Syneos Health (SYNH) 10-Q/A 11 May 17 2017 Q1 Quarterly report (amended) Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2017	May 03, 2017
Document and Entity Information [Abstract]
Entity Registrant Name	INC Research Holdings, Inc.
Entity Central Index Key	1,610,950
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Document Type	10-Q/A
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
Amendment Flag	true
Amendment Description	The sole purpose of this amendment is to reflect corrections of typographical errors in Note 15 "Subsequent Events".
Entity Common Stock, Shares Outstanding		54,103,923

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Income Statement [Abstract]
Net service revenue	$ 252,078	$ 248,997
Reimbursable out-of-pocket expenses	129,840	164,090
Total revenue	381,918	413,087
Costs and operating expenses:
Direct costs (exclusive of depreciation and amortization)	154,835	152,058
Reimbursable out-of-pocket expenses	129,840	164,090
Selling, general, and administrative	44,934	43,479
Restructuring, CEO transition, and other costs	1,927	6,038
Transaction expenses	2	561
Depreciation	6,164	4,892
Amortization	9,464	9,461
Total operating expenses	347,166	380,579
Income from operations	34,752	32,508
Other (expense) income, net:
Interest income	112	34
Interest expense	(3,100)	(3,004)
Other (expense) income, net	(3,457)	(5,117)
Total other (expense) income, net	(6,445)	(8,087)
Income before provision for income taxes	28,307	24,421
Income tax expense	(7,120)	(7,016)
Net income	$ 21,187	$ 17,405
Earnings per share:
Basic (USD per share)	$ 0.39	$ 0.32
Diluted (USD per share)	$ 0.38	$ 0.31
Weighted average common shares outstanding:
Basic (shares)	54,015	53,955
Diluted (shares)	55,123	55,862

Condensed Consolidated Stateme3

Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017		Mar. 31, 2016
Statement of Comprehensive Income [Abstract]
Net income	$ 21,187		$ 17,405
Unrealized gains on derivative instruments, net of income tax expense of $87 and $0, respectively	150		0
Foreign currency translation adjustments	4,846	[1]	5,336
Comprehensive income	$ 26,183		$ 22,741
[1]	Income taxes are not provided for foreign currency translation adjustments relating to investments in international subsidiaries that are intended to be held indefinitely.

Condensed Consolidated Stateme4

Condensed Consolidated Statements of Comprehensive Income (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Statement of Comprehensive Income [Abstract]
Unrealized gains on derivative instruments, income tax expense	$ (87)	$ 0

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 164,405	$ 102,471
Restricted cash	635	607
Accounts receivable billed, net	187,819	211,476
Accounts receivable unbilled	159,015	173,873
Prepaid expenses and other current assets	27,272	34,202
Total current assets	539,146	522,629
Property and equipment, net	57,485	58,306
Goodwill	553,071	552,502
Intangible assets, net	105,074	114,486
Deferred income taxes	18,136	14,726
Other long-term assets	18,686	25,858
Total assets	1,291,598	1,288,507
Current liabilities:
Accounts payable	18,851	23,693
Accrued liabilities	133,663	153,559
Deferred revenue	287,920	277,600
Current portion of long-term debt	17,813	11,875
Total current liabilities	458,247	466,727
Long-term debt, less current portion	470,053	485,849
Deferred income taxes	1,903	8,295
Other long-term liabilities	25,949	26,163
Total liabilities	956,152	987,034
Commitments and contingencies (Note 14)
Shareholders' equity:
Preferred stock, $0.01 par value; 30,000,000 shares authorized, 0 shares issued and outstanding at March 31, 2017 and December 31, 2016, respectively	0	0
Common stock, $0.01 par value; 600,000,000 shares authorized, 54,089,087 and 53,762,786 shares issued and outstanding at March 31, 2017 and December 31, 2016, respectively	541	538
Additional paid-in capital	582,972	573,176
Accumulated other comprehensive loss, net of taxes	(37,254)	(42,250)
Accumulated deficit	(210,813)	(229,991)
Total shareholders' equity	335,446	301,473
Total liabilities and shareholders' equity	$ 1,291,598	$ 1,288,507

Condensed Consolidated Balance6

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Preferred stock par value (USD per share)	$ 0.01	$ 0.01
Preferred stock shares authorized	30,000,000	30,000,000
Preferred stock shares issued	0	0
Preferred stock shares outstanding	0	0
Common stock par value (USD per share)	$ 0.01	$ 0.01
Common stock shares authorized	600,000,000	600,000,000
Common stock shares issued	54,089,087	53,762,786
Common stock shares outstanding	54,089,087	53,762,786

Condensed Consolidated Stateme7

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities:
Net income	$ 21,187	$ 17,405
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization	15,628	14,353
Amortization of capitalized loan fees	201	262
Share-based compensation	5,819	2,816
(Recovery of) provision for doubtful accounts	(7)	1,129
Deferred income taxes	87	(1,268)
Asset impairment charges	2,707	7,774
Other non-cash items	364	130
Changes in operating assets and liabilities:
Billed and unbilled accounts receivable	39,264	(60,833)
Accounts payable and accrued expenses	(20,457)	13,048
Deferred revenue	8,232	(1,058)
Other assets and liabilities	2,673	5,596
Net cash provided by (used in) operating activities	75,698	(646)
Cash flows from investing activities:
Purchases of property and equipment	(10,571)	(4,774)
Net cash used in investing activities	(10,571)	(4,774)
Cash flows from financing activities:
Proceeds from revolving line of credit	15,000	0
Repayments of revolving line of credit	(25,000)	(30,000)
Proceeds from exercise of stock options	5,153	3,559
Payments related to tax withholding for share-based compensation	(1,173)	(11)
Net cash used in financing activities	(6,020)	(26,452)
Effect of exchange rate changes on cash and cash equivalents	2,827	42
Net increase (decrease) in cash and cash equivalents	61,934	(31,830)
Cash and cash equivalents, beginning of period	102,471	85,011
Cash and cash equivalents, end of period	$ 164,405	$ 53,181

