PRA Health Sciences (PRAH) 10-Q 26 Oct 17 2017 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2017	Oct. 23, 2017
Document and Entity Information
Entity Registrant Name	PRA Health Sciences, Inc.
Entity Central Index Key	1,613,859
Document Type	10-Q
Document Period End Date	Sep. 30, 2017
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		63,369,729
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q3

CONSOLIDATED CONDENSED BALANCE

CONSOLIDATED CONDENSED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 193,581	$ 144,623
Restricted cash	697	4,715
Accounts receivable and unbilled services, net	628,029	439,053
Other current assets	70,361	36,346
Total current assets	892,668	624,737
Fixed assets, net	131,432	87,577
Goodwill	1,535,057	971,980
Intangible assets, net	711,727	473,976
Other assets	38,749	32,121
Total assets	3,309,633	2,190,391
Current liabilities:
Current portion of long-term debt	56,719	31,250
Accounts payable	60,438	51,335
Accrued expenses and other current liabilities	277,495	149,113
Advanced billings	493,368	332,501
Total current liabilities	888,020	564,199
Long-term debt, net	1,293,498	797,052
Deferred tax liabilities	128,366	73,703
Other long-term liabilities	63,452	26,185
Total liabilities	2,373,336	1,461,139
Commitments and contingencies
Stockholders' equity:
Preferred stock, $0.01 par value, 100,000,000 shares authorized; 0 shares issued and outstanding at September 30, 2017 and December 31, 2016, respectively	0	0
Common stock, $0.01 par value, 1,000,000,000 authorized shares at September 30, 2017 and December 31, 2016; 63,329,298 and 61,597,705 issued and outstanding at September 30, 2017 and December 31, 2016, respectively	633	616
Additional paid-in capital	898,862	879,067
Accumulated other comprehensive loss	(146,291)	(224,686)
Retained earnings	177,230	74,255
Equity attributable to PRA Health Sciences, Inc. stockholders	930,434	729,252
Noncontrolling interest	5,863	0
Total stockholders' equity	936,297	729,252
Total liabilities and stockholders' equity	$ 3,309,633	$ 2,190,391

CONSOLIDATED CONDENSED BALANCE3

CONSOLIDATED CONDENSED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	100,000,000	100,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	1,000,000,000	1,000,000,000
Common stock, shares issued (in shares)	63,329,298	61,597,705
Common stock, shares outstanding (in shares)	63,329,298	61,597,705

CONSOLIDATED CONDENSED STATEMEN

CONSOLIDATED CONDENSED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Revenue:
Service revenue	$ 494,550	$ 399,841	$ 1,379,572	$ 1,166,410
Reimbursement revenue	87,459	53,414	223,921	172,915
Total revenue	582,009	453,255	1,603,493	1,339,325
Operating expenses:
Direct costs	326,865	259,910	914,988	758,333
Reimbursable out-of-pocket costs	87,459	53,414	223,921	172,915
Selling, general and administrative	79,307	67,190	229,770	199,648
Transaction-related costs	12,740	0	12,740	31,785
Depreciation and amortization	18,853	17,708	50,146	52,246
Loss on disposal of fixed assets, net	8	219	240	290
Income from operations	56,777	54,814	171,688	124,108
Interest expense, net	(11,557)	(13,779)	(31,088)	(42,525)
Loss on modification or extinguishment of debt	(3,089)	0	(3,089)	(21,485)
Foreign currency (losses) gains, net	(12,794)	1,182	(35,004)	9,264
Other income (expense), net	1,004	20	724	(85)
Income before income taxes and equity in income of unconsolidated joint ventures	30,341	42,237	103,231	69,277
(Benefit from) provision for income taxes	(18,241)	10,821	(165)	17,869
Income before equity in income of unconsolidated joint ventures	48,582	31,416	103,396	51,408
Equity in income of unconsolidated joint ventures, net of tax	24	33	92	2,742
Net income	48,606	31,449	103,488	54,150
Net income attributable to noncontrolling interest	(401)	0	(513)	0
Net income attributable to PRA Health Sciences, Inc.	$ 48,205	$ 31,449	$ 102,975	$ 54,150
Net income per share attributable to common stockholders:
Basic (in dollars per share)	$ 0.77	$ 0.52	$ 1.66	$ 0.89
Diluted (in dollars per share)	$ 0.73	$ 0.49	$ 1.57	$ 0.84
Weighted average common shares outstanding:
Basic (in shares)	62,730	60,937	62,185	60,579
Diluted (in shares)	65,872	64,521	65,683	64,268

CONSOLIDATED CONDENSED STATEME5

CONSOLIDATED CONDENSED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Statement of Comprehensive Income [Abstract]
Net income	$ 48,606	$ 31,449	$ 103,488	$ 54,150
Other comprehensive income (loss):
Foreign currency translation adjustments	26,863	(11,211)	75,076	(55,548)
Unrealized income (loss) on derivative instruments, net of income tax of $(11), $0, $(11) and $0	46	127	(21)	(2,546)
Reclassification adjustments:
(Gain) loss on derivatives included in net income, net of income taxes of $1,926, $0, $1,926 and $0	(167)	1,617	3,249	4,242
Comprehensive income	75,348	21,982	181,792	298
Comprehensive income attributable to noncontrolling interest	(373)	0	(423)	0
Comprehensive income attributable to PRA Health Sciences, Inc.	$ 74,975	$ 21,982	$ 181,369	$ 298

CONSOLIDATED CONDENSED STATEME6

CONSOLIDATED CONDENSED STATEMENTS OF COMPREHENSIVE INCOME (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Statement of Comprehensive Income [Abstract]
Unrealized losses on derivative instruments, tax (benefit)	$ (11)	$ 0	$ (11)	$ 0
Losses on derivatives included in net income, tax	$ 1,926	$ 0	$ 1,926	$ 0

CONSOLIDATED CONDENSED STATEME7

CONSOLIDATED CONDENSED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net income	$ 103,488	$ 54,150
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	50,146	52,246
Amortization of debt issuance costs and discount	1,480	3,514
Amortization of terminated interest rate swaps	4,931	3,334
Stock-based compensation	7,686	4,940
Non-cash transaction-related costs	5,294	29,421
Unrealized foreign currency losses (gains)	35,406	(9,380)
Loss on modification or extinguishment of debt	3,089	21,485
Deferred income taxes	(27,340)	(8,076)
Equity in income of unconsolidated joint ventures	(92)	(2,742)
Other reconciling items	190	41
Changes in operating assets and liabilities:
Accounts receivable, unbilled services, and advanced billings	(51,883)	(52,290)
Other operating assets and liabilities	(14,567)	(29,935)
Net cash provided by operating activities	117,828	66,708
Cash flows from investing activities:
Purchase of fixed assets	(39,287)	(25,657)
Cash paid for interest on interest rate swap	(763)	(913)
Proceeds from the sale of WuXiPRA	0	3,700
Proceeds from the sale of fixed assets	55	0
Acquisition of Symphony Health Solutions Corporation, net of cash acquired	(522,581)	0
Acquisition of Parallel 6, Inc., net of cash acquired	(39,561)	0
Acquisition of Takeda PRA Development Center KK, net of cash acquired	2,680	0
Acquisition of Takeda Pharmaceutical Data Services, Ltd., net of cash acquired	(142)	0
Acquisition of Nextrials, Inc., net of cash acquired	0	(4,268)
Net cash used in investing activities	(599,599)	(27,138)
Cash flows from financing activities:
Borrowings on accounts receivable financing agreement	20,000	120,000
Repayments on accounts receivable financing agreement	(20,000)	0
Proceeds from issuance of long-term debt	550,000	0
Repayments of long-term debt	26,875	133,559
Borrowings on line of credit	30,000	110,000
Repayments on line of credit	(30,000)	(110,000)
Payments for debt issuance costs	(5,512)	0
Payment of debt prepayment and debt extinguishment costs	0	(17,824)
Proceeds from stock option exercises	6,457	638
Payment of acquisition-related contingent consideration	(400)	0
Net cash provided by (used in) financing activities	523,670	(30,745)
Effects of foreign exchange changes on cash, cash equivalents, and restricted cash	3,041	628
Change in cash, cash equivalents, and restricted cash	44,940	9,453
Cash, cash equivalents, and restricted cash, beginning of period	149,338	126,125
Cash, cash equivalents, and restricted cash, end of period	$ 194,278	$ 135,578

