue Recognition Fee-for-service revenue is recognized at the time of service and is recorded net of provisions for contractual discounts and estimated uncompensated care. Fee-for-service revenue represents billings for services provided to patients, for which the Company receives payment from the patient or their third-party payor. Provisions for contractual discounts are related to differences between gross charges and specific payor, including governmental, reimbursement schedules. The Company records fee-for-service revenue, net of the contractual discounts based on the information entered into the Company’s billing systems from received medical charts. An estimate for unprocessed medical charts for a given service period is made and adjusted in future periods based on actual medical charts processed. Information entered into the billing systems is subject to change, e.g. change in payor status, and may impact recorded fee-for-service revenue, net of the contractual discounts. Such changes are recognized in the period the change is known. Revenue from home health services, net of revenue adjustments and provisions for contractual discounts, is earned and billed either on an episode of care basis (“episodic-based revenue”), on a per visit basis, or on a daily basis depending upon the payment terms and conditions established with each payor for services provided. Revenue recognized on a non-episodic basis is recorded in a similar manner to the Company’s fee-for-service revenue. Home health service revenue under the Medicare prospective payment system is based on a 60 -day episode payment rate that is subject to adjustment based on certain variables. Adjustments are estimated based on historical experience and are recorded in the period in which services are rendered. Revenue from contract staffing assignments, net of sales adjustments and discounts, are recognized when earned, based on the hours worked by the Company’s contract professionals. Conversion and direct hire fees are recognized when the employment candidate accepts permanent employment and all obligations are satisfied. The Company includes reimbursed expenses in revenue, net of contractual discounts and the associated amount of reimbursement expense in compensation and benefits. Revenue generated under fire protection service contracts is recognized over the life of the contract. Subscription fees, which are generally received in advance, are deferred and recognized on a straight-line basis over the term of the subscription agreement, which is generally one year. Subsidy and fee revenue primarily represent hospital subsidies and fees at EmCare and fees for stand-by, special event and community subsidies at AMR. Provisions for estimated uncompensated care, or bad debts, are related principally to the number of self-pay patients treated in the period. Net revenue for the three months ended March 31, 2016, and 2015 consisted of the following (in thousands): Three Months Ended March 31, 2016 2015 Revenue, net of contractual discounts, excluding subsidies and fees: Medicare $ $ Medicaid Commercial insurance and managed care (excluding Medicare and Medicaid managed care) Self-pay Sub-total Subsidies and fees Revenue, net of contractual discounts Provision for uncompensated care Net revenue $ $ Healthcare reimbursement is complex and may involve lengthy delays. Third-party payors are continuing 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 (and correspondingly decreased net revenue) by approximately $2.9 million and $3.6 million for the three months ended March 31, 2016, and 2015, respectively. 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.
Reclassifications	Reclassifications Certain prior period balances in the consolidated balance sheets have been reclassified to conform to the current year presentation. Such reclassifications had no impact on the results of operations or cash flows previously reported.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In May 2014, the Financial Accounting Standards Board (the (“FASB”) issued Accounting Standards Update (“ASU”) 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. The guidance will be effective for public companies for annual reporting periods beginning after December 15, 2017, including interim periods within that reporting period, with early adoption for annual reporting periods beginning after December 15, 2016, permitted. The Company is currently evaluating the impact and 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 or the method of adoption. In August 2014, the FASB issued Accounting Standards Update No. 2014-15, Presentation of Financial Statements—Going Concern (Subtopic 205-40), Disclosure of Uncertainties about an Entity’s Ability to Continue as a Going Concern (“ASU 2014-15”), which requires management to evaluate, in connection with preparing financial statements for each annual and interim reporting period, whether there are conditions or events, considered in the aggregate, that raise substantial doubt about an entity’s ability to continue as a going concern within one year after the date that the financial statements are issued (or within one year after the date that the financial statements are available to be issued when applicable) and provide related disclosures. ASU 2014-15 is effective for the annual period ending after December 15, 2016, and for annual and interim periods thereafter. The adoption of ASU 2014-15 is not expected to impact the Company's consolidated financial statements. In February 2015, the FASB issued ASU No. 2015-02, Amendments to the Consolidation Analysis (“ASU 2015-02”), which amends existing accounting standards for consolidation under the variable interest entity and voting interest entity models. The new guidance changes the analysis for determining whether a fee paid to a decision maker or service provider is a variable interest. ASU 2015-02 is effective for interim and annual periods beginning after December 15, 2015. Entities may choose to adopt the standard using either a full retrospective approach or a modified retrospective approach. The Company adopted ASU 2015-02 under the modified retrospective approach during the current period and determined that its adoption does not impact our consolidated financial position or results of operations. In April 2015, the FASB issued ASU No. 2015-03, Interest — Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs (“ASU 2015-03”), which requires debt issuance costs to be presented in the balance sheet as a direct deduction from the associated debt liability. ASU 2015-03 is effective for annual reporting periods beginning after December 15, 2015, including interim periods within that reporting period. The Company adopted ASU 2015-03 retrospectively during the current period and, as a result, $34.6 million of debt issuance costs related to the Company’s senior secured credit facilities and senior unsecured notes were reclassified from other long-term assets to long-term debt and capital lease obligations on the Company’s consolidated balance sheets as of December 31, 2015. In November 2015, the FASB issued ASU No. 2015-17, Balance Sheet Classification of Deferred Taxes (“ASU 2015-17”), which simplifies the presentation of deferred income taxes and requires that deferred tax liabilities and assets be classified as non-current in the consolidated balance sheets. ASU 2015-17 is effective for annual reporting periods beginning after December 15, 2016, with early adoption permitted. The Company adopted ASU 2015-17 retrospectively during the current period and, as a result, $85.8 million of current deferred tax liabilities were reclassified to long-term deferred tax liabilities on the Company’s consolidated balance sheets as of December 31, 2015. In February 2016, the FASB issued ASU No. 2016-02, Leases (“ASU 2016-02”), which amends the existing accounting standards for lease accounting, including requiring lessees to recognize most leases on the consolidated balance sheets and making targeted changes to lessor accounting. ASU 2016-02 will be effective for annual periods beginning after December 15, 2018, with early adoption permitted. The new leases standard requires a modified retrospective transition approach for all leases existing at, or entered into after, the date of initial application, with an option to use certain transition relief. The Company is currently evaluating the impact and has not yet determined the effects, if any, that adoption of ASU 2016-02 may have on its consolidated financial position or results of operations. In March 2016, the FASB issued ASU No. 2016-09, Compensation—Stock Compensation (Topic 718) (“ASU 2016-09”), which was issued as part of the FASB's simplification initiative and affects all entities that issue share-based payment awards to their employees. This ASU covers accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. ASU 2016-09 will be effective for annual periods beginning after December 15, 2016, with early adoption permitted. The Company is currently evaluating the impact and has not yet determined the effects, if any, that adoption of ASU 2016-09 may have on its consolidated financial position or results of operations.

Summary of Significant Accoun21

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2016
Summary of Significant Accounting Policies
Schedule of accounts receivable and allowances	March 31, December 31, 2016 2015 Gross trade accounts receivable $ $ Allowance for contractual discounts Allowance for uncompensated care Trade accounts receivable, net Other receivables, net Trade and other accounts receivable, net $ $
Schedule of net revenue	Net revenue for the three months ended March 31, 2016, and 2015 consisted of the following (in thousands): Three Months Ended March 31, 2016 2015 Revenue, net of contractual discounts, excluding subsidies and fees: Medicare $ $ Medicaid Commercial insurance and managed care (excluding Medicare and Medicaid managed care) Self-pay Sub-total Subsidies and fees Revenue, net of contractual discounts Provision for uncompensated care Net revenue $ $
Summary of the valuation of the Company's financial instruments by the fair value hierarchy levels	The following table summarizes the valuation of the Company’s financial instruments by the above fair value hierarchy levels as of March 31, 2016, and December 31, 2015 (in thousands): March 31, 2016 Description Level 1 Level 2 Level 3 Total Assets: Available-for-sale securities (insurance collateral) $ $ $ — $ Liabilities: Contingent consideration — — Fuel hedge — — December 31, 2015 Description Level 1 Level 2 Level 3 Total Assets: Available-for-sale securities (insurance collateral) $ $ $ — $ Liabilities: Contingent consideration — — Fuel hedge — —