Basis of Presentation and Chang

Basis of Presentation and Changes in Significant Accounting Policies	3 Months Ended
	Mar. 31, 2017
Accounting Policies [Abstract]
Basis of Presentation and Changes in Significant Accounting Policies	Basis of Presentation and Changes in Significant Accounting Policies Nature of Operations INC Research Holdings, Inc. (the "Company") is a global Contract Research Organization ("CRO"). The Company derives its revenue from providing an integrated suite of therapeutically aligned investigative site support and clinical development services focused on Phase I to Phase IV stages of clinical trials. The Company's customers include large, mid-sized, and small companies in the pharmaceutical, biotechnology, and medical device industries. Use of Estimates The preparation of the consolidated financial statements in conformity with generally accepted accounting principles ("GAAP") in the United States of America requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and the disclosures of contingent assets and liabilities as of the date of the financial statements, and the reported amounts of revenue and expenses for the periods presented in the financial statements. Examples of estimates and assumptions include fair value of goodwill and intangible assets and their potential impairment, useful lives of tangible and intangible assets, allowances for doubtful accounts, potential future outcomes of events for which income tax consequences have been recognized in our consolidated financial statements or tax returns, valuation of allowances for deferred tax assets, fair value of share-based compensation and its amortization period, loss contingencies, fair value of derivative instruments and related hedge effectiveness, and judgments related to revenue recognition, among others. The Company evaluates its estimates and assumptions on an ongoing basis and bases its estimates on experience, current and expected future conditions, third-party evaluations, and various other assumptions that management believes are reasonable under the circumstances based on the information available to management at the time these estimates and assumptions are made. Actual results and outcomes may differ materially from these estimates and assumptions. Unaudited Interim Financial Information The Company prepared the accompanying unaudited condensed consolidated financial statements in accordance with GAAP for interim financial information. The significant accounting policies followed by the Company for interim financial reporting are consistent with the accounting policies followed for annual financial reporting. The unaudited condensed consolidated financial statements, in management’s opinion, include all adjustments of a normal recurring nature necessary for a fair presentation. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company's audited consolidated financial statements and notes thereto included in the Company's Annual Report on Form 10-K for the year ended December 31, 2016 filed with the Securities and Exchange Commission on February 27, 2017 . The results of operations for the three months ended March 31, 2017 are not necessarily indicative of the results to be expected for the full year ending December 31, 2017 or any other future period. The amounts in the consolidated condensed balance sheet as of December 31, 2016 are derived from the amounts in the audited consolidated balance sheet as of December 31, 2016 . Recently Adopted Accounting Standards Income Taxes. Effective January 1, 2017, the Company elected to early adopt Accounting Standard Update ("ASU") No. 2016-16, Income Taxes - Intra-Entity Transfers of Assets Other Than Inventory . Under the updated accounting guidance the Company recognizes income tax consequences immediately when the transfer of an inter-entity asset other than inventory occurs across jurisdictions rather than deferring the tax effects of those transactions until a transfer is made to a third party. The Company adopted this standard using the modified retrospective approach and recorded a cumulative-effect adjustment as of January 1, 2017. As a result, the Company recorded (i) a reduction in prepaid income taxes of $11.7 million , (ii) a net increase in deferred income tax assets of $9.7 million , and (iii) a decrease in retained earnings of $2.0 million . Prior periods have not been adjusted. Recently Issued Accounting Standards Not Yet Adopted Test for Goodwill Impairment. In January 2017, the Financial Accounting Standards Board ("FASB") issued ASU No. 2017-04, Intangibles - Goodwill and Other - Simplifying the Test for Goodwill Impairment , which eliminates the second step of the current two-step GAAP guidance for testing goodwill for impairment and is intended to reduce the cost and complexity of goodwill impairment testing. The entity will apply a one-step quantitative test and record the amount of goodwill impairment as the excess of a reporting unit's carrying amount over its fair value, not to exceed the total amount of goodwill allocated to the reporting unit. The new guidance does not amend the optional qualitative assessments of goodwill impairment. ASU 2017-04 is effective for annual periods beginning after December 15, 2019, including interim periods within those annual periods. Early adoption is permitted for interim or annual goodwill impairment tests performed on testing dates after January 1, 2017. The Company is currently evaluating the impact of adopting this standard on its consolidated financial statements. Statement of Cash Flows - Restricted Cash. In November 2016, FASB issued ASU No. 2016-18, Statement of Cash Flows - Restricted Cash , which requires that the statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. Therefore, amounts generally described as restricted cash and restricted cash equivalents will be required to be included with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. ASU 2016-18 is effective for public business entities for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption is permitted including adoption in an interim period. The Company believes the impact of adopting this standard on its consolidated financial statements will be immaterial. Statement of Cash Flows - Classification of Cash Receipts and Payments. In August 2016, FASB issued ASU No. 2016-15, Statement of Cash Flows - Classification of Certain Cash Receipts and Cash Payments , which provides guidance on reducing the diversity in how certain cash receipts and cash payments are presented and classified in the statement of cash flows. In addition to other specific cash flow issues, ASU 2016-15 provides clarification on when an entity should separate cash receipts and cash payments into more than one class of cash flows and when an entity should classify those cash receipts and payments into one class of cash flows on the basis of predominance. The new guidance is effective for the fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption is permitted including adoption in an interim period. The Company believes the impact of adopting this standard on its consolidated financial statements will be immaterial. Financial Instruments - Credit Losses. In June 2016, FASB issued ASU No. 2016-13, Credit Losses, Measurement of Credit Losses on Financial Instruments . ASU 2016-13 amends guidance on reporting credit losses for assets held at amortized cost basis and available for sale debt securities. The ASU also introduces a new forward-looking “expected loss” approach, to estimate credit losses on most financial assets and certain other instruments, including trade receivables. To estimate expected credit losses, entities will be required to consider historical information, current information, and reasonable and supportable forecasts. This ASU also expands the disclosure requirements regarding the entity’s assumptions, models and methods for estimating expected credit losses. Entities will apply the standard’s provisions as a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. ASU 2016-13 is effective for public entities for annual and interim periods beginning after December 15, 2019. Early adoption is permitted for all entities for annual periods beginning after December 15, 2018, and interim periods therein. The Company is currently evaluating the impact of adopting this standard on its consolidated financial statements. Leases. In February 2016, FASB issued ASU No. 2016-02, Leases . ASU 2016-02 requires organizations to recognize lease assets and lease liabilities on the balance sheet, including leases that were previously classified as operating leases. The ASU also requires additional disclosures about leasing arrangements related to the amount, timing, and uncertainty of cash flows arising from leases. The amendments in this ASU are effective for financial statements issued for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption of the amendments is permitted and the new guidance will be applied using a modified retrospective approach. The Company has begun its assessment of the impact of this standard and plans to complete the assessment during the second half of 2017. The Company plans to early adopt the amendments of this update as of January 1, 2018. Financial Instruments - Recognition and Measurement. In January 2016, FASB issued ASU No. 2016-01, Financial Instruments – Recognition and Measurement of Financial Assets and Liabilities . ASU 2016-01 requires all equity investments to be measured at fair value with changes in the fair value recognized through net income (other than those accounted for under the equity method of accounting or those that result in consolidating the investee). The amendments in this ASU also require an entity to present separately in other comprehensive income the portion of the total change in the fair value of a liability resulting from a change in the instrument-specific credit risk when the entity has elected to measure the liability at fair value in accordance with the fair value option for financial instruments. In addition, the amendments in this ASU eliminate the requirement to disclose the method(s) and significant assumptions used to estimate the fair value that is required to be disclosed for financial instruments measured at amortized cost on the balance sheet for public business entities. ASU 2016-01 is effective for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption of the amendments is not permitted for public companies. The Company is currently evaluating the impact of adopting this standard on its consolidated financial statements. Revenue from Contracts with Customers. In May 2014, FASB issued ASU No. 2014-09, Revenue from Contracts with Customers . ASU 2014-09 eliminates transaction- and industry-specific revenue recognition guidance under current GAAP and replaces it with a single principles based model for determining revenue recognition. ASU 2014-09 requires that companies recognize revenue when a customer obtains control of promised goods or services. Revenue will be recognized in the amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. The standard also requires disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers, including significant judgments and changes in judgments, as well as assets recognized from costs incurred to obtain or fulfill a contract. FASB recently issued several amendments to the standard, including clarifications on principal versus agent considerations, identifying performance obligations, disclosure of prior-period performance obligations and accounting for licenses of intellectual property. For public entities, the standard is effective for reporting periods beginning after December 15, 2017. Earlier adoption is permitted only as of annual reporting periods beginning after December 15, 2016, including interim reporting periods within that reporting period. Entities can adopt the standard either retrospectively to each period presented (full retrospective approach), or retrospectively with the cumulative effect of initially applying the guidance recognized as of the date of adoption (modified retrospective or cumulative effect approach). The Company has made progress toward completing its evaluation of the potential changes from adopting this new standard on its financial reporting and disclosures, drafting accounting policies, and designing changes to business processes, controls, and systems. The Company expects to change its method of recognizing revenue from the majority of its contracts with customers from an outputs-based methodology to an inputs-based methodology. Additionally, the Company expects that the majority of its contracts will have a single performance obligation. The Company continues to evaluate questions relating to timing of the recognition of contracts and modifications in contract backlog, the timing and quantification of variable components of estimated service revenue, and the selection of the appropriate inputs to be used in the calculation of service delivery. The Company expects to complete this process in the second half of 2017 and expects to adopt the new standard effective January 1, 2018, using the modified retrospective approach. The Company is currently evaluating the financial impact of adopting this standard.

Financial Statement Details

Financial Statement Details	3 Months Ended
	Mar. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Financial Statement Details	Financial Statement Details Billed accounts receivable, net Billed accounts receivable, net consisted of the following (in thousands): March 31, 2017 December 31, 2016 Billed accounts receivable $ 193,708 $ 217,360 Allowance for doubtful accounts (5,889 ) (5,884 ) Billed accounts receivable, net $ 187,819 $ 211,476 Goodwill Changes in carrying amount of goodwill by segment for the three months ended March 31, 2017 were as follows (in thousands): Total Clinical Phase I Balance at December 31, 2016: Gross carrying amount $ 568,668 $ 560,526 $ 8,142 Accumulated impairment losses (16,166 ) (8,024 ) (8,142 ) Goodwill net of accumulated impairment losses 552,502 552,502 — 2017 Activity: Impact of foreign currency translation 569 569 — Balance at March 31, 2017: Gross carrying amount 569,237 561,095 8,142 Accumulated impairment losses (16,166 ) (8,024 ) (8,142 ) Goodwill net of accumulated impairment losses $ 553,071 $ 553,071 $ — Accumulated other comprehensive loss, net of tax Accumulated other comprehensive loss, net of tax, consisted of the following (in thousands): March 31, 2017 December 31, 2016 Foreign currency translation adjustments $ (38,510 ) $ (43,356 ) Unrealized gains on derivative instruments, net of tax 1,256 1,106 Accumulated other comprehensive loss, net of tax $ (37,254 ) $ (42,250 ) Changes in accumulated other comprehensive loss, net of tax were as follows (in thousands): Unrealized gain on derivative instruments, net of tax Foreign currency translation adjustments Total Balance at December 31, 2016 $ 1,106 $ (43,356 ) $ (42,250 ) Other comprehensive gain before reclassifications 193 4,846 5,039 Amount of gain reclassified from accumulated other comprehensive loss into statement of operations (43 ) — (43 ) Net current period other comprehensive gain, net of tax 150 4,846 4,996 Balance at March 31, 2017 $ 1,256 $ (38,510 ) $ (37,254 ) Unrealized gains on derivative instruments represent the effective portion of gains associated with interest rate swaps designated as cash flow hedges of the variable interest rate exposure of the Company's term loan. The Company reclassifies these gains into net income as it makes interest payments on its term loan. Amounts to be reclassified to net income in the next 12 months are expected to be immaterial. The tax effects allocated to each component of other comprehensive income for the three months ended March 31, 2017 were as follows (in thousands): Before-Tax Amount Tax (Expense) or Benefit Net-of-Tax Amount Foreign currency translation adjustments (a) $ 4,846 $ — $ 4,846 Unrealized gain on derivative instruments: Unrealized gains arising during period 305 (112 ) 193 Less: reclassification adjustment for gains realized in net income (68 ) 25 (43 ) Net unrealized gains 237 (87 ) 150 Other comprehensive income $ 5,083 $ (87 ) $ 4,996 (a) Income taxes are not provided for foreign currency translation adjustments relating to investments in international subsidiaries that are intended to be held indefinitely. Other (expense) income, net Other (expense) income, net consisted of the following (in thousands): Three Months Ended March 31, 2017 2016 Net realized foreign currency (loss) gain $ (670 ) $ 2,870 Net unrealized foreign currency (loss) gain (2,707 ) (7,774 ) Other, net (80 ) (213 ) Total other (expense) income, net $ (3,457 ) $ (5,117 )