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The Company PRA Health Sciences, Inc. and its subsidiaries, or the Company, is a full-service global contract research organization providing a broad range of product development and data solution services to pharmaceutical and biotechnology companies around the world. The Company’s integrated services include data management, statistical analysis, clinical trial management, and regulatory and drug development consulting. Unaudited Interim Financial Information The interim consolidated condensed financial statements include the accounts of the Company and variable interest entities where the Company is the primary beneficiary. These financial statements are prepared in conformity with U.S. generally accepted accounting principles, or GAAP, and are unaudited. In the opinion of the Company’s management, all adjustments of a normal recurring nature necessary for a fair presentation have been reflected. Certain financial information that is normally included in annual financial statements prepared in accordance with GAAP, but that is not required for interim reporting purposes, has been omitted. The accompanying interim consolidated condensed financial statements and related notes should be read in conjunction with the Company’s consolidated financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 . The preparation of the interim consolidated condensed financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the interim consolidated condensed financial statements and the reported amounts of revenues and claims and expenses during the reporting period. Actual results could differ from those estimates. Variable Interest Entities A variable interest entity (“VIE”) is an entity in which a controlling financial interest may be achieved through arrangements that do not involve voting interests. A VIE is required to be consolidated by its primary beneficiary, which is the entity that possesses the power to direct the activities of the VIE that most significantly impact the VIEs economic performance and has the obligation to absorb losses or the right to receive benefits from the VIE that are significant to the entity. The Company consolidates VIEs when it is the primary beneficiary of the VIE, including joint ventures determined to be VIEs. For consolidated VIEs in which the Company owns less than 100% of the ownership interest or is exposed to less than 100% of the VIE’s economic performance, the outside stockholders' interests are shown as noncontrolling interests. Recently Implemented Accounting Pronouncements In March 2016, the Financial Accounting Standards Board, or FASB, issued Accounting Standards Update, or ASU, No. 2016-09, “Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting.” This update includes provisions intended to simplify various aspects of accounting for share-based compensation. In addition, ASU No. 2016-09 went into effect for public companies for annual periods beginning after December 15, 2016. The Company adopted this ASU beginning with the first quarter of 2017. The adoption of this ASU had the following effects on the consolidated condensed financial statements: Income taxes - The standard requires excess tax benefits and tax deficiencies to be recorded as income tax benefit or expense in the statement of operations. The Company applied the modified retrospective adoption approach beginning in 2017 and recorded a cumulative-effect adjustment to retained earnings and reduced its deferred tax liabilities by $12.7 million with an offsetting increase to the valuation allowance of $12.7 million . As such, the net impact to retained earnings was zero . The Company continuously evaluates its need for a valuation allowance on its net deferred tax assets based upon the weight of available evidence. If the Company is able to support the recognition of certain net deferred tax assets in the future, it is noted that an additional tax benefit from the release of this additional valuation could occur at that time. This adjustment relates to tax assets that had previously arisen from tax deductions for equity compensation expenses that were greater than the compensation recognized for financial reporting. Forfeitures – The standard provides an accounting policy election to account for forfeitures as they occur. The Company made this accounting policy election and the modified retrospective adoption for this component of the standard did not have a material impact on its financial statements. Statements of Cash Flows - Cash flows related to excess tax benefits are no longer separately classified as a financing activity apart from other income tax cash flows. The Company adopted this component of the standard on a prospective basis. Earnings Per Share - The Company uses the treasury stock method to compute diluted earnings per share, unless the effect would be anti-dilutive. Under this method, the Company is no longer required to estimate the tax rate and apply it to the dilutive share calculation for determining the dilutive earnings per share. The Company adopted this component of the standard on a prospective basis. In August 2016, the FASB issued ASU No. 2016-15, “Statement of Cash Flows Classification of Certain Cash Receipts and Cash Payments,” which clarifies existing guidance related to accounting for cash receipts and cash payments and classification on the statement of cash flows. In November 2016, the FASB issued ASU No. 2016-18, “Statement of Cash Flows (Topic 230): Restricted Cash,” which requires restricted cash 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. This guidance is effective for fiscal years, and interim periods within those years, beginning after December 15, 2017, with early adoption permitted. The guidance for both standards requires application using a retrospective transition method. The Company early adopted both ASUs during the fourth quarter of 2016. As a result of the retrospective application of ASU No. 2016-15, $17.8 million of payments of debt prepayment and debt extinguishment costs originally recorded as operating cash outflows were reclassified to financing outflows in the consolidated condensed statement of cash flows for the nine months ended September 30, 2016 . The retrospective application of ASU No. 2016-18 resulted in restricted cash being reclassified as a component of cash, cash equivalents, and restricted cash in the consolidated condensed statement of cash flows for all periods presented. Recently Issued Accounting Pronouncements In May 2014, the FASB issued ASU No. 2014-09, "Revenue from Contracts with Customers.” The new revenue standard establishes a single revenue recognition model for recognizing contracts from customers. Under the new standard, revenue is recognized when a customer obtains control of promised goods or services and is recognized in an amount that reflects the consideration which the entity expects to receive in exchange for those goods or services. In addition, the standard requires disclosure of the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The FASB has issued several amendments to the standard, including clarification on principal versus agent considerations, identifying performance obligations, and accounting for licenses of intellectual property. The new standard is effective for annual reporting periods beginning after December 15, 2017, including interim periods within that reporting period. The standard permits the use of either the retrospective or modified retrospective (cumulative effect) transition method. The Company plans to adopt the new revenue standard effective January 1, 2018 using the modified retrospective approach and continues to evaluate the potential impact to its consolidated financial statements. The Company’s implementation team consists of both internal resources and external advisors to assist with the adoption of the new standard. The Company completed a review of a representative sample of contracts from its contract portfolio and is continuing to evaluate key qualitative judgments associated with the adoption of the new revenue standard. The Company expects its long-term contracts currently accounted for using the proportional performance method may include additional contract value and costs used in the measure of progress as compared to its current accounting policies. The accounting for short-term contracts within the Clinical Research segment is expected to remain materially consistent with the current accounting treatment. The Company will complete its evaluation of the new standard in the fourth quarter, finalize its assessment of potential differences from its current accounting policies, and implement the necessary business processes, systems and controls required to support recognition and disclosure under the new standard. In February 2016, the FASB issued ASU No. 2016-02, “Leases,” which revises the accounting related to lessee accounting. Under the new guidance, lessees will be required to recognize a lease liability and a right-of-use asset for all leases with terms greater than 12 months. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the statement of operations. The provisions of ASU No. 2016-02 are effective for fiscal years beginning after December 15, 2018 and should be applied through a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. Early adoption is permitted. The Company is currently assessing the potential impact of ASU No. 2016-02 on the Company’s consolidated condensed financial statements. In January 2017, the FASB issued ASU No. 2017-01, “Business Combinations: Clarifying the Definition of a business,” which clarifies that when substantially all of the fair value of the gross assets acquired (or disposed of) is concentrated in a single identifiable asset or group of similar identifiable assets, it should be treated as an acquisition or disposal of an asset. The amendments to ASU No. 2017-01 are effective for fiscal years beginning after December 15, 2017, with early adoption permitted. The adoption of ASU No. 2017-01 is not expected to have a material impact on the Company's consolidated condensed financial statements. In January 2017, the FASB issued ASU No. 2017-04, “ Intangibles-Goodwill and Other: Simplifying the Test for Goodwill Impairment,” in order to simplify the subsequent measurement of goodwill by eliminating the Step 2 goodwill impairment test. Under the amendments in this ASU, an entity should perform its annual or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. An entity will then recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value; however the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. The amendments to ASU No. 2017-04 are effective for fiscal years beginning after December 15, 2019, with early adoption permitted. The adoption of ASU No. 2017-04 is not expected to have a material impact on the Company's consolidated condensed financial statements. In May 2017, the FASB issued ASU No. 2017-09, “Compensation-Stock Compensation: Scope of Modification Accounting,” which provides guidance about what changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting in ASC Topic 718, “Stock Compensation.” The amendments to ASU No. 2017-09 are effective for reporting periods beginning after December 15, 2017, with early adoption permitted. The adoption of ASU No. 2017-09 is not expected to have a material impact on the Company's consolidated condensed financial statements. In August 2017, the FASB issued ASU No. 2017-12, "Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities," in order to simplify certain aspects of hedge accounting and improve disclosures of hedging arrangements. ASU No. 2017-12 eliminates the need to separately measure and report hedge ineffectiveness and generally requires the entire change in fair value of a hedging instrument to be presented in the same income statement line as the hedged item. Entities must apply the amendments to cash flow and net investment hedge relationships that exist on the date of adoption using a modified retrospective approach. The presentation and disclosure requirements must be applied prospectively. The amendments to ASU No. 2017-12 are effective for fiscal years beginning after December 15, 2018, with early adoption permitted. The adoption of ASU No. 2017-12 is not expected to have a material impact on the Company's consolidated condensed financial statements. Restricted cash The Company receives cash advances from its customers to be used for the payment of investigator fees and other pass-through expenses. The terms of certain customer contracts require that such advances be maintained in separate escrow accounts; these accounts are not commingled with the Company’s cash and cash equivalents and are presented separately in the consolidated condensed balance sheets as restricted cash. The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the consolidated condensed balance sheets that sum to the total of the same amounts shown in the consolidated condensed statements of cash flows: September 30, December 31, 2017 2016 2016 2015 Cash and cash equivalents $ 193,581 $ 130,343 $ 144,623 $ 121,065 Restricted cash 697 5,235 4,715 5,060 Total cash, cash equivalents, and restricted cash $ 194,278 $ 135,578 $ 149,338 $ 126,125 Secondary Offerings In August 2017, KKR PRA Investors L.P., or KKR, and certain executive officers of the Company sold 10,000,000 shares of the Company’s common stock as part of a secondary offering, or the Secondary Offering. The Company incurred expenses in connection with the Secondary Offering of $1.0 million during the nine months ended September 30, 2017. The expenses are included in transaction-related costs in the accompanying consolidated condensed statement of operations. As of September 30, 2017, KKR owned 20.8% of the Company’s outstanding common stock.

Business Combination

Business Combination	9 Months Ended
	Sep. 30, 2017
Business Combinations [Abstract]
Business Combinations	Business Combinations Symphony Health Solutions, Inc. On September 6, 2017, the Company acquired all of the outstanding equity interest of Symphony Health Solutions Corporation, or Symphony Health, a provider of data and analytics to help professionals understand the full market lifecycle of products offered for sale by companies in the pharmaceutical industry, for $540.8 million in cash and contingent consideration, which is not capped, in the form of potential earn-out payments based on a multiple of future earnings for the twelve month periods ending December 2017 and December 2018. The Company recognized a liability of approximately $108.8 million representing the estimated fair value of the earn-out on the acquisition date, $90.4 million is included in accrued expenses and other current liabilities and $18.4 million is included in other long-term liabilities in the consolidated condensed balance sheet as of September 30, 2017 . The fair value was based on significant inputs not observed in the market and thus represents a Level 3 measurement. Any change in the fair value of the contingent consideration subsequent to the acquisition date, excluding adjustments that qualify as measurement period adjustments, will be recognized in earnings in the period of any such change. With this acquisition, the Company expects to enhance its ability to serve customers throughout the clinical research process with technologies that provide data and analytics. The acquisition of Symphony Health was accounted for as a business combination and, accordingly, the assets acquired and the liabilities assumed have been recorded at their respective fair values as of the acquisition date. In connection with the acquisition, the Company recorded approximately $500.5 million of goodwill, which was assigned to the Data Solutions segment and is not deductible for income tax purposes. The goodwill is attributable to the workforce of the acquired business and expected synergies with the Company’s existing operations. The Company incurred $6.4 million in acquisition related costs that are included in transaction-related costs in the consolidated condensed statement of operations. Due to the timing of the acquisition, the valuation of net assets acquired has not been finalized and is expected to be completed by the end of December 2017, and in any case, no later than one year from the acquisition date in accordance with GAAP. The Company’s preliminary estimate of the purchase price allocation is as follows (in thousands): Purchase Price Allocation Weighted Amortization Period Cash and cash equivalents $ 26,297 Accounts receivable 39,056 Other current assets 24,048 Fixed assets 12,340 Software and other intangibles 13,000 5 years Database 64,600 9 years Customer relationships 161,000 12 years Accounts payable and accrued expenses (42,700 ) Deferred revenue (65,511 ) Deferred tax liabilities (75,056 ) Other long-term liabilities (7,940 ) Estimated fair value of net assets acquired 149,134 Purchase price, including contingent consideration 649,609 Total goodwill $ 500,475 The results of operations for Symphony Health are included in the consolidated condensed financial statements of the Company from the date of acquisition. During this period, Symphony Health's service revenues and net income totaled $19.0 million and $1.1 million , respectively. The following unaudited pro-forma information assumes the acquisition of Symphony Health occurred as of the beginning of 2016. This pro-forma financial information is not necessarily indicative of operating results if the acquisition had been completed at the date indicated, nor is it necessarily an indication of future operating results. Nine Months Ended (in thousands, except per share amounts) 2017 2016 Total revenue $ 1,752,514 $ 1,484,013 Net income attributable to PRA Health Sciences, Inc. 126,092 35,830 Net income per share: Basic $ 2.03 $ 0.59 Diluted $ 1.92 $ 0.56 The unaudited pro-forma financial information for the nine months ended September 30, 2016 includes the following non-recurring adjustments: • a $6.4 million increase to transaction-related costs incurred by the Company during the nine months ended September 30, 2017 attributable to the transaction, with a corresponding $2.5 million increase to the benefit from income taxes. • a $3.1 million increase to loss on the modification or extinguishment of long-term debt incurred by the Company during the nine months ended September 30, 2017 attributable to the above transaction, with a corresponding $1.2 million increase to the benefit from income taxes. Takeda Transactions On June 1, 2017, the Company acquired all of the outstanding shares of Takeda Pharmaceutical Data Services, Ltd., or TDS, from Takeda Pharmaceutical Company Ltd., or Takeda, for $0.7 million in cash. The Company recorded approximately $1.0 million of goodwill, which is assigned to the Clinical Research segment and is not deductible for income tax purposes. pro-forma results of operations and a complete purchase price allocation have not been presented because the results of this acquisition did not have a material effect on the Company's consolidated condensed financial statements. On June 1, 2017, the Company and Takeda also closed on a joint venture transaction that enables the Company to provide clinical trial delivery and pharmacovigilance services as a strategic partner of Takeda in Japan. The joint venture transaction was effected through the creation of a new legal entity, Takeda PRA Development Center KK, or TDC joint venture. The Company paid $5.4 million for a 50% equity interest in the TDC joint venture, which represents 50% of the fair value of the net assets and workforce that Takeda contributed to the joint venture. The joint venture provides services including clinical trial monitoring, project management, regulatory strategy and submissions, data management, biostatistics, drug safety reporting, and medical monitoring. The Company is required to buy-out Takeda’s 50% interest in the TDC joint venture in two years . The Company also has an early buy-out option of Takeda’s 50% interest in December 2018 if both parties agree. The Company determined that the TDC joint venture is a VIE in which the Company is the primary beneficiary. Accordingly, the Company accounted for the $5.4 million contribution to the TDC joint venture as a business combination and consolidated the VIE in its financial statements with a noncontrolling interest for the 50% portion owned by Takeda. The assets acquired and the liabilities assumed have been recorded at their respective estimated fair values as of June 1, 2017. The Company recorded approximately $2.7 million of goodwill, which is assigned to the Clinical Research segment and is not deductible for income tax purposes. The goodwill is primarily attributable to assembled workforce. The Company incurred $0.6 million in acquisition related costs that are included in selling, general and administrative expenses in the consolidated condensed statement of operations. Due to the timing of the transaction, the valuation of net assets acquired has not been finalized and is expected to be completed by the end of December 2017, and in any case, no later than one year from the transaction closing date in accordance with GAAP. The Company’s preliminary estimate of the fair value of the net assets acquired as part of the TDC joint venture transaction at the closing date of the business combination is as follows (in thousands): Purchase Price Allocation Cash and cash equivalents $ 8,120 Other current assets 1,671 Other non-current assets 1,742 Accounts payable and accrued expenses (2,380 ) Other long-term liabilities (943 ) Estimated fair value of net assets acquired 8,210 PRA purchase price 5,440 Fair value of Takeda's noncontrolling interest 5,440 Total goodwill $ 2,670 The Company has not disclosed post-acquisition or pro-forma revenue and earnings attributable to the TDC joint venture as they did not have a material effect on the Company’s consolidated condensed financial statements. Parallel 6, Inc. On May 10, 2017, the Company acquired all of the outstanding equity interest of Parallel 6, Inc., or Parallel 6, a developer of technologies for improving patient enrollment, engagement, and management of clinical trials, for $39.7 million in cash and contingent consideration in the form of a potential earn-out payment of up to $10.0 million . The earn-out payment is contingent upon the achievement of certain external software sales targets during the 18 -month period following closing. The Company recognized a liability of approximately $8.4 million representing the estimated fair value of the earn-out on the acquisition date, which is included in other long-term liabilities in the consolidated condensed balance sheet as of September 30, 2017 . The fair value was based on significant inputs not observed in the market and thus represented a Level 3 measurement. Any change in the fair value of the contingent consideration subsequent to the acquisition date, excluding adjustments that qualify as measurement period adjustments, will be recognized in earnings in the period of any such change. With this acquisition, the Company expects to enhance its ability to serve customers throughout the clinical research process with technologies that provide improved efficiencies by reducing study durations and costs through integrated operational management. The acquisition of Parallel 6 was accounted for as a business combination and, accordingly, the assets acquired and the liabilities assumed have been recorded at their respective fair values as of the acquisition date. In connection with the acquisition, the Company recorded approximately $33.1 million of goodwill, which was assigned to the Clinical Research segment and is not deductible for income tax purposes. The goodwill is attributable to the workforce of the acquired business and expected synergies with the Company’s existing information technology operations. The Company incurred $1.3 million in acquisition related costs that are included in selling, general and administrative expenses in the consolidated condensed statement of operations. Due to the timing of the acquisition, the valuation of net assets acquired has not been finalized and is expected to be completed by the end of December 2017, and in any case, no later than one year from the acquisition date in accordance with GAAP. The Company’s preliminary estimate of the purchase price allocation is as follows (in thousands): Purchase Price Allocation Weighted Amortization Period Cash and cash equivalents $ 132 Accounts receivable 1,231 Other current assets 26 Software intangible 15,500 5 years Other intangibles 920 5 years Accounts payable and accrued expenses (885 ) Deferred revenue (994 ) Other long-term liabilities (2,414 ) Estimated fair value of net assets acquired 13,516 Purchase price, including contingent consideration 46,652 Total goodwill $ 33,136 The Company has not disclosed post-acquisition or pro-forma revenue and earnings attributable to Parallel 6 as they did not have a material effect on the Company’s consolidated condensed financial statements. Nextrials On March 18, 2016, the Company acquired all of the outstanding shares of Nextrials, Inc., or Nextrials, a developer of web-based software which integrates electronic health records with clinical trials, for $4.8 million in cash and contingent consideration in the form of potential earn-out payments of up to $3.0 million . Earn-out payments totaling $2.0 million and $1.0 million are contingent upon the achievement of project milestones and certain external software sales targets, respectively, during the 30 -month period following closing. The Company recognized a liability of approximately $2.3 million as the estimated acquisition date fair value of the earn-out; the fair value was based on significant inputs not observed in the market and thus represented a Level 3 measurement. Changes in the fair value of the contingent consideration subsequent to the acquisition date are recognized in earnings in the period of the change. The fair value of the contingent consideration increased by $0.1 million for the nine months ended September 30, 2017 . The Company made a payment of $0.4 million on the contingent consideration during the nine months ended September 30, 2017 . As of September 30, 2017 , the earn-out liability totaled $1.4 million ; which is included in accrued expenses and other current liabilities in the consolidated condensed balance sheet. With this acquisition, the Company expects to enhance its ability to serve customers throughout the clinical research process with technologies that include improved efficiencies by reducing study durations and costs through integrated operational management. The acquisition of Nextrials was accounted for as a business combination and, accordingly, the assets acquired and the liabilities assumed have been recorded at their respective fair values as of the acquisition date. In connection with the acquisition, the Company recorded approximately $4.3 million of goodwill, which is assigned to the Clinical Research segment and is not deductible for income tax purposes. The goodwill is attributable to the workforce of the acquired business and expected synergies with the Company’s existing information technology operations. The Company’s purchase price allocation is as follows (in thousands): Purchase Price Allocation Weighted Amortization Period Cash and cash equivalents $ 94 Accounts receivable 211 Other current assets 96 Property, plant and equipment 111 Software intangible 5,574 5 years Accounts payable and accrued expenses (1,585 ) Other long-term liabilities (1,663 ) Estimated fair value of net assets acquired 2,838 Purchase price, including contingent consideration and net of working capital settlement 7,145 Total goodwill $ 4,307 The Company has not disclosed fiscal year 2016 or pro-forma revenue and earnings attributable to Nextrials as they did not have a material effect on the Company’s consolidated condensed financial statements.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements The Company records certain assets and liabilities at fair value. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. A three-level fair value hierarchy that prioritizes the inputs used to measure fair value is described below. This hierarchy requires entities to maximize the use of observable inputs and minimize the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: • Level 1 — Quoted prices in active markets for identical assets or liabilities. • Level 2 — Observable inputs other than quoted prices included in Level 1, such as quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated by observable market data. • Level 3 — Unobservable inputs that are supported by little or no market activity. This includes certain pricing models, discounted cash flow methodologies and similar techniques that use significant unobservable inputs. The carrying amount of financial instruments, including cash and cash equivalents, accounts receivable, unbilled services, accounts payable and advanced billings, approximate fair value due to the short maturities of these instruments. Recurring Fair Value Measurements The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured on a recurring basis as of September 30, 2017 (in thousands): Level 1 Level 2 Level 3 Total Assets: Interest rate swap $ — $ 73 $ — $ 73 Marketable securities 366 — — 366 Total $ 366 $ 73 $ — $ 439 Liabilities: Contingent consideration $ — $ — $ 118,564 $ 118,564 Total $ — $ — $ 118,564 $ 118,564 The Company's marketable securities are included in other current assets in the consolidated condensed balance sheet. These marketable securities are recorded at fair value using quoted prices in an active market. The interest rate swap is measured at fair value using a market approach valuation technique. The valuation is based on an estimate of net present value of the expected cash flows using relevant mid-market observable data inputs and based on the assumption of no unusual market conditions or forced liquidation. The Company values contingent consideration, related to business combinations, using a weighted probability of potential payment scenarios discounted at rates reflective of the weighted average cost of capital for the businesses acquired. Key assumptions used to estimate the fair value of contingent consideration include operational milestones and the probability of achieving the specific milestones The following table summarizes the changes in Level 3 financial liabilities measured on a recurring basis for the nine months ended September 30, 2017 (in thousands): Contingent Consideration - Accrued expenses and other liabilities Contingent Consideration - Other long-term liabilities Balance at December 31, 2016 $ 1,735 $ 1,019 Initial estimate of Symphony Health contingent consideration 90,394 18,390 Initial estimate of Parallel 6 contingent consideration — 8,350 Payments on Nextrials contingent consideration (400 ) — Reclassification adjustment 1,019 (1,019 ) Change in fair value recognized in other (income) expense, net (924 ) — Balance at September 30, 2017 $ 91,824 $ 26,740 During the nine months ended September 30, 2017, the Company released the remaining $1.0 million contingent consideration liability associated with the acquisition of Value Health Solutions, Inc. as the earn-out targets were not met. Non-recurring Fair Value Measurements Certain assets and liabilities are carried on the accompanying consolidated condensed balance sheets at cost and are not remeasured to fair value on a recurring basis. These assets include finite-lived intangible assets which are tested when a triggering event occurs and goodwill and identifiable indefinite-lived intangible assets which are tested for impairment annually on October 1 or when a triggering event occurs. As of September 30, 2017 , assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaling approximately $2,246.8 million were identified as Level 3. These assets are comprised of goodwill of $1,535.1 million and identifiable intangible assets, net of $711.7 million . Refer to Note 7, Long-Term Debt, for additional information regarding the fair value of long-term debt balances.

