Alliance HealthCare Services (AIQ) 10-Q 4 Aug 16 2016 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2016	Aug. 01, 2016
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q2
Trading Symbol	AIQ
Entity Registrant Name	Alliance HealthCare Services, Inc
Entity Central Index Key	817,135
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		10,738,551

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 24,319	$ 38,070
Accounts receivable, net of allowance for doubtful accounts of $4,376 in 2016 and $5,461 in 2015	73,514	73,208
Prepaid expenses	13,191	13,463
Other receivables	2,532	3,206
Total current assets	113,556	127,947
Plant, property and equipment, net	204,447	177,188
Goodwill	106,129	102,782
Other intangible assets, net	164,587	162,923
Other assets	25,858	32,820
Total assets	614,577	603,660
Current liabilities:
Accounts payable	24,973	20,796
Accrued compensation and related expenses	22,753	19,933
Accrued interest payable	3,253	3,323
Current portion of long-term debt	19,174	17,732
Current portion of obligations under capital leases	2,606	2,674
Other accrued liabilities	34,783	36,453
Total current liabilities	107,542	100,911
Long-term debt, net of current portion and deferred financing costs	509,800	540,353
Obligations under capital leases, net of current portion	11,524	10,332
Deferred income taxes	23,960	23,020
Other liabilities	7,149	6,664
Total liabilities	659,975	681,280
Commitments and contingencies (Note 12)
Stockholders’ deficit:
Preferred stock, $0.01 par value; 1,000,000 shares authorized and no shares issued and outstanding
Common stock, $0.01 par value; 100,000,000 shares authorized; 10,896,524 and 10,774,857 issued in 2016 and 2015, respectively; 10,738,551 and 10,616,884 outstanding in 2016 and 2015, respectively	109	108
Treasury stock, at cost - 157,973 shares in 2016 and 2015	(3,138)	(3,138)
Additional paid-in capital	60,635	29,297
Accumulated comprehensive loss	(465)	(511)
Accumulated deficit	(197,124)	(198,393)
Total stockholders’ deficit attributable to Alliance HealthCare Services, Inc.	(139,983)	(172,637)
Noncontrolling interest	94,585	95,017
Total stockholders’ deficit	(45,398)	(77,620)
Total liabilities and stockholders’ deficit	$ 614,577	$ 603,660

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Statement Of Financial Position [Abstract]
Allowance for doubtful accounts	$ 4,376	$ 5,461
Preferred Stock, par value (dollars per share)	$ 0.01	$ 0.01
Preferred Stock, shares authorized (shares)	1,000,000	1,000,000
Preferred Stock, shares issued (shares)	0	0
Preferred Stock, shares outstanding (shares)	0	0
Common Stock, par value (dollars per share)	$ 0.01	$ 0.01
Common Stock, shares authorized (shares)	100,000,000	100,000,000
Common Stock, shares issued (shares)	10,896,524	10,774,857
Common Stock, shares outstanding (shares)	10,738,551	10,616,884
Treasury Stock, shares (shares)	157,973	157,973

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Income Statement [Abstract]
Revenues	$ 125,317	$ 118,504	$ 249,041	$ 227,933
Costs and expenses:
Cost of revenues, excluding depreciation and amortization	69,939	67,485	140,853	129,371
Selling, general and administrative expenses	23,175	20,800	48,440	41,755
Transaction costs	431	1,113	848	1,532
Shareholder transaction costs	1,498		2,507
Severance and related costs	708	195	2,424	454
Impairment charges		6,670	0	6,746
Depreciation expense	13,730	12,072	26,778	23,705
Amortization expense	2,494	2,495	4,937	4,530
Interest expense and other, net	8,872	6,904	16,367	12,922
Other (income) and expense, net	(3,546)	486	(4,334)	127
Total costs and expenses	117,301	118,220	238,820	221,142
Income before income taxes, earnings from unconsolidated investees, and noncontrolling interest	8,016	284	10,221	6,791
Income tax expense (benefit)	2,221	(1,366)	1,275	206
Earnings from unconsolidated investees	(393)	(1,292)	(645)	(2,455)
Net income	6,188	2,942	9,591	9,040
Less: Net income attributable to noncontrolling interest	(3,729)	(4,903)	(8,322)	(9,250)
Net income (loss) attributable to Alliance HealthCare Services, Inc.	2,459	(1,961)	1,269	(210)
Comprehensive income (loss), net of taxes:
Net income (loss) attributable to Alliance HealthCare Services, Inc.	2,459	(1,961)	1,269	(210)
Unrealized gain (loss) on hedging transactions, net of taxes	84	(13)	46	(141)
Comprehensive income (loss), net of taxes:	$ 2,543	$ (1,974)	$ 1,315	$ (351)
Income (loss) per common share attributable to Alliance HealthCare Services, Inc.:
Basic	$ 0.23	$ (0.18)	$ 0.12	$ (0.02)
Diluted	$ 0.23	$ (0.18)	$ 0.12	$ (0.02)
Weighted-average number of shares of common stock and common stock equivalents:
Basic	10,882	10,715	10,771	10,714
Diluted	10,893	10,836	10,796	10,839

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Operating activities:
Net income	$ 9,591	$ 9,040
Adjustments to reconcile net income to net cash provided by operating activities:
Provision for doubtful accounts	1,356	1,054
Share-based payment	1,780	819
Depreciation and amortization	31,715	28,235
Amortization of deferred financing costs	3,312	2,098
Accretion of discount on long-term debt	254	232
Adjustment of derivatives to fair value	(45)	98
Distributions more than undistributed earnings from investees	107	189
Deferred income taxes	940	(697)
Gain on sale of assets	(169)	(406)
Changes in fair value of contingent consideration related to acquisitions	(3,640)
Impairment charges		6,746
Excess tax benefit from share-based payment arrangements	436	5
Changes in operating assets and liabilities, net of the effects of acquisitions:
Accounts receivable	(1,389)	(577)
Prepaid expenses	(119)	(1,499)
Other receivables	674	(242)
Other assets	4,240	534
Accounts payable	2,578	627
Accrued compensation and related expenses	2,820	340
Accrued interest payable	(70)	(31)
Income taxes payable	(36)	131
Other accrued liabilities	3,614	964
Net cash provided by operating activities	57,949	47,660
Investing activities:
Equipment purchases	(33,975)	(26,382)
Increase in deposits on equipment	(13,847)	(9,935)
Acquisitions, net of cash received	(6,659)	(24,061)
Proceeds from sale of assets	370	520
Net cash used in investing activities	(54,111)	(59,858)
Financing activities:
Principal payments on equipment debt and capital lease obligations	(8,035)	(4,639)
Proceeds from equipment debt	4,809	15,691
Principal payments on term loan facility	(2,600)	(7,351)
Proceeds from term loan facility		29,850
Principal payments on revolving loan facility	(24,000)	(28,000)
Proceeds from revolving loan facility	21,000	26,000
Payments of debt issuance costs and deferred financing costs	(25,059)	(654)
Noncontrolling interest in subsidiaries	(11,703)	(8,353)
Excess tax benefit from share-based payment arrangements	(436)	(5)
Issuance of common stock	1
Proceeds from exercise of stock options	614	25
Settlement of contingent consideration related to acquisitions	(810)
Proceeds from shareholder transaction	28,630
Net cash (used in) provided by financing activities	(17,589)	22,564
Net (decrease) increase in cash and cash equivalents	(13,751)	10,366
Cash and cash equivalents, beginning of period	38,070	33,033
Cash and cash equivalents, end of period	24,319	43,399
Supplemental disclosure of cash flow information:
Interest paid	12,957	11,110
Income taxes refunded, net of payments	(92)	(146)
Supplemental disclosure of non-cash investing and financing activities:
Capital lease obligations related to the purchase of equipment	1,499	1,294
Equipment purchases in accounts payable and accrued equipment	352	2,477
Noncontrolling interest assumed in connection with acquisitions (Note 3)	2,948	20,598
Fair value of contingent consideration related to acquisitions (Note 3)	$ 420
Extinguishment of note receivable		$ 3,071

Basis of Presentation, Principl

Basis of Presentation, Principles of Consolidation, and Use of Estimates	6 Months Ended
	Jun. 30, 2016
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Basis of Presentation, Principles of Consolidation, and Use of Estimates	1. Basis of Presentation, Principles of Consolidation, and Use of Estimates Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared by Alliance HealthCare Services, Inc. (the “Company” or “Alliance”) in accordance with accounting principles generally accepted in the United States of America and with the instructions to Form 10-Q and Article 10 of Regulation S-X of the Securities and Exchange Commission. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (including normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three and six months ended June 30, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. The accompanying unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes to the consolidated financial statements for the year ended December 31, 2015. Principles of Consolidation The accompanying unaudited condensed consolidated financial statements of the Company include the assets, liabilities, revenues and expenses of all subsidiaries over which the Company exercises control. Intercompany transactions have been eliminated. The Company evaluates participating rights in its assessment of control in determining consolidation of joint venture partners. The Company records noncontrolling interest related to its consolidated subsidiaries that are not wholly owned. Investments in non-consolidated investees over which it exercises significant influence but does not control are accounted for under the equity method. Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could differ from those estimates. Critical Accounting Policies Information with respect to the Company’s critical accounting policies which management believes could have the most significant effect on the Company’s reported results and require subjective or complex judgments by management is contained in Item 7, Management’s Discussion and Analysis of Financial Condition and Results of Operations, of the 2015 Form 10-K/A. Management believes that there have been no significant changes during the three and six months ended June 30, 2016 in the Company’s critical accounting policies from those disclosed in Item 7 of the 2015 Form 10-K/A.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	6 Months Ended
	Jun. 30, 2016
New Accounting Pronouncements And Changes In Accounting Principles [Abstract]
Recent Accounting Pronouncements	2. Recent Accounting Pronouncements Revenue Recognition In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09, “Revenue from Contracts with Customers (Topic 606)” — to clarify and converge the revenue recognition principles under U.S. GAAP and International Financial Reporting Standards and to develop guidance that would streamline and enhance revenue recognition requirements while also providing a more robust framework for addressing revenue issues. ASU 2014-09 outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry specific guidance. Key provisions of the ASU involve a 5-step model specific to recognizing revenue derived from customer contracts. In addition, ASU 2014-09 provides implementation guidance on several other important topics, including the accounting for certain revenue-related costs. The Company is currently assessing the impacts this guidance may have on its consolidated financial statements and disclosures as well as the transition method it will use to adopt the guidance. The Company is considering the impacts of the new guidance on its ability to recognize revenue for certain contracts. In addition, the Company will be required to capitalize costs to acquire new contracts, whereas currently, the Company expenses those costs as incurred. In August 2015, the FASB issued an amendment to provide a one year deferral of the effective date to annual reporting periods beginning on or after December 15, 2017, as well as an option to early adopt the standard for annual periods beginning on or after December 15, 2016. The Company does not plan to early adopt the standard. Going Concern In August 2014, the FASB issued ASU 2014-15, “Presentation of Financial Statements—Going Concern (Subtopic 205-40)”. Under U.S. GAAP, a going concern is presumed unless and until an entity’s liquidation becomes imminent. When an entity’s liquidation becomes imminent, financial statements should be prepared under the liquidation basis of accounting in accordance with Subtopic 205-30, “Presentation of Financial Statements—Liquidation Basis of Accounting.” However, there may be conditions or events that raise substantial doubt about an entity’s ability to continue as a going concern, even if liquidation is not imminent. In those situations, financial statements should continue to be prepared under the going concern basis of accounting. ASU 2014-15 provides guidance about management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to determine whether to disclose information about relevant conditions and events. ASU 2014-15 is effective for annual periods ending after December 15, 2016, and for annual periods and interim periods thereafter. Early application is permitted. The Company is assessing the impact, if any, that the adoption of ASU 2014-15 may have on the Company's consolidated financial statements. Simplifying the Presentation of Debt Issuance Costs In April 2015, the FASB issued ASU 2015-03, “Simplifying the Presentation of Debt Issuance Cost” that changes the presentation of debt issuance costs in financial statements. ASU 2015-03 requires entities to present such costs in the balance sheet as a direct reduction to the related debt liability rather than as a deferred cost (i.e., an asset) as required by current guidance. In August 2015, the FASB issued clarifying authoritative guidance for debt issuance costs incurred in connection with line-of-credit arrangements. The guidance states that an entity should defer and present these debt issuance costs as an asset and subsequently amortize the deferred debt issuance costs ratably over the term of the line-of-credit arrangement. ASU 2015-03 does not change the recognition or measurement of debt issuance costs and is effective for fiscal years beginning after December 15, 2015. The guidance is required to be applied retrospectively to all prior periods presented. As of December 31, 2015, the Company had $6,594 in deferred financing costs, net that was reclassified to offset long-term debt, net of current portion. The adoption of the guidance did not have a material impact on the Company's consolidated financial statements. Balance Sheet Classification of Deferred Taxes In November 2015, the FASB issued ASU 2015-17, “Balance Sheet Classification of Deferred Taxes,” which will require entities to present deferred tax assets (“DTAs”) and deferred tax liabilities (“DTLs”) as noncurrent in a classified balance sheet. The ASU simplifies the current guidance, which requires entities to separately present DTAs and DTLs as current and noncurrent in a classified balance sheet. The adoption of ASU 2015-17 is effective for publicly traded business entities for annual reporting periods beginning after December 15, 2016, including interim reporting periods within that reporting period. Early adoption is permitted. The Company has elected to early adopt this guidance and applied it retrospectively to periods presented in the consolidated financial statements. As of December 31, 2015, the Company had $6,496 in DTAs that was reclassified to long-term DTLs. The adoption of ASU No. 2015-17 did not have a material impact on the Company’s consolidated financial statements. Leases In February 2016, the FASB issued ASU 2016-02, “Leases,” to increase transparency and comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and disclosing key information about leasing arrangements. The ASU supersedes the current guidance. The primary difference between current guidance and ASU 2015-02 is the recognition of lease assets and lease liabilities by lessees for those leases classified as operating leases under previous GAAP. ASU 2016-02 also requires an entity to separate the lease components from the nonlease components (for example, maintenance services or other activities that transfer a good or service to the customer) in a contract. Only the lease components must be accounted for in accordance with this guidance. ASU 2016-02 is effective for publicly traded business entities for annual reporting periods beginning after December 15, 2018, including interim reporting periods within that reporting period. Early adoption is permitted. The Company is assessing the impact, if any, that the adoption of ASU 2016-02 may have on the Company's consolidated financial statements. Share-Based Payments In March 2016, the FASB issued ASU 2016-09, “Compensation – Stock Compensation (Topic 718),” which simplifies several aspects of the accounting for employee share-based payment transactions for both public and nonpublic traded entities, including the accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. The new guidance, which is part of the FASB’s simplification initiative, also contains two practical expedients under which nonpublic entities can use the simplified method to estimate the expected term of an award and make a one-time election to switch from fair value measurement to intrinsic value measurement for liability-classified awards. ASU 2016-09 is effective for public business entities for annual reporting periods beginning after December 15, 2016, including interim periods within those annual reporting periods. Early adoption is permitted. The Company is assessing the impact, if any, that the adoption of ASU 2016-09 may have on the Company's consolidated financial statements.