Basic and Diluted Net Income 22

Basic and Diluted Net Income (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2016
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 earnings per share 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 March 31, 2016 2015 Net income (loss) attributable to Envision Healthcare Holdings, Inc. stockholders $ $ Net income (loss) allocated to participating securities (a) — Net income (loss) attributable to Envision Healthcare Holdings, Inc. common stockholders Weighted-average common shares outstanding — common stock: Basic Dilutive impact of stock awards outstanding Diluted Net income (loss) per share attributable to Envision Healthcare Holdings, Inc. common stockholders: Basic $ $ Diluted $ $

Acquisitions (Tables)

Acquisitions (Tables)	3 Months Ended
	Mar. 31, 2016
SEA
Schedule of allocation of the purchase price	The final allocation of the purchase price is in the table below (in thousands): Cash and cash equivalents $ Accounts receivable Prepaid and other current assets Acquired intangible assets Goodwill Accounts payable Accrued liabilities Long-term deferred tax liabilities Total purchase price $
VISTA
Schedule of allocation of the purchase price	The final allocation of the purchase price is in the table below (in thousands): Cash and cash equivalents $ Accounts receivable Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Accrued liabilities Long-term deferred tax liabilities Insurance reserves Other long-term liabilities Total purchase price $
EMA
Schedule of allocation of the purchase price	The final allocation of the purchase price is in the table below (in thousands): Cash and cash equivalents $ Accounts receivable Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Accrued liabilities Long-term deferred tax liabilities Insurance reserves Total purchase price $
Rural Metro
Schedule of allocation of the purchase price	The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations and working capital adjustments (in thousands): Cash and cash equivalents $ Insurance collateral Accounts receivable Parts and supplies inventory Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Other current liabilities Accrued liabilities Capital lease obligations Insurance reserves Long-term deferred tax liabilities Other long-term liabilities Total purchase price $
Questcare
Schedule of allocation of the purchase price	The allocation of the purchase price is in the table below, which is subject to adjustment based upon the completion of purchase price allocations and working capital adjustments (in thousands): Cash and cash equivalents $ Insurance collateral Accounts receivable Prepaid and other current assets Property, plant and equipment Acquired intangible assets Goodwill Other long-term assets Accounts payable Accrued liabilities Insurance reserves Long-term deferred tax liabilities Other long-term liabilities Total purchase price $
SEA, VISTA, EMA and Rural/ Metro
Schedule of unaudited pro forma operating results	Three Months Ended (in thousands) March 31, 2015 Net revenue $ Net income (loss)

Insurance Collateral (Tables)

Insurance Collateral (Tables)	3 Months Ended
	Mar. 31, 2016
Insurance Collateral
Schedule of insurance collateral	Insurance collateral consisted of the following as of March 31, 2016 and December 31, 2015 (in thousands): March 31, December 31, 2016 2015 Available-for-sale securities: Corporate bonds/ Fixed income $ $ Corporate equity Total available-for-sale securities Insurance receivable Cash deposits and other Total insurance collateral $ $
Schedule of amortized cost basis and aggregate fair value of the Company's available-for-sale securities	Amortized cost basis and aggregate fair value of the Company’s available-for-sale securities as of March 31, 2016 and December 31, 2015 were as follows (in thousands): March 31, 2016 Gross Gross Unrealized Unrealized Fair Description Cost Basis Gains Losses Value Corporate bonds/ Fixed income $ $ $ — $ Corporate equity — Total available-for-sale securities $ $ $ $ December 31, 2015 Gross Gross Unrealized Unrealized Fair Description Cost Basis Gains Losses Value Corporate bonds/ Fixed income $ $ $ $ Corporate equity — Total available-for-sale securities $ $ $ $
Schedule of the Company's temporarily impaired investment securities available-for-sale	The Company’s temporarily impaired investment securities available-for-sale as of March 31, 2016 and December 31, 2015 were as follows (in thousands): March 31, 2016 December 31, 2015 Unrealized Unrealized Fair Value Loss Fair Value Loss Corporate bonds/ Fixed income: Less than 12 months $ $ — $ $ 12 months or more — — Corporate equity: Less than 12 months — — 12 months or more Total $ $ $ $

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	3 Months Ended
	Mar. 31, 2016
Accrued Liabilities
Schedule of accrued liabilities	Accrued liabilities were as follows as of March 31, 2016 and December 31, 2015 (in thousands): March 31, December 31, 2016 2015 Accrued wages and benefits $ $ Current portion of self-insurance reserve Current portion of compliance and legal Accrued incentive compensation Accrued income taxes Accrued medical claim liabilities Deferred revenue Other Total accrued liabilities $ $

Debt and Capital Lease Obliga26

Debt and Capital Lease Obligations (Tables)	3 Months Ended
	Mar. 31, 2016
Debt and Capital Lease Obligations
Schedule of debt and capital leases	Debt and capital lease obligations consisted of the following as of March 31, 2016 and December 31, 2015 (in thousands): March 31, December 31, 2016 2015 Senior unsecured notes due 2022 $ $ Senior secured term loans due 2018 (4.25% to 4.50% as of March 31, 2016 and December 31, 2015) ABL Facility — — Notes due at various dates from 2016 to 2022 with interest rates from 6% to 10% Capital lease obligations due at various dates from 2016 to 2018 Total Less current portion Discount on senior secured term loan Debt issuance costs on senior unsecured notes, senior secured term loan and ABL Facility Total long-term debt and capital lease obligations $ $

Changes in Accumulated Other 27

Changes in Accumulated Other Comprehensive Income (Loss) by Component (Tables)	3 Months Ended
	Mar. 31, 2016
Changes in Accumulated Other Comprehensive Income (Loss) by Component
Summary of changes in the Company's accumulated other comprehensive income ("AOCI") by component, after tax	The following table summarizes the changes in the Company’s accumulated other comprehensive income (loss) (“AOCI”) by component as of March 31, 2016 and December 31, 2015 (in thousands). All amounts are after tax. Unrealized holding gains (losses) on Interest rate available-for-sale Fuel hedge swap securities Other Total Balance as of January 1, 2015 $ $ $ $ — $ Other comprehensive income (loss) before reclassifications Amounts reclassified from accumulated other comprehensive income (loss) — Net current-period other comprehensive income (loss) Balance as of December 31, 2015 — Other comprehensive income (loss) before reclassifications — Amounts reclassified from accumulated other comprehensive income (loss) — — Net current-period other comprehensive income (loss) — Balance as of March 31, 2016 $ $ — $ $ $
Schedule of Statements of Operations affected by reclassifications out of AOCI	The following table shows the line on the statements of operations affected by reclassifications out of AOCI (in thousands): Amount reclassified from AOCI Three Months Ended March 31, Details about AOCI components 2016 2015 Statements of Operations Gains and losses on cash flow hedges: Fuel hedge $ $ Operating expenses Interest rate swap — Interest expense, net Total before tax Tax benefit (expense) $ $ Net of tax Unrealized holding gains (losses) on available-for-sale securities $ $ — Realized gains (losses) on investments — Total before tax — Tax benefit (expense) $ $ — Net of tax

Retirement Plans and Employee B

Retirement Plans and Employee Benefits (Tables)	3 Months Ended
	Mar. 31, 2016
Retirement Plans and Employee Benefits
Schedule of the reconciliation of plan assets	Change in plan assets: Fair value of plan assets as of December 31, 2015 $ Actual return on plan assets Employer contributions Benefits paid Plan participants' contributions — Fair value of plan assets at March 31, 2016 $
Schedule of the fair value of the Pension Plan assets by asset class	March 31, 2016 Description Level 1 Level 2 Level 3 Total Assets: Equity securities $ $ $ — $ Debt securities — Real estate — Total equity securities $ $ $ $ December 31, 2015 Description Level 1 Level 2 Level 3 Total Assets: Equity securities $ $ $ — $ Debt securities — Real estate — Total equity securities $ $ $ $
Schedule of components of net periodic benefit cost and other amounts recognized as comprehensive (loss) income	Net periodic benefit cost: Service cost $ Interest cost Expected return on plan assets Net periodic benefit cost $ Other changes in plan assets and benefit obligations recognized as other comprehensive loss (income) Net loss (gain) Net gain recognized during the period — Total recognized in other comprehensive loss (income) $ Total recognized as net periodic benefit cost and other comprehensive loss (income) $