Concentration of Credit Risk

Concentration of Credit Risk	9 Months Ended
	Sep. 30, 2017
Risks and Uncertainties [Abstract]
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject the Company to credit risk consist of cash and cash equivalents, accounts receivable, and unbilled services. As of September 30, 2017 , substantially all of the Company’s cash and cash equivalents were held in or invested with large financial institutions. Accounts receivable include amounts due from pharmaceutical and biotechnology companies. The Company establishes an allowance for potentially uncollectible receivables. In management’s opinion, there is no additional material credit risk beyond amounts provided for such losses. Service revenue from individual customers greater than 10% of consolidated service revenue in the respective periods was as follows: Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Customer A 10.1 % 11.7 % 10.6 % 10.8 % Customer B — 10.4 % — 10.7 % Customer C — 10.2 % — — Accounts receivable and unbilled receivables from individual customers that were equal to or greater than 10% of consolidated accounts receivable and unbilled receivables at the respective dates were as follows: September 30, December 31, 2017 2016 Customer A 10.7 % 12.0 %

Accounts Receivable and Unbille

Accounts Receivable and Unbilled Services	9 Months Ended
	Sep. 30, 2017
Receivables [Abstract]
Accounts Receivable and Unbilled Services	Accounts Receivable and Unbilled Services Accounts receivable and unbilled services include service revenue, reimbursement revenue, and amounts associated with work performed by investigators. Accounts receivable and unbilled services were as follows (in thousands): September 30, December 31, 2017 2016 Accounts receivable $ 457,306 $ 284,647 Unbilled services 172,152 155,609 629,458 440,256 Less allowance for doubtful accounts (1,429 ) (1,203 ) Total accounts receivable and unbilled services, net $ 628,029 $ 439,053

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill The changes in the carrying amount of goodwill by reportable segment are as follows (in thousands): Clinical Research Data Solutions Consolidated Balance at December 31, 2016 $ 971,980 $ — $ 971,980 Acquisition of Symphony Health — 500,475 500,475 Acquisition of Parallel 6 33,136 — 33,136 Acquisition of TDC joint venture 2,670 — 2,670 Acquisition of TDS 966 — 966 Currency translation 25,830 — 25,830 Balance at September 30, 2017 $ 1,034,582 $ 500,475 $ 1,535,057 There are no accumulated impairment charges as of September 30, 2017 and December 31, 2016 . Intangible Assets Intangible assets consist of the following (in thousands): September 30, December 31, 2017 2016 Customer relationships $ 535,135 $ 360,328 Customer backlog 123,358 119,223 Trade names (definite-lived) 28,457 25,740 Patient list, software and other intangibles 55,574 28,974 Database 64,600 — Non-competition agreements 2,767 2,737 Total finite-lived intangible assets, gross 809,891 537,002 Accumulated amortization (216,174 ) (181,036 ) Total finite-lived intangible assets, net 593,717 355,966 Trade names (indefinite-lived) 118,010 118,010 Total intangible assets, net $ 711,727 $ 473,976 Amortization expense was $11.3 million and $29.5 million for the three and nine months ended September 30, 2017 , respectively, and $11.3 million and $34.3 million for the three and nine months ended September 30, 2016 , respectively. The estimated future amortization expense of finite-lived intangible assets is expected to be as follows (in thousands): 2017 (remaining) $ 16,368 2018 60,075 2019 54,375 2020 52,462 2021 50,331 2022 and thereafter 360,106 Total $ 593,717 The estimated fair value of the Early Development Services, or EDS, reporting unit closely approximated its carrying value when the Company performed its annual goodwill impairment test during the fourth quarter of 2014. The Company made operational improvements during 2015 and 2016 in order to improve the profitability of the EDS reporting unit. As a result of these changes, EDS saw growth in both backlog and new business awards that contributed to its improved financial performance during both years and led the Company to update its forecast for future periods. The Company considered all of these factors when it performed its most recent goodwill impairment test during the fourth quarter of 2016 and it was concluded that the estimated fair value of the EDS reporting unit exceeded its carrying value by approximately $70.0 million , or 33% . Any negative changes in assumptions on revenue, new business awards, cancellations, or the Company's ability to improve operations while maintaining a competitive cost structure could adversely affect the fair value of EDS and result in significant goodwill impairment charges in 2017 or later.