Acquisitions and Transactions

Acquisitions and Transactions	6 Months Ended
	Jun. 30, 2016
Business Combinations Restructuring And Related Activities [Abstract]
Acquisitions and Transactions	3. Acquisitions and Transactions Acquisitions have been recorded using the acquisition method of accounting and, accordingly, results of their operations have been included in the Company’s consolidated financial statements since the effective date of each respective acquisition. Thai Hot Transaction On September 16, 2015, Fujian Thai Hot Investment Co., Ltd. (“Thai Hot”) agreed to purchase approximately 5,537,945 shares of Company common stock from funds managed by Oaktree Capital Management, L.P. (“Oaktree”) and MTS Health Investors, LLC (“MTS”), and Larry C. Buckelew (together, The Thai Hot Transaction closed on March 29, 2016. As a result of the Thai Hot Transaction, Thai Hot, through a wholly owned subsidiary, owns an aggregate of approximately 51.5% of the outstanding shares of common stock of the Company. The Company has not agreed to pay any management fees to Thai Hot for any financial advisory services to the Company. 2016 Acquisition American Health Centers, Inc. On April 22, 2016, t he Company, through its Radiology Division, acquired the mobile business practice of American Health Centers, Inc., a provider of fixed and mobile radiology and nuclear medicine services in New Hampshire and Vermont. The Company acquired eight mobile radiology sites, and five mobile nuclear medicine sites, effective May 19, 2016. The combined cash purchase price consisted of $4,209. The Company financed this acquisition using the revolving line of credit. Note 8 – Long-Term Debt and Senior Subordinated Credit Facility . The following table summarizes recognized amounts of identifiable assets acquired and liabilities assumed at the acquisition date: Equipment, net $ 2,354 Goodwill 335 Identifiable intangible assets 1,940 Total consideration $ 4,629 As a result of this acquisition, the Company recorded goodwill of $335, which largely represents intangible assets that do not qualify for separate recognition, including existing patients and the solid record of patient care in the local community. In addition, the Company recorded intangible assets of $1,940, of which $1,600 was assigned to customer contracts, which is being amortized over 15 years, and $340 was assigned to a non-competition agreement, which is being amortized over five years. A portion of the recorded goodwill and intangible assets is being amortized over 15 years for tax purposes. The Company recorded the intangible assets at fair value at the acquisition date, which was estimated using the income approach. The results for the three and six months ended June 30, 2016 included $637 of net revenue and $269 of net income before income taxes. The values assigned to the various assets and liabilities acquired in this transaction are preliminary and may be subject to adjustment as the calculation of their respective fair values could be subject to change. The agreement includes contingent consideration arrangements, which are based on performance of the 18-month period following the transaction date. The fair value of these contingent consideration arrangements of $420 was estimated using management’s estimates as of the acquisition date and as of June 30, 2016. 2015 Acquisitions Pacific Cancer Institute, Inc. On December 31, 2015, the Company, through its Oncology Division, acquired a 95% controlling interest in the Pacific Cancer Institute, Inc. (“PCI”), a state-of-the-art radiation therapy and SRS center located in Maui, Hawaii. The purchase price consisted of $11,013 in cash, net of holdback liabilities. The Company financed this acquisition using the revolving line of credit. For additional information, see Note 8 – Long-Term Debt and Senior Subordinated Credit Facility of the Notes to Condensed Consolidated Financial Statements As a result of this acquisition, the Company recorded goodwill of $6,505, The results for the three and six months ended June 30, 2016 included $1,280 and $2,714 of net revenue, respectively, and $22 and $219 of net income, respectively, generated by PCI. The agreement includes contingent consideration arrangements, which are based on performance of the 12-month period following the transaction date. The fair value of these contingent consideration arrangements of $200 was estimated using management’s estimates as of June 30, 2016. The values assigned to the various assets and liabilities acquired in this transaction are preliminary and may be subject to adjustment as the calculation of their respective fair values could be subject to change. AHIP-Florida, LLC On October 14, 2015, the Company, through its Interventional Division, acquired a 60% controlling interest in PRC Associates, LLC, (“PRC”), a premier provider of interventional pain management healthcare with eight locations in Central Florida and the Palm Coast. The purchase price consisted of $15,014 in cash, net of $264 cash acquired. The Company financed this acquisition using the revolving line of credit. As a result of this acquisition, the Company recorded goodwill of $8,234, The results for the three and six months ended June 30, 2016 included $3,150 and $6,597 of net revenue, respectively, and $204 and $746 of net income, respectively, generated by PRC. The agreement includes contingent consideration arrangements, which are based on performance of the 12-month period following the transaction date. The fair value of these contingent consideration arrangements of $950 was estimated using management’s estimates as of June 30, 2016. The values assigned to the various assets and liabilities acquired in this transaction are preliminary and may be subject to adjustment as the calculation of their respective fair values could be subject to change. Alliance-HNI, LLC and Subsidiaries On August 1, 2015, the Company obtained through its Radiology Division an additional 15.5% interest in its previously non-consolidated investment, Alliance-HNI, LLC (“AHNI”) through a step acquisition. Prior to August 1, 2015, the Company held a noncontrolling interest in AHNI, pursuant to its acquisition of Medical Consultants Imaging, Co. (“MCIC”), which held a 50% interest in a joint venture that was subsequently renamed AHNI. Prior to the step acquisition on August 1, 2015, AHNI had three subsidiaries: Alliance-HNI Leasing Co. (“AHNIL”), Alliance-HNV PET/CT Services, LLC (“AHNVPS”), and Alliance-HNV PET/CT Leasing, LLC (“AHNVPL”). AHNI On August 1, 2015, the Company contributed its 46.6% interest in HNVPS and its rights to certain assets to AHNI in exchange for an additional 15.5% interest in AHNI. After the transaction the Company holds a 65.5% interest in AHNI which, in turn, holds all of the outstanding interest in AHNVPS. As a result of gaining a controlling interest in AHNI, the Company began consolidating AHNI effective August 1, 2015. Pursuant to ASC 805, “Business Combinations,” the transaction is considered a step acquisition and the Company was required to remeasure its previously held equity interest in AHNI at its acquisition-date fair value and recognize any resulting gain or loss. AHNVPS assets that the Company was in control of before and after the acquisition were maintained at their carrying amounts immediately before the acquisition date and no gain or loss or resulting goodwill was recognized on these assets. The fair value of the consideration transferred was based on the net book value of the assets transferred by the Company to AHNI at the acquisition date because the Company had control of those assets before and after the transaction. The Company recorded goodwill of $2,988, The values assigned to the various assets and liabilities acquired in this transaction are preliminary and may be subject to adjustment as the calculation of their respective fair values could be subject to change. The Pain Center of Arizona On February 17, 2015, the Company purchased approximately a 59% membership interest in The Pain Center of Arizona (“TPC”), a comprehensive full-time pain management medical practice with 12 locations within the state of Arizona. The acquisition took place in two stages: a purchase of a 60% membership interest in TPC by the Company, and a 50% membership interest in Medical Practice Innovations, Inc. (“MPI”), followed by a transfer of MPI assets to TPC. The MPI transaction diluted the ownership interests of TPC, with the Company retaining approximately 59% membership interest in TPC. The purchase price consisted of $24,087 in cash, net of $234 cash acquired, and net of extinguishment of $3,071 of related-party notes receivable. The Company financed this acquisition using the revolving line of credit. As a result of this acquisition, the Company recorded goodwill of $22,566, which largely represents intangible assets that do not qualify for separate recognition, such as prominent leadership and the solid record of patient care programs that set national standards for quality coordinated care in pain management. In addition, the Company recorded intangible assets of $24,600, of which $13,500 was assigned to physician referral network and $11,100 was assigned to trademarks, which are being amortized over 20 years. The Company recorded the intangible assets at fair value at the acquisition date, which was estimated using the income approach. A portion of the recorded goodwill and intangible assets is being amortized over 15 years for tax purposes. The fair value of noncontrolling interest related to this transaction was estimated to be $20,598 as of the acquisition date using the implied fair value based on the Company's ownership percentage. The results for the three and six months ended June 30, 2016 included $7,961 and $15,793 of net revenue, respectively, and $417 and $1,056 of net loss, respectively, generated by TPC. The results for the three and six months ended June 30, 2015 included $8,167 and $12,023 of net revenue, respectively, and $20 and $291 of net income, respectively, generated by TPC. The agreement includes contingent consideration arrangements, which are based on performance of the 12-month period following the transaction date. The fair value of these contingent consideration arrangements of $960 at June 30, 2016, of which $150 remained in other accrued liabilities on the consolidated balance sheets, was calculated using achieved performance estimates. Pro Forma Impact of Acquisitions The following table provides unaudited pro forma revenues and results of operations for the three and six months ended June 30, 2016 and 2015, as if the acquisitions had occurred on January 1, 2015. The pro forma results were prepared from financial information obtained from the sellers of the businesses, as well as information obtained during the due diligence process associated with the acquisitions. The unaudited pro forma results reflect certain adjustments related to the acquisitions, such as increased depreciation and amortization expense resulting from the stepped-up basis to fair value of assets acquired and adjustments to reflect the Company’s borrowing and tax rates. The pro forma operating results do not include any anticipated synergies related to combining the businesses. Accordingly, such pro forma operating results were prepared for comparative purposes only and do not purport to be indicative of what would have occurred had the acquisitions been made as of January 1, 2015 or of results that may occur in the future. Quarter Ended June 30, Six Months Ended June 30, (In thousands, except per share amounts) 2016 2015 2016 2015 Revenues $ 125,496 $ 126,116 $ 249,856 $ 246,766 Net income (loss) attributable to Alliance HealthCare Services, Inc. 2,533 (978 ) 1,612 1,477 Basic earnings (loss) per share 0.23 (0.09 ) 0.15 0.14 Diluted earnings (loss) per share 0.23 (0.09 ) 0.15 0.14 Restructuring Plan During the six months ended June 30, 2016, the Company recorded $1,351 related to restructuring charges, of which the Company recorded $598 in Selling, general and administrative expenses, and $753 and in Cost of revenues, excluding depreciation and amortization. The Company also recorded $2,424 in Severance and related costs during the six months ended June 30, 2016 during the six months ended June 30, 2015