Leases

Leases	3 Months Ended
	Mar. 31, 2017
Leases [Abstract]
Leases	Leases In January 2017, the Company entered into a 12 -year lease for its new corporate headquarters building in Morrisville, North Carolina, where it intends to relocate all employees from its two existing locations in Raleigh, North Carolina. The Company expects the construction of the new building to be completed in mid-2018 and anticipates completing its relocation efforts prior to the current leases expiring in early 2019. Additionally, in February 2017, the Company entered into a new 11 -year lease agreement for new office space in Farnborough, United Kingdom, which is near its existing Camberley, United Kingdom site. The Company also anticipates completing its relocation efforts prior to the Camberley lease expiring in 2018. Lease payments are subject to increases as specified in the lease agreements. As of March 31, 2017 , future minimum lease payments under non-cancellable operating leases for the fiscal years following December 31, 2016 are summarized as follows (in thousands): Fiscal Year Operating Leases 2017 (remaining 9 months) $ 15,765 2018 17,860 2019 15,076 2020 11,793 2021 10,396 2022 and thereafter 58,844 Total minimum payments $ 129,734

Derivative Financial Instrument

Derivative Financial Instruments	3 Months Ended
	Mar. 31, 2017
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments	Derivative Financial Instruments In May 2016, the Company entered into interest rate swap agreements with a combined notional value of $300.0 million in an effort to limit its exposure to variable interest rates on its term loan. Interest began accruing on the interest rate swaps on June 30, 2016, and the swaps will expire on June 30, 2018, and May 14, 2020. The material terms of these agreements are substantially the same as those contained within the credit agreement, including the monthly settlements with the counterparty. The interest rate swaps have been designated as cash flow hedges because these transactions were executed to manage the Company's exposure to variable interest rate movements and their impact on future interest payments. The effective portion of changes in fair value of derivative instruments that qualify as cash flow hedges is recorded in accumulated other comprehensive loss and is subsequently reclassified to net income in the period the hedged transaction is recognized in earnings. The ineffective portion of the change in fair value of derivative instruments is recognized as non-operating income or expense immediately when incurred and included in the "Interest expense" line item in the accompanying unaudited condensed consolidated statements of operations. The amount of hedge ineffectiveness recorded in net income during the three months ended March 31, 2017 , was immaterial and was attributable to the inconsistencies in certain terms between the interest rate swaps and the credit agreement. The fair values of the Company’s interest rate swaps designated as hedging instruments and the line items on the accompanying unaudited condensed consolidated balance sheets at the end of each period were as follows (in thousands): Balance Sheet Classification March 31, 2017 December 31, 2016 Interest rate swaps - current Prepaid expenses and other current assets $ 808 $ 461 Interest rate swaps - non-current Other long-term assets $ 1,600 $ 1,717

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2017
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Assets and Liabilities Carried at Fair Value As of March 31, 2017 , the Company’s financial assets and liabilities carried at fair value included cash and cash equivalents, restricted cash, accounts receivable, accounts payable, accrued liabilities, outstanding debt, and interest rate derivative instruments. The fair value of cash and cash equivalents, restricted cash, accounts receivable, accounts payable, and accrued liabilities approximates their respective carrying amounts because of the liquidity and short-term nature of these financial instruments. The estimated fair value of the outstanding long-term debt and revolver was determined based on the market prices for similar financial instruments or model-derived valuations based on observable inputs. As of March 31, 2017 , the estimated fair value of the outstanding long-term debt and revolver was approximately $490.0 million and these liabilities were considered to be Level 2 fair value measurements. Recurring Fair Value Measurements The fair value of interest rate derivative instruments is determined using the market standard methodology of discounted future variable cash receipts. The variable cash receipts are determined by discounting the future expected cash receipts that would occur if variable interest rates rise above the fixed rate of the swaps. The variable interest rates used in the calculation of projected receipts on the swap are based on an expectation of future interest rates derived from observable market interest rate curves and volatilities. As of March 31, 2017 , the fair value of the interest rate derivative instruments was approximately $2.4 million and these derivative instruments were considered Level 2 fair value measurements. As of March 31, 2017 , the Company did not have any assets or liabilities subject to recurring measurement that were considered Level 3 fair value measurement (which require the use of significant unobservable inputs). During the three months ended March 31, 2017 there were no transfers between Level 1, Level 2 or Level 3 fair value measurements. Non-Recurring Fair Value Measurements Certain assets, including goodwill and identifiable intangible assets, are carried on the accompanying unaudited condensed consolidated balance sheets at cost and are re-measured to fair value on a non-recurring basis. These assets are classified as Level 3 fair value measurements within the fair value hierarchy. Goodwill and indefinite-lived intangible assets, net are tested for impairment annually or more frequently if events or changes in circumstances indicate a triggering event has occurred. The Company tests finite-lived intangible assets for impairment upon the occurrence of certain triggering events.

Restructuring, CEO Transition a

Restructuring, CEO Transition and Other Costs	3 Months Ended
	Mar. 31, 2017
Restructuring and Related Activities [Abstract]
Restructuring, CEO Transition and Other Costs	Restructuring, CEO Transition, and Other Costs In July 2016, the Company entered into a transition agreement with its former Chief Executive Officer ("CEO") related to his transition from the position of CEO effective October 1, 2016, and subsequent services to be rendered through his separation date of February 28, 2017. Payments under this agreement are expected to be made through August 2018. In addition, in September 2016, the Company entered into retention agreements with certain key employees coinciding with the CEO transition for retention periods of up to one year. For the three months ended March 31, 2017 , the Company recognized $0.4 million of costs associated with these retention agreements and expects to incur an additional $0.4 million of costs related to these agreements through August 2017. For the three months ended March 31, 2017 the Company incurred $0.7 million of facility closure and lease costs related to the Company's focus on optimizing its resources worldwide. Additionally, during the three months ended March 31, 2017 , the Company incurred $0.3 million of consulting costs related to the continued consolidation of its legal entities and restructuring of its contract management process to meet the requirements of upcoming accounting regulation changes and $0.6 million of other costs. The following table summarizes activity related to the liabilities associated with restructuring, CEO transition, and other costs during the three months ended March 31, 2017 (in thousands): Employee Severance Costs, Including Executive Transition Costs Facility Closure and Lease Costs Other Costs Total Balance at December 31, 2016 $ 4,695 $ 3,817 $ 80 $ 8,592 Restructuring charges incurred (a) 352 722 527 1,601 Cash payments made (1,658 ) (974 ) (562 ) (3,194 ) Balance at March 31, 2017 $ 3,389 $ 3,565 $ 45 $ 6,999 (a) Total restructuring, CEO transition, and other costs for the three months ended March 31, 2017 include $0.3 million of other non-cash expenses that were not recorded as a restructuring liability and are therefore excluded from the rollforward above. Liabilities associated with these costs are included in the "Accrued liabilities" and "Other long-term liabilities" line items in the accompanying unaudited condensed consolidated balance sheets. Costs recognized in net income during the period related to these activities are included in the "Restructuring, CEO transition, and other costs" line item in the unaudited condensed consolidated statements of operations. These costs are not allocated to the Company’s reportable segments because they are not part of the segment performance measures regularly reviewed by management.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share Basic earnings per share is computed based on the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed based on the weighted average number of common shares plus the effect of dilutive potential common shares outstanding during the period. A reconciliation of the numerators and denominators of the basic and diluted per share computations of common stock based on the Company's consolidated earnings is as follows (in thousands, except per share amounts): Three Months Ended March 31, 2017 2016 Numerator: Net income $ 21,187 $ 17,405 Denominator: Basic weighted average common shares outstanding 54,015 53,955 Effect of dilutive securities: Stock options and other awards under deferred share-based compensation programs 1,108 1,907 Diluted weighted average common shares outstanding 55,123 55,862 Earnings per share: Basic $ 0.39 $ 0.32 Diluted $ 0.38 $ 0.31 Potential common shares outstanding that are considered antidilutive are excluded from the computation of diluted earnings per share. Potential common shares related to stock options and other awards under deferred share-based compensation programs may be determined antidilutive based on the application of the treasury stock method. Potential common shares are also considered antidilutive in the event of net loss from operations. The number of potential shares outstanding that were considered antidilutive using the treasury stock method and were excluded from the computation of diluted earnings per share, weighted for the portion of the period they were outstanding are as follows (in thousands): Three Months Ended March 31, 2017 2016 Antidilutive stock options and other awards 908 881