Long-Term Debt

Long-Term Debt	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following (in thousands): September 30, December 31, 2017 2016 Term loans, first lien $ 1,148,125 $ 625,000 Senior notes 91,441 91,441 Accounts receivable financing agreement 120,000 120,000 1,359,566 836,441 Less debt issuance costs and discount (9,349 ) (8,139 ) 1,350,217 828,302 Less current portion (56,719 ) (31,250 ) Total long-term debt, net $ 1,293,498 $ 797,052 Principal payments on long-term debt are due as follows (in thousands): 2017 (remaining) $ 11,250 2018 60,625 2019 180,625 2020 76,250 2021 939,375 2022 and thereafter 91,441 Total $ 1,359,566 2016 Credit Facilities As collateral for borrowings under the senior secured credit facilities, or 2016 Credit Facilities, the Company granted a pledge on primarily all of its assets, and the stock of wholly-owned U.S. restricted subsidiaries. The Company is subject to certain financial covenants, which require the Company to maintain certain debt-to-EBITDA and interest expense-to-EBITDA ratios. The 2016 Credit Facilities also contain covenants that, among other things, restrict the Company’s ability to create any liens, make investments and acquisitions, incur or guarantee additional indebtedness, enter into mergers or consolidations and other fundamental changes, conduct sales and other dispositions of property or assets, enter into sale-leaseback transactions or hedge agreements, prepay subordinated debt, pay dividends or make other payments in respect of capital stock, change the line of business, enter into transactions with affiliates, enter into burdensome agreements with negative pledge clauses and clauses restriction, and make subsidiary distributions. After giving effect to the applicable restrictions on the payment of dividends under the 2016 Credit Facilities, subject to compliance with applicable law, as of September 30, 2017 and December 31, 2016 , all amounts in retained earnings were free of restriction and were available for the payment of dividends. The Company does not expect to pay dividends in the foreseeable future. The Company does not expect these covenants to restrict its liquidity, financial condition or access to capital resources in the foreseeable future. The 2016 Credit Facilities also contains customary representations, warranties, affirmative covenants, and events of default. On September 6, 2017, the Company borrowed $550.0 million under the 2016 Credit Facilities, or the Incremental Borrowing. The proceeds were primarily used to fund the acquisition of Symphony Health. In accordance with the guidance in FASB’s Accounting Standards Codification, or ASC, 470-50, "Debt - Modifications and Extinguishments," the Incremental Borrowing was accounted for as a debt modification. The Incremental Borrowing resulted in a $3.1 million loss on modification of debt, which consists of fees associated with the transaction for the nine months ended September 30, 2017 . The 2016 Credit Facilities' first lien term loan's scheduled, fixed quarterly principal payments, including the Incremental Borrowing, are as follows: • $11.3 million per quarter, to be made commencing September 30, 2017 and made on or prior to December 31, 2017; • $15.2 million per quarter, to be made on or after March 31, 2018, but on or prior to December 31, 2019; • $19.1 million per quarter, to be made on or after March 31, 2020, but on or prior to December 31, 2020; • $23.0 million per quarter, to be made on or after March 31, 2021, but prior to September 30, 2021; and • the remaining principal amount of the term loan on December 6, 2021. The variable interest rate on the Incremental Borrowing is a rate equal to the London Interbank Offered Rate, or LIBOR, or the adjusted base rate, or ABR rate, at the election of the Company, plus a margin based on the ratio of total indebtedness to EBITDA and ranges from 1.00% to 2.00% , in the case of LIBOR rate loans, and 0.00% to 1.00% , in the case of ABR rate loans. There were no other changes to the 2016 Credit Facilities as a result of the Incremental Borrowing. For the nine months ended September 30, 2017 , the weighted average interest rate on the first lien term loan was 3.45% . Revolving Credit Facilities The Company’s revolving credit facilities provide for $125.0 million of potential borrowings and expire on December 6, 2021. The interest rate on the revolving credit facilities is based on the LIBOR with a 0% LIBOR floor or ABR rate, at the election of the Company, plus an applicable margin, based on the leverage ratio of the Company. The Company, at its discretion, may elect interest periods of 1 , 2 , 3 or 6 months. The Company is required to pay to the lenders a commitment fee ranging from 0.2% to 0.4% based on the Company’s debt-to-EBITDA ratio. At September 30, 2017 and December 31, 2016 , the Company had no outstanding borrowings under the revolving credit facilities. In addition, at September 30, 2017 and December 31, 2016 , the Company had $4.5 million and $7.0 million , respectively, in letters of credit outstanding, which are secured by the revolving credit facilities. Senior Notes On March 17, 2016, the Company repaid $133.6 million aggregate principal amount of its 9.5% senior notes due 2023, or Senior Notes, as part of a cash tender offer. In accordance with the guidance in the ASC 470 -50 , "Debt—Modifications and Extinguishments," the debt repayment was accounted for as a partial debt extinguishment. The repayment resulted in a $21.5 million loss on extinguishment of debt, which consists of a $17.4 million early tender premium, a $3.7 million write-off of unamortized debt issuance costs and $0.4 million of fees associated with the transaction for the nine months ended September 30, 2016 . The Senior Notes agreement contains certain provisions that restrict the payment of dividends from the Company’s subsidiaries to the parent company. As a result, there are no material balances present within the parent company that are available for the payment of dividends as the parent company did not have any net income during 2016 or the nine months ended September 30, 2017 , that was free of restrictions. The Company does not expect to pay dividends in the foreseeable future. Accounts Receivable Financing Agreement In March 2016, the Company entered into a $140.0 million accounts receivable financing agreement, of which $120.0 million was outstanding as of September 30, 2017 and December 31, 2016 . The borrowings were used to repay amounts outstanding on the Company’s revolving credit facility that were used to fund the cash tender offer for the Senior Notes. Loans under the accounts receivable financing agreement accrue interest at either a reserve-adjusted LIBOR or a base rate , plus 1.6% . The Company may prepay loans upon one business day prior notice and may terminate the accounts receivable financing agreement with 15 days’ prior notice. For the nine months ended September 30, 2017 , the weighted average interest rate on the accounts receivable financing agreement was 2.91% . The accounts receivable financing agreement contains various customary representations and warranties and covenants, and default provisions which provide for the termination and acceleration of the commitments and loans under the agreement in circumstances including, but not limited to, failure to make payments when due, breach of representations, warranties or covenants, certain insolvency events or failure to maintain the security interest in the trade receivables, and defaults under other material indebtedness. The accounts receivable financing agreement terminates on March 22, 2019, unless terminated earlier pursuant to its terms. At September 30, 2017 and December 31, 2016 , there was $20.0 million of remaining capacity available under the accounts receivable financing agreement. Fair Value of Debt The estimated fair value of the Company’s debt was $1,368.8 million and $844.2 million at September 30, 2017 and December 31, 2016 , respectively. The fair value of the Senior Notes, which totaled $100.7 million and $99.2 million at September 30, 2017 and December 31, 2016 , respectively, was determined based on Level 2 inputs using the market approach, which is primarily based on rates at which the debt is traded among financial institutions. The fair value of the term loans, borrowings under credit facilities, and accounts receivable financing agreement which totaled $1,268.1 million and $745.0 million at September 30, 2017 and December 31, 2016 , respectively, was determined based on Level 3 inputs, which is primarily based on rates at which the debt is traded among financial institutions adjusted for the Company's credit standing.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2017
Stockholders' Equity Note [Abstract]
Stockholders' Equity	Stockholders’ Equity Authorized Shares The Company is authorized to issue up to one billion shares of common stock, with a par value of $0.01 . The Company is authorized to issue up to one hundred million shares of preferred stock, with a par value of $0.01 . Noncontrolling Interest Below is a summary of noncontrolling interest for the nine months ended September 30 (in thousands): 2017 2016 Balance as of January 1, $ — $ — Investment by noncontrolling interest 5,440 — Comprehensive income (loss) Net income 513 — Foreign currency adjustments, net of income tax (90 ) — Balance as of September 30, $ 5,863 $ —

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	Stock-Based Compensation The Company granted 1,831,000 service-based options and 131,044 restricted stock awards and units, or RSAs/RSUs, with a total grant date fair value of $46.0 million and $8.3 million , respectively, during the nine months ended September 30, 2017 . Aggregated information regarding the Company’s option plans is summarized below: Options Wtd. Average Exercise Price Wtd. Average Remaining Contractual Life (in years) Intrinsic Value (millions) Outstanding at December 31, 2016 5,507,347 $ 15.38 6.7 $ 218.9 Granted 1,831,000 74.93 Exercised (1,758,846 ) 9.47 Expired or forfeited (73,072 ) 26.94 Outstanding at September 30, 2017 5,506,429 $ 36.91 7.7 $ 216.2 Exercisable at September 30, 2017 2,557,710 $ 13.70 6.3 $ 159.8 The Company’s RSAs/RSUs activity in 2017 is as follows: Awards Wtd. Average Grant-Date Fair Value Intrinsic Value (millions) Unvested at December 31, 2016 188,590 $ 32.63 $ 10.4 Granted 131,044 63.05 Forfeited (2,000 ) 58.95 Vested (5,805 ) 38.81 Unvested at September 30, 2017 311,829 $ 45.14 $ 23.8 Stock-based compensation expense related to employee stock options and RSAs/RSUs is summarized below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Direct costs $ 956 $ 438 $ 2,208 $ 1,319 Selling, general and administrative 2,493 1,228 5,478 3,621 Transaction-related costs 5,294 — 5,294 29,421 Total stock-based compensation expense $ 8,743 $ 1,666 $ 12,980 $ 34,361 All stock options granted under the 2013 Stock Incentive Plan for Key Employees of PRA Health Sciences, Inc. and its Subsidiaries, or the Plan, are subject to transfer restrictions of the stock option's underlying shares once vested and exercised. This lack of marketability was included as a discount when calculating the grant date value of these options. In conjunction with secondary offerings, the transfer restrictions on a portion of such shares issuable upon exercise of vested options granted under the Plan were released. The release of the transfer restrictions is considered a modification under ASC Topic 718, “Stock Compensation.” As a result of these modifications, the Company incurred approximately $5.3 million and $4.9 million of incremental compensation expense associated with service-based options during the nine months ended September 30, 2017 and September 30, 2016 , respectively, which is included in transaction-related costs in the accompanying consolidated condensed statement of operations. In December 2013, the Company granted certain employees market-based options under the Plan that vest only upon the achievement of a specified internal rate of return from a liquidity event (“ 2.0 x Options”). At the time of grant, no compensation expense was recorded as the 2.0 x Options vest upon a liquidity event, which is not considered probable until the date it occurs. On January 20, 2016, the Compensation Committee of the Board of Directors adopted a resolution to adjust the vesting criteria for all 2.0 x Options granted and still outstanding on such date. Under the revised vesting criteria, the 2.0 x Options vest upon the announcement of a secondary offering. This modification resulted in Type IV Improbable-to-Improbable modification. Since the secondary offering was deemed improbable due to the fact that it is outside of the Company’s control and cannot be considered probable until the date it occurs, no compensation expense was recognized on the January 20, 2016 modification date. On March 2, 2016, the Company announced a secondary offering of shares by KKR and certain management stockholders, and it became probable that the 2.0 x Options would vest. In total, 835,551 2.0 x Options held by current employees were modified. As a result of this modification, and the modification associated with the transfer restrictions releases noted above, the Company incurred approximately $24.5 million of incremental compensation expense associated with the 2.0 x Options during the nine months ended September 30, 2016 , which is included in transaction-related costs in the accompanying consolidated condensed statement of operations. Employee Stock Purchase Plan In April 2017, the Board of Directors approved the PRA Health Sciences, Inc. 2017 Employee Stock Purchase Plan (“ESPP”) which was approved by the Company’s shareholders on June 1, 2017. The ESPP allows eligible employees to authorize payroll deductions of up to 10% of their base salary or wages to be applied toward the purchase of shares of the Company’s common stock on the last trading day of the offering period. Participating employees will purchase shares of the Company's common stock at a discount of up to 15% on the lesser of the closing price of the Company's common stock on the NASDAQ Global Select Market (i) on the first trading day of the offering period or (ii) the last day of any offering period. Offering periods under the ESPP will generally be in six month increments, commencing on January 1 and July 1 of each calendar year with the compensation committee having the right to establish different offering periods.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company’s effective income tax rate was (0.2)% and 25.8% for the nine months ended September 30, 2017 and 2016 , respectively. The variation between the Company’s effective income tax rate and the U.S. statutory rate of 35% for the nine months ended September 30, 2017 is primarily due to (i) the benefit realized from the tax deduction of stock awards in excess of the amount recognized in the financial statements per the guidance under ASU No. 2016-09, and (ii) the release of the valuation allowance against the Company's federal net deferred tax assets as a result of the acquisition of Symphony Health. GAAP requires a two-step approach when evaluating uncertain tax positions. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence demonstrates that it is more likely than not that the position will be sustained upon audit, including resolution of any related appeals or litigation processes. The second step is to quantify the amount of tax benefit to recognize as the amount that is cumulatively more than 50% likely to be realized upon ultimate settlement with the taxing authorities. As of September 30, 2017 , the Company’s liability for unrecognized tax benefits was $13.0 million . If any portion of this $13.0 million is recognized that impacts the effective tax rate, the Company will then include that portion in the computation of its effective tax rate. Although the ultimate timing of the resolution of audits is highly uncertain, the Company believes it is reasonably possible that approximately $4.5 million of gross unrecognized tax benefits will change in the next 12 months as a result of pending audit settlements or statute of limitations expirations. The Company files federal, state, and foreign tax returns. For federal purposes, the Company is generally no longer subject to tax examinations for years ended December 31, 2013 and prior. For state tax returns, the Company is generally no longer subject to tax examinations for years prior to 2012. For foreign purposes, the Company is generally no longer subject to examination for tax periods 2009 and prior. Certain carryforward tax attributes generated in prior years remain subject to examination and adjustment.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2017
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Legal Proceedings The Company is involved in legal proceedings from time to time in the ordinary course of its business, including employment claims and claims related to other business transactions. Although the outcome of such claims is uncertain, management believes that these legal proceedings will not have a material adverse effect on the financial condition or results of future operations of the Company. The Company is currently a party to litigation with the City of Sao Paulo, Brazil. The dispute relates to whether the export of services provided by the Company is subject to a local tax on services. The Company has not recorded a liability associated with the claim, which totaled $5.4 million at September 30, 2017 , given that it is not deemed probable the Company will incur a loss related to this case. However, a deposit totaling $5.4 million has been made to the Brazilian court in order to annul the potential tax obligation and to avoid the accrual of additional interest and penalties. This balance is recorded in other assets on the consolidated condensed balance sheet. In June 2015, the Judiciary Court of Justice of the State of Sao Paulo ruled in the favor of the Company, however, the judgment was appealed by the City of Sao Paulo. The Company expects to recover the full amount of the deposit when the case is settled. In September 2017, a judge from the Superior Court of Justice of Brazil denied relief to the City of Sao Paulo's appeal and upheld the lower court's ruling in the favor of the Company for the years 2011, 2012, and in the period from January to October 2013. The judge from the Superior Court of Justice of Brazil also ruled that the Company must appeal the lower court's verdict for the period November 2013 through September 2017 as the Judiciary Court of Justice of the State of Sao Paulo only reviewed the facts that pertained to the period before November 2013.