Share-Based Payment

Share-Based Payment	6 Months Ended
	Jun. 30, 2016
Share Based Compensation [Abstract]
Share-Based Payment	4. Share-Based Payment The Company has adopted ASC 718, “Compensation—Stock Compensation,” and has elected to follow the alternative transition method as described in ASC 718 for computing its beginning additional paid-in capital pool. In addition, the Company treats the tax deductions from stock options as being realized when they reduce taxes payable in accordance with the principles and timing under the relevant tax law. Stock Option Plans and Awards In November 1999, the Company adopted an employee stock option plan (as amended and restated, the “1999 Equity Plan”) pursuant to which options and awards with respect to a total of 3,005,000 shares have become available for grant. As of June 30, 2016, a total of 1,091,795 shares remained available for grant under the 1999 Equity Plan. Options are granted with exercise prices equal to the fair value of the Company’s common stock at the date of grant. All options have 10-year terms. Options granted after January 1, 2008 were typically time based and vest in equal tranches over three or four years. During the first quarter of 2016, 71,057 options were accelerated due to a change in control in connection with the closing of the Thai Hot Transaction. There were no options in which vesting was accelerated during 2015. The Company uses the Black-Scholes option pricing model to value the compensation expense associated with share-based payment awards. The fair value of each option award is estimated on the date of grant using the Black-Scholes option pricing model using the assumptions presented in the table below. In addition, forfeitures are estimated when recognizing compensation expense and the estimate of forfeitures will be adjusted over the requisite service period to the extent that actual forfeitures differ, or are expected to differ, from such estimates. Changes in estimated forfeitures will be recognized through a cumulative catch-up adjustment in the period of change and will also impact the amount of compensation expense to be recognized in future periods. The following weighted average assumptions were used in the estimated grant date fair value calculations for stock option awards: Six months ended June 30, 2016 2015 Risk free interest rate 1.53 % 1.65 % Expected dividend yield — % — % Expected stock price volatility 66.5 % 65.2 % Average expected life (in years) 6.00 6.00 The Company calculates its stock price volatility and average expected life based on its own historical data. The risk free interest rates are based on the United States Treasury yield curve in effect at the time of grant for periods corresponding with the expected life of the option or award. The following table summarizes the Company’s stock option activity: Number of Shares Weighted- Average Exercise Price Weighted- Average Remaining Contractual Term Aggregate Intrinsic Value Outstanding at December 31, 2015 646,290 $ 19.91 Granted 200,388 7.16 Exercised (121,667 ) 5.05 Canceled (27,431 ) 19.15 Outstanding at June 30, 2016 697,580 18.83 6.56 $ 35 Vested and expected to vest in the future at June 30, 2016 655,280 19.53 6.36 $ 35 Vested and exercisable at June 30, 2016 452,021 22.81 5.11 $ 35 The following table summarizes the Company’s unvested stock option activity: Shares Weighted- Average Grant-Date Fair Value Unvested at December 31, 2015 158,671 $ 15.01 Granted 200,388 4.32 Vested (107,613 ) 14.01 Canceled (5,887 ) 7.81 Unvested at June 30, 2016 245,559 $ 6.90 Cash proceeds, along with fair value disclosures related to grants, exercises, and vesting options, are as follows: Three months ended June 30, Six months ended June 30, 2016 2015 2016 2015 Proceeds from stock options exercised $ 129 $ 19 $ 614 $ 25 Intrinsic value of stock options exercised (1) 21 9 1,386 25 Weighted-average fair value of options granted (per share) N. A. N. A. 4.32 14.25 Total fair value of shares vested during the period — 107 1,508 479 (1) The intrinsic value of stock options exercised is the amount by which the market price of the stock on the date of exercise exceeded the market price of the stock on the date of grant. For the three months ended June 30, 2016 and 2015, the Company recorded share-based payment related to stock options of $174 and $257, respectively. For the six months ended June 30, 2016 and 2015, the Company recorded share-based payment related to stock options of $1,406 and $475, respectively. At June 30, 2016, the total unrecognized fair value share-based payment related to unvested stock options granted to employees was $992, which is expected to be recognized over a remaining weighted-average period of 2.1 years. The valuation model applied in this calculation utilizes highly subjective assumptions that could potentially change over time, including the expected forfeiture rate and performance targets. Therefore, the amount of unrecognized share-based payment noted above does not necessarily represent the value that will ultimately be realized by the Company in the Condensed Consolidated Statements of Operations and Comprehensive Income (Loss). Stock Awards The 1999 Equity Plan, as amended and restated, permits the award of restricted stock, restricted stock units, stock bonus awards and performance-based stock awards (collectively referred to as “stock awards”). During the six months ended June 30, 2016, 85,206 restricted stock units were granted to employees. There were no stock awards granted to employees during the six months ended June 30, 2015. For the three months ended June 30, 2016 and 2015, the Company recorded share-based payment related to stock awards of $205 and $172, respectively. For the six months ended June 30, 2016 and 2015, the Company recorded share-based payment related to stock awards of $837 and $344, respectively. In the third quarter of 2014, 25,000 restricted stock units (“RSU”) were granted to executive management, which vest based upon achieving certain market performance conditions. Specifically, the Company's closing stock price per common share must equal or exceed a value of $40.00 per share for 10 consecutive days between the dates of January 1, 2015 and April 21, 2017. If these conditions are not achieved before April 21, 2017, these RSUs will expire. In accordance with ASC 718, expense related to restricted stock units that vest based on achieving a market condition should not be recognized until the derived vesting period has been met, and at such time the derived vesting period becomes the requisite service period. Since the market condition has not been met, and is currently not probable of being met based on the current market condition, the Company has not recognized any expense related to these RSUs. These RSUs contain provisions that vesting may be accelerated under a change in control of the Company. The RSU Award provided that in the event of a change in control, the unvested portion of the award will convert into the right to receive a cash amount (the “Cash Right”) equal to the number of unvested restricted stock units multiplied by the per share consideration received by the holders of the Company’s Common Stock in the change in control and the Cash Right shall vest on the six month anniversary of the consummation of the change in control subject to the executive’s continued service through such date; provided, that in the event the executive is terminated without “cause” or for “good reason” (each as defined in the executive’s Employment Agreement) the Cash Right shall vest in full on the date of such termination (the “Cash Right Conversion”). The Thai Hot Transaction constituted a change in control under the terms of the RSU Award agreement and for purposes of the Cash Right Conversion, the Special Committee approved that the per share consideration received by the holders of the Company’s Common Stock upon the consummation of the Thai Hot Transaction was $18.50 per share. The monetary value of the Cash Right of $463 is included as accrued compensation and related expenses on the Company’s Condensed Consolidated Balance Sheets. For additional information on the Thai Hot Transaction, see Note 3 – Acquisitions and Transactions of the Notes to Condensed Consolidated Financial Statements. The following table summarizes the Company’s restricted stock activity: Shares Weighted- Average Grant-Date Fair Value Unvested at December 31, 2015 74,413 $ 9.18 Granted to employees 85,206 6.93 Vested — — Canceled — — Unvested at June 30, 2016 159,619 $ 7.98 At June 30, 2016 and 2015, the total unrecognized fair value share-based payment related to stock awards granted to unaffiliated directors was $331 and $345, respectively, which is expected to be recognized over a remaining weighted-average period of 0.50 year. At June 30, 2016, unrecognized fair value share-based payments related to stock awards granted to employees was $426, which is expected to be recognized over a remaining weighted-average period of 2.7 years. At June 30, 2015, there were no unrecognized fair value share-based payments related to stock awards granted to employees.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2016
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	5. Fair Value of Financial Instruments The Company used the following methods and assumptions in estimating fair value disclosure for financial instruments: Cash and cash equivalents The carrying amounts of cash and cash equivalents approximate fair value due to the short-term maturity or variable rates of these instruments. Debt The carrying amounts of variable-rate borrowings at June 30, 2016 and December 31, 2015 approximate fair value estimates based on current market rates and credit spreads for similar debt instruments. Contingent consideration The carrying amounts of contingent consideration related to acquisitions at June 30, 2016 and December 31, 2015 approximate fair value using probability-adjusted or achieved performance estimates. Mandatorily redeemable noncontrolling interest The carrying amount of mandatorily redeemable noncontrolling interest related to the PRC acquisition at June 30, 2016 and December 31, 2015 approximates fair value using the estimated implied fair value based on the Company's ownership percentage. Further discussion of the mandatorily redeemable noncontrolling interest is disclosed in Note 3 – Acquisitions and Transactions of the Notes to Condensed Consolidated Financial Statements. Derivative instruments Fair value of derivative instruments was determined based on the income approach and standard valuation techniques to convert future amounts to a single present amount and approximates the net gains and losses that would have been realized if the contracts had been settled at each period-end. The estimated fair values of the Company’s financial instruments are as follows: June 30, 2016 December 31, 2015 Carrying Value Fair Value Carrying Value Fair Value Cash and cash equivalents $ 24,319 $ 24,319 $ 38,070 $ 38,070 Fixed-rate capital leases and debt 40,116 39,242 40,667 40,262 Variable-rate debt 532,007 531,254 537,018 538,520 Contingent consideration related to acquisition 1,720 1,720 5,750 5,750 Mandatorily redeemable noncontrolling interest 2,386 2,386 2,386 2,386 Derivative instruments - asset position — — — — Derivative instruments - liability position 205 205 86 86 ASC 820, “Fair Value Measurement,” applies to all assets and liabilities that are being measured and reported at fair value on a recurring basis. ASC 820 requires disclosure that establishes a framework for measuring fair value in GAAP by establishing a hierarchy for ranking the quality and reliability of the information used to determine fair values. The statement requires that assets and liabilities carried at fair value will be classified and disclosed in one of the following three categories: Level 1 Quoted market prices in active markets for identical assets or liabilities. Level 2 Observable market-based inputs or unobservable inputs, including identical securities in inactive markets or similar securities in active markets, which are corroborated by market data. Level 3 Unobservable inputs that are not corroborated by market data. The Company’s fixed and variable-rate debt represent level 2 liabilities not measured at fair value on a recurring basis. None of the Company’s instruments has transferred from one level to another. The following table summarizes the valuation of the Company’s financial instruments that are reported at fair value on a recurring basis by the above ASC 820 pricing levels as of June 30, 2016: Total Quoted market prices in active markets (Level 1) Significant other observable inputs (Level 2) Significant unobservable inputs (Level 3) Cash and cash equivalents $ 24,319 $ 24,319 $ — $ — Contingent consideration related to acquisition 1,720 — — 1,720 Mandatorily redeemable noncontrolling interest 2,386 — — 2,386 Interest rate contracts - asset position — — — — Interest rate contracts - liability position 205 — 205 — The following table summarizes the valuation of the Company’s financial instruments that are reported at fair value on a recurring basis by the above ASC 820 pricing levels as of December 31, 2015: Total Quoted market prices in active markets (Level 1) Significant other observable inputs (Level 2) Significant unobservable inputs (Level 3) Cash and cash equivalents $ 38,070 $ 38,070 $ — $ — Contingent consideration related to acquisition 5,750 — — 5,750 Mandatorily redeemable noncontrolling interest 2,386 — — 2,386 Interest rate contracts - asset position — — — — Interest rate contracts - liability position 86 — 86 — The Company’s derivative instruments are primarily pay-fixed, receive-variable interest rate swaps and caps based on the LIBOR swap rate. The Company has elected to use the income approach to value these derivatives, using observable Level 2 market expectations at measurement date and standard valuation techniques to convert future amounts to a single present amount assuming that participants are motivated, but not compelled to transact. Level 2 inputs for interest rate swap and cap valuations are limited to quoted prices for similar assets or liabilities in active markets (specifically futures contracts on LIBOR for the first two years) and inputs other than quoted prices that are observable for the asset or liability (specifically LIBOR cash and swap rates at commonly quoted intervals and implied volatilities for options). ASC 820 states that the fair value measurement of an asset or liability must reflect the nonperformance risk of the entity and the counterparty. Therefore, the impact of the counterparty’s creditworthiness and the Company’s creditworthiness has also been factored into the fair value measurement of the derivative instruments. For additional information see Note 9 - Derivatives

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2016
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	6. Goodwill and Intangible Assets Changes in the carrying amount of goodwill are as follows: Balance at December 31, 2014 $ 63,864 Goodwill acquired during the period 38,918 Impairment charges — Adjustments to goodwill during the period — Balance at December 31, 2015 102,782 Goodwill acquired during the period 2,379 Impairment charges — Adjustments to goodwill during the period 968 Balance at June 30, 2016 $ 106,129 Gross goodwill $ 280,373 Accumulated impairment charges (174,244 ) Balance at June 30, 2016 $ 106,129 Intangible assets consisted of the following: June 30, 2016 December 31, 2015 Gross Carrying Amount Accumulated Amortization Intangible Assets, net Gross Carrying Amount Accumulated Amortization Intangible Assets, net Amortizing intangible assets: Customer contracts $ 192,431 $ (96,399 ) $ 96,032 $ 186,316 $ (92,280 ) $ 94,036 Other 39,009 (21,359 ) 17,650 38,522 (20,540 ) 17,982 Total amortizing intangible assets $ 231,440 $ (117,758 ) $ 113,682 $ 224,838 $ (112,820 ) $ 112,018 Intangible assets not subject to amortization 50,905 50,905 Total other intangible assets $ 164,587 $ 162,923 In 2016, the Company intends to perform its annual impairment test in the fourth quarter for goodwill and indefinite life intangible assets, absent other events occurring or changes in circumstances that would more likely than not reduce the fair value of a reporting unit below its carrying amount. The Company compares the fair value of its reporting units to its carrying amount to determine if there is potential impairment. The fair value of the reporting unit is determined by an income approach and a market capitalization approach. Significant management judgment is required in the forecasts of future operating results that are used in the income approach. The estimates that the Company has used are consistent with the plans and estimates that it uses to manage its business. The Company bases its fair value estimates on forecasted revenue and operating costs which include a number of factors including, but not limited to, securing new customers, retention of existing customers, growth in radiology, oncology and interventional revenues and the impact of continued cost savings initiatives. However, it is possible that plans and estimates may change. Based on financial information as of June 30, 2016, impairment testing was not required during the three months then ended. Although the Company concluded that no impairment was present in its intangible assets in the six months of 2016, the Company intends to test its goodwill and other intangibles assets for impairment during the fourth quarter of 2016, as described above. The Company uses the estimated useful life to amortize customer contracts, which is a weighted-average of 15 years. Other intangible assets subject to amortization are estimated to have a weighted-average useful life of 11 years. Amortization expense for intangible assets subject to amortization was $2,494 and $2,495 for the three months ended June 30, 2016 and 2015, respectively, and $4,937 and $4,530 for the six months ended June 30, 2016 and 2015, respectively As of June 30, 2016, estimated annual amortization expense for each of the fiscal years ending December 31, is presented below: Remainder of 2016 $ 5,050 2017 9,751 2018 9,378 2019 8,889 2020 8,374 Thereafter 72,240