Variable Interest Entities (Tab

Variable Interest Entities (Tables)	3 Months Ended
	Mar. 31, 2016
AHAH-Evolution 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 AHAH-Evolution JV assets and liabilities as of March 31, 2016, which are included in the Company’s consolidated financial statements (in thousands): March 31, December 31, 2016 2015 Current assets $ $ Current liabilities
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 March 31, 2016 and December 31, 2015, which are included in the Company’s consolidated financial statements (in thousands): March 31, December 31, 2016 2015 Current assets $ $ Current liabilities
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 March 31, 2016 and December 31, 2015, which are included in the Company’s consolidated financial statements (in thousands): March 31, December 31, 2016 2015 Current assets $ $ Current liabilities

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2016
Schedule of the Company's operating segment results	The Company’s operating segment results were as follows (in thousands): Three Months Ended March 31, 2016 2015 Facility-Based and Post-Acute Care Physician Services Net revenue $ $ Income from operations Adjusted EBITDA Healthcare Transportation Services Net revenue $ $ Income from operations Adjusted EBITDA Segment Totals Net revenue $ $ Income from operations Adjusted EBITDA
Schedule of reconciliation of net income (loss) to Adjusted EBITDA	A reconciliation of net income (loss) to Adjusted EBITDA (in thousands): Three Months Ended March 31, 2016 2015 Net income (loss) $ $ Add-back of non-operating expense (income): Interest expense, net Income tax expense (benefit) Realized losses (gains) on investments — Interest income from restricted assets Equity in earnings of unconsolidated subsidiary Other expense (income), net Income from operations — segment totals Add-back of operating expense (income): Depreciation and amortization expense Restructuring and other charges — Severance and related costs Net (income) loss attributable to noncontrolling interest Interest income from restricted assets Equity-based compensation expense Transaction costs Adjusted EBITDA $ $
Facility-Based Physician Services
Schedule of reconciliation Adjusted EBITDA to Segments	Three Months Ended March 31, Facility-Based and Post-Acute Care Physician Services 2016 2015 Adjusted EBITDA $ $ Depreciation and amortization expense Restructuring and other charges — Severance and related costs Net (income) loss attributable to noncontrolling interest Interest income from restricted assets Equity-based compensation expense Transaction costs Income from operations $ $
Healthcare Transportation Services
Schedule of reconciliation Adjusted EBITDA to Segments	Three Months Ended March 31, Healthcare Transportation Services 2016 2015 Adjusted EBITDA $ $ Depreciation and amortization expense Severance and related costs Interest income from restricted assets Equity-based compensation expense Transaction costs Income from operations $ $

Consolidating Financial Infor31

Consolidating Financial Information (Tables)	3 Months Ended
	Mar. 31, 2016
Consolidating Financial Information
Schedule of Consolidating Balance Sheet	Consolidating Balance Sheet As of March 31, 2016 (in thousands, unaudited) EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Assets Current assets: Cash and cash equivalents $ $ $ — $ Insurance collateral — — Trade and other accounts receivable, net — — Parts and supplies inventory — — Prepaids and other current assets — — Total current assets — Property, plant, and equipment, net — — Intangible assets, net — — Goodwill — — Other long-term assets Investment in wholly owned subsidiary — — Total assets $ $ $ $ Liabilities and Equity Current liabilities: Accounts payable $ — $ $ — $ Accrued liabilities — — Current portion of long-term debt and capital lease obligations — — Total current liabilities — — Long-term debt and capital lease obligations — — Long-term deferred tax liabilities — Insurance reserves — — Other long-term liabilities — — Total liabilities — Equity: Common stock — — Preferred stock — — — — Additional paid-in capital Retained earnings Accumulated other comprehensive income (loss) Total Envision Healthcare Holdings, Inc. equity Noncontrolling interest — — Total equity Total liabilities and equity $ $ $ $ Consolidating Balance Sheet As of December 31, 2015 (in thousands) EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Assets Current assets: Cash and cash equivalents $ $ $ — $ Insurance collateral — — Trade and other accounts receivable, net — — Parts and supplies inventory — — Prepaids and other current assets Total current assets Property, plant, and equipment, net — — Intangible assets, net — — Goodwill — — Other long-term assets Investment in wholly owned subsidiary — — Total assets $ $ $ $ Liabilities and Equity Current liabilities: Accounts payable $ $ $ — $ Accrued liabilities — Current portion of long-term debt and capital lease obligations — — Total current liabilities Long-term debt and capital lease obligations — — Long-term deferred tax liabilities — Insurance reserves — — Other long-term liabilities — — Total liabilities Equity: Common stock — — Preferred stock — — — — Additional paid-in capital Retained earnings Accumulated other comprehensive income (loss) Total Envision Healthcare Holdings, Inc. equity Noncontrolling interest — — Total equity Total liabilities and equity $ $ $ $
Schedule of Condensed Consolidating Statements of Operations	Condensed Consolidating Statement of Operations (in thousands, unaudited) Three Months Ended March 31, 2016 EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Net revenue $ — $ $ — $ Compensation and benefits — — Operating expenses — — Insurance expense — — Selling, general and administrative expenses — — Depreciation and amortization expense — — Restructuring and other charges — — Income (loss) from operations — — Interest income from restricted assets — — Interest expense, net — — Realized gains (losses) on investments — — Other income (expense), net — Income (loss) before taxes and equity in earnings of unconsolidated subsidiary — Income tax benefit (expense) — Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary — Equity in net income (loss) of subsidiary — — Equity in earnings of unconsolidated subsidiary — — Net income (loss) Less: Net (income) loss attributable to noncontrolling interest — — Net income (loss) attributable to Envision Healthcare Holdings, Inc. $ $ $ $ Condensed Consolidating Statement of Operations (in thousands, unaudited) Three Months Ended March 31, 2015 EVHC Corporation (excluding and Consolidating Corporation) Subsidiaries Adjustments Total Net revenue $ — $ $ — $ Compensation and benefits — — Operating expenses — — Insurance expense — — Selling, general and administrative expenses — — Depreciation and amortization expense — — Income from operations — — Interest income from restricted assets — — Interest expense, net — — Other income (expense), net — — Income (loss) before taxes and equity in earnings of unconsolidated subsidiary — Income tax benefit (expense) — Income (loss) before equity in net income (loss) of subsidiary and equity in earnings of unconsolidated subsidiary — Equity in net income (loss) of subsidiary — — Equity in earnings of unconsolidated subsidiary — — Net income (loss) Less: Net (income) loss attributable to noncontrolling interest — — Net income (loss) attributable to Envision Healthcare Holdings, Inc. $ $ $ $
Schedule of Condensed Consolidating Statement of Cash Flows	Condensed Consolidating Statement of Cash Flows (in thousands, unaudited) Three Months Ended March 31, 2016 EVHC (excluding Corporation and Corporation) Subsidiaries Total Cash Flows from Operating Activities Net cash provided by (used in) operating activities $ $ $ Cash Flows from Investing Activities Purchases of available-for-sale securities — Sales and maturities of available-for-sale securities — Purchase of property, plant and equipment — Proceeds from sale of property, plant and equipment — Acquisition of businesses, net of cash received — Net change in insurance collateral — Other investing activities — Net cash provided by (used in) investing activities — Cash Flows from Financing Activities Borrowings under the ABL Facility — Repayments of the ABL Facility — Repayments of the Term Loan — Debt issuance costs — Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan — Excess tax benefits from equity-based compensation — Other financing activities — Net intercompany borrowings (payments) — Net cash provided by (used in) financing activities Change in cash and cash equivalents — Cash and cash equivalents, beginning of period Cash and cash equivalents, end of period $ $ $ Condensed Consolidating Statement of Cash Flows (in thousands, unaudited) Three Months Ended March 31, 2015 EVHC (excluding Corporation and Corporation) Subsidiaries Total Cash Flows from Operating Activities Net cash provided by (used in) operating activities $ $ $ Cash Flows from Investing Activities Purchases of available-for-sale securities — Sales and maturities of available-for-sale securities — Purchase of property, plant and equipment — Proceeds from sale of property, plant and equipment — Acquisition of businesses, net of cash received — Net change in insurance collateral — Other investing activities — Net cash provided by (used in) investing activities — Cash Flows from Financing Activities Borrowings under the ABL Facility — Repayments of the Term Loan — Repayments of the ABL Facility — Debt issuance costs — Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan — Excess tax benefits from equity-based compensation — Contributions from noncontrolling interest, net — Other financing activities — Net intercompany borrowings (payments) — Net cash provided by (used in) financing activities Change in cash and cash equivalents — Cash and cash equivalents, beginning of period Cash and cash equivalents, end of period $ $ $