Share-Based Compensation

Share-Based Compensation	3 Months Ended
	Mar. 31, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-Based Compensation	Share-Based Compensation Restricted Stock Units Awards The following table summarizes the number of outstanding RSUs and activity as of and during the three months ended March 31, 2017 : Number of Shares Weighted Average Non-vested at December 31, 2016 708,695 Granted 473,949 $ 51.55 Vested (62,795 ) Forfeited (8,451 ) Non-vested at March 31, 2017 1,111,398 Employee Stock Purchase Plan The Company recognized share-based compensation expense of $0.4 million under the 2016 Employee Stock Purchase Plan ("ESPP") for the three months ended March 31, 2017 . As of March 31, 2017 , there were 60,237 shares issued and 939,763 shares reserved for future issuance under the ESPP. Share-based Compensation Expense The amount of share-based compensation expense recognized in the unaudited condensed consolidated statements of operations was as follows (in thousands): Three Months Ended March 31, Income Statement Classification 2017 2016 Direct costs $ 2,713 $ 1,259 Selling, general, and administrative expenses 3,106 1,557 Total share-based compensation expense $ 5,819 $ 2,816

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2017
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company’s effective tax rate for the three months ended March 31, 2017 was 25.2% . The effective tax rate for the three months ended March 31, 2017 was lower than the U.S. federal statutory income tax rate primarily due to (i) income earned in various international tax jurisdictions that apply lower income tax rates, (ii) research tax credits, and (iii) discrete tax adjustments related to excess tax benefits on share-based compensation payments. The Company’s effective tax rate for the three months ended March 31, 2016 was 28.7% . The effective tax rate for the three months ended March 31, 2016 was lower than the U.S. federal statutory income tax rate primarily due to (i) income or losses generated in jurisdictions where the income tax expense or benefit was offset by a corresponding change in the valuation allowance on net deferred tax assets, (ii) income earned in various international tax jurisdictions that apply lower income tax rates, and (iii) discrete tax adjustments related to the release of valuation allowances and unrecognized tax benefits. The Company's gross unrecognized tax benefits, exclusive of associated interest and penalties, were $15.7 million as of March 31, 2017 and December 31, 2016 , respectively, all of which would impact the Company's effective income tax rate if recognized. The Company recognizes accrued interest and penalties related to unrecognized tax benefits as part of the provision for income tax expense. As of March 31, 2017 and December 31, 2016, accrued interest and accrued penalties totaled $0.1 million , respectively. Effective January 1, 2017, the Company adopted new guidance under ASU No. 2016-16, Income Taxes - Intra-Entity Transfers of Assets Other Than Inventory. For additional discussion of the new guidance, see Note 1 - Basis of Presentation and Changes in Significant Accounting Policies to the accompanying unaudited condensed consolidated financial statements.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Segment Information	Segment Information The Company is managed through two reportable segments: Clinical Development Services and Phase I Services. Clinical Development Services offers a variety of services, including full-service global studies, as well as ancillary services such as clinical monitoring, investigator recruitment, patient recruitment, data management, study reports to assist customers with their drug development process, and specialized consulting services. Phase I Services focuses on clinical development services for Phase I trials that include scientific exploratory medicine, first-in-human studies through proof-of-concept stages, and support for Phase I studies in established compounds. The Company’s Chief Operating Decision Maker ("CODM") reviews segment performance and allocates resources based upon segment revenue and segment contribution margin. Inter-segment revenue is eliminated from the segment reporting presented to the CODM and is not included in the segment revenue presented in the table below. Revenue, direct costs, and contribution margin for each of the Company's segments were as follows (in thousands): Three Months Ended March 31, 2017 2016 Revenue: Clinical Development Services $ 249,727 $ 245,973 Phase I Services 2,351 3,024 Segment revenue 252,078 248,997 Reimbursable out-of-pocket expenses not allocated to segments 129,840 164,090 Total revenue $ 381,918 $ 413,087 Direct costs: Clinical Development Services $ 152,620 $ 149,314 Phase I Services 2,215 2,744 Segment direct costs 154,835 152,058 Reimbursable out-of-pocket expenses not allocated to segments 129,840 164,090 Direct costs and reimbursable out-of-pocket expenses $ 284,675 $ 316,148 Segment contribution margin: Clinical Development Services $ 97,107 $ 96,659 Phase I Services 136 280 Segment contribution margin 97,243 96,939 Less expenses not allocated to segments: Selling, general, and administrative 44,934 43,479 Restructuring, CEO transition and other costs 1,927 6,038 Transaction expenses 2 561 Depreciation and amortization 15,628 14,353 Consolidated income from operations $ 34,752 $ 32,508 The CODM reviews the Company's assets on a consolidated basis. The Company does not allocate assets to its reportable segments as they are not included in the review performed by the CODM for purposes of assessing segment performance or allocating resources.

Operations by Geographic Locati

Operations by Geographic Location	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Operations by Geographic Location	Operations by Geographic Location The Company conducts operations in North America, Europe, Middle East and Africa, Asia-Pacific, and Latin America through wholly-owned subsidiaries and representative sales offices. The Company attributes net service revenue to geographical locations based upon the location of the customer (i.e., the location to which the Company invoices the end customer). Total revenue by geographic area was as follows (in thousands, all intercompany transactions have been eliminated): Three Months Ended March 31, 2017 2016 Revenue: North America (a) $ 184,287 $ 185,714 Europe, Middle East and Africa 57,262 56,898 Asia-Pacific 10,529 6,372 Latin America — 13 Total net service revenue 252,078 248,997 Reimbursable-out-of-pocket expenses 129,840 164,090 Total revenue $ 381,918 $ 413,087 (a) Net service revenue for the North America region includes revenue attributable to the United States of $178.4 million and $180.5 million , or 70.8% and 72.5% of net service revenue, for the three months ended March 31, 2017 and March 31, 2016 , respectively. No other country represented more than 10% of net service revenue for any period. Long-lived assets by geographic area for each period were as follows (in thousands): March 31, 2017 December 31, 2016 Property and equipment, net: North America (a) $ 37,871 $ 41,057 Europe, Middle East and Africa 11,975 11,235 Asia-Pacific 6,755 5,101 Latin America 884 913 Total property and equipment, net $ 57,485 $ 58,306 (a) Long-lived assets for the North America region include property and equipment, net attributable to the United States of $37.4 million and $40.6 million as of March 31, 2017 and December 31, 2016 , respectively.

Concentration of Credit Risk

Concentration of Credit Risk	3 Months Ended
	Mar. 31, 2017
Risks and Uncertainties [Abstract]
Concentration of Credit Risk	Concentration of Credit Risk The Company maintains cash depository accounts with several financial institutions worldwide and is exposed to credit risk related to potential inability to access liquidity in financial institutions where its cash and cash equivalents are concentrated. The Company has not historically incurred any losses with respect to these balances and believes that they bear minimal credit risk. As of March 31, 2017 , the amount of cash and cash equivalents held outside the Unites States by the Company's foreign subsidiaries was $79.4 million , or 48.3% of the total consolidated cash and cash equivalents balance. No single customer accounted for greater than 10% total consolidated net service revenue for the three months ended March 31, 2017 or March 31, 2016 . As of March 31, 2017 and December 31, 2016 , no single customer accounted for greater than 10% of billed and unbilled trade accounts receivable balances.

Related-Party Transactions

Related-Party Transactions	3 Months Ended
	Mar. 31, 2017
Related Party Transactions [Abstract]
Related-Party Transactions	Related-Party Transactions For the three months ended March 31, 2016 , the Company recorded net service revenue of $0.2 million from a customer who had a significant shareholder who was also a significant shareholder of the Company through August 2016. There were no related party transactions for the three months ended March 31, 2017 .