Disclosure - Supplemental Balan

Disclosure - Supplemental Balance Sheet Information	6 Months Ended
	Jun. 30, 2016
Supplemental Balance Sheet Information [Abstract]
Supplemental Balance Sheet Information	7. Supplemental Balance Sheet Information Other accrued liabilities as of June 30, 2016 and December 31, 2015 are as follows: June 30, 2016 December 31, 2015 Systems rental and maintenance costs $ 1,599 $ 1,808 Site rental fees 1,661 1,121 Property and sales taxes payable 8,352 8,695 Self-insurance accrual 2,376 2,037 Legal fees 1,673 1,971 Deferred gain on sale of equipment 87 312 Equipment purchases 3,541 4,756 Contingent consideration related to acquisition 1,720 5,750 Mandatorily redeemable noncontrolling interest 2,386 2,386 Other accrued liabilities 11,388 7,617 Total $ 34,783 $ 36,453 Plant, property and equipment, net of depreciation, as of June 30, 2016 and December 31, 2015 are as follows: June 30, 2016 December 31, 2015 Furniture and fixtures $ 4,979 $ 4,825 Office equipment 77,904 71,245 Transportation and service equipment 14,052 5,884 Major equipment 786,581 758,718 Tenant improvements 43,600 42,792 Buildings and land 342 340 927,458 883,804 Accumulated depreciation (723,011 ) (706,616 ) Plant, property and equipment, net $ 204,447 $ 177,188

Long-Term Debt and Senior Subor

Long-Term Debt and Senior Subordinated Credit Facility	6 Months Ended
	Jun. 30, 2016
Debt Disclosure [Abstract]
Long-Term Debt and Senior Subordinated Credit Facility	8. Long-Term Debt and Senior Subordinated Credit Facility Long-term debt consisted of the following: June 30, 2016 December 31, 2015 Term loan facility $ 500,274 $ 502,874 Discount on term loan facility (1,569 ) (1,823 ) Revolving credit facility 16,500 19,500 Equipment under capital leases 14,131 13,006 Equipment debt 42,787 44,128 Deferred financing costs, net (29,019 ) (6,594 ) Long-term debt, including current portion 543,104 571,091 Less current portion 21,780 20,406 Long-term debt $ 521,324 $ 550,685 Equipment debt, collateralized by equipment, has interest rates ranging from 1.93% to 7.50% and are payable in various monthly principal and interest installments through 2021. Capital leases, collateralized by equipment, have interest rates ranging from 4.00% to 13.97% and are payable in various monthly principal and interest installments through 2021. Credit Facility and Senior Secured Term Loan Refinancing On June 3, 2013, the Company replaced its existing credit facility with a new senior secured credit agreement with Credit Suisse AG, Cayman Islands Branch, as administrative agent, and the other lenders party thereto (the “Credit Agreement”). The Credit Agreement consists of (i) a $340,000, six-year term loan facility, (ii) a $50,000, five-year revolving loan facility, including a $20,000 sublimit for letters of credit, (iii) uncommitted incremental loan facilities of $100,000 of revolving or term loans, plus an additional amount if the Company’s pro forma leverage ratio is less than or equal to 3.25, subject to receipt of lender commitments and satisfaction of specified conditions, and (iv) an $80,000 delayed draw term loan facility, which was required to be drawn within thirty days of June 3, 2013 and used for the redemption of the Company's $190,000 of 8% Senior Notes (“Notes”). On July 3, 2013 the delayed draw term loan facility was utilized, of which the proceeds were used to redeem $80,000 in aggregate principal amount of the Company's outstanding Notes that were originally issued in December 2009 as a cash tender offer for any and all of its outstanding 7.25% Notes originally issued in December of 2004. The delayed draw term loan facility converted into, and matched the terms of, the new $340,000 term loan facility. Borrowings under the Credit Agreement bear interest through maturity at a variable rate based upon, at the Company's option, either the LIBOR or the base rate (which is the highest of the administrative agent’s prime rate, one-half of 1.00% in excess of the overnight federal funds rate, and 1.00% in excess of the one-month LIBOR rate), plus, in each case, an applicable margin. With respect to the term loan facilities, the applicable margin for LIBOR loans is 3.25% per annum, and with respect to the revolving loan facilities, the applicable margin for LIBOR loans ranges, based on the applicable leverage ratio, from 3.00% to 3.25% per annum, in each case, with a LIBOR floor of 1.00%. The applicable margin for base rate loans under the term loan facilities is 2.25% per annum and under the revolving loan facility ranges, based on the applicable leverage ratio, from 2.00% to 2.25% per annum. Prior to the refinancing of the term loan facilities, the applicable margin for base rate loans was 4.25% per annum and the applicable margin for revolving loans was 5.25% per annum, with a LIBOR floor of 2.00%. The Company is required to pay a commitment fee which ranges, based on the applicable leverage ratio, from 0.38% to 0.50% per annum on the undrawn portion available under the revolving loan facility and variable per annum fees with respect to outstanding letters of credit. During the first five and one-half years after the closing date, and including the full amount of the delayed draw term loan facility, the Company is required to make quarterly amortization payments of the term loans in the amount of $1,050. The Company is also required to make mandatory prepayments of term loans under the Credit Agreement, subject to specified exceptions, from excess cash flow (as defined in the Credit Agreement) and with the proceeds of asset sales, debt issuances and specified other events. Obligations under the Credit Agreement are guaranteed by substantially all the Company's direct and indirect domestic subsidiaries. The obligations under the Credit Agreement and the guarantees are secured by a lien on substantially all tangible and intangible property, and by a pledge of all of the shares of stock and limited liability company interests of the Company's direct and indirect domestic subsidiaries, of which the Company now owns or later acquires more than a 50% interest, subject to limited exceptions. In addition to other covenants, the Credit Agreement places limits on the ability of the Company and its subsidiaries to declare dividends or redeem or repurchase capital stock, prepay, redeem or purchase debt, incur liens and engage in sale-leaseback transactions, make loans and investments, incur additional indebtedness, amend or otherwise alter debt and other material agreements, engage in mergers, acquisitions and asset sales, transact with affiliates and alter the business conducted by the Company and its subsidiaries. The Credit Agreement also contains a leverage ratio covenant requiring the Company to maintain a maximum ratio of consolidated total debt to Consolidated Adjusted EBITDA that ranges from 4.95 to 1.00 to 4.30 to 1.00. At June 30, 2016, the Credit Agreement requires a maximum leverage ratio of not more than 4.55 to 1.00. Failure to comply with the covenants in the Credit Agreement could permit the lenders under the Credit Agreement to declare all amounts borrowed under the Credit Agreement, together with accrued interest and fees, to be immediately due and payable, and to terminate all commitments under the Credit Agreement. Amendments to the Credit Agreement On October 11, 2013, the Company entered into an amendment to the Credit Agreement with Credit Suisse AG, Cayman Islands Branch, as administrative agent, and the other lenders party thereto (the “First Amendment”). Pursuant to the First Amendment, the Company raised $70,000 On June 19, 2015, the Company entered into a second amendment to the Credit Agreement with Credit Suisse AG, Cayman Islands Branch, as administrative agent, and the other lenders party thereto (the “Second Amendment”). Pursuant to the Second Amendment, the Company raised the remaining $30,000 in incremental term loan commitments. The funds were used to repay all outstanding borrowings under the Company's revolving credit facility, pay fees and expenses related to the Second Amendment, and general corporate purposes. The Second Amendment did not impact the borrowing capacity on the revolving credit facility, which remains at $50,000. The incremental term loan under the Second Amendment was funded at 99.5% of principal amount and will mature on the same date as the existing term loan under the Company’s credit agreement, which is June 3, 2019. Upon funding, the incremental term loans were converted to match all the terms of existing term loans. Interest on the incremental term loan is calculated, at the Company’s option, at a base rate plus a 2.25% margin or LIBOR plus a 3.25% margin, subject to a 1.00% LIBOR floor. The quarterly amortization payments of all term loans under the credit facility for the first five and one-half years was initially established at $1,050. The quarterly amortization payment was increased to $1,300 in June 2015, pursuant to the Second Amendment. On March 29, 2016, the Company entered into a third amendment to the Credit Agreement with Credit Suisse AG, Cayman Islands Branch, as administrative agent, and the other lenders party thereto (the “Third Amendment”). Pursuant to the Third Amendment, (i) the defined term “Investors” was amended to include THAIHOT Investment Company Limited, so that the sale by the Selling Stockholders would not be deemed to constitute a change of control and (ii) the soft call provision was reinstated to commence on the date the Third Amendment is effective and end the date that is twelve months after such commencement. Under the soft call provision, if the Company makes a voluntary prepayment of any Term Loan or prepays, refinances, substitutes or replaces any Term Loan, and such action results in a reduction in the effective interest cost or weighted average yield of the Term Loan, then the Company shall pay to the administrative agent, for the ratable account of each of the lenders holding Term Loans a prepayment premium equal to 1.0% of the aggregate principal amount of the Term Loans so prepaid, refinanced, substituted or replaced. In connection with the Third Amendment, the Company paid fees totaling $25.0 million, which were capitalized and amortized on a straight-line basis as interest expense over the term of the Credit Agreement. As of June 30, 2016, the Company’s ratio of consolidated total debt to Consolidated Adjusted EBITDA calculated pursuant to the Credit Agreement was 4.15 to 1.00. As of June 30, 2016, the Company had $29.1 million of available borrowings under the revolving line of credit, net of $16.5 million outstanding on the revolving line of credit and $4.4 million outstanding in letters of credit. Notes Payable and Line of Credit with PNC As a result of the step acquisition on August 1, 2015, and subsequent consolidation of AHNI, the Company had notes payable to PNC Equipment Finance, LLC (“PNC”) totaling $6,746 at June 30, 2016. The notes payable are due in various installments through December 2020 at interest rates between 1.83% and 1.95% per annum. The notes are also collateralized by equipment and contain restrictive covenants. AHNI also has a $4,700 line of credit with PNC, with interest calculated based on LIBOR plus 1.4%. As of June 30, 2016, there was $1,389 amount outstanding on the line of credit. For additional information on the step acquisition, refer to Note 3 – Acquisitions and Transactions .