General (Details)

General (Details)	3 Months Ended
	Mar. 31, 2016item
General
Number of operating segments	2

Summary of Significant Accoun33

Summary of Significant Accounting Policies - Insurance Collateral, Trade and Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Insurance Collateral
Reinsurance receivable	$ 1,106	$ 644
Trade and Other Accounts Receivable, net
Gross trade accounts receivable	6,420,259	6,375,473
Allowance for contractual discounts	(3,249,291)	(3,340,078)
Allowance for uncompensated care	(1,874,934)	(1,779,200)
Trade accounts receivable, net	1,296,034	1,256,195
Other receivables, net	286	826
Trade and other accounts receivable, net	$ 1,296,320	$ 1,257,021
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		94.00%
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		86.00%

Summary of Significant Accoun34

Summary of Significant Accounting Policies - Insurance Reserves (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Insurance Reserves
Discount rate for claims other than general liability claims (as a percent)	1.50%
Increase (decrease) in provisions for insurance liabilities for prior year losses	$ 0.9	$ 2.6
Minimum
Insurance Reserves
Liability exposure in instances where third-party insurance coverage is obtained	1
Maximum
Insurance Reserves
Liability exposure in instances where third-party insurance coverage is obtained	$ 3

Summary of Significant Accoun35

Summary of Significant Accounting Policies - Concentration of Credit Risk (Details) - Net revenue - Customer concentration risk	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Medicare and Medicaid
Concentration of Credit Risk
Percentage of concentration risk	34.00%	34.00%
Insurance providers and contracted payors
Concentration of Credit Risk
Percentage of concentration risk	63.00%	64.00%
Self-pay
Concentration of Credit Risk
Percentage of concentration risk	3.00%	2.00%

Summary of Significant Accoun36

Summary of Significant Accounting Policies - Financial Instruments (Details) - Senior subordinated unsecured notes purchased by the Company's subsidiary - USD ($) $ in Millions	Mar. 31, 2016	Dec. 31, 2015
Financial Instruments
Estimated fair value of the senior subordinate notes	$ 757.5	$ 735
Carrying value of the senior subordinate notes	$ 750	$ 750

Summary of Significant Accoun37

Summary of Significant Accounting Policies - Fair Value (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015
Fair Value Measurement
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
Available-for-sale securities (insurance collateral)
Fair Value Measurement
Assets	21,791	$ 23,192
Contingent consideration
Fair Value Measurement
Liabilities	2,116	2,116
Fuel hedge
Fair Value Measurement
Liabilities	2,279	2,777
Level 1 | Available-for-sale securities (insurance collateral)
Fair Value Measurement
Assets	17,990	19,116
Level 2 | Available-for-sale securities (insurance collateral)
Fair Value Measurement
Assets	3,801	4,076
Level 2 | Fuel hedge
Fair Value Measurement
Liabilities	2,279	2,777
Level 3 | Contingent consideration
Fair Value Measurement
Liabilities	$ 2,116	$ 2,116

Summary of Significant Accoun38

Summary of Significant Accounting Policies - Revenue Recognition (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Revenue Recognition
Episode period	60 days
Revenue, net of contractual discounts, excluding subsidies and fees:	$ 2,521,139	$ 2,000,976
Subsidies and fees	342,775	251,742
Net revenue	2,863,914	2,252,718
Provision for uncompensated care	(1,266,368)	(1,008,216)
Net revenue	1,597,546	1,244,502
Revenue Recognition
Increase (decrease) in contractual discount or uncompensated care provisions	2,900	3,600
Medicare
Revenue Recognition
Revenue, net of contractual discounts, excluding subsidies and fees:	460,327	362,069
Medicaid
Revenue Recognition
Revenue, net of contractual discounts, excluding subsidies and fees:	180,768	130,976
Commercial insurance and managed care (excluding Medicare and Medicaid managed care)
Revenue Recognition
Revenue, net of contractual discounts, excluding subsidies and fees:	802,715	651,816
Self-pay
Revenue Recognition
Revenue, net of contractual discounts, excluding subsidies and fees:	$ 1,077,329	$ 856,115

Summary of Significant Accoun39

Summary of Significant Accounting Policies - Recent Accounting Pronouncements (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Recent Accounting Pronouncements
Decrease in other long-term assets due to reclassification	$ (95,421)	$ (95,712)
Decrease in long-term debt and capital lease obligations due to reclassification	(2,954,829)	(2,958,481)
Increase in Long-term deferred tax liabilities due to reclassification	$ 391,248	369,110
Accounting Standards Update 2015-03 | Adjustment
Recent Accounting Pronouncements
Decrease in other long-term assets due to reclassification		34,600
Decrease in long-term debt and capital lease obligations due to reclassification		34,600
Accounting Standards Update 2015-17 | Early Adoption
Recent Accounting Pronouncements
Decrease in current deferred tax liabilities due to reclassification		85,800
Increase in Long-term deferred tax liabilities due to reclassification		$ 85,800

Basic and Diluted Net Income 40

Basic and Diluted Net Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Basic and Diluted Net Income Per Share
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$ 26,850	$ 33,375
Net income (loss) allocated to participating securities	69
Net income (loss) attributable to Envision Healthcare Holdings, Inc. common stockholders	$ 26,781	$ 33,375
Weighted-average common shares outstanding - common stock:
Basic (in shares)	187,047,309	184,586,249
Dilutive impact of stock awards outstanding (in shares)	4,883,502	6,655,427
Diluted (in shares)	191,930,811	191,241,676
Net income (loss) per share attributable to Envision Healthcare Holdings, Inc.:
Basic (in dollars per share)	$ 0.14	$ 0.18
Diluted (in dollars per share)	$ 0.14	$ 0.17
Stock awards of common stock outstanding excluded from the computations of diluted loss per share and weighted-average common shares outstanding	1,153,129	36,957

Acquisitions (Details)