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2017
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	Derivatives The Company is exposed to certain risks relating to its ongoing business operations. The primary risk that the Company seeks to manage by using derivative instruments is interest rate risk. Accordingly, the Company has instituted interest rate hedging programs that are accounted for in accordance with ASC 815, “Derivatives and Hedging.” The interest rate hedging program is a cash flow hedge program designed to minimize interest rate volatility. The Company swaps the difference between fixed and variable interest amounts calculated by reference to an agreed-upon notional principal amount, at specified intervals. The Company’s interest rate contracts are designated as hedging instruments. The following table presents the notional amounts and fair values (determined using Level 2 inputs) of the Company’s derivatives as of September 30, 2017 and December 31, 2016 (in thousands): September 30, 2017 December 31, 2016 Balance Sheet Classification Notional amount Asset/ (Liability) Notional amount Asset/ (Liability) Derivatives in an asset position: Interest rate swap Other assets $ 250,000 $ 73 $ — $ — Derivatives in a liability position: Interest rate swap Other long-term liabilities $ — $ — $ 250,000 $ (590 ) The Company records the effective portion of any change in the fair value of derivatives designated as hedging instruments under ASC 815 to other accumulated comprehensive loss in the Company's consolidated condensed balance sheet, net of deferred taxes, and will later reclassify into earnings when the hedged item affects earnings or is no longer expected to occur. Gains and losses from the ineffective portion of any hedge are recognized in earnings immediately. For other derivative contracts that do not qualify or no longer qualify for hedge accounting, changes in the fair value of the derivatives are recognized in earnings each period. The table below presents the effect of the Company's derivatives on the consolidated condensed statements of operations and comprehensive income (loss) for the three and nine months ended September 30, 2017 and 2016 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Derivatives in Cash Flow Hedging Relationships (Interest Rate Contracts) 2017 2016 2017 2016 Amount of pre-tax gain (loss) recognized in other comprehensive income (loss) on derivatives $ 35 $ 127 $ (32 ) $ (2,546 ) Amount of loss recognized in other income (expense), net on derivatives (ineffective portion) — — — — Amount of loss reclassified from accumulated other comprehensive loss into interest expense, net on derivatives (1,758 ) (1,617 ) (5,175 ) (4,242 ) The Company expects that $6.6 million of unrealized losses will be reclassified out of accumulated other comprehensive loss and into interest expense, net over the next 12 months.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Loss	9 Months Ended
	Sep. 30, 2017
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Accumulated Other Comprehensive Loss	Accumulated Other Comprehensive Loss Below is a summary of the components of accumulated other comprehensive loss (in thousands): Foreign Currency Translation Derivative Instruments, Net of Tax Total Balance at December 31, 2016 $ (201,091 ) $ (23,595 ) $ (224,686 ) Other comprehensive income before reclassifications 75,167 (21 ) 75,146 Reclassification adjustments — 3,249 3,249 Balance at September 30, 2017 $ (125,924 ) $ (20,367 ) $ (146,291 ) The change in the Company's foreign currency translation adjustment was due primarily to the movements in the British pound and Euro exchange rates against the U.S. dollar. The U.S. dollar weakened by 8.6% and 12.0% versus the British pound and Euro, respectively, between December 31, 2016 and September 30, 2017 . The movement in the British pound and Euro represented $42.1 million and $26.8 million , respectively, out of the $75.2 million foreign currency translation adjustment during the nine months ended September 30, 2017 . The remaining foreign currency translation adjustment is primarily attributable to the U.S. dollar’s depreciation against other major world-wide currencies, including the Canadian dollar and the Russian ruble.

Net Income Per Share

Net Income Per Share	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Net Income Per Share	Net Income Per Share Basic net income per share is calculated by dividing net income by the weighted average number of common shares outstanding for the applicable period. Diluted net income per share is calculated after adjusting the denominator of the basic net income per share calculation for the effect of all potentially dilutive common shares, which, in the Company’s case, includes shares issuable under the stock option and incentive award plan. The following table reconciles the basic to diluted weighted average shares outstanding (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Basic weighted average common shares outstanding 62,730 60,937 62,185 60,579 Effect of dilutive stock options and RSAs/RSUs 3,142 3,584 3,498 3,689 Diluted weighted average common shares outstanding 65,872 64,521 65,683 64,268 Anti-dilutive shares 733 359 381 314 The anti-dilutive shares disclosed above were calculated using the treasury stock method. The treasury stock method calculates dilution assuming the exercise of all in-the-money options and vesting of RSAs/RSUs, reduced by the repurchase of shares with the proceeds from the assumed exercises, and unrecognized compensation expense for outstanding awards.

Segments

Segments	9 Months Ended
	Sep. 30, 2017
Segment Reporting [Abstract]
Segments	Segments In conjunction with the acquisition of Symphony Health on September 6, 2017, the Company expanded its reporting segments. The Company is now managed through two reportable segments, Clinical Research and Data Solutions. Clinical Research, which primarily serves biopharmaceutical clients, provides outsourced clinical research and clinical trial related services. Data Solutions provides mission critical information, technology solutions and real-world insights and services to the Company’s life science clients. Reimbursement revenue and reimbursable out-of-pocket costs are not presented, as this measure is not used by the chief operating decision maker to assess the Company's performance. The Company’s reportable segment information is presented below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Service revenue: Clinical Research $ 475,588 $ 399,841 $ 1,360,610 $ 1,166,410 Data Solutions 18,962 — 18,962 — Total service revenue 494,550 399,841 1,379,572 1,166,410 Direct Costs: Clinical Research 314,904 259,910 903,027 758,333 Data Solutions 11,961 — 11,961 — Total direct costs 326,865 259,910 914,988 758,333 Gross Profit: Clinical Research 160,684 139,931 457,583 408,077 Data Solutions 7,001 — 7,001 — Total gross profit $ 167,685 $ 139,931 $ 464,584 $ 408,077 Less expenses not allocated to segments: Selling, general and administrative 79,307 67,190 229,770 199,648 Transaction-related costs 12,740 — 12,740 31,785 Depreciation and amortization 18,853 17,708 50,146 52,246 Loss on disposal of fixed assets, net 8 219 240 290 Consolidated income from operations 56,777 54,814 171,688 124,108 Interest expense, net (11,557 ) (13,779 ) (31,088 ) (42,525 ) Loss on modification or extinguishment of debt (3,089 ) — (3,089 ) (21,485 ) Foreign currency (losses) gains, net (12,794 ) 1,182 (35,004 ) 9,264 Other income (expense), net 1,004 20 724 (85 ) Consolidated income before income taxes and equity in income of unconsolidated joint ventures $ 30,341 $ 42,237 $ 103,231 $ 69,277

Basis of Presentation (Tables)

Basis of Presentation (Tables)	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of cash, cash equivalents, and restricted cash	The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the consolidated condensed balance sheets that sum to the total of the same amounts shown in the consolidated condensed statements of cash flows: September 30, December 31, 2017 2016 2016 2015 Cash and cash equivalents $ 193,581 $ 130,343 $ 144,623 $ 121,065 Restricted cash 697 5,235 4,715 5,060 Total cash, cash equivalents, and restricted cash $ 194,278 $ 135,578 $ 149,338 $ 126,125

Business Combination (Tables)

Business Combination (Tables)	9 Months Ended
	Sep. 30, 2017
Symphony Health Solutions
Business Combination
Schedule of purchase price allocation	The Company’s preliminary estimate of the purchase price allocation is as follows (in thousands): Purchase Price Allocation Weighted Amortization Period Cash and cash equivalents $ 26,297 Accounts receivable 39,056 Other current assets 24,048 Fixed assets 12,340 Software and other intangibles 13,000 5 years Database 64,600 9 years Customer relationships 161,000 12 years Accounts payable and accrued expenses (42,700 ) Deferred revenue (65,511 ) Deferred tax liabilities (75,056 ) Other long-term liabilities (7,940 ) Estimated fair value of net assets acquired 149,134 Purchase price, including contingent consideration 649,609 Total goodwill $ 500,475
Schedule of unudited pro-forma information	The following unaudited pro-forma information assumes the acquisition of Symphony Health occurred as of the beginning of 2016. This pro-forma financial information is not necessarily indicative of operating results if the acquisition had been completed at the date indicated, nor is it necessarily an indication of future operating results. Nine Months Ended (in thousands, except per share amounts) 2017 2016 Total revenue $ 1,752,514 $ 1,484,013 Net income attributable to PRA Health Sciences, Inc. 126,092 35,830 Net income per share: Basic $ 2.03 $ 0.59 Diluted $ 1.92 $ 0.56
Acquisition of TDC joint venture
Business Combination
Schedule of purchase price allocation	The Company’s preliminary estimate of the fair value of the net assets acquired as part of the TDC joint venture transaction at the closing date of the business combination is as follows (in thousands): Purchase Price Allocation Cash and cash equivalents $ 8,120 Other current assets 1,671 Other non-current assets 1,742 Accounts payable and accrued expenses (2,380 ) Other long-term liabilities (943 ) Estimated fair value of net assets acquired 8,210 PRA purchase price 5,440 Fair value of Takeda's noncontrolling interest 5,440 Total goodwill $ 2,670
Parallel 6
Business Combination
Schedule of purchase price allocation	The Company’s preliminary estimate of the purchase price allocation is as follows (in thousands): Purchase Price Allocation Weighted Amortization Period Cash and cash equivalents $ 132 Accounts receivable 1,231 Other current assets 26 Software intangible 15,500 5 years Other intangibles 920 5 years Accounts payable and accrued expenses (885 ) Deferred revenue (994 ) Other long-term liabilities (2,414 ) Estimated fair value of net assets acquired 13,516 Purchase price, including contingent consideration 46,652 Total goodwill $ 33,136
Nextrials
Business Combination
Schedule of purchase price allocation	The Company’s purchase price allocation is as follows (in thousands): Purchase Price Allocation Weighted Amortization Period Cash and cash equivalents $ 94 Accounts receivable 211 Other current assets 96 Property, plant and equipment 111 Software intangible 5,574 5 years Accounts payable and accrued expenses (1,585 ) Other long-term liabilities (1,663 ) Estimated fair value of net assets acquired 2,838 Purchase price, including contingent consideration and net of working capital settlement 7,145 Total goodwill $ 4,307

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Summary of the fair value of financial assets and liabilities measured on a recurring basis	The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured on a recurring basis as of September 30, 2017 (in thousands): Level 1 Level 2 Level 3 Total Assets: Interest rate swap $ — $ 73 $ — $ 73 Marketable securities 366 — — 366 Total $ 366 $ 73 $ — $ 439 Liabilities: Contingent consideration $ — $ — $ 118,564 $ 118,564 Total $ — $ — $ 118,564 $ 118,564
Summary of the changes in Level 3 financial assets and liabilities measured on a recurring basis	The following table summarizes the changes in Level 3 financial liabilities measured on a recurring basis for the nine months ended September 30, 2017 (in thousands): Contingent Consideration - Accrued expenses and other liabilities Contingent Consideration - Other long-term liabilities Balance at December 31, 2016 $ 1,735 $ 1,019 Initial estimate of Symphony Health contingent consideration 90,394 18,390 Initial estimate of Parallel 6 contingent consideration — 8,350 Payments on Nextrials contingent consideration (400 ) — Reclassification adjustment 1,019 (1,019 ) Change in fair value recognized in other (income) expense, net (924 ) — Balance at September 30, 2017 $ 91,824 $ 26,740

Concentration of Credit Risk (T

Concentration of Credit Risk (Tables)	9 Months Ended
	Sep. 30, 2017
Service revenue
Concentration risk
Schedule of concentration of risk by risk factor	Service revenue from individual customers greater than 10% of consolidated service revenue in the respective periods was as follows: Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Customer A 10.1 % 11.7 % 10.6 % 10.8 % Customer B — 10.4 % — 10.7 % Customer C — 10.2 % — —
Accounts receivable and unbilled receivables
Concentration risk
Schedule of concentration of risk by risk factor	Accounts receivable and unbilled receivables from individual customers that were equal to or greater than 10% of consolidated accounts receivable and unbilled receivables at the respective dates were as follows: September 30, December 31, 2017 2016 Customer A 10.7 % 12.0 %

Accounts Receivable and Unbil27

Accounts Receivable and Unbilled Services (Tables)	9 Months Ended
	Sep. 30, 2017
Receivables [Abstract]
Schedule of accounts receivable and unbilled services	Accounts receivable and unbilled services include service revenue, reimbursement revenue, and amounts associated with work performed by investigators. Accounts receivable and unbilled services were as follows (in thousands): September 30, December 31, 2017 2016 Accounts receivable $ 457,306 $ 284,647 Unbilled services 172,152 155,609 629,458 440,256 Less allowance for doubtful accounts (1,429 ) (1,203 ) Total accounts receivable and unbilled services, net $ 628,029 $ 439,053

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of changes in the carrying amount of goodwill	The changes in the carrying amount of goodwill by reportable segment are as follows (in thousands): Clinical Research Data Solutions Consolidated Balance at December 31, 2016 $ 971,980 $ — $ 971,980 Acquisition of Symphony Health — 500,475 500,475 Acquisition of Parallel 6 33,136 — 33,136 Acquisition of TDC joint venture 2,670 — 2,670 Acquisition of TDS 966 — 966 Currency translation 25,830 — 25,830 Balance at September 30, 2017 $ 1,034,582 $ 500,475 $ 1,535,057
Schedule of intangible assets	Intangible assets consist of the following (in thousands): September 30, December 31, 2017 2016 Customer relationships $ 535,135 $ 360,328 Customer backlog 123,358 119,223 Trade names (definite-lived) 28,457 25,740 Patient list, software and other intangibles 55,574 28,974 Database 64,600 — Non-competition agreements 2,767 2,737 Total finite-lived intangible assets, gross 809,891 537,002 Accumulated amortization (216,174 ) (181,036 ) Total finite-lived intangible assets, net 593,717 355,966 Trade names (indefinite-lived) 118,010 118,010 Total intangible assets, net $ 711,727 $ 473,976
Schedule of estimated future amortization expense	The estimated future amortization expense of finite-lived intangible assets is expected to be as follows (in thousands): 2017 (remaining) $ 16,368 2018 60,075 2019 54,375 2020 52,462 2021 50,331 2022 and thereafter 360,106 Total $ 593,717