Derivatives

Derivatives	6 Months Ended
	Jun. 30, 2016
Summary Of Derivative Instruments [Abstract]
Derivatives	9. Derivatives The Company accounts for derivative instruments and hedging activities in accordance with the provisions of ASC 815, “Derivatives and Hedging.” Management generally designates derivatives in a hedge relationship with the identified exposure on the date the Company enters into a derivative contract, as disclosed below. The Company has only executed derivative instruments that are economic hedges of exposures that can qualify in hedge relationships under ASC 815. The Company formally documents all relationships between hedging instruments and hedged items, as well as the risk-management objective and strategy for undertaking various hedge transactions. In this documentation, the Company specifically identifies the firm commitment or forecasted transaction that has been designated as a hedged item and states how the hedging instrument is expected to hedge the risks related to the hedged item. The Company formally assesses effectiveness of its hedging relationships, both at the hedge inception and on an ongoing basis, then measures and records ineffectiveness. The Company would discontinue hedge accounting prospectively (i) if it is determined that the derivative is no longer effective in offsetting change in the cash flows of a hedged item, (ii) when the derivative expires or is sold, terminated or exercised, (iii) because it is probable that the forecasted transaction will not occur, or (iv) if management determines that designation of the derivative as a hedge instrument is no longer appropriate. The Company’s derivatives are recorded on the balance sheet at their fair value. For additional information refer to Note 5 – Fair Value of Financial Instruments Cash Flow Hedges Interest Rate Cash Flow Hedges The Company has entered into multiple interest rate swap and cap agreements to hedge the future cash interest payments on portions of its variable rate bank debt. For the six months ended June 30, 2016 and 2015, the Company had interest rate swap and cap agreements to hedge approximately $263,520 and $257,057 of its variable rate bank debt, respectively, or 46.1% and 47.3% of total debt, respectively. Over the next twelve months, the Company expects to reclassify $563 from unrealized gain (loss) on hedging transactions, net of taxes to interest expense and other, net. In the fourth quarter of 2012, the Company entered into an interest rate swap agreement in connection with equipment financing. The swap, which matures in December 2017, had a notional amount of $1,658 as of June 30, 2016. Under the terms of this agreement, the Company receives one-month LIBOR plus 2.50% and pays a fixed rate of 3.75%. The net effect of the hedge is to convert interest expense to a fixed rate of 3.75%, as the underlying debt incurred interest based on one-month LIBOR plus 2.50%. In the first quarter of 2013, the Company entered into an interest rate swap agreement in connection with equipment financing. The swap, which matures in April 2018, had a notional amount of $1,612 as of June 30, 2016. Under the terms of this agreement, the Company receives one-month LIBOR plus 2.00% and pays a fixed rate of 2.87%. The net effect of the hedge is to convert interest expense to a fixed rate of 2.87%, as the underlying debt incurred interest based on one-month LIBOR plus 2.00%. In the fourth quarter of 2013, the Company entered into five interest rate cap agreements ("2013 Caps"). The 2013 Caps, which mature in December 2016, had a notional amount of $250,000 and were designated as cash flow hedges of future cash interest payments associated with a portion of the Company’s variable rate bank debt. Under these arrangements, the Company has purchased a cap on LIBOR at 2.50%. The Company paid $815 to enter into the caps, which is being amortized through Interest expense and other, net over the life of the agreements. In the fourth quarter of 2014, the Company entered into an interest rate swap agreement in connection with equipment financing. The swap, which matures in November 2019, had a notional amount of $1,175 as of June 30, 2016. Under the terms of this agreement, the Company receives one-month LIBOR and pays a fixed rate of 1.34%. The net effect of the hedge is to convert Interest expense to a fixed rate of 1.34%, as the underlying debt incurred interest based on one-month LIBOR. In the third quarter of 2015, the Company acquired eight non-designated interest rate swaps (the "AHNI Swaps") as a result of the step acquisition of AHNI. The AHNI swaps mature on various dates ranging from April 2017 through April 2020 and had notional amounts totaling $2,631 as of June 30, 2016. Under the terms of these arrangements, the Company receives one-month LIBOR and pays fixed rates ranging from 0.75% to 1.68%. The changes in fair market value of the AHNI Swaps are recorded in interest expense and other, net, as incurred. In the fourth quarter of 2015, the Company entered into two interest rate swap agreements in connection with equipment financing. The swaps mature in December 2020 and in December 2021 and had notional amounts totaling $6,445 as of June 30, 2016. Under the terms of these agreements, the Company receives one-month LIBOR and one-month LIBOR plus 2.00% and pays fixed rates of 1.37% and 3.69%, respectively. The net effect of these hedges is to convert interest expense to fixed rates of 1.37% and 3.69%, as the underlying debt incurred interest based on one-month LIBOR and one-month LIBOR plus 2.00%, respectively. The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Three Months Ended June 30, 2016 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ 6 Interest expense and other, net $ (140 ) Interest expense and other, net $ — Total $ 6 $ (140 ) $ — The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Six Months Ended June 30, 2016 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ (74 ) Interest expense and other, net $ (223 ) Interest expense and other, net $ (1 ) Total $ (74 ) $ (223 ) $ (1 ) The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Three Months Ended June 30, 2015 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ (19 ) Interest expense and other, net $ 5 Interest expense and other, net $ — Total $ (19 ) $ 5 $ — The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Six Months Ended June 30, 2015 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ (208 ) Interest expense and other, net $ 16 Interest expense and other, net $ 1 Total $ (208 ) $ 16 $ 1 The effect of non-designated derivative instruments on the Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) for the three and six months ended June 30, 2016 and 2015 was immaterial.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2016
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes For the three and six months ended June 30, 2016, the Company recorded income tax expense of $2.2 million and $1.3 million, respectively, or 47.4% and 50.1%, respectively, of the Company’s pretax income. For the three and six months ended June 30, 2015, the Company recorded income tax (benefit) expense of $(1,366) and $206, respectively, or 41.0% and (5,275.0)%, respectively, of the Company’s pretax income. The provision for income taxes for interim periods is determined using an estimate of the Company’s annual effective tax rate, which is applied to current year to date pre-tax income. Each quarter, the estimate of the annual effective tax rate is updated, and if the estimated effective tax rate changes, a cumulative adjustment is recorded. The Company’s effective tax rate for the three and six months ended June 30, 2016 and 2015 differed from the federal statutory rate principally as a result of state income taxes and permanent non-deductible tax items, including share-based payments, unrecognized tax benefits and other permanent differences. As of June 30, 2016, the Company has provided a liability for $263 of unrecognized tax benefits related to various federal and state income tax matters. The tax-effected amount that would reduce the Company’s effective income tax rate if recognized is $221. As of December 31, 2015, the Company has provided a liability for $229 of unrecognized tax benefits related to various federal and state income tax matters. The tax-effected amount that would reduce the Company’s effective income tax rate if recognized is $192. The Company recognizes accrued interest and penalties related to unrecognized tax benefits in income tax expense. As of June 30, 2016 and 2015, the Company had approximately $13 and $16, respectively, in accrued interest and penalties related to unrecognized tax benefits. The Company is subject to United States federal income tax as well as income tax of multiple state tax jurisdictions. The Company is currently open to audit under the statute of limitations by the Internal Revenue Service for the years ended December 31, 2012 through 2015. The Company’s and its subsidiaries’ state income tax returns are open to audit under the applicable statutes of limitations for the years ended December 31, 2011 through 2015. The Company does not anticipate a significant change to the total amount of unrecognized tax benefits within the next 12 months.

Earnings Per Common Share

Earnings Per Common Share	6 Months Ended
	Jun. 30, 2016
Earnings Per Share [Abstract]
Earnings Per Common Share	11. Earnings Per Common Share Basic net income (loss) per share is computed utilizing the two-class method and is calculated based on the weighted-average number of common shares outstanding during the periods presented, excluding unvested restricted stock units which do not contain nonforfeitable rights to dividend and dividend equivalents. Diluted net income (loss) per share is computed using the weighted-average number of common and common equivalent shares outstanding during the periods utilizing the two-class method for stock options, unvested restricted stock and unvested restricted stock units. Potentially dilutive securities are not considered in the calculation of net loss per share as their impact would be anti-dilutive. The following table sets forth the computation of basic and diluted net income (loss) per share (amounts in thousands, except per share amounts): Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Numerator: Net income (loss) attributable to Alliance HealthCare Services, Inc. $ 2,459 $ (1,961 ) $ 1,269 $ (210 ) Denominator: Weighted-average shares-basic 10,882 10,715 10,771 10,714 Effect of dilutive securities: Employee stock options 11 121 25 125 Weighted-average shares-diluted 10,893 10,836 10,796 10,839 Net income (loss) per common share attributable to Alliance HealthCare Services, Inc.: Basic $ 0.23 $ (0.18 ) $ 0.12 $ (0.02 ) Diluted $ 0.23 $ (0.18 ) $ 0.12 $ (0.02 ) Stock options excluded from the computation of diluted per share amounts: Weighted-average shares for which the exercise price exceeds average market price of common stock 776 394 478 335 Average exercise price per share that exceeds average market price of common stock $ 17.89 $ 30.15 $ 24.79 $ 31.57

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2016
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	12. Commitments and Contingencies Purchase Commitments The Company has maintenance contracts with its equipment vendors for substantially all of its radiology and oncology equipment. The contracts range from one to seven years from inception and extend through the year 2022, but may be canceled by the Company under certain circumstances. The Company's total contract payments for the three and six months ended June 30, 2016 and 2015 were $9,978 and $20,262, respectively, and $9,893 and $19,780, respectively. At June 30, 2016, the Company had binding equipment purchase commitments totaling $17,745. Guarantees and Indemnities The Company has applied the disclosure provisions of ASC 460, “Guarantees,” to its agreements that contain guarantee or indemnification clauses. These disclosure provisions expand those required by ASC 440, “Commitments,” and ASC 450, “Contingencies,” by requiring a guarantor to disclose certain types of guarantees, even if the likelihood of requiring the guarantor's performance is remote. In the normal course of business, the Company has made certain guarantees and indemnities, under which it may be required to make payments to a guaranteed or indemnified party, in relation to certain transactions. The Company indemnifies other parties, including customers, lessors, and parties to other transactions with the Company, with respect to certain matters. The Company has agreed to hold the other party harmless against losses arising from certain events as defined within the particular contract, which may include, for example, litigation or claims arising from a breach of representations or covenants. In addition, the Company has entered into indemnification agreements with its executive officers and directors and the Company's bylaws contain similar indemnification obligations. Under these arrangements, the Company is obligated to indemnify, to the fullest extent permitted under applicable law, its current or former officers and directors for various amounts incurred with respect to actions, suits or proceedings in which they were made, or threatened to be made, a party as a result of acting as an officer or director. It is not possible to determine the maximum potential amount under these indemnification agreements due to the limited history of prior indemnification claims and the unique facts and circumstances involved in each particular agreement. Historically, payments made related to these indemnifications have been immaterial. At June 30, 2016, the Company has determined that no liability is necessary related to these guarantees and indemnities. Litigation In November 2015, the Company was served with a lawsuit in the United States District Court for the Northern District of Ohio by Todd S. Elwert, DC, Inc. The Complaint alleges violations of the Junk Fax Prevention Act for allegedly sending an unsolicited advertisement to Plaintiff which promoted commercial availability and/or quality of the Company’s services. The Plaintiff further alleges that it is part of a class of similarly situated chiropractors who received the blast fax, and as such, requested class certification. The Company filed its response on December 17, 2015 and is currently in the discovery phase of the lawsuit. Other Matters The Company from time to time is involved in routine litigation and regulatory matters incidental to the conduct of its business. The Company believes that resolution of such matters will not have a material adverse effect on its consolidated financial statements.

Related-Party Transactions

Related-Party Transactions	6 Months Ended
	Jun. 30, 2016
Related Party Transactions [Abstract]
Related-Party Transactions	13. Related-Party Transactions Ownership Structure On April 16, 2007, Oaktree and MTS purchased 4,900,301 shares of the Company’s common stock. Upon completion of the transaction, Oaktree and MTS owned in the aggregate approximately 50% of the outstanding shares of common stock of the Company. At December 31, 2015, Oaktree and MTS owned in the aggregate approximately 51% of the outstanding shares of common stock of the Company. The Company has not paid management fees to Oaktree and MTS for their financial advisory services to the Company. On September 16, 2015, Fujian Thai Hot Investment Co., Ltd. (“Thai Hot”) agreed to purchase approximately 5,537,945 shares of Company common stock from funds managed by the Selling Stockholders for approximately $102.5 million or $18.50 per share. In connection with the Thai Hot Transaction, Thai Hot and the Selling Stockholders agreed to bear a specified portion of the following Company expenses related to the Thai Hot Transaction: (i) 100% of the fees and expenses incurred by the Company in connection with the amendment or waiver of its credit agreement, and (ii) all reasonable and documented fees and expenses incurred by the Company in connection with the Thai Hot Transaction in excess of $1 million. In addition, subject to the approval of the Board or an authorized special committee of the Board, Thai Hot agreed to fund a new management incentive arrangement which involves the issuance of $1.5 million in cash-based awards to the Company’s management. The expenses associated with the cash-based awards will be recognized by the Company over the required service period of the awards. The Company accounted for reimbursements received prior to the Thai Hot Transaction close from the Selling Stockholders of $15,343 as capital contributions and reimbursements received subsequent to the Thai Hot Transaction close from Thai Hot of $13,500 as capital contributions. In addition, the Selling Stockholders provided $1.5 million related to the potential tax impact of the credit amendment costs incurred by the Company, measured after the close of the Thai Hot Transaction. This amount was subsequently returned to the Selling Stockholders. The Thai Hot Transaction closed on March 29, 2016. As a result of the Thai Hot Transaction, Thai Hot, through its wholly owned subsidiary, owns an aggregate of approximately 51.5% of the outstanding shares of common stock of the Company. The Company has not agreed to pay any management fees to Thai Hot for any financial advisory services to the Company. Management Agreements The Company had direct ownership in two unconsolidated investees at June 30, 2016 and December 31, 2015. The Company obtained an additional 15.5% interest in one of its previously unconsolidated investees, AHNI, on August 1, 2015, thereby increasing its ownership position in AHNI to 65.5% and giving it a controlling interest. Revenues from management agreements with unconsolidated equity investees were $352 and $2,209 during the three months ended June 30, 2016 and 2015, respectively, and $705 and $4,587 during the six months ended June 30, 2016 and 2015, respectively. The Company provides services as part of its ongoing operations for and on behalf of the unconsolidated equity investees, which are included in the management agreement revenue, and reimburse the Company for the actual amount of the expenses incurred. The Company records the expenses as cost of revenues and the reimbursement as revenue in its Condensed Consolidated Statements of Operations and Comprehensive Income (Loss). For the three months ended June 30, 2016 and 2015, the amounts of the revenues and expenses were $233 and $1,782, respectively. For the six months ended June 30, 2016 and 2015, the amounts of the revenues and expenses were $485 and $3,729, respectively.