Acquisitions (Details) $ in Thousands	Dec. 24, 2015USD ($)	Dec. 03, 2015USD ($)item	Oct. 28, 2015USD ($)item	Sep. 30, 2015USD ($)item	Jul. 10, 2015USD ($)	Feb. 27, 2015USD ($)item	Feb. 23, 2015USD ($)	Feb. 01, 2015USD ($)	Jan. 30, 2015USD ($)item	Mar. 31, 2016USD ($)	Mar. 31, 2015USD ($)	Dec. 31, 2015USD ($)
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Goodwill										$ 3,299,231		$ 3,271,933
Net income (loss)										26,781	$ 33,375
Net revenue										1,597,546	1,244,502
SEA
Acquisitions
Total consideration of acquisitions paid in cash									$ 104,800
Number of Physicians Employed | item									40
Tax deductible goodwill									$ 0
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents									545
Accounts receivable									7,516
Prepaid and other current assets									210
Acquired intangible assets									86,200
Goodwill									46,961
Accounts payable									(1,153)
Accrued liabilities									(182)
Long-term deferred tax liabilities									(35,263)
Total purchase price									$ 104,834
Increase (decrease) in goodwill due to purchase price allocation adjustments										(400)
SEA | Minimum
Acquisitions
Number of mid-level providers | item									12
VISTA
Acquisitions
Total consideration of acquisitions paid in cash								$ 123,800
Tax deductible goodwill								15,400
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents								1,062
Accounts receivable								22,219
Prepaid and other current assets								1,245
Property, plant and equipment								2,739
Acquired intangible assets								53,270
Goodwill								73,458
Other long-term assets								5,920
Accounts payable								(1,940)
Accrued liabilities								(5,493)
Long-term deferred tax liabilities								(13,138)
Insurance reserves								(13,639)
Other long-term liabilities								(1,365)
Total purchase price								124,338
Working capital adjustment								$ 500
Purchase price allocation, accounts receivable										300
Purchase price allocation adjustment, long-term deferred tax liabilities										(400)
EMA
Acquisitions
Total consideration of acquisitions paid in cash						$ 282,300
Increase in total consideration										10,500
Number of Health Care Facilities | item						47
Tax deductible goodwill						$ 117,800
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents						7,388
Accounts receivable						53,099
Prepaid and other current assets						5,922
Property, plant and equipment						2,276
Acquired intangible assets						147,300
Goodwill						128,590
Other long-term assets						22,327
Accounts payable						(12,863)
Accrued liabilities						(35,631)
Long-term deferred tax liabilities						(6,442)
Insurance reserves						(29,700)
Total purchase price						$ 282,266
Increase (decrease) in goodwill due to purchase price allocation adjustments										10,500
Purchase price allocation adjustment, current assets										1,100
Purchase price allocation adjustment, accrued liabilities										900
Rural Metro
Acquisitions
Total consideration of acquisitions paid in cash			$ 620,000
Tax deductible goodwill			$ 4,200
Number of states where ambulance and fire protections servcies are provided | item			19
Number of communities where ambulance and fire protection services are provided | item			700
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents			$ 18,559
Insurance collateral			39,934
Accounts receivable			89,000
Parts and supplies inventory			7,835
Prepaid and other current assets			19,914
Property, plant and equipment			92,360
Acquired intangible assets			224,800
Goodwill			406,467
Other long-term assets			2,676
Accounts payable			(16,802)
Accrued liabilities			(904)
Accrued Liablities			(83,707)
Capital Lease Obligations			(1,408)
Long-term deferred tax liabilities			(71,172)
Insurance reserves			(25,510)
Other long-term liabilities			(27,899)
Total purchase price			674,143
Working capital adjustment			$ 54,100
Working capital adjustment paid during the period										6,100
Increase (decrease) in goodwill due to purchase price allocation adjustments										6,100
Purchase price allocation adjustment, current assets										1,700
Purchase price allocation adjustment, accrued liabilities										(1,000)
Purchase price allocation adjustment, other long-term liabilities										1,000
Questcare
Acquisitions
Total consideration of acquisitions paid in cash		$ 136,300
Tax deductible goodwill		22,600
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Cash and cash equivalents		1,682
Insurance collateral		6,420
Accounts receivable		22,210
Prepaid and other current assets		2,609
Property, plant and equipment		2,623
Acquired intangible assets		67,200
Goodwill		56,813
Other long-term assets		2,188
Accounts payable		(2,646)
Accrued liabilities		(12,628)
Long-term deferred tax liabilities		(2,132)
Insurance reserves		(8,047)
Other long-term liabilities		(33)
Total purchase price		$ 136,259
Purchase price allocation adjustment, long-term deferred tax liabilities										3,700
Questcare | Minimum
Acquisitions
Number of Clinical Providers | item		800
Number of Health Care Facilities | item		50
SEA, VISTA, EMA, Rural/ Metro and Questcare
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Net revenue										313,800
Care First, Inc.
Acquisitions
Total consideration of acquisitions paid in cash							$ 7,300
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Working capital adjustment							$ 700
Vital Marlboro Entities [Member]
Acquisitions
Total consideration of acquisitions paid in cash					$ 42,500
Tax deductible goodwill					$ 9,300
NTEP
Acquisitions
Total consideration of acquisitions paid in cash				$ 25,000
Number of Physicians Employed | item				27
Number of mid-level providers | item				5
Tax deductible goodwill				$ 0
MetroCare
Acquisitions
Total consideration	$ 5,000
Tax deductible goodwill	$ 1,100
Phoenix Physicians
Unaudited pro forma operating results
Net revenue											1,454,606
Net income											$ 31,516
Other 2015 Acquisition
Allocation of the purchase price, which is subject to adjustment based upon the completion of purchase price allocations
Net current assets												6,700
Acquired intangible assets												53,100
Goodwill												24,300
Long-term deferred tax liabilities												$ (11,500)
SEA Pension Plan | SEA
Acquisitions
Pension plan assets										10,100
Pension plan liabilities										10,100
NTEP Pension Plan | NTEP
Acquisitions
Pension plan assets										2,800
Pension plan liabilities										$ 2,800

Insurance Collateral - Summary

Insurance Collateral - Summary (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Insurance collateral
Available-for-sale securities	$ 21,791	$ 23,192
Insurance receivable	1,106	644
Cash deposits and other	43,471	54,078
Total insurance collateral	66,368	77,914
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Available-for-sale Securities, Amortized Cost Basis, Total	22,474	24,047
Gross Unrealized Gains	163	43
Gross Unrealized Losses	(846)	(898)
Fair Value	21,791	23,192
Other long-term assets
Insurance collateral
Insurance collateral	8,700	9,100
Corporate bonds / Fixed income
Insurance collateral
Available-for-sale securities	12,510	13,096
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Available-for-sale Securities, Amortized Cost Basis, Total	12,347	13,073
Gross Unrealized Gains	163	43
Gross Unrealized Losses		(20)
Fair Value	12,510	13,096
Equity securities
Insurance collateral
Available-for-sale securities	9,281	10,096
Amortized cost basis and aggregate fair value of the Company's available-for-sale securities
Available-for-sale Securities, Amortized Cost Basis, Total	10,127	10,974
Gross Unrealized Losses	(846)	(878)
Fair Value	9,281	$ 10,096
U.S. Treasuries and Corporate bonds / Fixed income securities
Contractual maturities of available-for-sale securities
Within one year	3,400
Longer than one year through five years	$ 9,100

Insurance Collateral - Cost and

Insurance Collateral - Cost and Fair Value (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Insurance collateral
Securities available-for-sale, Fair Value, Total	$ 9,982		$ 16,449
Securities available-for-sale, Unrealized Loss, Total	(846)		(898)
Realized net gains on the sale and maturities of available-for-sale securities	100	$ 0
Corporate bonds / Fixed income
Insurance collateral
Securities available-for-sale, Less than 12 months, Fair Value	700		6,103
Securities available-for-sale, 12 months or more, Fair Value			250
Securities available-for-sale, Less than 12 months, Unrealized Loss			(19)
Securities available-for-sale, 12 months or more, Unrealized Loss			(1)
Equity securities
Insurance collateral
Securities available-for-sale, Less than 12 months, Fair Value	1,829
Securities available-for-sale, 12 months or more, Fair Value	7,453		10,096
Securities available-for-sale, Less than 12 months, Unrealized Loss	(64)
Securities available-for-sale, 12 months or more, Unrealized Loss	$ (782)		$ (878)

Accrued Liabilities (Details)

Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Accrued Liabilities
Accrued wages and benefits	$ 316,877	$ 285,660
Current portion of self-insurance reserves	105,705	103,922
Current portion of compliance and legal	35,433	34,021
Accrued incentive compensation	32,066	33,090
Accrued income taxes	13,996	17,719
Accrued medical claim liabilities	59,734	6,115
Deferred revenue	26,285	27,461
Other	106,002	104,457
Total accrued liabilities	$ 696,098	$ 612,445

Debt and Capital Lease Obliga45

Debt and Capital Lease Obligations - Summary (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2016	Dec. 31, 2015
Long-Term Debt
Debt and Capital Lease Obligations, Total	$ 3,023,538	$ 3,029,725
Less current portion	(24,453)	(24,550)
Debt issuance costs on senior unsecured notes, senior secured term loan and ABL Facility	(32,802)	(34,619)
Long-term debt	2,954,829	2,958,481
Outstanding letters of credit	172,900	140,800
Senior Unsecured Notes due 2022
Long-Term Debt
Debt and Capital Lease Obligations, Total	750,000	750,000
Term Loan Facility
Long-Term Debt
Debt and Capital Lease Obligations, Total	2,270,361	2,276,204
Discount on debt	$ (11,454)	$ (12,075)
Interest rate, minimum (as a percent)	4.25%	4.25%
Interest rate, maximum (as a percent)	4.50%	4.50%
ABL Facility
Long-Term Debt
Outstanding letters of credit	$ 149,800
Maximum available borrowing capacity	400,200
Notes due at various dates from 2016 to 2022
Long-Term Debt
Debt and Capital Lease Obligations, Total	$ 420	$ 432
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 2016 to 2018
Long-Term Debt
Debt and Capital Lease Obligations, Total	$ 2,757	$ 3,089

Derivative Instruments and He46

Derivative Instruments and Hedging Activities (Details) - Fuel hedge item in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2016USD ($)itemagreement$ / gal	Mar. 31, 2015USD ($)	Dec. 31, 2015USD ($)
Derivative Instruments and Hedging Activities
Number of master agreements | agreement	1
Total gallons of diesel fuel | item	1.9
Gallons of diesel fuel as a percentage of total estimated annual usage	18.00%
Fair value of derivative asset	$ 2.3		$ 2.8
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	$ 2.3
Net payments to the counterparty	$ 0.8	$ 0.2
Minimum
Derivative Instruments and Hedging Activities
Diesel fuel price (in dollars per gallon) | $ / gal	3.16
Maximum
Derivative Instruments and Hedging Activities
Diesel fuel price (in dollars per gallon) | $ / gal	3.58