Long-Term Debt (Tables)

Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Schedule of long-term debt	Long-term debt consists of the following (in thousands): September 30, December 31, 2017 2016 Term loans, first lien $ 1,148,125 $ 625,000 Senior notes 91,441 91,441 Accounts receivable financing agreement 120,000 120,000 1,359,566 836,441 Less debt issuance costs and discount (9,349 ) (8,139 ) 1,350,217 828,302 Less current portion (56,719 ) (31,250 ) Total long-term debt, net $ 1,293,498 $ 797,052
Schedule of principal payments on long-term debt due	Principal payments on long-term debt are due as follows (in thousands): 2017 (remaining) $ 11,250 2018 60,625 2019 180,625 2020 76,250 2021 939,375 2022 and thereafter 91,441 Total $ 1,359,566

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2017
Stockholders' Equity Note [Abstract]
Summary of noncontrolling interest	Below is a summary of noncontrolling interest for the nine months ended September 30 (in thousands): 2017 2016 Balance as of January 1, $ — $ — Investment by noncontrolling interest 5,440 — Comprehensive income (loss) Net income 513 — Foreign currency adjustments, net of income tax (90 ) — Balance as of September 30, $ 5,863 $ —

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Summary of stock option activity	Aggregated information regarding the Company’s option plans is summarized below: Options Wtd. Average Exercise Price Wtd. Average Remaining Contractual Life (in years) Intrinsic Value (millions) Outstanding at December 31, 2016 5,507,347 $ 15.38 6.7 $ 218.9 Granted 1,831,000 74.93 Exercised (1,758,846 ) 9.47 Expired or forfeited (73,072 ) 26.94 Outstanding at September 30, 2017 5,506,429 $ 36.91 7.7 $ 216.2 Exercisable at September 30, 2017 2,557,710 $ 13.70 6.3 $ 159.8
Schedule of RSA/RSU activity	The Company’s RSAs/RSUs activity in 2017 is as follows: Awards Wtd. Average Grant-Date Fair Value Intrinsic Value (millions) Unvested at December 31, 2016 188,590 $ 32.63 $ 10.4 Granted 131,044 63.05 Forfeited (2,000 ) 58.95 Vested (5,805 ) 38.81 Unvested at September 30, 2017 311,829 $ 45.14 $ 23.8
Schedule of stock-based compensation expense	Stock-based compensation expense related to employee stock options and RSAs/RSUs is summarized below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Direct costs $ 956 $ 438 $ 2,208 $ 1,319 Selling, general and administrative 2,493 1,228 5,478 3,621 Transaction-related costs 5,294 — 5,294 29,421 Total stock-based compensation expense $ 8,743 $ 1,666 $ 12,980 $ 34,361

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2017
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of notional amounts and fair values (determined using level 2 inputs) of derivatives	The following table presents the notional amounts and fair values (determined using Level 2 inputs) of the Company’s derivatives as of September 30, 2017 and December 31, 2016 (in thousands): September 30, 2017 December 31, 2016 Balance Sheet Classification Notional amount Asset/ (Liability) Notional amount Asset/ (Liability) Derivatives in an asset position: Interest rate swap Other assets $ 250,000 $ 73 $ — $ — Derivatives in a liability position: Interest rate swap Other long-term liabilities $ — $ — $ 250,000 $ (590 )
Schedule of the effect of derivatives on the condensed consolidated statements of operations and comprehensive (loss) income	The table below presents the effect of the Company's derivatives on the consolidated condensed statements of operations and comprehensive income (loss) for the three and nine months ended September 30, 2017 and 2016 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, Derivatives in Cash Flow Hedging Relationships (Interest Rate Contracts) 2017 2016 2017 2016 Amount of pre-tax gain (loss) recognized in other comprehensive income (loss) on derivatives $ 35 $ 127 $ (32 ) $ (2,546 ) Amount of loss recognized in other income (expense), net on derivatives (ineffective portion) — — — — Amount of loss reclassified from accumulated other comprehensive loss into interest expense, net on derivatives (1,758 ) (1,617 ) (5,175 ) (4,242 )

Accumulated Other Comprehensi33

Accumulated Other Comprehensive Loss (Tables)	9 Months Ended
	Sep. 30, 2017
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Summary of components of accumulated other comprehensive loss	Below is a summary of the components of accumulated other comprehensive loss (in thousands): Foreign Currency Translation Derivative Instruments, Net of Tax Total Balance at December 31, 2016 $ (201,091 ) $ (23,595 ) $ (224,686 ) Other comprehensive income before reclassifications 75,167 (21 ) 75,146 Reclassification adjustments — 3,249 3,249 Balance at September 30, 2017 $ (125,924 ) $ (20,367 ) $ (146,291 )

Net Income Per Share (Tables)

Net Income Per Share (Tables)	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Schedule of weighted average basic and diluted common shares	The following table reconciles the basic to diluted weighted average shares outstanding (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Basic weighted average common shares outstanding 62,730 60,937 62,185 60,579 Effect of dilutive stock options and RSAs/RSUs 3,142 3,584 3,498 3,689 Diluted weighted average common shares outstanding 65,872 64,521 65,683 64,268 Anti-dilutive shares 733 359 381 314

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2017
Segment Reporting [Abstract]
Schedule of Segment Reporting Information	The Company’s reportable segment information is presented below (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Service revenue: Clinical Research $ 475,588 $ 399,841 $ 1,360,610 $ 1,166,410 Data Solutions 18,962 — 18,962 — Total service revenue 494,550 399,841 1,379,572 1,166,410 Direct Costs: Clinical Research 314,904 259,910 903,027 758,333 Data Solutions 11,961 — 11,961 — Total direct costs 326,865 259,910 914,988 758,333 Gross Profit: Clinical Research 160,684 139,931 457,583 408,077 Data Solutions 7,001 — 7,001 — Total gross profit $ 167,685 $ 139,931 $ 464,584 $ 408,077 Less expenses not allocated to segments: Selling, general and administrative 79,307 67,190 229,770 199,648 Transaction-related costs 12,740 — 12,740 31,785 Depreciation and amortization 18,853 17,708 50,146 52,246 Loss on disposal of fixed assets, net 8 219 240 290 Consolidated income from operations 56,777 54,814 171,688 124,108 Interest expense, net (11,557 ) (13,779 ) (31,088 ) (42,525 ) Loss on modification or extinguishment of debt (3,089 ) — (3,089 ) (21,485 ) Foreign currency (losses) gains, net (12,794 ) 1,182 (35,004 ) 9,264 Other income (expense), net 1,004 20 724 (85 ) Consolidated income before income taxes and equity in income of unconsolidated joint ventures $ 30,341 $ 42,237 $ 103,231 $ 69,277

Basis of Presentation - Recentl

Basis of Presentation - Recently Implemented Accounting Pronouncements (Details) - USD ($)	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Jan. 01, 2017	Dec. 31, 2016
Recently Implemented Accounting Pronouncements
Deferred tax liabilities	$ (128,366,000)			$ (73,703,000)
Operating cash flows	(117,828,000)	$ (66,708,000)
Financing cash outflows	523,670,000	$ (30,745,000)
Accounting Standards Update 2016-09
Recently Implemented Accounting Pronouncements
Deferred tax liabilities			$ 12,700,000
Valuation allowance			12,700,000
Accounting Standards Update 2016-09 | Retained Earnings
Recently Implemented Accounting Pronouncements
Retained earnings			$ 0
Accounting Standards Update 2016-15 | Effect of early adoption of ASU
Recently Implemented Accounting Pronouncements
Operating cash flows	17,800,000
Financing cash outflows	$ 17,800,000

Basis of Presentation - Restric

Basis of Presentation - Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016	Sep. 30, 2016	Dec. 31, 2015
Cash, cash equivalents, and restricted cash
Cash and cash equivalents	$ 193,581	$ 144,623	$ 130,343	$ 121,065
Restricted cash	697	4,715	5,235	5,060
Total cash, cash equivalents, and restricted cash	$ 194,278	$ 149,338	$ 135,578	$ 126,125

Basis of Presentation Basis of

Basis of Presentation Basis of Presentation - Secondary Offerings (Details) - USD ($) $ in Millions	1 Months Ended	9 Months Ended
	Aug. 31, 2017	Sep. 30, 2017
Subsidiary, Sale of Stock [Line Items]
KKR ownership of the Company's outstanding common stock (as a percentage)		20.80%
Secondary stock offering
Subsidiary, Sale of Stock [Line Items]
Shares sold in secondary offering (in shares)	10,000,000
Secondary stock offering - shares from existing shareholders (in shares)
Subsidiary, Sale of Stock [Line Items]
Professional fees for secondary offering		$ 1

Business Combination - Narrativ

Business Combination - Narrative (Details) - USD ($) $ in Thousands	Sep. 06, 2017	Jun. 01, 2017	May 10, 2017	Mar. 18, 2016	Sep. 30, 2017	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Business Combination
Benefit from income taxes						$ 18,241	$ (10,821)	$ 165	$ (17,869)
Loss on modification or extinguishment of debt						$ (3,089)	$ 0	$ (3,089)	$ (21,485)
Takeda
Business Combination
Noncontrolling interest owned by Takeda (as a percentage)					50.00%	50.00%		50.00%
Acquisition of Symphony Health
Business Combination
Cash consideration	$ 540,800
Total goodwill	500,475
Service revenue					$ 19,000
Net income					1,100
Acquisition of Symphony Health | Clinical Research
Business Combination
Total goodwill	$ 0
Acquisition of Symphony Health | Acquisition-related costs
Business Combination
Acquisition-related costs					6,400	$ 6,400		$ 6,400
Loss on modification or extinguishment of debt								3,100
Acquisition of Symphony Health | Acquisition-related transaction costs
Business Combination
Benefit from income taxes								2,500
Acquisition of Symphony Health | Acquisition-related modification or extinguishment of long-term debt
Business Combination
Benefit from income taxes								1,200
Acquisition of Symphony Health | Recurring | Level 3 | Other Current Liabilities [Member] | Contingent Earn-out Payments
Business Combination
Contingent liability recognized					108,800	108,800		108,800
Acquisition of Symphony Health | Recurring | Level 3 | Other long-term liabilities | Contingent Earn-out Payments
Business Combination
Contingent liability recognized					18,400	18,400		18,400
Acquisition of Symphony Health | Recurring | Level 3 | Contingent Consideration - Accrued expenses and other liabilities | Contingent Earn-out Payments
Business Combination
Contingent liability recognized					90,400	90,400		$ 90,400
Acquisition of TDS
Business Combination
Cash consideration		$ 700
Total goodwill		1,000
Acquisition of TDC joint venture
Business Combination
Cash consideration		5,400
Total goodwill		$ 2,670
Equity interest in VIE (as a percentage)		50.00%
Period after which buy-out of the noncontrolling interest of the Variable Interest Entity (VIE) is required		2 years
Acquisition of TDC joint venture | Maximum
Business Combination
Period to complete the final valuation of net assets acquired		1 year
Acquisition of TDC joint venture | Selling, general and administrative
Business Combination
Acquisition-related costs		$ 600
Acquisition of TDC joint venture | Takeda
Business Combination
Noncontrolling interest ownership (as a percentage)		50.00%
Required buy-out of Takeda's ownership (as a percentage)								50.00%
Early ownership buy-out option (as a percentage)								50.00%
Parallel 6
Business Combination
Cash consideration			$ 39,700
Parallel 6 | Maximum
Business Combination
Period to complete the final valuation of net assets acquired			1 year
Parallel 6 | Clinical Research
Business Combination
Total goodwill			$ 33,100
Parallel 6 | Contingent Earn-out Payments - Sales Targets
Business Combination
Potential contingent earn-out payments			$ 10,000
Earn-out period for contingent consideration			18 months
Parallel 6 | Selling, general and administrative
Business Combination
Acquisition-related costs			$ 1,300
Parallel 6 | Level 3 | Other long-term liabilities
Business Combination
Contingent liability recognized					8,400	8,400		$ 8,400
Nextrials
Business Combination
Cash consideration				$ 4,800
Nextrials | Clinical Research
Business Combination
Total goodwill				4,307
Nextrials | Contingent Earn-out Payments
Business Combination
Potential contingent earn-out payments				$ 3,000
Earn-out period for contingent consideration				30 months
Increase in fair value of contingent consideration								100
Payment of contingent consideration								400
Nextrials | Contingent Earn-out Payments - Sales Targets
Business Combination
Potential contingent earn-out payments				$ 1,000
Nextrials | Contingent Earn-out Payments - Milestones
Business Combination
Potential contingent earn-out payments				2,000
Nextrials | Contingent Consideration - Accrued expenses and other liabilities | Contingent Earn-out Payments
Business Combination
Contingent liability, current					$ 1,400	$ 1,400		$ 1,400
Nextrials | Level 3 | Contingent Earn-out Payments
Business Combination
Contingent liability recognized				$ 2,300