Investments in Unconsolidated I

Investments in Unconsolidated Investees	6 Months Ended
	Jun. 30, 2016
Equity Method Investments And Joint Ventures [Abstract]
Investments in Unconsolidated Investees	14. Investments in Unconsolidated Investees The Company has direct ownership in two unconsolidated investees at June 30, 2016. The Company owns 15% and 50% of these investees, respectively, and provides management services under agreements with these investees, expiring at various dates through 2025. Both of these investees are accounted for under the equity method because the Company does not exercise control over the operations of these investees. On August 1, 2015, the Company obtained an additional 15.5% interest in a previously unconsolidated investee, AHNI, thereby increasing its ownership position to 65.5% and giving it a controlling interest. Prior to August 1, 2015, the Company's interest in AHNI was deemed a noncontrolling interest and, as such, the Company accounted for the investment using the equity method. Set forth below are certain operating results for the aggregate of the Company’s unconsolidated investees for the three and six months ended June 30, 2016 and 2015. Operating results for AHNI are included for the three and six months ended June 30, 2015: June 30, 2016 December 31, 2015 Balance Sheet Data: Current assets $ 2,254 $ 2,644 Noncurrent assets 143 273 Current liabilities 646 676 Noncurrent liabilities 34 35 Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Operating Results: Revenues $ 2,662 $ 6,469 $ 4,963 $ 13,106 Expenses 782 2,920 1,560 6,256 Net income 1,880 3,549 3,403 6,850 Earnings from unconsolidated investees 393 1,292 645 2,455

Stockholders' Deficit

Stockholders' Deficit	6 Months Ended
	Jun. 30, 2016
Stockholders Equity Note [Abstract]
Stockholders' Deficit	15. Stockholders’ Deficit The following table summarizes consolidated stockholders’ deficit, including noncontrolling interest. Stockholders’ Equity (Deficit) Attributable to Common Stock Treasury Stock Additional Paid-In Accumulated Comprehensive Retained Earnings (Accumulated Alliance HealthCare Non-controlling Total Stockholders’ Shares Amount Shares Amount Capital Income (Loss) Deficit) Services, Inc. Interest Equity (Deficit) Balance at December 31, 2015 10,774,857 108 (157,973 ) (3,138 ) 29,297 (511 ) (198,393 ) (172,637 ) 95,017 (77,620 ) Exercise of stock options 121,667 1 — — 614 — — 615 — 615 Shareholder transaction — — — — 28,629 — — 28,629 — 28,629 Share-based payment — — — — 1,780 — — 1,780 — 1,780 Share-based payment income tax benefit — — — — 315 — — 315 — 315 Unrealized loss on hedging transaction, net of tax — — — — — 46 — 46 — 46 Net investments in subsidiaries — — — — — — — — (8,754 ) (8,754 ) Net income — — — — — — 1,269 1,269 8,322 9,591 Balance at June 30, 2016 10,896,524 109 (157,973 ) (3,138 ) 60,635 (465 ) (197,124 ) (139,983 ) 94,585 (45,398 )

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 2016
Segment Reporting [Abstract]
Segment Information	16. Segment Information Operating segments are defined as components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker (“CODM”) in deciding how to allocate resources and in assessing performance. In accordance with ASC 280, “Segment Reporting,” and based on the nature of the financial information that is received by the CODM, the Company operates in three operating segments (Radiology Division, Oncology Division, and Interventional Division) that also qualify as reportable segments under the definition of ASC 280. Prior to 2016, the Company operated in two reportable business segments – Radiology and Oncology Divisions. Effective January 1, 2016, the Interventional Division qualified as an additional reportable business segment. Accordingly, the information contained herein has been revised to reflect this change in presentation. Each of these reportable segments, on a stand-alone basis, provides and makes available their respective medical services in similar settings, and operates within a singular regulatory environment. Further, management assesses the segment operations and each segment’s degree of efficiency and performance based on this structure of financial reporting, and primarily makes operating decisions from these reportable segment results. The radiology segment is comprised of diagnostic imaging services including MRI, PET/CT and other imaging services. The oncology segment is comprised of radiation oncology services. The interventional operating segment is comprised of therapeutic minimally invasive pain management procedures medical management, laboratory testing, and other services. All intercompany revenues, expenses, payables and receivables are eliminated in consolidation and are not reviewed when evaluating segment performance. Each segment’s performance is evaluated based on Revenue, Segment Income and Net Income. The following table summarizes the Company’s revenue by segment: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Revenue Radiology $ 87,546 $ 84,994 $ 173,185 $ 166,381 Oncology 25,829 25,330 51,891 49,516 Interventional 11,398 8,167 23,061 12,023 Corporate / Other 544 13 904 13 Total $ 125,317 $ 118,504 $ 249,041 $ 227,933 The following are components of revenue: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Revenue MRI revenue $ 48,755 $ 45,249 $ 96,325 $ 88,136 PET/CT revenue 32,099 32,594 63,765 64,144 Oncology 25,829 25,330 51,891 49,516 Interventional 11,398 8,167 23,061 12,023 Other radiology 6,692 7,151 13,095 14,101 Corporate / Other 544 13 904 13 Total $ 125,317 $ 118,504 $ 249,041 $ 227,933 Segment income represents net income (loss) before income tax expense (benefit); interest expense and other, net; amortization expense; depreciation expense; share-based payment; severance and related costs; noncontrolling interest in subsidiaries; restructuring charges; transaction costs; shareholder transaction costs; impairment charges; legal matters expense and other non-cash charges. Segment income is the most frequently used measure of each segment’s performance and is commonly used in setting performance goals. The following table summarizes the Company’s segment income: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Segment income Radiology $ 28,802 $ 28,419 $ 55,246 $ 54,793 Oncology 12,559 12,581 24,717 24,344 Interventional 1,787 990 3,042 1,374 Corporate / Other (8,706 ) (7,975 ) (18,191 ) (16,380 ) Total $ 34,442 $ 34,015 $ 64,814 $ 64,131 The reconciliation of net income (loss) to total segment income is shown below: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Net income (loss) attributable to Alliance HealthCare Services, Inc. $ 2,459 $ (1,961 ) $ 1,269 $ (210 ) Income tax expense (benefit) 2,221 (1,366 ) 1,275 206 Interest expense and other, net 8,872 6,904 16,367 12,922 Amortization expense 2,494 2,495 4,937 4,530 Depreciation expense 13,730 12,072 26,778 23,705 Share-based payment (included in selling, general and administrative expenses) 379 430 2,243 819 Severance and related costs 708 195 2,424 454 Noncontrolling interest in subsidiaries 3,729 4,903 8,322 9,250 Restructuring charges (Note 3) 1,120 236 1,351 491 Transaction costs 431 1,113 848 1,532 Shareholder transaction costs 1,498 — 2,507 — Impairment charges — 6,670 — 6,746 Legal matters expense (included in selling, general and administrative expenses) 39 1,543 194 2,903 Other non-cash (gains) charges (included in other (income) and expense, net) (3,238 ) 781 (3,701 ) 783 Total segment income $ 34,442 $ 34,015 $ 64,814 $ 64,131 Net income (loss) for the radiology, oncology and interventional segments does not include charges for interest expense, net of interest income, income taxes or certain selling, general and administrative expenses. These costs are charged against the Corporate / Other segment. The following table summarizes the Company’s net income (loss) by segment: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Net income (loss) Radiology $ 19,173 $ 17,937 $ 34,826 $ 34,934 Oncology 7,334 (1,629 ) 11,521 3,395 Interventional 1,401 253 1,588 422 Corporate / Other (25,449 ) (18,522 ) (46,666 ) (38,961 ) Total $ 2,459 $ (1,961 ) $ 1,269 $ (210 ) The following table summarizes the Company’s identifiable assets by segment: As of June 30, As of December 31, 2016 2015 Identifiable assets Radiology $ 298,655 $ 280,497 Oncology 208,222 213,698 Interventional 82,460 83,480 Corporate / Other 25,240 25,985 Total $ 614,577 $ 603,660 The following table summarizes the Company’s goodwill by segment: Radiology Oncology Interventional Total Balance at December 31, 2014 $ 42,166 $ 21,698 $ — $ 63,864 Goodwill acquired during the period 2,656 5,891 30,371 38,918 Impairment charges — — — — Adjustments to goodwill during the period — — — — Balance at December 31, 2015 $ 44,822 $ 27,589 $ 30,371 $ 102,782 Goodwill acquired during the period 335 1,115 929 2,379 Impairment charges — — — — Adjustments to goodwill during the period — 615 353 968 Balance at June 30, 2016 $ 45,157 $ 29,319 $ 31,653 $ 106,129 Gross goodwill $ 199,499 $ 49,221 $ 31,653 $ 280,373 Accumulated impairment charges (154,342 ) (19,902 ) — (174,244 ) Balance at June 30, 2016 $ 45,157 $ 29,319 $ 31,653 $ 106,129 Capital expenditures in the radiology, oncology, interventional and corporate/other segments were $13,749, $1,954, $20 and $576, respectively for the three months ended June 30, 2016, and $5,865, $3,022, $0 and $2,806, respectively, for the three months ended June 30, 2015. Capital expenditures in the radiology, oncology, interventional and corporate/other segments were $30,675, $2,438, $53 and $809, respectively, for the six months ended June 30, 2016, and $12,695, $3,757, $0 and $2,806 respectively, for the six months ended June 30, 2015.