Changes in Accumulated Other 47

Changes in Accumulated Other Comprehensive Income (Loss) by Component - Changes in AOCI (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period	$ (1,649)	$ (1,856)	$ (1,856)
Other comprehensive income (loss) before reclassifications	(1,767)		(1,505)
Amounts reclassified from accumulated other comprehensive income (loss)	302		1,712
Total other comprehensive income (loss), net of tax	(1,465)	137	207
Balance at the end of the period	(3,114)		(1,649)
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	(510)	(24)	(24)
Other comprehensive income (loss) before reclassifications	(23)		(473)
Amounts reclassified from accumulated other comprehensive income (loss)	(9)		(13)
Total other comprehensive income (loss), net of tax	(32)		(486)
Balance at the end of the period	(542)		(510)
Other
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period	601
Other comprehensive income (loss) before reclassifications	(1,745)		601
Total other comprehensive income (loss), net of tax	(1,745)		601
Balance at the end of the period	(1,144)		601
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	(1,740)	(897)	(897)
Other comprehensive income (loss) before reclassifications	1		(1,627)
Amounts reclassified from accumulated other comprehensive income (loss)	311		784
Total other comprehensive income (loss), net of tax	312		(843)
Balance at the end of the period	$ (1,428)		(1,740)
Interest rate swap agreements | Gains and losses on cash flow hedges
Changes in the company's AOCI by component, after tax
Balance at the beginning of the period		$ (935)	(935)
Other comprehensive income (loss) before reclassifications			(6)
Amounts reclassified from accumulated other comprehensive income (loss)			941
Total other comprehensive income (loss), net of tax			$ 935

Changes in Accumulated Other 48

Changes in Accumulated Other Comprehensive Income (Loss) by Component - Reclassifications (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Amounts Reclassified from Accumulated Other Comprehensive Income
Operating expenses	$ (253,215)	$ (151,726)
Interest expense, net	(38,883)	(26,687)
Realized gains (losses) on investments	15
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	49,726	56,374
Tax benefit (expense)	(19,392)	(22,516)
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	26,850	33,375
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	(497)	(692)
Tax benefit (expense)	186	260
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	(311)	(432)
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	(497)	(196)
Gains and losses on cash flow hedges | Interest rate swap agreements | Amounts Reclassified from Accumulated Other Comprehensive Income
Amounts Reclassified from Accumulated Other Comprehensive Income
Interest expense, net		$ (496)
Unrealized holding gains on available-for-sale securities | Amounts Reclassified from Accumulated Other Comprehensive Income
Amounts Reclassified from Accumulated Other Comprehensive Income
Realized gains (losses) on investments	15
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	15
Tax benefit (expense)	(6)
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$ 9

Retirement Plans and Employee49

Retirement Plans and Employee Benefits - Change in Plan Assets (Details) - Pension Plan $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)
Change in plan assets:
Fair value of plan assets, Beginning balance	$ 18,382
Actual return on plan assets	52
Employer contributions	700
Benefits paid	(25)
Fair value of plan assets, Ending balance	$ 19,109

Retirement Plans and Employee50

Retirement Plans and Employee Benefits - Fair Value of Plan Assets (Details) - Pension Plan - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Dec. 31, 2015
Defined Benefit Pension Plan
Total plan assets	$ 19,109	$ 18,382
Equity securities
Defined Benefit Pension Plan
Total plan assets	10,924	10,627
Debt securities
Defined Benefit Pension Plan
Total plan assets	6,571	6,239
Real estate
Defined Benefit Pension Plan
Total plan assets	1,614	1,516
Level 1
Defined Benefit Pension Plan
Total plan assets	12,737	12,312
Level 1 | Equity securities
Defined Benefit Pension Plan
Total plan assets	10,627	10,350
Level 1 | Debt securities
Defined Benefit Pension Plan
Total plan assets	1,672	1,560
Level 1 | Real estate
Defined Benefit Pension Plan
Total plan assets	438	402
Level 2
Defined Benefit Pension Plan
Total plan assets	5,196	4,956
Level 2 | Equity securities
Defined Benefit Pension Plan
Total plan assets	297	277
Level 2 | Debt securities
Defined Benefit Pension Plan
Total plan assets	4,899	4,679
Level 3
Defined Benefit Pension Plan
Total plan assets	1,176	1,114
Level 3 | Real estate
Defined Benefit Pension Plan
Total plan assets	1,176	$ 1,114
Increase in plan assets as a result of purchases and net unrealized gains	$ 100

Retirement Plans and Employee51

Retirement Plans and Employee Benefits - Components of Net Periodic Benefit Cost (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)
Other changes in plan assets and benefit obligations recognized as other comprehensive loss (income)
Accumulated net actuarial losses.	$ 1,100
Pension Plan
Net periodic benefit costs
Service cost	789
Interest cost	474
Expected return on plan assets	(305)
Net periodic benefit cost	958
Other changes in plan assets and benefit obligations recognized as other comprehensive loss (income)
Net gain	1,745
Total recognized as net periodic benefit cost and other comprehensive loss (income)	$ 2,703

Retirement Plans and Employee52

Retirement Plans and Employee Benefits - Other Pension Plans (Details) - USD ($) $ in Millions	Sep. 30, 2015	Jan. 30, 2015
SEA Pension Plan
Other pension plans
Accumulated benefit obligation		$ 10.1
NTEP Pension Plan
Other pension plans
Accumulated benefit obligation	$ 2.8

Retirement Plans and Employee53

Retirement Plans and Employee Benefits - Employee Stock Purchase Plan and Provider Stock Purchase Plan (Details) $ in Thousands	May. 01, 2015USD ($)itemshares	Mar. 31, 2016shares	Mar. 31, 2015shares
the ESPP and the PSPP
Employee Stock Purchase Plan and Provider Stock Purchase Plan
Maximum fair value of common stock in any offering period | $	$ 25
Purchase price of stock expressed as a percentage of the closing price of the common stock on the last trading day of the offering period	90.00%
Stock issued under plans (in shares)		0	0
the ESPP
Employee Stock Purchase Plan and Provider Stock Purchase Plan
Common stock, shares authorized for issuance		1,200,000
Requisite service period for participation in plan		60 days
the PSPP
Employee Stock Purchase Plan and Provider Stock Purchase Plan
Common stock, shares authorized for issuance	1,200,000
Requisite service provider work hours per month for participation in plan | item	120
Requisite service provider hours | item	240

Equity Based Compensation (Deta

Equity Based Compensation (Details) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	3 Months Ended
	Feb. 29, 2016	Mar. 31, 2016	Mar. 31, 2015	Aug. 31, 2013
Equity based compensation
Compensation charges		$ 2.3	$ 1.4
Total unrecognized compensation cost related to unvested awards		$ 34.8
Total unrecognized compensation cost related to unvested awards, period of recognition		2 years 1 month 6 days
Omnibus Incentive Plan
Equity based compensation
Number or common shares available for grant (in shares)		13,953,321		16,708,289
Maximum value of shares available for grant in any calendar year per participant under the share-based compensation plan		$ 5
Omnibus Incentive Plan | Stock options
Equity based compensation
Maximum number of shares available for grant in any calendar year per participant (in shares)		2,500,000
Term of awards		10 years
Omnibus Incentive Plan | Performance based awards
Equity based compensation
Maximum number of shares available for grant in any calendar year per participant (in shares)		1,500,000
2016 LTIP | Stock options
Equity based compensation
Vesting period of awards	3 years
Number of awards issued (in shares)		1,573,288
Grant date fair value (in dollars per share)		$ 8.38
2016 LTIP | Performance based awards
Equity based compensation
Vesting period of awards	3 years
Number of awards issued (in shares)		585,587
Grant date fair value (in dollars per share)		$ 22.41
2016 LTIP | RSUs
Equity based compensation
Vesting period of awards	3 years
Number of awards issued (in shares)		278,904
Grant date fair value (in dollars per share)		$ 21.99