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies In the normal course of business, the Company periodically becomes involved in various claims and lawsuits that are incidental to its business. While the outcome of these matters could differ from management's expectations, the Company does not believe the resolution of these matters will have a material effect upon the Company's financial statements. The Company is self-insured for certain losses relating to health insurance claims for the majority of its employees located within the United States. The Company purchases stop-loss coverage from third-party insurance carriers to limit individual or aggregate loss exposure with respect to the Company's health insurance claims. Accrued insurance liabilities and related expenses are based on estimates of claims incurred but not reported. As of March 31, 2017 and December 31, 2016 , the Company had accrued self-insurance reserves of $2.8 million and $3.6 million , respectively.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2017
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On May 10, 2017 , the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with inVentiv Health, Inc.’s parent company, Double Eagle Parent, Inc., a Delaware corporation (“inVentiv”), pursuant to which inVentiv will merge with and into the Company (the “Merger”), with the Company surviving the Merger. Subject to the terms and conditions of the Merger Agreement, the aggregate merger consideration to be paid in respect of all outstanding shares of inVentiv’s common stock, par value $0.0001 per share, inVentiv options and inVentiv restricted stock units shall be approximately 50.0 million shares of the Company's common stock and the Company's assumption of approximately $2.4 billion in net debt. Consummation of the Merger is subject to various conditions, including, among others, customary conditions relating to the adoption of the Merger Agreement by the requisite vote of the Company’s and inVentiv’s respective stockholders; expiration of the applicable waiting period under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended; and that the consents from the competition regulatory authorities in certain other jurisdictions be obtained. The transaction is currently expected to be completed in the second half of 2017. In order to correct previous typographical errors, the Company has restated the above disclosures to (i) amend the transaction date from May 9, 2017 to May 10, 2017, and (ii) restate the amount of net debt expected to be assumed by the Company in the proposed merger from $4.2 billion to $2.4 billion .

Basis of Presentation and Cha23

Basis of Presentation and Changes in Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2017
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of the consolidated financial statements in conformity with generally accepted accounting principles ("GAAP") in the United States of America requires management to make estimates and assumptions. These estimates and assumptions affect the reported amounts of assets and liabilities and the disclosures of contingent assets and liabilities as of the date of the financial statements, and the reported amounts of revenue and expenses for the periods presented in the financial statements. Examples of estimates and assumptions include fair value of goodwill and intangible assets and their potential impairment, useful lives of tangible and intangible assets, allowances for doubtful accounts, potential future outcomes of events for which income tax consequences have been recognized in our consolidated financial statements or tax returns, valuation of allowances for deferred tax assets, fair value of share-based compensation and its amortization period, loss contingencies, fair value of derivative instruments and related hedge effectiveness, and judgments related to revenue recognition, among others. The Company evaluates its estimates and assumptions on an ongoing basis and bases its estimates on experience, current and expected future conditions, third-party evaluations, and various other assumptions that management believes are reasonable under the circumstances based on the information available to management at the time these estimates and assumptions are made. Actual results and outcomes may differ materially from these estimates and assumptions.
Unaudited Interim Financial Information	Unaudited Interim Financial Information The Company prepared the accompanying unaudited condensed consolidated financial statements in accordance with GAAP for interim financial information. The significant accounting policies followed by the Company for interim financial reporting are consistent with the accounting policies followed for annual financial reporting. The unaudited condensed consolidated financial statements, in management’s opinion, include all adjustments of a normal recurring nature necessary for a fair presentation. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company's audited consolidated financial statements and notes thereto included in the Company's Annual Report on Form 10-K for the year ended December 31, 2016 filed with the Securities and Exchange Commission on February 27, 2017 . The results of operations for the three months ended March 31, 2017 are not necessarily indicative of the results to be expected for the full year ending December 31, 2017 or any other future period. The amounts in the consolidated condensed balance sheet as of December 31, 2016 are derived from the amounts in the audited consolidated balance sheet as of December 31, 2016 .
Income Taxes	Income Taxes. Effective January 1, 2017, the Company elected to early adopt Accounting Standard Update ("ASU") No. 2016-16, Income Taxes - Intra-Entity Transfers of Assets Other Than Inventory . Under the updated accounting guidance the Company recognizes income tax consequences immediately when the transfer of an inter-entity asset other than inventory occurs across jurisdictions rather than deferring the tax effects of those transactions until a transfer is made to a third party. The Company adopted this standard using the modified retrospective approach and recorded a cumulative-effect adjustment as of January 1, 2017. As a result, the Company recorded (i) a reduction in prepaid income taxes of $11.7 million , (ii) a net increase in deferred income tax assets of $9.7 million , and (iii) a decrease in retained earnings of $2.0 million . Prior periods have not been adjusted.
Recently Issued Accounting Standards Not Yet Adopted	Recently Issued Accounting Standards Not Yet Adopted Test for Goodwill Impairment. In January 2017, the Financial Accounting Standards Board ("FASB") issued ASU No. 2017-04, Intangibles - Goodwill and Other - Simplifying the Test for Goodwill Impairment , which eliminates the second step of the current two-step GAAP guidance for testing goodwill for impairment and is intended to reduce the cost and complexity of goodwill impairment testing. The entity will apply a one-step quantitative test and record the amount of goodwill impairment as the excess of a reporting unit's carrying amount over its fair value, not to exceed the total amount of goodwill allocated to the reporting unit. The new guidance does not amend the optional qualitative assessments of goodwill impairment. ASU 2017-04 is effective for annual periods beginning after December 15, 2019, including interim periods within those annual periods. Early adoption is permitted for interim or annual goodwill impairment tests performed on testing dates after January 1, 2017. The Company is currently evaluating the impact of adopting this standard on its consolidated financial statements. Statement of Cash Flows - Restricted Cash. In November 2016, FASB issued ASU No. 2016-18, Statement of Cash Flows - Restricted Cash , which requires that the statement of cash flows explain the change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted cash equivalents. Therefore, amounts generally described as restricted cash and restricted cash equivalents will be required to be included with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. ASU 2016-18 is effective for public business entities for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption is permitted including adoption in an interim period. The Company believes the impact of adopting this standard on its consolidated financial statements will be immaterial. Statement of Cash Flows - Classification of Cash Receipts and Payments. In August 2016, FASB issued ASU No. 2016-15, Statement of Cash Flows - Classification of Certain Cash Receipts and Cash Payments , which provides guidance on reducing the diversity in how certain cash receipts and cash payments are presented and classified in the statement of cash flows. In addition to other specific cash flow issues, ASU 2016-15 provides clarification on when an entity should separate cash receipts and cash payments into more than one class of cash flows and when an entity should classify those cash receipts and payments into one class of cash flows on the basis of predominance. The new guidance is effective for the fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption is permitted including adoption in an interim period. The Company believes the impact of adopting this standard on its consolidated financial statements will be immaterial. Financial Instruments - Credit Losses. In June 2016, FASB issued ASU No. 2016-13, Credit Losses, Measurement of Credit Losses on Financial Instruments . ASU 2016-13 amends guidance on reporting credit losses for assets held at amortized cost basis and available for sale debt securities. The ASU also introduces a new forward-looking “expected loss” approach, to estimate credit losses on most financial assets and certain other instruments, including trade receivables. To estimate expected credit losses, entities will be required to consider historical information, current information, and reasonable and supportable forecasts. This ASU also expands the disclosure requirements regarding the entity’s assumptions, models and methods for estimating expected credit losses. Entities will apply the standard’s provisions as a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. ASU 2016-13 is effective for public entities for annual and interim periods beginning after December 15, 2019. Early adoption is permitted for all entities for annual periods beginning after December 15, 2018, and interim periods therein. The Company is currently evaluating the impact of adopting this standard on its consolidated financial statements. Leases. In February 2016, FASB issued ASU No. 2016-02, Leases . ASU 2016-02 requires organizations to recognize lease assets and lease liabilities on the balance sheet, including leases that were previously classified as operating leases. The ASU also requires additional disclosures about leasing arrangements related to the amount, timing, and uncertainty of cash flows arising from leases. The amendments in this ASU are effective for financial statements issued for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption of the amendments is permitted and the new guidance will be applied using a modified retrospective approach. The Company has begun its assessment of the impact of this standard and plans to complete the assessment during the second half of 2017. The Company plans to early adopt the amendments of this update as of January 1, 2018. Financial Instruments - Recognition and Measurement. In January 2016, FASB issued ASU No. 2016-01, Financial Instruments – Recognition and Measurement of Financial Assets and Liabilities . ASU 2016-01 requires all equity investments to be measured at fair value with changes in the fair value recognized through net income (other than those accounted for under the equity method of accounting or those that result in consolidating the investee). The amendments in this ASU also require an entity to present separately in other comprehensive income the portion of the total change in the fair value of a liability resulting from a change in the instrument-specific credit risk when the entity has elected to measure the liability at fair value in accordance with the fair value option for financial instruments. In addition, the amendments in this ASU eliminate the requirement to disclose the method(s) and significant assumptions used to estimate the fair value that is required to be disclosed for financial instruments measured at amortized cost on the balance sheet for public business entities. ASU 2016-01 is effective for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption of the amendments is not permitted for public companies. The Company is currently evaluating the impact of adopting this standard on its consolidated financial statements. Revenue from Contracts with Customers. In May 2014, FASB issued ASU No. 2014-09, Revenue from Contracts with Customers . ASU 2014-09 eliminates transaction- and industry-specific revenue recognition guidance under current GAAP and replaces it with a single principles based model for determining revenue recognition. ASU 2014-09 requires that companies recognize revenue when a customer obtains control of promised goods or services. Revenue will be recognized in the amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. The standard also requires disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers, including significant judgments and changes in judgments, as well as assets recognized from costs incurred to obtain or fulfill a contract. FASB recently issued several amendments to the standard, including clarifications on principal versus agent considerations, identifying performance obligations, disclosure of prior-period performance obligations and accounting for licenses of intellectual property. For public entities, the standard is effective for reporting periods beginning after December 15, 2017. Earlier adoption is permitted only as of annual reporting periods beginning after December 15, 2016, including interim reporting periods within that reporting period. Entities can adopt the standard either retrospectively to each period presented (full retrospective approach), or retrospectively with the cumulative effect of initially applying the guidance recognized as of the date of adoption (modified retrospective or cumulative effect approach). The Company has made progress toward completing its evaluation of the potential changes from adopting this new standard on its financial reporting and disclosures, drafting accounting policies, and designing changes to business processes, controls, and systems. The Company expects to change its method of recognizing revenue from the majority of its contracts with customers from an outputs-based methodology to an inputs-based methodology. Additionally, the Company expects that the majority of its contracts will have a single performance obligation. The Company continues to evaluate questions relating to timing of the recognition of contracts and modifications in contract backlog, the timing and quantification of variable components of estimated service revenue, and the selection of the appropriate inputs to be used in the calculation of service delivery. The Company expects to complete this process in the second half of 2017 and expects to adopt the new standard effective January 1, 2018, using the modified retrospective approach. The Company is currently evaluating the financial impact of adopting this standard.