Basis of Presentation, Princi22

Basis of Presentation, Principles of Consolidation, and Use of Estimates (Policies)	6 Months Ended
	Jun. 30, 2016
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared by Alliance HealthCare Services, Inc. (the “Company” or “Alliance” ) in accordance with accounting principles generally accepted in the United States of America and with the instructions to Form 10-Q and Article 10 of Regulation S-X of the Securities and Exchange Commission. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (including normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three and six months ended June 30, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. The accompanying unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes to the consolidated financial statements for the year ended December 31, 2015.
Principles of Consolidation	Principles of Consolidation The accompanying unaudited condensed consolidated financial statements of the Company include the assets, liabilities, revenues and expenses of all subsidiaries over wh ich the Company exercises control. Intercompany transactions have been eliminated. The Company evaluates participating rights in its assessment of control in determining consolidation of joint venture partners. The Company records noncontrolling interest related to its consolidated subsidiaries that are not wholly owned. Investments in non-consolidated investees over which it exercises significant influence but does not control are accounted for under the equity method.
Use of Estimates	Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could differ from those estimates.
Critical Accounting Policies	Critical Accounting Policies Information with respect to the Company’s critical accounting policies which management believes could have the most significant effect on the Company’s reported results and require subjective or complex judgments by management is contained in Item 7, Management’s Discussion and Analysis of Financial Condition and Results of Operations, of the 2015 Form 10-K/A. Management believes that there have been no significant changes during the three and six months ended June 30, 2016 in the Company’s critical accounting policies from those disclosed in Item 7 of the 2015 Form 10-K/A.
Recent Accounting Pronouncements	Recent Accounting Pronouncements Revenue Recognition In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09, “Revenue from Contracts with Customers (Topic 606)” — to clarify and converge the revenue recognition principles under U.S. GAAP and International Financial Reporting Standards and to develop guidance that would streamline and enhance revenue recognition requirements while also providing a more robust framework for addressing revenue issues. ASU 2014-09 outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry specific guidance. Key provisions of the ASU involve a 5-step model specific to recognizing revenue derived from customer contracts. In addition, ASU 2014-09 provides implementation guidance on several other important topics, including the accounting for certain revenue-related costs. The Company is currently assessing the impacts this guidance may have on its consolidated financial statements and disclosures as well as the transition method it will use to adopt the guidance. The Company is considering the impacts of the new guidance on its ability to recognize revenue for certain contracts. In addition, the Company will be required to capitalize costs to acquire new contracts, whereas currently, the Company expenses those costs as incurred. In August 2015, the FASB issued an amendment to provide a one year deferral of the effective date to annual reporting periods beginning on or after December 15, 2017, as well as an option to early adopt the standard for annual periods beginning on or after December 15, 2016. The Company does not plan to early adopt the standard. Going Concern In August 2014, the FASB issued ASU 2014-15, “Presentation of Financial Statements—Going Concern (Subtopic 205-40)”. Under U.S. GAAP, a going concern is presumed unless and until an entity’s liquidation becomes imminent. When an entity’s liquidation becomes imminent, financial statements should be prepared under the liquidation basis of accounting in accordance with Subtopic 205-30, “Presentation of Financial Statements—Liquidation Basis of Accounting.” However, there may be conditions or events that raise substantial doubt about an entity’s ability to continue as a going concern, even if liquidation is not imminent. In those situations, financial statements should continue to be prepared under the going concern basis of accounting. ASU 2014-15 provides guidance about management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to determine whether to disclose information about relevant conditions and events. ASU 2014-15 is effective for annual periods ending after December 15, 2016, and for annual periods and interim periods thereafter. Early application is permitted. The Company is assessing the impact, if any, that the adoption of ASU 2014-15 may have on the Company's consolidated financial statements. Simplifying the Presentation of Debt Issuance Costs In April 2015, the FASB issued ASU 2015-03, “Simplifying the Presentation of Debt Issuance Cost” that changes the presentation of debt issuance costs in financial statements. ASU 2015-03 requires entities to present such costs in the balance sheet as a direct reduction to the related debt liability rather than as a deferred cost (i.e., an asset) as required by current guidance. In August 2015, the FASB issued clarifying authoritative guidance for debt issuance costs incurred in connection with line-of-credit arrangements. The guidance states that an entity should defer and present these debt issuance costs as an asset and subsequently amortize the deferred debt issuance costs ratably over the term of the line-of-credit arrangement. ASU 2015-03 does not change the recognition or measurement of debt issuance costs and is effective for fiscal years beginning after December 15, 2015. The guidance is required to be applied retrospectively to all prior periods presented. As of December 31, 2015, the Company had $6,594 in deferred financing costs, net that was reclassified to offset long-term debt, net of current portion. The adoption of the guidance did not have a material impact on the Company's consolidated financial statements. Balance Sheet Classification of Deferred Taxes In November 2015, the FASB issued ASU 2015-17, “Balance Sheet Classification of Deferred Taxes,” which will require entities to present deferred tax assets (“DTAs”) and deferred tax liabilities (“DTLs”) as noncurrent in a classified balance sheet. The ASU simplifies the current guidance, which requires entities to separately present DTAs and DTLs as current and noncurrent in a classified balance sheet. The adoption of ASU 2015-17 is effective for publicly traded business entities for annual reporting periods beginning after December 15, 2016, including interim reporting periods within that reporting period. Early adoption is permitted. The Company has elected to early adopt this guidance and applied it retrospectively to periods presented in the consolidated financial statements. As of December 31, 2015, the Company had $6,496 in DTAs that was reclassified to long-term DTLs. The adoption of ASU No. 2015-17 did not have a material impact on the Company’s consolidated financial statements. Leases In February 2016, the FASB issued ASU 2016-02, “Leases,” to increase transparency and comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and disclosing key information about leasing arrangements. The ASU supersedes the current guidance. The primary difference between current guidance and ASU 2015-02 is the recognition of lease assets and lease liabilities by lessees for those leases classified as operating leases under previous GAAP. ASU 2016-02 also requires an entity to separate the lease components from the nonlease components (for example, maintenance services or other activities that transfer a good or service to the customer) in a contract. Only the lease components must be accounted for in accordance with this guidance. ASU 2016-02 is effective for publicly traded business entities for annual reporting periods beginning after December 15, 2018, including interim reporting periods within that reporting period. Early adoption is permitted. The Company is assessing the impact, if any, that the adoption of ASU 2016-02 may have on the Company's consolidated financial statements. Share-Based Payments In March 2016, the FASB issued ASU 2016-09, “Compensation – Stock Compensation (Topic 718),” which simplifies several aspects of the accounting for employee share-based payment transactions for both public and nonpublic traded entities, including the accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. The new guidance, which is part of the FASB’s simplification initiative, also contains two practical expedients under which nonpublic entities can use the simplified method to estimate the expected term of an award and make a one-time election to switch from fair value measurement to intrinsic value measurement for liability-classified awards. ASU 2016-09 is effective for public business entities for annual reporting periods beginning after December 15, 2016, including interim periods within those annual reporting periods. Early adoption is permitted. The Company is assessing the impact, if any, that the adoption of ASU 2016-09 may have on the Company's consolidated financial statements.

Acquisitions and Transactions (

Acquisitions and Transactions (Tables)	6 Months Ended
	Jun. 30, 2016
Business Combinations Restructuring And Related Activities [Abstract]
Summary of recognized amounts of identifiable assets acquired and liabilities assumed	The following table summarizes recognized amounts of identifiable assets acquired and liabilities assumed at the acquisition date: Equipment, net $ 2,354 Goodwill 335 Identifiable intangible assets 1,940 Total consideration $ 4,629
Schedule of Pro Forma Operating Result of Acquisition	Accordingly, such pro forma operating results were prepared for comparative purposes only and do not purport to be indicative of what would have occurred had the acquisitions been made as of January 1, 2015 or of results that may occur in the future. Quarter Ended June 30, Six Months Ended June 30, (In thousands, except per share amounts) 2016 2015 2016 2015 Revenues $ 125,496 $ 126,116 $ 249,856 $ 246,766 Net income (loss) attributable to Alliance HealthCare Services, Inc. 2,533 (978 ) 1,612 1,477 Basic earnings (loss) per share 0.23 (0.09 ) 0.15 0.14 Diluted earnings (loss) per share 0.23 (0.09 ) 0.15 0.14

Share-Based Payment (Tables)

Share-Based Payment (Tables)	6 Months Ended
	Jun. 30, 2016
Share Based Compensation [Abstract]
Weighted average assumptions for stock option awards	The following weighted average assumptions were used in the estimated grant date fair value calculations for stock option awards: Six months ended June 30, 2016 2015 Risk free interest rate 1.53 % 1.65 % Expected dividend yield — % — % Expected stock price volatility 66.5 % 65.2 % Average expected life (in years) 6.00 6.00
Summary of stock option activity	The following table summarizes the Company’s stock option activity: Number of Shares Weighted- Average Exercise Price Weighted- Average Remaining Contractual Term Aggregate Intrinsic Value Outstanding at December 31, 2015 646,290 $ 19.91 Granted 200,388 7.16 Exercised (121,667 ) 5.05 Canceled (27,431 ) 19.15 Outstanding at June 30, 2016 697,580 18.83 6.56 $ 35 Vested and expected to vest in the future at June 30, 2016 655,280 19.53 6.36 $ 35 Vested and exercisable at June 30, 2016 452,021 22.81 5.11 $ 35
Summary of unvested stock option activity	The following table summarizes the Company’s unvested stock option activity: Shares Weighted- Average Grant-Date Fair Value Unvested at December 31, 2015 158,671 $ 15.01 Granted 200,388 4.32 Vested (107,613 ) 14.01 Canceled (5,887 ) 7.81 Unvested at June 30, 2016 245,559 $ 6.90
Summary of cash proceeds, along with fair value disclosures related to grants, exercises, and vesting options	Cash proceeds, along with fair value disclosures related to grants, exercises, and vesting options, are as follows: Three months ended June 30, Six months ended June 30, 2016 2015 2016 2015 Proceeds from stock options exercised $ 129 $ 19 $ 614 $ 25 Intrinsic value of stock options exercised (1) 21 9 1,386 25 Weighted-average fair value of options granted (per share) N. A. N. A. 4.32 14.25 Total fair value of shares vested during the period — 107 1,508 479 (1) The intrinsic value of stock options exercised is the amount by which the market price of the stock on the date of exercise exceeded the market price of the stock on the date of grant.
Summary of restricted stock activity	The following table summarizes the Company’s restricted stock activity: Shares Weighted- Average Grant-Date Fair Value Unvested at December 31, 2015 74,413 $ 9.18 Granted to employees 85,206 6.93 Vested — — Canceled — — Unvested at June 30, 2016 159,619 $ 7.98

Fair Value of Financial Instr25

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2016
Fair Value Disclosures [Abstract]
Estimated fair values of financial instruments	The estimated fair values of the Company’s financial instruments are as follows: June 30, 2016 December 31, 2015 Carrying Value Fair Value Carrying Value Fair Value Cash and cash equivalents $ 24,319 $ 24,319 $ 38,070 $ 38,070 Fixed-rate capital leases and debt 40,116 39,242 40,667 40,262 Variable-rate debt 532,007 531,254 537,018 538,520 Contingent consideration related to acquisition 1,720 1,720 5,750 5,750 Mandatorily redeemable noncontrolling interest 2,386 2,386 2,386 2,386 Derivative instruments - asset position — — — — Derivative instruments - liability position 205 205 86 86
Summary of valuation of financial instruments reported at fair value on a recurring basis by pricing level	The following table summarizes the valuation of the Company’s financial instruments that are reported at fair value on a recurring basis by the above ASC 820 pricing levels as of June 30, 2016: Total Quoted market prices in active markets (Level 1) Significant other observable inputs (Level 2) Significant unobservable inputs (Level 3) Cash and cash equivalents $ 24,319 $ 24,319 $ — $ — Contingent consideration related to acquisition 1,720 — — 1,720 Mandatorily redeemable noncontrolling interest 2,386 — — 2,386 Interest rate contracts - asset position — — — — Interest rate contracts - liability position 205 — 205 — The following table summarizes the valuation of the Company’s financial instruments that are reported at fair value on a recurring basis by the above ASC 820 pricing levels as of December 31, 2015: Total Quoted market prices in active markets (Level 1) Significant other observable inputs (Level 2) Significant unobservable inputs (Level 3) Cash and cash equivalents $ 38,070 $ 38,070 $ — $ — Contingent consideration related to acquisition 5,750 — — 5,750 Mandatorily redeemable noncontrolling interest 2,386 — — 2,386 Interest rate contracts - asset position — — — — Interest rate contracts - liability position 86 — 86 —

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2016
Goodwill And Intangible Assets Disclosure [Abstract]
Changes in the carrying amount of goodwill	Changes in the carrying amount of goodwill are as follows: Balance at December 31, 2014 $ 63,864 Goodwill acquired during the period 38,918 Impairment charges — Adjustments to goodwill during the period — Balance at December 31, 2015 102,782 Goodwill acquired during the period 2,379 Impairment charges — Adjustments to goodwill during the period 968 Balance at June 30, 2016 $ 106,129 Gross goodwill $ 280,373 Accumulated impairment charges (174,244 ) Balance at June 30, 2016 $ 106,129
Components of intangible assets	Intangible assets consisted of the following: June 30, 2016 December 31, 2015 Gross Carrying Amount Accumulated Amortization Intangible Assets, net Gross Carrying Amount Accumulated Amortization Intangible Assets, net Amortizing intangible assets: Customer contracts $ 192,431 $ (96,399 ) $ 96,032 $ 186,316 $ (92,280 ) $ 94,036 Other 39,009 (21,359 ) 17,650 38,522 (20,540 ) 17,982 Total amortizing intangible assets $ 231,440 $ (117,758 ) $ 113,682 $ 224,838 $ (112,820 ) $ 112,018 Intangible assets not subject to amortization 50,905 50,905 Total other intangible assets $ 164,587 $ 162,923
Estimated annual amortization expense	As of June 30, 2016, estimated annual amortization expense for each of the fiscal years ending December 31, is presented below: Remainder of 2016 $ 5,050 2017 9,751 2018 9,378 2019 8,889 2020 8,374 Thereafter 72,240

Disclosure - Supplemental Bal27

Disclosure - Supplemental Balance Sheet Information (Tables)	6 Months Ended
	Jun. 30, 2016
Supplemental Balance Sheet Information [Abstract]
Components of other accrued liabilities	Other accrued liabilities as of June 30, 2016 and December 31, 2015 are as follows: June 30, 2016 December 31, 2015 Systems rental and maintenance costs $ 1,599 $ 1,808 Site rental fees 1,661 1,121 Property and sales taxes payable 8,352 8,695 Self-insurance accrual 2,376 2,037 Legal fees 1,673 1,971 Deferred gain on sale of equipment 87 312 Equipment purchases 3,541 4,756 Contingent consideration related to acquisition 1,720 5,750 Mandatorily redeemable noncontrolling interest 2,386 2,386 Other accrued liabilities 11,388 7,617 Total $ 34,783 $ 36,453
Plant ,Property and Equipment Net of Depreciation	Plant, property and equipment, net of depreciation, as of June 30, 2016 and December 31, 2015 are as follows: June 30, 2016 December 31, 2015 Furniture and fixtures $ 4,979 $ 4,825 Office equipment 77,904 71,245 Transportation and service equipment 14,052 5,884 Major equipment 786,581 758,718 Tenant improvements 43,600 42,792 Buildings and land 342 340 927,458 883,804 Accumulated depreciation (723,011 ) (706,616 ) Plant, property and equipment, net $ 204,447 $ 177,188

Long-Term Debt and Senior Sub28

Long-Term Debt and Senior Subordinated Credit Facility (Tables)	6 Months Ended
	Jun. 30, 2016
Debt Disclosure [Abstract]
Components of long-term debt	Long-term debt consisted of the following: June 30, 2016 December 31, 2015 Term loan facility $ 500,274 $ 502,874 Discount on term loan facility (1,569 ) (1,823 ) Revolving credit facility 16,500 19,500 Equipment under capital leases 14,131 13,006 Equipment debt 42,787 44,128 Deferred financing costs, net (29,019 ) (6,594 ) Long-term debt, including current portion 543,104 571,091 Less current portion 21,780 20,406 Long-term debt $ 521,324 $ 550,685