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	Jun. 14, 2012USD ($)	May. 20, 2011USD ($)	Mar. 31, 2016USD ($)	Mar. 31, 2015USD ($)	Mar. 10, 2010item	Dec. 31, 2015USD ($)	Jan. 31, 2014item
Commitments and Contingencies
Rental expense			$ 19	$ 12.8
Outstanding letters of credit			172.9			$ 140.8
AMR | Predecessor
Commitments and Contingencies
Number of lawsuits purporting to be class actions filed | item					4
Subpoena from the DOJ | AMR
Commitments and Contingencies
Term of CIA		5 years
Subpoena from the DOJ | AMR | Predecessor
Commitments and Contingencies
Settlement amount to resolve the claims		$ 2.7
Rural Metro [Member]
Commitments and Contingencies
Term of CIA	5 years
Settlement amount to resolve the claims	$ 5.5
Pending Litigation | HMA Lawsuits
Commitments and Contingencies
Reserve			$ 30
Pending Litigation | HMA Lawsuits | EmCare
Commitments and Contingencies
Number of lawsuits, in which the Company is defendant | item							2

Variable Interest Entities (Det

Variable Interest Entities (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Dec. 31, 2015
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	$ 1,702,512	$ 1,598,427
Current liabilities	783,993	705,980
AHAH-Evolution JV
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	47,387	38,815
Current liabilities	$ 13,120	10,095
AHAH-Evolution JV | Evolution
Variable Interest Entities
Voting control (as a percent)	50.00%
UHS-EmCare JV
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	$ 31,302	37,448
Current liabilities	$ 11,326	12,638
UHS-EmCare JV | EmCare
Variable Interest Entities
Voting control (as a percent)	50.00%
HCA-EmCare JV
Summary of the assets and liabilities which are included in the Company's consolidated financial statements
Current assets	$ 195,930	179,632
Current liabilities	$ 55,817	$ 54,861
HCA-EmCare JV | EmCare
Variable Interest Entities
Voting control (as a percent)	50.00%

Segment Information - Operating

Segment Information - Operating Results (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)item	Mar. 31, 2015USD ($)
Segment Information
Number of separately managed business units | item	2
Segment Information
Net revenue	$ 1,597,546	$ 1,244,502
Income from operations	87,509	83,263
Adjusted EBITDA	151,588	128,866
Segment
Segment Information
Net revenue	1,597,546	1,244,502
Income from operations	87,509	83,263
Segment | Facility-Based Physician Services
Segment Information
Net revenue	1,012,848	825,108
Income from operations	58,981	52,175
Adjusted EBITDA	87,328	77,095
Segment | Healthcare Transportation Services
Segment Information
Net revenue	584,698	419,394
Income from operations	28,528	31,088
Adjusted EBITDA	$ 64,260	$ 51,771

Segment Information - Reconcili

Segment Information - Reconciliation of Net Income (Loss) to Adjusted EBITDA (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Reconciliation of net income (loss) to Adjusted EBITDA
Net income (loss)	$ 30,466	$ 33,930
Add-back of non-operating expense (income):
Interest expense, net	38,883	26,687
Income tax expense (benefit)	19,392	22,516
Realized (losses) gains on investments	(15)
Interest income from restricted assets	(363)	(130)
Equity in earnings of unconsolidated subsidiary	(132)	(72)
Other expense (income), net	(722)	332
Income from operations	87,509	83,263
Add-back of operating expense (income):
Depreciation and amortization expense	57,433	39,881
Restructuring charges	106
Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Interest income from restricted assets	363	130
Equity-based compensation expense	2,285	1,353
Adjusted EBITDA	151,588	128,866
Segment
Reconciliation of net income (loss) to Adjusted EBITDA
Net income (loss)	30,466	33,930
Add-back of non-operating expense (income):
Interest expense, net	38,883	26,687
Income tax expense (benefit)	19,392	22,516
Realized (losses) gains on investments	(15)
Interest income from restricted assets	(363)	(130)
Equity in earnings of unconsolidated subsidiary	(132)	(72)
Other expense (income), net	(722)	332
Income from operations	87,509	83,263
Add-back of operating expense (income):
Depreciation and amortization expense	57,433	39,881
Restructuring charges	106
Severance and related costs	1,822	1,694
Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Interest income from restricted assets	363	130
Equity-based compensation expense	2,285	1,353
Transaction costs	$ 5,686	$ 3,100

Segment Information - Adjusted

Segment Information - Adjusted EBITDA Reconciliation by Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Add-back of operating expense (income):
Adjusted EBITDA	$ 151,588	$ 128,866
Depreciation and amortization expense	(57,433)	(39,881)
Restructuring charges	(106)
Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Interest income from restricted assets	(363)	(130)
Equity-based compensation expense	(2,285)	(1,353)
Income from operations	87,509	83,263
Segment
Add-back of operating expense (income):
Depreciation and amortization expense	(57,433)	(39,881)
Restructuring charges	(106)
Severance and related costs	(1,822)	(1,694)
Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Interest income from restricted assets	(363)	(130)
Equity-based compensation expense	(2,285)	(1,353)
Transaction costs	(5,686)	(3,100)
Income from operations	87,509	83,263
Facility-Based Physician Services | Segment
Add-back of operating expense (income):
Adjusted EBITDA	87,328	77,095
Depreciation and amortization expense	(26,991)	(20,529)
Restructuring charges	(106)
Severance and related costs	(603)	(1,224)
Net (income) loss attributable to noncontrolling interest	3,616	555
Interest income from restricted assets	(252)	(19)
Equity-based compensation expense	(1,097)	(609)
Transaction costs	(2,914)	(3,094)
Income from operations	58,981	52,175
Healthcare Transportation Services | Segment
Add-back of operating expense (income):
Adjusted EBITDA	64,260	51,771
Depreciation and amortization expense	(30,442)	(19,352)
Severance and related costs	(1,219)	(470)
Interest income from restricted assets	(111)	(111)
Equity-based compensation expense	(1,188)	(744)
Transaction costs	(2,772)	(6)
Income from operations	$ 28,528	$ 31,088

Consolidating Financial Infor60

Consolidating Financial Information - Balance Sheet (Details) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015	Mar. 31, 2015	Dec. 31, 2014
Current assets:
Cash and cash equivalents	$ 191,657	$ 141,677	$ 92,875	$ 318,895
Insurance collateral	57,682	68,849
Trade and other accounts receivable, net	1,296,320	1,257,021
Parts and supplies inventory	33,675	34,023
Prepaids and other current assets	123,178	96,857
Total current assets	1,702,512	1,598,427
Property, plant, and equipment, net	351,469	335,869
Intangible assets, net	1,020,105	1,051,631
Goodwill	3,299,231	3,271,933
Other long-term assets	95,421	95,712
Total assets	6,468,738	6,353,572
Current liabilities:
Accounts payable	63,442	68,985
Accrued liabilities	696,098	612,445
Current portion of long-term debt and capital lease obligations	24,453	24,550
Total current liabilities	783,993	705,980
Long-term debt and capital lease obligations	2,954,829	2,958,481
Long-term deferred tax liabilities	391,248	369,110
Insurance reserves	249,169	252,650
Other long-term liabilities	54,953	65,910
Total liabilities	4,434,192	4,352,131
Equity:
Common stock	$ 1,871	$ 1,869
Preferred stock
Additional paid-in capital	$ 1,681,680	$ 1,677,578
Retained earnings	315,591	288,741
Accumulated other comprehensive income (loss)	(3,114)	(1,649)		(1,856)
Total Envision Healthcare Holdings, Inc. equity	1,996,028	1,966,539
Noncontrolling interest	38,518	34,902
Total equity	2,034,546	2,001,441
Total liabilities and equity	6,468,738	6,353,572
Consolidating Adjustments
Current assets:
Prepaids and other current assets		(3,650)
Total current assets		(3,650)
Other long-term assets	(104)	(103)
Investment in wholly owned subsidiary	(1,995,919)	(1,963,780)
Total assets	(1,996,023)	(1,967,533)
Current liabilities:
Accrued liabilities		(3,650)
Total current liabilities		(3,650)
Long-term deferred tax liabilities	(104)	(103)
Total liabilities	(104)	(3,753)
Equity:
Additional paid-in capital	(1,614,168)	(1,606,975)
Retained earnings	(384,865)	(358,454)
Accumulated other comprehensive income (loss)	3,114	1,649
Total Envision Healthcare Holdings, Inc. equity	(1,995,919)	(1,963,780)
Total equity	(1,995,919)	(1,963,780)
Total liabilities and equity	(1,996,023)	(1,967,533)
EVHC (excluding Corporation)
Current assets:
Cash and cash equivalents	5	5	5	5
EVHC (excluding Corporation) | Reportable legal entity
Current assets:
Cash and cash equivalents	5	5
Prepaids and other current assets		3,650
Total current assets	5	3,655
Other long-term assets	104	103
Investment in wholly owned subsidiary	1,995,919	1,963,780
Total assets	1,996,028	1,967,538
Current liabilities:
Accounts payable		999
Total current liabilities		999
Total liabilities		999
Equity:
Common stock	1,871	1,869
Additional paid-in capital	1,681,680	1,677,578
Retained earnings	315,591	288,741
Accumulated other comprehensive income (loss)	(3,114)	(1,649)
Total Envision Healthcare Holdings, Inc. equity	1,996,028	1,966,539
Total equity	1,996,028	1,966,539
Total liabilities and equity	1,996,028	1,967,538
Corporation and Subsidiaries
Current assets:
Cash and cash equivalents	191,652	141,672	$ 92,870	$ 318,890
Corporation and Subsidiaries | Reportable legal entity
Current assets:
Cash and cash equivalents	191,652	141,672
Insurance collateral	57,682	68,849
Trade and other accounts receivable, net	1,296,320	1,257,021
Parts and supplies inventory	33,675	34,023
Prepaids and other current assets	123,178	96,857
Total current assets	1,702,507	1,598,422
Property, plant, and equipment, net	351,469	335,869
Intangible assets, net	1,020,105	1,051,631
Goodwill	3,299,231	3,271,933
Other long-term assets	95,421	95,712
Total assets	6,468,733	6,353,567
Current liabilities:
Accounts payable	63,442	67,986
Accrued liabilities	696,098	616,095
Current portion of long-term debt and capital lease obligations	24,453	24,550
Total current liabilities	783,993	708,631
Long-term debt and capital lease obligations	2,954,829	2,958,481
Long-term deferred tax liabilities	391,352	369,213
Insurance reserves	249,169	252,650
Other long-term liabilities	54,953	65,910
Total liabilities	4,434,296	4,354,885
Equity:
Additional paid-in capital	1,614,168	1,606,975
Retained earnings	384,865	358,454
Accumulated other comprehensive income (loss)	(3,114)	(1,649)
Total Envision Healthcare Holdings, Inc. equity	1,995,919	1,963,780
Noncontrolling interest	38,518	34,902
Total equity	2,034,437	1,998,682
Total liabilities and equity	$ 6,468,733	$ 6,353,567