Business Combination - Prelimin

Business Combination - Preliminary Estimate of the Purchase Price Allocation - SHS (Details) - Acquisition of Symphony Health $ in Thousands	Sep. 06, 2017USD ($)
Business Acquisition [Line Items]
Cash and cash equivalents	$ 26,297
Accounts receivable	39,056
Other current assets	24,048
Fixed assets	12,340
Accounts payable and accrued expenses	(42,700)
Deferred revenue	(65,511)
Deferred tax liabilities	(75,056)
Other long-term liabilities	(7,940)
Estimated fair value of net assets acquired	149,134
Purchase price, including contingent consideration	649,609
Total goodwill	500,475
Software intangible
Business Acquisition [Line Items]
Software intangible	$ 13,000
Weighted Amortization Period	5 years
Database
Business Acquisition [Line Items]
Software intangible	$ 64,600
Weighted Amortization Period	9 years
Customer relationships
Business Acquisition [Line Items]
Software intangible	$ 161,000
Weighted Amortization Period	12 years

Business Combination - Unaudite

Business Combination - Unaudited Pro-Forma Information (Details) - Symphony Health Solutions - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Business Acquisition [Line Items]
Acquisition-related revenue	$ 1,752,514	$ 1,484,013
Net income attributable to PRA Health Sciences, Inc.	$ 126,092	$ 35,830
Net income per share, basic (in dollars per share)	$ 2.03	$ 0.59
Net income per share, diluted (in dollars per share)	$ 1.92	$ 0.56

Business Combination - Prelim42

Business Combination - Preliminary Estimate of Net Assets Acquired TDC Joint Venture (Details) - Acquisition of TDC joint venture $ in Thousands	Jun. 01, 2017USD ($)
Business Acquisition [Line Items]
Cash and cash equivalents	$ 8,120
Other current assets	1,671
Other non-current assets	1,742
Accounts payable and accrued expenses	(2,380)
Other long-term liabilities	(943)
Estimated fair value of net assets acquired	8,210
Purchase price, including contingent consideration	5,440
Fair value of Takeda's noncontrolling interest	5,440
Total goodwill	$ 2,670

Business Combination - Prelim43

Business Combination - Preliminary Estimate of the Purchase Price Allocation (Details) - Parallel 6 $ in Thousands	May 10, 2017USD ($)
Business Acquisition [Line Items]
Cash and cash equivalents	$ 132
Accounts receivable	1,231
Other current assets	26
Accounts payable and accrued expenses	(885)
Deferred revenue	(994)
Other long-term liabilities	(2,414)
Estimated fair value of net assets acquired	13,516
Purchase price, including contingent consideration	46,652
Software intangible
Business Acquisition [Line Items]
Software intangible	$ 15,500
Weighted Amortization Period	5 years
Other intangibles
Business Acquisition [Line Items]
Software intangible	$ 920
Weighted Amortization Period	5 years
Clinical Research
Business Acquisition [Line Items]
Total goodwill	$ 33,100

Business Combination - Company'

Business Combination - Company's Purchase Price Allocation (Details) - Nextrials $ in Thousands	Mar. 18, 2016USD ($)
Business Acquisition [Line Items]
Cash and cash equivalents	$ 94
Accounts receivable	211
Other current assets	96
Property, plant and equipment	111
Accounts payable and accrued expenses	(1,585)
Other long-term liabilities	(1,663)
Estimated fair value of net assets acquired	2,838
Purchase price, including contingent consideration	7,145
Software intangible
Business Acquisition [Line Items]
Software intangible	$ 5,574
Weighted Amortization Period	5 years
Clinical Research
Business Acquisition [Line Items]
Total goodwill	$ 4,307

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Financial Assets and Liabilities Measured on a Recurring Basis (Details) - Recurring $ in Thousands	Sep. 30, 2017USD ($)
Assets:
Assets fair value	$ 439
Liabilities:
Liabilities fair value	118,564
Interest rate swap
Assets:
Assets fair value	73
Contingent consideration
Liabilities:
Liabilities fair value	118,564
Marketable securities
Assets:
Assets fair value	366
Level 1
Assets:
Assets fair value	366
Liabilities:
Liabilities fair value	0
Level 1 | Interest rate swap
Assets:
Assets fair value	0
Level 1 | Contingent consideration
Liabilities:
Liabilities fair value	0
Level 1 | Marketable securities
Assets:
Assets fair value	366
Level 2
Assets:
Assets fair value	73
Liabilities:
Liabilities fair value	0
Level 2 | Interest rate swap
Assets:
Assets fair value	73
Level 2 | Contingent consideration
Liabilities:
Liabilities fair value	0
Level 2 | Marketable securities
Assets:
Assets fair value	0
Level 3
Assets:
Assets fair value	0
Liabilities:
Liabilities fair value	118,564
Level 3 | Interest rate swap
Assets:
Assets fair value	0
Level 3 | Contingent consideration
Liabilities:
Liabilities fair value	118,564
Level 3 | Marketable securities
Assets:
Assets fair value	$ 0

Fair Value Measurements - Level

Fair Value Measurements - Level 3 (Details) - Recurring - Level 3 $ in Thousands	9 Months Ended
	Sep. 30, 2017USD ($)
Contingent consideration | Value Heath Solutions, Inc.
Changes in the fair value of the Company's Level 3 financial liabilities
Initial estimate of contingent consideration	$ 1,000
Contingent Consideration - Accrued expenses and other liabilities
Changes in the fair value of the Company's Level 3 financial liabilities
December 31, 2016	1,735
Change in fair value recognized in other (income) expense, net	(924)
September 30, 2017	91,824
Contingent Consideration - Accrued expenses and other liabilities | Symphony Health Solutions
Changes in the fair value of the Company's Level 3 financial liabilities
Initial estimate of contingent consideration	90,394
Contingent Consideration - Accrued expenses and other liabilities | Parallel 6
Changes in the fair value of the Company's Level 3 financial liabilities
Initial estimate of contingent consideration	0
Contingent Consideration - Accrued expenses and other liabilities | Nextrials
Changes in the fair value of the Company's Level 3 financial liabilities
Payments on Nextrials contingent consideration	(400)
Reclassification adjustment	1,019
Contingent Consideration - Other long-term liabilities
Changes in the fair value of the Company's Level 3 financial liabilities
December 31, 2016	1,019
Change in fair value recognized in other (income) expense, net	0
September 30, 2017	26,740
Contingent Consideration - Other long-term liabilities | Symphony Health Solutions
Changes in the fair value of the Company's Level 3 financial liabilities
Initial estimate of contingent consideration	18,390
Contingent Consideration - Other long-term liabilities | Parallel 6
Changes in the fair value of the Company's Level 3 financial liabilities
Initial estimate of contingent consideration	8,350
Contingent Consideration - Other long-term liabilities | Nextrials
Changes in the fair value of the Company's Level 3 financial liabilities
Payments on Nextrials contingent consideration	0
Reclassification adjustment	$ (1,019)

Fair Value Measurements - Non-r

Fair Value Measurements - Non-recurring Fair Value Measurements (Details) - Nonrecurring - Level 3 $ in Millions	Sep. 30, 2017USD ($)
Assets fair value measurements
Assets fair value	$ 2,246.8
Goodwill	1,535.1
Identifiable intangible assets	$ 711.7

Concentration of Credit Risk (D

Concentration of Credit Risk (Details) - Customer Concentration Risk	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Service revenue | Customer A
Concentration risk
Concentration risk percentage	10.10%	11.70%	10.60%	10.80%
Service revenue | Customer B
Concentration risk
Concentration risk percentage	0.00%	10.40%	0.00%	10.70%
Service revenue | Customer C
Concentration risk
Concentration risk percentage	0.00%	10.20%	0.00%	0.00%
Accounts receivable and unbilled receivables | Customer A
Concentration risk
Concentration risk percentage			10.70%		12.00%

Accounts Receivable and Unbil49

Accounts Receivable and Unbilled Services (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Receivables [Abstract]
Accounts receivable	$ 457,306	$ 284,647
Unbilled services	172,152	155,609
Total accounts receivable, gross	629,458	440,256
Less allowance for doubtful accounts	(1,429)	(1,203)
Total accounts receivable and unbilled services, net	$ 628,029	$ 439,053

Goodwill and Intangible Asset50

Goodwill and Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Jun. 30, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Amortization expense	$ 11,300,000	$ 11,300,000	$ 29,500,000	$ 34,300,000
Accumulated impairment charges					$ 0	$ 0
EDS
Finite-Lived Intangible Assets [Line Items]
Fair value of reporting unit in excess of carrying amount						$ 70,000,000
Percent of fair value of reporting unit in excess of carrying amount						33.00%

Goodwill and Intangible Asset51

Goodwill and Intangible Assets - Schedule of Changes in the Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 06, 2017	Jun. 01, 2017	May 10, 2017
Changes in carrying amount of goodwill
December 31, 2016	$ 971,980
Currency translation	25,830
September 30, 2017	1,535,057
Acquisition of Symphony Health
Changes in carrying amount of goodwill
Total goodwill		$ 500,475
Acquisition of Parallel 6
Changes in carrying amount of goodwill
Acquisition	33,136
Acquisition of TDC joint venture
Changes in carrying amount of goodwill
Total goodwill			$ 2,670
Acquisition	2,670
Acquisition of TDS
Changes in carrying amount of goodwill
Total goodwill			$ 1,000
Acquisition	966
Clinical Research
Changes in carrying amount of goodwill
December 31, 2016	971,980
Currency translation	25,830
September 30, 2017	1,034,582
Clinical Research | Acquisition of Symphony Health
Changes in carrying amount of goodwill
Total goodwill		0
Clinical Research | Acquisition of Parallel 6
Changes in carrying amount of goodwill
Total goodwill				$ 33,100
Acquisition	33,136
Clinical Research | Acquisition of TDC joint venture
Changes in carrying amount of goodwill
Acquisition	2,670
Clinical Research | Acquisition of TDS
Changes in carrying amount of goodwill
Acquisition	966
Data Solutions
Changes in carrying amount of goodwill
December 31, 2016	0
Currency translation	0
September 30, 2017	500,475
Data Solutions | Acquisition of Symphony Health
Changes in carrying amount of goodwill
Total goodwill		$ 500,475
Data Solutions | Acquisition of Parallel 6
Changes in carrying amount of goodwill
Acquisition	0
Data Solutions | Acquisition of TDC joint venture
Changes in carrying amount of goodwill
Acquisition	0
Data Solutions | Acquisition of TDS
Changes in carrying amount of goodwill
Acquisition	$ 0

Goodwill and Intangible Asset52

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	$ 809,891	$ 537,002
Accumulated amortization	(216,174)	(181,036)
Total finite-lived intangible assets, net	593,717	355,966
Trade names (indefinite-lived)	118,010	118,010
Total intangible assets, net	711,727	473,976
Customer relationships
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	535,135	360,328
Customer backlog
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	123,358	119,223
Trade names (definite-lived)
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	28,457	25,740
Patient list, software and other intangibles
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	55,574	28,974
Database
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	64,600	0
Non-competition agreements
Goodwill And Intangible Assets
Total finite-lived intangible assets, gross	$ 2,767	$ 2,737

Goodwill and Intangible Asset53

Goodwill and Intangible Assets - Schedule of Estimated Future Amortization Expense of Finite-lived Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets, Amortization Expense, Maturity Schedule [Abstract]
2017 (remaining)	$ 16,368
2,018	60,075
2,019	54,375
2,020	52,462
2,021	50,331
2022 and thereafter	360,106
Total finite-lived intangible assets, net	$ 593,717	$ 355,966

Long-Term Debt - Summary (Detai

Long-Term Debt - Summary (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Long-term debt
Long-term debt, gross	$ 1,359,566	$ 836,441
Less debt issuance costs and discount	(9,349)	(8,139)
Total	1,350,217	828,302
Less current portion	(56,719)	(31,250)
Total long-term debt, net	1,293,498	797,052
Term loans, first lien
Long-term debt
Long-term debt, gross	1,148,125	625,000
Senior notes
Long-term debt
Long-term debt, gross	91,441	91,441
Accounts receivable financing agreement
Long-term debt
Long-term debt, gross	$ 120,000	$ 120,000

Long-Term Debt - Future Princip

Long-Term Debt - Future Principal Payments (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Principal payments on long-term debt
2017 (remaining)	$ 11,250
2,018	60,625
2,019	180,625
2,020	76,250
2,021	939,375
2022 and thereafter	91,441
Total	$ 1,359,566	$ 836,441