Financial Statement Details (Ta

Financial Statement Details (Tables)	3 Months Ended
	Mar. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Billed Accounts Receivable, Net	Billed accounts receivable, net consisted of the following (in thousands): March 31, 2017 December 31, 2016 Billed accounts receivable $ 193,708 $ 217,360 Allowance for doubtful accounts (5,889 ) (5,884 ) Billed accounts receivable, net $ 187,819 $ 211,476
Schedule of Goodwill	Changes in carrying amount of goodwill by segment for the three months ended March 31, 2017 were as follows (in thousands): Total Clinical Phase I Balance at December 31, 2016: Gross carrying amount $ 568,668 $ 560,526 $ 8,142 Accumulated impairment losses (16,166 ) (8,024 ) (8,142 ) Goodwill net of accumulated impairment losses 552,502 552,502 — 2017 Activity: Impact of foreign currency translation 569 569 — Balance at March 31, 2017: Gross carrying amount 569,237 561,095 8,142 Accumulated impairment losses (16,166 ) (8,024 ) (8,142 ) Goodwill net of accumulated impairment losses $ 553,071 $ 553,071 $ —
Schedule of Accumulated Other Comprehensive Loss, Net of Taxes	Accumulated other comprehensive loss, net of tax, consisted of the following (in thousands): March 31, 2017 December 31, 2016 Foreign currency translation adjustments $ (38,510 ) $ (43,356 ) Unrealized gains on derivative instruments, net of tax 1,256 1,106 Accumulated other comprehensive loss, net of tax $ (37,254 ) $ (42,250 )
Reclassification out of Accumulated Other Comprehensive Income	The tax effects allocated to each component of other comprehensive income for the three months ended March 31, 2017 were as follows (in thousands): Before-Tax Amount Tax (Expense) or Benefit Net-of-Tax Amount Foreign currency translation adjustments (a) $ 4,846 $ — $ 4,846 Unrealized gain on derivative instruments: Unrealized gains arising during period 305 (112 ) 193 Less: reclassification adjustment for gains realized in net income (68 ) 25 (43 ) Net unrealized gains 237 (87 ) 150 Other comprehensive income $ 5,083 $ (87 ) $ 4,996 (a) Income taxes are not provided for foreign currency translation adjustments relating to investments in international subsidiaries that are intended to be held indefinitely. Changes in accumulated other comprehensive loss, net of tax were as follows (in thousands): Unrealized gain on derivative instruments, net of tax Foreign currency translation adjustments Total Balance at December 31, 2016 $ 1,106 $ (43,356 ) $ (42,250 ) Other comprehensive gain before reclassifications 193 4,846 5,039 Amount of gain reclassified from accumulated other comprehensive loss into statement of operations (43 ) — (43 ) Net current period other comprehensive gain, net of tax 150 4,846 4,996 Balance at March 31, 2017 $ 1,256 $ (38,510 ) $ (37,254 )
Schedule of Other (Expense) Income, Net	Other (expense) income, net consisted of the following (in thousands): Three Months Ended March 31, 2017 2016 Net realized foreign currency (loss) gain $ (670 ) $ 2,870 Net unrealized foreign currency (loss) gain (2,707 ) (7,774 ) Other, net (80 ) (213 ) Total other (expense) income, net $ (3,457 ) $ (5,117 )

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2017
Leases [Abstract]
Schedule of Future Minimum Lease Payments	Fiscal Year Operating Leases 2017 (remaining 9 months) $ 15,765 2018 17,860 2019 15,076 2020 11,793 2021 10,396 2022 and thereafter 58,844 Total minimum payments $ 129,734

Derivative Financial Instrume26

Derivative Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2017
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Interest Rate Swaps Designated as Hedging Instruments on the Consolidated Balance Sheets	The fair values of the Company’s interest rate swaps designated as hedging instruments and the line items on the accompanying unaudited condensed consolidated balance sheets at the end of each period were as follows (in thousands): Balance Sheet Classification March 31, 2017 December 31, 2016 Interest rate swaps - current Prepaid expenses and other current assets $ 808 $ 461 Interest rate swaps - non-current Other long-term assets $ 1,600 $ 1,717

Restructuring, CEO Transition27

Restructuring, CEO Transition and Other Costs (Tables)	3 Months Ended
	Mar. 31, 2017
Restructuring and Related Activities [Abstract]
Schedule of Restructuring and Related Costs	The following table summarizes activity related to the liabilities associated with restructuring, CEO transition, and other costs during the three months ended March 31, 2017 (in thousands): Employee Severance Costs, Including Executive Transition Costs Facility Closure and Lease Costs Other Costs Total Balance at December 31, 2016 $ 4,695 $ 3,817 $ 80 $ 8,592 Restructuring charges incurred (a) 352 722 527 1,601 Cash payments made (1,658 ) (974 ) (562 ) (3,194 ) Balance at March 31, 2017 $ 3,389 $ 3,565 $ 45 $ 6,999

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	A reconciliation of the numerators and denominators of the basic and diluted per share computations of common stock based on the Company's consolidated earnings is as follows (in thousands, except per share amounts): Three Months Ended March 31, 2017 2016 Numerator: Net income $ 21,187 $ 17,405 Denominator: Basic weighted average common shares outstanding 54,015 53,955 Effect of dilutive securities: Stock options and other awards under deferred share-based compensation programs 1,108 1,907 Diluted weighted average common shares outstanding 55,123 55,862 Earnings per share: Basic $ 0.39 $ 0.32 Diluted $ 0.38 $ 0.31
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The number of potential shares outstanding that were considered antidilutive using the treasury stock method and were excluded from the computation of diluted earnings per share, weighted for the portion of the period they were outstanding are as follows (in thousands): Three Months Ended March 31, 2017 2016 Antidilutive stock options and other awards 908 881

Share-Based Compensation (Table

Share-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Summary of Restricted Stock Units Activity	The following table summarizes the number of outstanding RSUs and activity as of and during the three months ended March 31, 2017 : Number of Shares Weighted Average Non-vested at December 31, 2016 708,695 Granted 473,949 $ 51.55 Vested (62,795 ) Forfeited (8,451 ) Non-vested at March 31, 2017 1,111,398
Summary of Share-Based Compensation Expense Recognized in Statements of Operations	The amount of share-based compensation expense recognized in the unaudited condensed consolidated statements of operations was as follows (in thousands): Three Months Ended March 31, Income Statement Classification 2017 2016 Direct costs $ 2,713 $ 1,259 Selling, general, and administrative expenses 3,106 1,557 Total share-based compensation expense $ 5,819 $ 2,816

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Schedule of Segment Information	Revenue, direct costs, and contribution margin for each of the Company's segments were as follows (in thousands): Three Months Ended March 31, 2017 2016 Revenue: Clinical Development Services $ 249,727 $ 245,973 Phase I Services 2,351 3,024 Segment revenue 252,078 248,997 Reimbursable out-of-pocket expenses not allocated to segments 129,840 164,090 Total revenue $ 381,918 $ 413,087 Direct costs: Clinical Development Services $ 152,620 $ 149,314 Phase I Services 2,215 2,744 Segment direct costs 154,835 152,058 Reimbursable out-of-pocket expenses not allocated to segments 129,840 164,090 Direct costs and reimbursable out-of-pocket expenses $ 284,675 $ 316,148 Segment contribution margin: Clinical Development Services $ 97,107 $ 96,659 Phase I Services 136 280 Segment contribution margin 97,243 96,939 Less expenses not allocated to segments: Selling, general, and administrative 44,934 43,479 Restructuring, CEO transition and other costs 1,927 6,038 Transaction expenses 2 561 Depreciation and amortization 15,628 14,353 Consolidated income from operations $ 34,752 $ 32,508