Consolidating Financial Infor61

Consolidating Financial Information - Income Statement (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Condensed Consolidating Statements of Operations
Net revenue	$ 1,597,546	$ 1,244,502
Compensation and benefits	1,123,873	907,657
Operating expenses	253,215	151,726
Insurance expense	37,420	35,526
Selling, general and administrative expenses	37,990	26,449
Depreciation and amortization expense	57,433	39,881
Restructuring charges	106
Income from operations	87,509	83,263
Interest income from restricted assets	363	130
Interest expense, net	(38,883)	(26,687)
Realized gains (losses) on investments	15
Other income (expense), net	722	(332)
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	49,726	56,374
Income tax benefit (expense)	(19,392)	(22,516)
Income (loss) before equity in earnings of unconsolidated subsidiary	30,334	33,858
Equity in earnings of unconsolidated subsidiary	132	72
Net income (loss)	30,466	33,930
Less: Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	26,850	33,375
Consolidating Adjustments
Condensed Consolidating Statements of Operations
Equity in earnings of unconsolidated subsidiary	(26,411)	(33,578)
Net income (loss)	(26,411)	(33,578)
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	(26,411)	(33,578)
EVHC (excluding Corporation) | Reportable legal entity
Condensed Consolidating Statements of Operations
Other income (expense), net	718	(332)
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	718	(332)
Income tax benefit (expense)	(279)	129
Income (loss) before equity in earnings of unconsolidated subsidiary	439	(203)
Equity in earnings of unconsolidated subsidiary	26,411	33,578
Net income (loss)	26,850	33,375
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	26,850	33,375
Corporation and Subsidiaries | Reportable legal entity
Condensed Consolidating Statements of Operations
Net revenue	1,597,546	1,244,502
Compensation and benefits	1,123,873	907,657
Operating expenses	253,215	151,726
Insurance expense	37,420	35,526
Selling, general and administrative expenses	37,990	26,449
Depreciation and amortization expense	57,433	39,881
Restructuring charges	106
Income from operations	87,509	83,263
Interest income from restricted assets	363	130
Interest expense, net	(38,883)	(26,687)
Realized gains (losses) on investments	15
Other income (expense), net	4
Income (loss) before income taxes and equity in earnings of unconsolidated subsidiary	49,008	56,706
Income tax benefit (expense)	(19,113)	(22,645)
Income (loss) before equity in earnings of unconsolidated subsidiary	29,895	34,061
Equity in earnings of unconsolidated subsidiary	132	72
Net income (loss)	30,027	34,133
Less: Net (income) loss attributable to noncontrolling interest	(3,616)	(555)
Net income (loss) attributable to Envision Healthcare Holdings, Inc.	$ 26,411	$ 33,578

Consolidating Financial Infor62

Consolidating Financial Information - Cash Flow Statement (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	$ 89,618	$ 45,315
Cash Flows from Investing Activities
Purchases of available-for-sale securities	(8)	(472)
Sales and maturities of available-for-sale securities	1,448	200
Purchase of property, plant and equipment	(39,121)	(13,507)
Proceeds from sale of property, plant and equipment	28	44
Acquisition of businesses, net of cash received	(6,686)	(498,283)
Net change in insurance collateral	10,075	(4,508)
Other investing activities	(301)	(912)
Net cash provided by (used in) investing activities	(34,565)	(517,438)
Cash Flows from Financing Activities
Borrowings under the ABL Facility	70,000	285,000
Repayments of the ABL Facility	(70,000)	(50,000)
Repayments of the Term Loan	(5,843)	(3,343)
Debt issuance costs	(703)	(27)
Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan	689	3,548
Excess tax benefits from equity-based compensation	1,130	10,945
Contributions from noncontrolling interest, net		100
Other financing activities	(346)	(120)
Net cash provided by (used in) financing activities	(5,073)	246,103
Change in cash and cash equivalents	49,980	(226,020)
Cash and cash equivalents, beginning of period	141,677	318,895
Cash and cash equivalents, end of period	191,657	92,875
EVHC (excluding Corporation)
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	(561)	(204)
Cash Flows from Financing Activities
Net intercompany borrowings (payments)	561	204
Net cash provided by (used in) financing activities	561	204
Cash and cash equivalents, beginning of period	5	5
Cash and cash equivalents, end of period	5	5
Corporation and Subsidiaries
Cash Flows from Operating Activities
Net cash provided by (used in) operating activities	90,179	45,519
Cash Flows from Investing Activities
Purchases of available-for-sale securities	(8)	(472)
Sales and maturities of available-for-sale securities	1,448	200
Purchase of property, plant and equipment	(39,121)	(13,507)
Proceeds from sale of property, plant and equipment	28	44
Acquisition of businesses, net of cash received	(6,686)	(498,283)
Net change in insurance collateral	10,075	(4,508)
Other investing activities	(301)	(912)
Net cash provided by (used in) investing activities	(34,565)	(517,438)
Cash Flows from Financing Activities
Borrowings under the ABL Facility	70,000	285,000
Repayments of the ABL Facility	(70,000)	(50,000)
Repayments of the Term Loan	(5,843)	(3,343)
Debt issuance costs	(703)	(27)
Proceeds from stock options exercised and issuance of shares under employee stock purchase plan and provider stock purchase plan	689	3,548
Excess tax benefits from equity-based compensation	1,130	10,945
Contributions from noncontrolling interest, net		100
Other financing activities	(346)	(120)
Net intercompany borrowings (payments)	(561)	(204)
Net cash provided by (used in) financing activities	(5,634)	245,899
Change in cash and cash equivalents	49,980	(226,020)
Cash and cash equivalents, beginning of period	141,672	318,890
Cash and cash equivalents, end of period	$ 191,652	$ 92,870

Subsequent Events (Details)

Subsequent Events (Details) - EPMG - Subsequent Event $ in Millions	Apr. 07, 2016USD ($)item
Subsequent events
Total cost of acquisitions | $	$ 122.1
Number of facilities	37
Minimum
Subsequent events
Number of clinical providers	500