Long-Term Debt - Credit Facilit

Long-Term Debt - Credit Facilities (Details) - USD ($)	Sep. 06, 2017	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Long-term debt
Current borrowing capacity				$ 550,000,000	$ 0
Loss on modification or extinguishment of debt		$ 3,089,000	$ 0	$ 3,089,000	$ 21,485,000
Term loans, first lien
Long-term debt
Debt, Weighted Average Interest Rate		3.45%		3.45%
Credit Facilities 2016 | LIBOR | Minimum
Long-term debt
Applicable margin on variable rate basis (as a percent)				1.00%
Credit Facilities 2016 | LIBOR | Maximum
Long-term debt
Applicable margin on variable rate basis (as a percent)				2.00%
Credit Facilities 2016 | ABR | Minimum
Long-term debt
Applicable margin on variable rate basis (as a percent)				0.00%
Credit Facilities 2016 | ABR | Maximum
Long-term debt
Applicable margin on variable rate basis (as a percent)				1.00%
Credit Facilities 2016
Long-term debt
Current borrowing capacity	$ 550,000,000
Loss on modification or extinguishment of debt				$ 3,100,000
Credit Facilities 2016 | Term loans, first lien | Quarterly payments - March 31, 2017 to December 31, 2017
Long-term debt
Quarterly term loan amortization payments				11,300,000
Credit Facilities 2016 | Term loans, first lien | Quarterly payments - March 31, 2018 to December 31, 2019
Long-term debt
Quarterly term loan amortization payments				15,200,000
Credit Facilities 2016 | Term loans, first lien | Quarterly payments - March 31, 2020 to December 31, 2020
Long-term debt
Quarterly term loan amortization payments				19,100,000
Credit Facilities 2016 | Term loans, first lien | Quarterly payments - March 31, 2021 to December 31, 2021
Long-term debt
Quarterly term loan amortization payments				23,000,000
Credit Facilities 2016 | Revolving Credit Facility
Long-term debt
Maximum borrowing capacity		$ 125,000,000		$ 125,000,000
Interest period, option one				1 month
Interest period, option two				2 months
Interest period, option three				3 months
Interest period, option four				6 months
Outstanding borrowings		0		$ 0		$ 0
Outstanding letters of credit		$ 4,500,000		$ 4,500,000		$ 7,000,000
Credit Facilities 2016 | Revolving Credit Facility | Minimum
Long-term debt
Commitment fee (as a percent)				0.20%
Credit Facilities 2016 | Revolving Credit Facility | Maximum
Long-term debt
Commitment fee (as a percent)				0.40%
Credit Facilities 2016 | Revolving Credit Facility | LIBOR | Minimum
Long-term debt
Variable base rate minimum floor (as a percent)				0.00%
Credit Facilities 2016 | Revolving Credit Facility | ABR
Long-term debt
Variable rate basis				ABR

Long-Term Debt - Senior Notes a

Long-Term Debt - Senior Notes and AR Financing Agreement (Details) - USD ($) $ in Thousands	Mar. 17, 2016	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016	Mar. 31, 2016
Long-term debt
Loss on extinguishment of debt		$ 3,089	$ 0	$ 3,089	$ 21,485
Fair Value of Debt
Estimated fair value of long-term debt		1,368,800		1,368,800		$ 844,200
Level 3
Fair Value of Debt
Fair value of the term loans, borrowings under credit facilities, and accounts receivable financing agreement		1,268,100		1,268,100		745,000
Senior notes
Long-term debt
Repayment of principal	$ 133,600
Interest rate (as a percent)	9.50%
Loss on extinguishment of debt		21,500
Prepayment penalty				17,400
Write-off of unamortized debt issuance costs				3,700
Fees associated with extinguishment of debt				400
Senior notes | Level 2
Fair Value of Debt
Fair value of Senior Notes		100,700		100,700		99,200
Accounts receivable financing agreement
Long-term debt
Maximum borrowing capacity							$ 140,000
Outstanding borrowings		120,000		$ 120,000		120,000
Notice period for prepayment of loans				1 day
Notice period required for termination of agreement				15 days
Weighted average interest rate (as a percent)				2.91%
Remaining borrowing capacity		$ 20,000		$ 20,000		$ 20,000
Accounts receivable financing agreement | LIBOR
Long-term debt
Applicable margin on variable rate basis (as a percent)				1.60%

Stockholders' Equity (Details)

Stockholders' Equity (Details) - $ / shares	Sep. 30, 2017	Dec. 31, 2016
Stockholders' Equity Note [Abstract]
Common stock, shares authorized (in shares)	1,000,000,000	1,000,000,000
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	100,000,000	100,000,000
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01

Stockholders' Equity - Noncontr

Stockholders' Equity - Noncontrolling Interest (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Summary of noncontrolling interest
Balance as of January 1,			$ 0	$ 0
Investment by noncontrolling interest			5,440	0
Comprehensive income (loss)
Net income	$ 401	$ 0	513	0
Foreign currency adjustments, net of income tax			(90)	0
September 30	$ 5,863	$ 0	$ 5,863	$ 0

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options (Details) - USD ($) $ / shares in Units, $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Restricted Stock Awards (RSAs)
Awards
Restricted stock awards granted in period	131,044
Total grant date fair value of awards granted	$ 8.3
Employee stock options
Options
Outstanding at beginning of period (in shares)	5,507,347
Granted (in shares)	1,831,000
Exercised (in shares)	(1,758,846)
Expired or forfeited (in shares)	(73,072)
Outstanding at end of period (in shares)	5,506,429	5,507,347
Exercisable (in shares)	2,557,710
Wtd. Average Exercise Price
Outstanding at beginning of period (in dollars per share)	$ 15.38
Granted (in dollars per share)	74.93
Exercised (in dollars per share)	9.47
Expired or forfeited (in dollars per share)	26.94
Outstanding at end of period (in dollars per share)	36.91	$ 15.38
Exercisable (in dollars per share)	$ 13.70
Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]
Weighted average remaining contractual life, Outstanding	7 years 8 months 12 days	6 years 8 months 12 days
Weighted average remaining contractual life, Exercisable	6 years 3 months 18 days
Intrinsic value, Outstanding	$ 216.2	$ 218.9
Intrinsic value, Exercisable	159.8
Service-based options | Employee stock options
Awards
Total grant date fair value of awards granted	$ 46
Options
Granted (in shares)	1,831,000

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Awards and Units (Details) - RSAs and RSUs - USD ($) $ / shares in Units, $ in Millions	9 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Awards
Outstanding at beginning of period (in shares)	188,590
Granted (in shares)	131,044
Forfeited (in shares)	(2,000)
Vested (in shares)	(5,805)
Outstanding at end of period (in shares)	311,829
Wtd. Average Grant-Date Fair Value
Outstanding at beginning of period (in dollars per share)	$ 32.63
Granted (in dollars per share)	63.05
Forfeited (in dollars per share)	58.95
Vested (in dollars per share)	38.81
Outstanding at end of period (in dollars per share)	$ 45.14
Intrinsic Value
Outstanding at end of period	$ 23.8	$ 10.4

Stock-Based Compensation - St62

Stock-Based Compensation - Stock-Based Compensation Expense (Details) - USD ($)	Mar. 02, 2016	Jan. 20, 2016	Dec. 31, 2013	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Stock options, RSAs and RSUs
Stock-based compensation
Compensation expense				$ 8,743,000	$ 1,666,000	$ 12,980,000	$ 34,361,000
Direct costs | Stock options, RSAs and RSUs
Stock-based compensation
Compensation expense				956,000	438,000	2,208,000	1,319,000
Selling, general and administrative | Stock options, RSAs and RSUs
Stock-based compensation
Compensation expense				2,493,000	1,228,000	5,478,000	3,621,000
Transaction-related costs | Stock options, RSAs and RSUs
Stock-based compensation
Compensation expense				$ 5,294,000	$ 0	5,294,000	29,421,000
Transaction-related costs | 2013 Plan | Stock options, RSAs and RSUs
Stock-based compensation
Compensation expense						5,300,000	$ 4,900,000
Vesting based on market conditions rate one | 2013 Plan | Employee stock options
Stock-based compensation
Compensation expense		$ 0	$ 0
Number of stock options modified	835,551
Vesting based on market conditions rate one | Transaction-related costs | 2013 Plan | Employee stock options
Stock-based compensation
Incremental compensation expense						$ 24,500,000

Stock-Based Compensation - Empl

Stock-Based Compensation - Employee Stock Purchase Plan (Details) - 2017 Employee Stock Purchase Plan	9 Months Ended
	Sep. 30, 2017
Employee Stock Purchase Plan
Offering period increments under the ESPP	6 months
Maximum
Employee Stock Purchase Plan
Payroll deduction, as a percentage of base wages, an employee may authorize to be applied toward the purchase of common stock under the ESPP	10.00%
Percentage of discount on the purchase price of common stock during the offering period under the ESPP	15.00%

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Income Tax Disclosure [Abstract]
Effective income tax rate (as a percent)	(0.20%)	25.80%
U.S. statutory rate (as a percent)	35.00%
Liability for unrecognized tax benefits	$ 13
Amount of gross unrecognized tax benefits that will change in the next 12 months as a result of pending audit settlements or statute of limitations expirations	$ 4.5

Commitments and Contingencies (

Commitments and Contingencies (Details) - Tax related claim on export of services provided $ in Millions	Sep. 30, 2017USD ($)
Commitments and Contingencies
Amount of tax claimed to be due in litigation	$ 5.4
Other assets
Commitments and Contingencies
Deposit made to Brazilian court in tax litigation	$ 5.4

Derivatives - Hedging Instrumen

Derivatives - Hedging Instruments (Details) - Interest rate swap - Designated as hedging instruments - Level 2 - USD ($)	Sep. 30, 2017	Dec. 31, 2016
Other assets
Derivatives in an asset position:
Notional amount	$ 250,000,000	$ 0
Asset/ (Liability)	73,000	0
Other long-term liabilities
Derivatives in a liability position:
Notional amount	0	250,000,000
Asset/ (Liability)	$ 0	$ (590,000)

Derivatives - Cash Flow Hedging

Derivatives - Cash Flow Hedging Instruments (Details) - Cash flow hedging - Interest rate contracts - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Effect of derivatives on the consolidated statements of operations and comprehensive income (loss)
Amount of pre-tax gain (loss) recognized in other comprehensive income (loss) on derivatives	$ 35,000	$ 127,000	$ (32,000)	$ (2,546,000)
Amount of loss recognized in other income (expense), net on derivatives (ineffective portion)	0	0	0	0
Amount of loss reclassified from accumulated other comprehensive loss into interest expense, net on derivatives	$ (1,758,000)	$ (1,617,000)	(5,175,000)	$ (4,242,000)
Unrealized losses expected to be reclassified out of accumulated other comprehensive loss into interest expense over the next 12 months			$ 6,600,000

Accumulated Other Comprehensi68

Accumulated Other Comprehensive Loss - Components (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive income (loss)	$ 936,297	$ 729,252
Foreign Currency Translation
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive income (loss)	(125,924)	(201,091)
Other comprehensive income before reclassifications	75,167
Reclassification adjustments	0
Derivative Instruments, Net of Tax
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive income (loss)	(20,367)	(23,595)
Other comprehensive income before reclassifications	(21)
Reclassification adjustments	3,249
Total
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive income (loss)	(146,291)	$ (224,686)
Other comprehensive income before reclassifications	75,146
Reclassification adjustments	3,249
Foreign currency translation
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income before reclassifications	$ 75,167
British Pound, GBP | Foreign currency translation
Accumulated Other Comprehensive Income (Loss) [Line Items]
Increase (Decrease) In Currency Valuation, Percent	(8.60%)
Other comprehensive income before reclassifications	$ 42,100
Euro, EUR | Foreign currency translation
Accumulated Other Comprehensive Income (Loss) [Line Items]
Increase (Decrease) In Currency Valuation, Percent	(12.00%)
Other comprehensive income before reclassifications	$ 26,800

Net Income Per Share (Details)

Net Income Per Share (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Reconciliation of basic to diluted weighted average shares outstanding
Basic weighted average common shares outstanding (in shares)	62,730	60,937	62,185	60,579
Effect of dilutive stock options and RSAs/RSUs (in shares)	3,142	3,584	3,498	3,689
Diluted weighted average common shares outstanding (in shares)	65,872	64,521	65,683	64,268
Anti-dilutive shares (in shares)	733	359	381	314

Segments (Details)

Segments (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2017USD ($)reportable_segments	Sep. 30, 2016USD ($)
Segment Reporting Information [Line Items]
Reportable segments | reportable_segments			2
Service revenue	$ 494,550	$ 399,841	$ 1,379,572	$ 1,166,410
Direct costs	326,865	259,910	914,988	758,333
Gross profit	167,685	139,931	464,584	408,077
Selling, general and administrative	79,307	67,190	229,770	199,648
Transaction-related costs	12,740	0	12,740	31,785
Depreciation and amortization	18,853	17,708	50,146	52,246
Loss on disposal of fixed assets, net	8	219	240	290
Consolidated income from operations	56,777	54,814	171,688	124,108
Interest expense, net	(11,557)	(13,779)	(31,088)	(42,525)
Loss on modification or extinguishment of debt	(3,089)	0	(3,089)	(21,485)
Foreign currency (losses) gains, net	(12,794)	1,182	(35,004)	9,264
Other income (expense), net	1,004	20	724	(85)
Consolidated income before income taxes and equity in income of unconsolidated joint ventures	30,341	42,237	103,231	69,277
Operating segments | Clinical Research
Segment Reporting Information [Line Items]
Service revenue	475,588	399,841	1,360,610	1,166,410
Direct costs	314,904	259,910	903,027	758,333
Gross profit	160,684	139,931	457,583	408,077
Operating segments | Data Solutions
Segment Reporting Information [Line Items]
Service revenue	18,962	0	18,962	0
Direct costs	11,961	0	11,961	0
Gross profit	7,001	0	7,001	0
Segment Reconciling Items
Segment Reporting Information [Line Items]
Selling, general and administrative	79,307	67,190	229,770	199,648
Transaction-related costs	12,740	0	12,740	31,785
Depreciation and amortization	18,853	17,708	50,146	52,246
Loss on disposal of fixed assets, net	8	219	240	290
Interest expense, net	(11,557)	(13,779)	(31,088)	(42,525)
Loss on modification or extinguishment of debt	(3,089)	0	(3,089)	(21,485)
Foreign currency (losses) gains, net	(12,794)	1,182	(35,004)	9,264
Other income (expense), net	$ 1,004	$ 20	$ 724	$ (85)