Operations by Geographic Loca31

Operations by Geographic Location (Tables)	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Total Revenue by Geographic Area	Total revenue by geographic area was as follows (in thousands, all intercompany transactions have been eliminated): Three Months Ended March 31, 2017 2016 Revenue: North America (a) $ 184,287 $ 185,714 Europe, Middle East and Africa 57,262 56,898 Asia-Pacific 10,529 6,372 Latin America — 13 Total net service revenue 252,078 248,997 Reimbursable-out-of-pocket expenses 129,840 164,090 Total revenue $ 381,918 $ 413,087 (a) Net service revenue for the North America region includes revenue attributable to the United States of $178.4 million and $180.5 million , or 70.8% and 72.5% of net service revenue, for the three months ended March 31, 2017 and March 31, 2016 , respectively. No other country represented more than 10% of net service revenue for any period.
Long-Lived Assets by Geographic Area	Long-lived assets by geographic area for each period were as follows (in thousands): March 31, 2017 December 31, 2016 Property and equipment, net: North America (a) $ 37,871 $ 41,057 Europe, Middle East and Africa 11,975 11,235 Asia-Pacific 6,755 5,101 Latin America 884 913 Total property and equipment, net $ 57,485 $ 58,306 (a) Long-lived assets for the North America region include property and equipment, net attributable to the United States of $37.4 million and $40.6 million as of March 31, 2017 and December 31, 2016 , respectively.

Basis of Presentation and Cha32

Basis of Presentation and Changes in Significant Accounting Policies (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Jan. 01, 2017	Dec. 31, 2016
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Deferred income taxes	$ 18,136		$ 14,726
New Accounting Pronouncement, Early Adoption, Effect | Accounting Standards Update 2016-16
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Prepaid income taxes		$ (11,700)
Deferred income taxes		9,700
Retained earnings		$ 2,000

Financial Statement Details - B

Financial Statement Details - Billed Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Receivables [Abstract]
Billed accounts receivable	$ 193,708	$ 217,360
Allowance for doubtful accounts	(5,889)	(5,884)
Billed accounts receivable, net	$ 187,819	$ 211,476

Financial Statement Details - S

Financial Statement Details - Schedule of Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Goodwill [Roll Forward]
Gross goodwill, beginning balance	$ 568,668
Accumulated impairment losses	(16,166)
Goodwill net of accumulated impairment losses	552,502
Impact of foreign currency translation	569
Gross goodwill, ending balance	569,237
Accumulated impairment losses	(16,166)
Goodwill net of accumulated impairment losses	553,071
Clinical Development Services
Goodwill [Roll Forward]
Gross goodwill, beginning balance	560,526
Accumulated impairment losses	(8,024)
Goodwill net of accumulated impairment losses	552,502
Impact of foreign currency translation	569
Gross goodwill, ending balance	561,095
Accumulated impairment losses	(8,024)
Goodwill net of accumulated impairment losses	553,071
Phase I Services
Goodwill [Roll Forward]
Gross goodwill, beginning balance	8,142
Accumulated impairment losses	(8,142)
Goodwill net of accumulated impairment losses	0
Impact of foreign currency translation	0
Gross goodwill, ending balance	8,142
Accumulated impairment losses	(8,142)
Goodwill net of accumulated impairment losses	$ 0

Financial Statement Details - A

Financial Statement Details - Accumulated Other Comprehensive Loss, Net of Taxes (Details) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Foreign currency translation adjustments	$ (38,510)	$ (43,356)
Unrealized gains on derivative instruments, net of tax	1,256	1,106
Accumulated other comprehensive loss, net of tax	$ (37,254)	$ (42,250)

Financial Statement Details -36

Financial Statement Details - Summary of Changes of Reclassification out of AOCI (Details) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017		Mar. 31, 2016
Accumulated Other Comprehensive Income (Loss) [Line Items]
Foreign currency translation adjustments, before tax	[1]	$ 4,846
Foreign currency translation adjustments, tax effect	[1]	0
Foreign currency translation adjustments, net of tax		4,846	[1]	$ 5,336
Unrealized gain on derivative instruments:
Unrealized gains arising during period, before tax		305
Unrealized gains arising during period, tax effect		(112)
Unrealized gains arising during period, net of tax		193
Reclassification adjustment for gains realized in net income, before tax		(68)
Reclassification adjustment for gains realized in net income, tax effect		25
Reclassification adjustment for gains realized in net income, net of tax		(43)
Net unrealized gains, before tax		237
Net unrealized gains, tax effect		(87)		0
Net unrealized gains, net of tax		150		$ 0
Other comprehensive income, before tax		5,083
Other comprehensive income, tax effect		(87)
Other comprehensive income, net of tax		4,996
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Balance at December 31, 2016		301,473
Net current period other comprehensive gain, net of tax		4,996
Balance at March 31, 2017		335,446
Total
Unrealized gain on derivative instruments:
Other comprehensive income, net of tax		4,996
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Balance at December 31, 2016		(42,250)
Other comprehensive gain before reclassifications		5,039
Amount of gain reclassified from accumulated other comprehensive loss into statement of operations		(43)
Net current period other comprehensive gain, net of tax		4,996
Balance at March 31, 2017		(37,254)
Unrealized gain on derivative instruments, net of tax
Unrealized gain on derivative instruments:
Other comprehensive income, net of tax		150
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Balance at December 31, 2016		1,106
Other comprehensive gain before reclassifications		193
Amount of gain reclassified from accumulated other comprehensive loss into statement of operations		(43)
Net current period other comprehensive gain, net of tax		150
Balance at March 31, 2017		1,256
Foreign currency translation adjustments
Unrealized gain on derivative instruments:
Other comprehensive income, net of tax		4,846
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Balance at December 31, 2016		(43,356)
Other comprehensive gain before reclassifications		4,846
Amount of gain reclassified from accumulated other comprehensive loss into statement of operations		0
Net current period other comprehensive gain, net of tax		4,846
Balance at March 31, 2017		$ (38,510)
[1]	Income taxes are not provided for foreign currency translation adjustments relating to investments in international subsidiaries that are intended to be held indefinitely.

Financial Statement Details - O

Financial Statement Details - Other (Expense) Income, Net (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Other Income and Expenses [Abstract]
Net realized foreign currency (loss) gain	$ (670)	$ 2,870
Net unrealized foreign currency (loss) gain	(2,707)	(7,774)
Other, net	(80)	(213)
Total other (expense) income, net	$ (3,457)	$ (5,117)

Leases - Narrative (Details)

Leases - Narrative (Details)	1 Months Ended
	Feb. 28, 2017	Jan. 31, 2017
Camberley, United Kingdom
Leased Assets [Line Items]
Term of lease	11 years
Corporate Headquarters | Morrisville, North Carolina
Leased Assets [Line Items]
Term of lease		12 years

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Lease Payments (Details) $ in Thousands	Mar. 31, 2017USD ($)
Future Minimum Lease Payments Due [Abstract]
2017 (remaining 9 months)	$ 15,765
2,018	17,860
2,019	15,076
2,020	11,793
2,021	10,396
2022 and thereafter	58,844
Total minimum payments	$ 129,734

Derivative Financial Instrume40

Derivative Financial Instruments - Additional Information (Details) $ in Millions	Mar. 31, 2017USD ($)
Interest Rate Swap
Derivative [Line Items]
Interest rate swaps, notional amount	$ 300

Derivative Financial Instrume41

Derivative Financial Instruments - Interest Rate Swaps Designated as Hedging Instruments on the Consolidated Balance Sheets (Details) - Cash Flow Hedging - Interest Rate Swap - Designated as Hedging Instrument - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Interest rate swaps - current	$ 808	$ 461
Other long-term assets
Derivatives, Fair Value [Line Items]
Interest rate swaps - non-current	$ 1,600	$ 1,717

Fair Value Measurements (Detail

Fair Value Measurements (Details) - Level 2 $ in Millions	Mar. 31, 2017USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term debt and revolver, fair value	$ 490
Interest Rate Swap | Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash flow hedge derivative instrument assets, fair value	$ 2.4

Restructuring, CEO Transition43

Restructuring, CEO Transition and Other Costs - Schedule of Restructuring and Related Costs (Details) - Business Restructuring Reserves $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Restructuring Reserve
Balance at December 31, 2016	$ 8,592
Restructuring charges incurred	1,601	[1]
Cash payments made	(3,194)
Balance at March 31, 2017	6,999
Employee Severance Costs, Including Executive Transition Costs
Restructuring Reserve
Balance at December 31, 2016	4,695
Restructuring charges incurred	352	[1]
Cash payments made	(1,658)
Balance at March 31, 2017	3,389
Facility Closure and Lease Costs
Restructuring Reserve
Balance at December 31, 2016	3,817
Restructuring charges incurred	722	[1]
Cash payments made	(974)
Balance at March 31, 2017	3,565
Other Costs
Restructuring Reserve
Balance at December 31, 2016	80
Restructuring charges incurred	527	[1]
Cash payments made	(562)
Balance at March 31, 2017	$ 45
[1]	Total restructuring, CEO transition, and other costs for the three months ended March 31, 2017 include $0.3 million of other non-cash expenses that were not recorded as a restructuring liability and are therefore excluded from the rollforward above.

Restructuring, CEO Transition44

Restructuring, CEO Transition and Other Costs - Narrative (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)
Restructuring Cost and Reserve [Line Items]
Consulting costs	$ 300
Other costs	600
Employee Severance Costs, Including Executive Transition Costs
Restructuring Cost and Reserve [Line Items]
Restructuring costs, expected cost remaining	400
Business Restructuring Reserves
Restructuring Cost and Reserve [Line Items]
Restructuring charges incurred	1,601	[1]
Business Restructuring Reserves | Employee Severance Costs, Including Executive Transition Costs
Restructuring Cost and Reserve [Line Items]
Restructuring charges incurred	352	[1]
Business Restructuring Reserves | Facility Closure and Lease Costs
Restructuring Cost and Reserve [Line Items]
Restructuring charges incurred	722	[1]
Business Restructuring Reserves | Other Costs
Restructuring Cost and Reserve [Line Items]
Restructuring charges incurred	527	[1]
Other restructuring expenses, non-cash	$ 300
[1]	Total restructuring, CEO transition, and other costs for the three months ended March 31, 2017 include $0.3 million of other non-cash expenses that were not recorded as a restructuring liability and are therefore excluded from the rollforward above.

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Numerator:
Net income	$ 21,187	$ 17,405
Denominator:
Basic weighted average common shares outstanding (in shares)	54,015	53,955
Stock options and other awards under deferred share-based compensation programs (in shares)	1,108	1,907
Diluted weighted average common shares outstanding (in shares)	55,123	55,862
Earnings per share:
Basic (USD per share)	$ 0.39	$ 0.32
Diluted (USD per share)	$ 0.38	$ 0.31

Earnings Per Share - Schedule46

Earnings Per Share - Schedule of Antidilutive Securities Excluded from Computation of Earnings (Loss) Per Share (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Stock-Based Compensation Plans
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive stock options and other awards	908	881

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total share-based compensation expense	$ 5,819	$ 2,816
Employee Stock Purchase Plan (ESPP)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total share-based compensation expense	$ 366
Shares issued (in shares)	60,237
Shares reserved for future issuance (in shares)	939,763

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Restricted Stock Units Activity (Details) - Restricted Stock Units (RSUs)	3 Months Ended
	Mar. 31, 2017$ / sharesshares
Number of Shares
Non-vested at December 31, 2016 (in shares)	708,695
Granted (in shares)	473,949
Vested (in shares)	(62,795)
Forfeited (in shares)	(8,451)
Non-vested at March 31, 2017 (in shares)	1,111,398
Weighted Average Grant Date Fair Value
Granted (in USD per share) | $ / shares	$ 51.55

Share-Based Compensation - Su49

Share-Based Compensation - Summary of Share-Based Compensation Expense Recognized in Statements of Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	$ 5,819	$ 2,816
Direct costs
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	2,713	1,259
Selling, general, and administrative expenses
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	$ 3,106	$ 1,557

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Effective income tax rate (percent)	25.20%	28.70%
Unrecognized tax benefits	$ 15.7		$ 15.7
Unrecognized tax benefits, income tax interest and penalties accrued	$ 0.1		$ 0.1

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2017USD ($)segment	Mar. 31, 2016USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment	2
Revenue:
Segment revenue	$ 252,078	$ 248,997
Reimbursable out-of-pocket expenses not allocated to segments	129,840	164,090
Total revenue	381,918	413,087
Direct costs:
Segment direct costs	154,835	152,058
Reimbursable out-of-pocket expenses not allocated to segments	129,840	164,090
Direct costs and reimbursable out-of-pocket expenses	284,675	316,148
Segment contribution margin:
Segment contribution margin	97,243	96,939
Less expenses not allocated to segments:
Selling, general, and administrative	44,934	43,479
Restructuring, CEO transition and other costs	1,927	6,038
Transaction expenses	2	561
Depreciation and amortization	15,628	14,353
Income from operations	34,752	32,508
Clinical Development Services
Revenue:
Segment revenue	249,727	245,973
Direct costs:
Segment direct costs	152,620	149,314
Segment contribution margin:
Segment contribution margin	97,107	96,659
Phase I Services
Revenue:
Segment revenue	2,351	3,024
Direct costs:
Segment direct costs	2,215	2,744
Segment contribution margin:
Segment contribution margin	$ 136	$ 280

Operations by Geographic Loca52

Operations by Geographic Location - Total Revenue by Geographic Area (Details) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2017	Mar. 31, 2016
Revenues by Geographic Location
Total net service revenue		$ 252,078	$ 248,997
Reimbursable out-of-pocket expenses		129,840	164,090
Total revenue		381,918	413,087
North America
Revenues by Geographic Location
Total net service revenue	[1]	184,287	185,714
United States
Revenues by Geographic Location
Total net service revenue		178,400	180,500
Europe, Middle East and Africa
Revenues by Geographic Location
Total net service revenue		57,262	56,898
Asia-Pacific
Revenues by Geographic Location
Total net service revenue		10,529	6,372
Latin America
Revenues by Geographic Location
Total net service revenue		$ 0	$ 13
Geographic Concentration Risk | Net Service Revenue | United States
Revenues by Geographic Location
Concentration risk percentage		70.80%	72.50%
[1]	Net service revenue for the North America region includes revenue attributable to the United States of $178.4 million and $180.5 million, or 70.8% and 72.5% of net service revenue, for the three months ended March 31, 2017 and March 31, 2016, respectively. No other country represented more than 10% of net service revenue for any period.

Operations by Geographic Loca53

Operations by Geographic Location - Long-Lived Assets by Geographic Area (Details) - USD ($) $ in Thousands		Mar. 31, 2017	Dec. 31, 2016
Long-Lived Assets by Geographic Location
Total property and equipment, net		$ 57,485	$ 58,306
North America
Long-Lived Assets by Geographic Location
Total property and equipment, net	[1]	37,871	41,057
United States
Long-Lived Assets by Geographic Location
Total property and equipment, net		37,400	40,600
Europe, Middle East and Africa
Long-Lived Assets by Geographic Location
Total property and equipment, net		11,975	11,235
Asia-Pacific
Long-Lived Assets by Geographic Location
Total property and equipment, net		6,755	5,101
Latin America
Long-Lived Assets by Geographic Location
Total property and equipment, net		$ 884	$ 913
[1]	Long-lived assets for the North America region include property and equipment, net attributable to the United States of $37.4 million and $40.6 million as of March 31, 2017 and December 31, 2016, respectively.

Concentration of Credit Risk -

Concentration of Credit Risk - Concentration of Cash Balances (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Dec. 31, 2016	Mar. 31, 2016	Dec. 31, 2015
Concentration Risk [Line Items]
Cash and cash equivalents	$ 164,405	$ 102,471	$ 53,181	$ 85,011
Geographic Concentration Risk | Cash and Cash Equivalents | Non-US
Concentration Risk [Line Items]
Cash and cash equivalents	$ 79,400
Concentration risk percentage	48.30%

Related-Party Transactions (Det

Related-Party Transactions (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Affiliated Entity
Related Party Transaction [Line Items]
Revenue from related parties	$ 0	$ 0.2

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	Mar. 31, 2017	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Self-insurance reserves, U.S. health care plan	$ 2.8	$ 3.6

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Billions	May 10, 2017	May 09, 2017	Dec. 31, 2017	Mar. 31, 2017	Dec. 31, 2016
Subsequent Event [Line Items]
Common stock par value (USD per share)				$ 0.01	$ 0.01
Subsequent Event | InVentiv Merger | Forecast
Subsequent Event [Line Items]
Common stock par value (USD per share)			$ 0.0001
Business combination, consideration transferred, equity interested issuable, shares			50
Business combination, consideration transferred, net debt expected to be assumed			$ 2.4
Subsequent Event | InVentiv Merger | Previously Reported
Subsequent Event [Line Items]
Business combination, consideration transferred, net debt expected to be assumed		$ 4.2
Subsequent Event | InVentiv Merger | Restatement
Subsequent Event [Line Items]
Business combination, consideration transferred, net debt expected to be assumed	$ 2.4