Derivatives (Tables)

Derivatives (Tables)	6 Months Ended
	Jun. 30, 2016
Summary Of Derivative Instruments [Abstract]
Effect of designated derivative instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss)	The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Three Months Ended June 30, 2016 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ 6 Interest expense and other, net $ (140 ) Interest expense and other, net $ — Total $ 6 $ (140 ) $ — The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Six Months Ended June 30, 2016 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ (74 ) Interest expense and other, net $ (223 ) Interest expense and other, net $ (1 ) Total $ (74 ) $ (223 ) $ (1 ) The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Three Months Ended June 30, 2015 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ (19 ) Interest expense and other, net $ 5 Interest expense and other, net $ — Total $ (19 ) $ 5 $ — The Effect of Designated Derivative Instruments on the Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) For the Six Months Ended June 30, 2015 Derivatives in Cash Flow Hedging Relationships Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Interest rate contracts $ (208 ) Interest expense and other, net $ 16 Interest expense and other, net $ 1 Total $ (208 ) $ 16 $ 1

Earnings Per Common Share (Tabl

Earnings Per Common Share (Tables)	6 Months Ended
	Jun. 30, 2016
Earnings Per Share [Abstract]
Computation of basic and diluted net income (loss) per share	The following table sets forth the computation of basic and diluted net income (loss) per share (amounts in thousands, except per share amounts): Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Numerator: Net income (loss) attributable to Alliance HealthCare Services, Inc. $ 2,459 $ (1,961 ) $ 1,269 $ (210 ) Denominator: Weighted-average shares-basic 10,882 10,715 10,771 10,714 Effect of dilutive securities: Employee stock options 11 121 25 125 Weighted-average shares-diluted 10,893 10,836 10,796 10,839 Net income (loss) per common share attributable to Alliance HealthCare Services, Inc.: Basic $ 0.23 $ (0.18 ) $ 0.12 $ (0.02 ) Diluted $ 0.23 $ (0.18 ) $ 0.12 $ (0.02 ) Stock options excluded from the computation of diluted per share amounts: Weighted-average shares for which the exercise price exceeds average market price of common stock 776 394 478 335 Average exercise price per share that exceeds average market price of common stock $ 17.89 $ 30.15 $ 24.79 $ 31.57

Investments in Unconsolidated31

Investments in Unconsolidated Investees (Tables)	6 Months Ended
	Jun. 30, 2016
Equity Method Investments And Joint Ventures [Abstract]
Schedule of financial data of unconsolidated investees, Balance Sheet Data	Set forth below are certain operating results for the aggregate of the Company’s unconsolidated investees for the three and six months ended June 30, 2016 and 2015. Operating results for AHNI are included for the three and six months ended June 30, 2015: June 30, 2016 December 31, 2015 Balance Sheet Data: Current assets $ 2,254 $ 2,644 Noncurrent assets 143 273 Current liabilities 646 676 Noncurrent liabilities 34 35
Schedule of financial data of unconsolidated investees, Combined Operating Results	Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Operating Results: Revenues $ 2,662 $ 6,469 $ 4,963 $ 13,106 Expenses 782 2,920 1,560 6,256 Net income 1,880 3,549 3,403 6,850 Earnings from unconsolidated investees 393 1,292 645 2,455

Stockholders' Deficit (Tables)

Stockholders' Deficit (Tables)	6 Months Ended
	Jun. 30, 2016
Stockholders Equity Note [Abstract]
Summary of stockholders' deficit, including noncontrolling interest	The following table summarizes consolidated stockholders’ deficit, including noncontrolling interest. Stockholders’ Equity (Deficit) Attributable to Common Stock Treasury Stock Additional Paid-In Accumulated Comprehensive Retained Earnings (Accumulated Alliance HealthCare Non-controlling Total Stockholders’ Shares Amount Shares Amount Capital Income (Loss) Deficit) Services, Inc. Interest Equity (Deficit) Balance at December 31, 2015 10,774,857 108 (157,973 ) (3,138 ) 29,297 (511 ) (198,393 ) (172,637 ) 95,017 (77,620 ) Exercise of stock options 121,667 1 — — 614 — — 615 — 615 Shareholder transaction — — — — 28,629 — — 28,629 — 28,629 Share-based payment — — — — 1,780 — — 1,780 — 1,780 Share-based payment income tax benefit — — — — 315 — — 315 — 315 Unrealized loss on hedging transaction, net of tax — — — — — 46 — 46 — 46 Net investments in subsidiaries — — — — — — — — (8,754 ) (8,754 ) Net income — — — — — — 1,269 1,269 8,322 9,591 Balance at June 30, 2016 10,896,524 109 (157,973 ) (3,138 ) 60,635 (465 ) (197,124 ) (139,983 ) 94,585 (45,398 )

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2016
Segment Reporting [Abstract]
Summary of revenue by segment	The following table summarizes the Company’s revenue by segment: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Revenue Radiology $ 87,546 $ 84,994 $ 173,185 $ 166,381 Oncology 25,829 25,330 51,891 49,516 Interventional 11,398 8,167 23,061 12,023 Corporate / Other 544 13 904 13 Total $ 125,317 $ 118,504 $ 249,041 $ 227,933 The following are components of revenue: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Revenue MRI revenue $ 48,755 $ 45,249 $ 96,325 $ 88,136 PET/CT revenue 32,099 32,594 63,765 64,144 Oncology 25,829 25,330 51,891 49,516 Interventional 11,398 8,167 23,061 12,023 Other radiology 6,692 7,151 13,095 14,101 Corporate / Other 544 13 904 13 Total $ 125,317 $ 118,504 $ 249,041 $ 227,933
Summary of segment income	The following table summarizes the Company’s segment income: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Segment income Radiology $ 28,802 $ 28,419 $ 55,246 $ 54,793 Oncology 12,559 12,581 24,717 24,344 Interventional 1,787 990 3,042 1,374 Corporate / Other (8,706 ) (7,975 ) (18,191 ) (16,380 ) Total $ 34,442 $ 34,015 $ 64,814 $ 64,131
Reconciliation of net income (loss) to total segment income	The reconciliation of net income (loss) to total segment income is shown below: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Net income (loss) attributable to Alliance HealthCare Services, Inc. $ 2,459 $ (1,961 ) $ 1,269 $ (210 ) Income tax expense (benefit) 2,221 (1,366 ) 1,275 206 Interest expense and other, net 8,872 6,904 16,367 12,922 Amortization expense 2,494 2,495 4,937 4,530 Depreciation expense 13,730 12,072 26,778 23,705 Share-based payment (included in selling, general and administrative expenses) 379 430 2,243 819 Severance and related costs 708 195 2,424 454 Noncontrolling interest in subsidiaries 3,729 4,903 8,322 9,250 Restructuring charges (Note 3) 1,120 236 1,351 491 Transaction costs 431 1,113 848 1,532 Shareholder transaction costs 1,498 — 2,507 — Impairment charges — 6,670 — 6,746 Legal matters expense (included in selling, general and administrative expenses) 39 1,543 194 2,903 Other non-cash (gains) charges (included in other (income) and expense, net) (3,238 ) 781 (3,701 ) 783 Total segment income $ 34,442 $ 34,015 $ 64,814 $ 64,131
Summary of net income (loss) by segment	The following table summarizes the Company’s net income (loss) by segment: Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Net income (loss) Radiology $ 19,173 $ 17,937 $ 34,826 $ 34,934 Oncology 7,334 (1,629 ) 11,521 3,395 Interventional 1,401 253 1,588 422 Corporate / Other (25,449 ) (18,522 ) (46,666 ) (38,961 ) Total $ 2,459 $ (1,961 ) $ 1,269 $ (210 )
Summary of company's identifiable assets by segment	The following table summarizes the Company’s identifiable assets by segment: As of June 30, As of December 31, 2016 2015 Identifiable assets Radiology $ 298,655 $ 280,497 Oncology 208,222 213,698 Interventional 82,460 83,480 Corporate / Other 25,240 25,985 Total $ 614,577 $ 603,660
Summary of company's goodwill by segment	The following table summarizes the Company’s goodwill by segment: Radiology Oncology Interventional Total Balance at December 31, 2014 $ 42,166 $ 21,698 $ — $ 63,864 Goodwill acquired during the period 2,656 5,891 30,371 38,918 Impairment charges — — — — Adjustments to goodwill during the period — — — — Balance at December 31, 2015 $ 44,822 $ 27,589 $ 30,371 $ 102,782 Goodwill acquired during the period 335 1,115 929 2,379 Impairment charges — — — — Adjustments to goodwill during the period — 615 353 968 Balance at June 30, 2016 $ 45,157 $ 29,319 $ 31,653 $ 106,129 Gross goodwill $ 199,499 $ 49,221 $ 31,653 $ 280,373 Accumulated impairment charges (154,342 ) (19,902 ) — (174,244 ) Balance at June 30, 2016 $ 45,157 $ 29,319 $ 31,653 $ 106,129

Recent Accounting Pronounceme34

Recent Accounting Pronouncements - Additional Information (Details) $ in Thousands	Dec. 31, 2015USD ($)
Accounting Standards Update 201503
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Reclassification Of Deferred Financing Costs To Offset Long-Term Debt, net of current portion	$ 6,594
Accounting Standards Update 201517
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Reclassification of Deferred Tax Assets to Long Term Deferred Tax Liability	$ 6,496

Acquisitions and Transactions -

Acquisitions and Transactions - Additional Information (Details) $ / shares in Units, $ in Thousands

Apr. 22, 2016USD ($)

Dec. 31, 2015USD ($)

Oct. 14, 2015USD ($)Location

Sep. 16, 2015USD ($)$ / sharesshares

Feb. 17, 2015USD ($)LocationStage

Jun. 30, 2016USD ($)Site

Jun. 30, 2015USD ($)

Jun. 30, 2016USD ($)Site

Jun. 30, 2015USD ($)

Dec. 31, 2015USD ($)

Mar. 29, 2016USD ($)

Aug. 01, 2015USD ($)

Jul. 31, 2015

Dec. 31, 2014USD ($)

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

15.50%

15.50%

Payments to acquire businesses, net of cash

$ 6,659

$ 24,061

Goodwill

$ 102,782

$ 106,129

106,129

$ 102,782

$ 63,864

Contingent consideration related to acquisition

$ 5,750

1,720

1,720

$ 5,750

Ownership interest by parent

65.50%

Restructuring charges

$ 1,120

$ 236

1,351

491

Selling, General and Administrative Expenses

Restructuring Cost and Reserve [Line Items]

Restructuring charges

598

95

Cost of Revenues Excluding Depreciation and Amortization

Restructuring Cost and Reserve [Line Items]

Restructuring charges

753

396

Severance and Related Costs

Restructuring Cost and Reserve [Line Items]

Restructuring charges

$ 2,424

454

Alliance-HNV PET/CT Services, LLC (AHNVPS)

Restructuring Cost and Reserve [Line Items]

Percentage of ownership from investees (percent)

46.60%

Minimum

Restructuring Cost and Reserve [Line Items]

Percentage of ownership from investees (percent)

15.00%

15.00%

Maximum

Restructuring Cost and Reserve [Line Items]

Percentage of ownership from investees (percent)

50.00%

50.00%

American Health Centers, Inc. ("AHC")

Restructuring Cost and Reserve [Line Items]

Payments to acquire businesses, net of cash

$ 4,209

Goodwill

$ 335

$ 335

Identifiable intangible assets

1,940

1,940

Net revenue generated from acquisition

637

637

Net income (loss) generated from acquisition

269

$ 269

Contingent consideration performance period (in months)

18 months

Contingent consideration related to acquisition

420

$ 420

American Health Centers, Inc. ("AHC") | Customer Contracts

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

1,600

$ 1,600

Useful life

15 years

Weighted average useful life

15 years

American Health Centers, Inc. ("AHC") | Non-Competition Agreement

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

$ 340

$ 340

Useful life

5 years

American Health Centers, Inc. ("AHC") | New Hampshire And Vermont Mobile Radiology Sites

Restructuring Cost and Reserve [Line Items]

Number of radiology sites acquired | Site

8

8

Sites acquired, effective date

Apr. 22, 2016

American Health Centers, Inc. ("AHC") | New Hampshire And Vermont Mobile Nuclear Medicine Sites.

Restructuring Cost and Reserve [Line Items]

Sites acquired, effective date

May 19, 2016

Number of nuclear medicine sites acquired | Site

5

5

Pacific Cancer Institute Inc (PCI)

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

95.00%

95.00%

Payments to acquire businesses, net of cash

$ 11,013

Goodwill

6,505

$ 6,505

Identifiable intangible assets

8,800

$ 8,800

Weighted average useful life

15 years

Net revenue generated from acquisition

$ 1,280

$ 2,714

Net income (loss) generated from acquisition

22

$ 219

Contingent consideration performance period (in months)

12 months

Contingent consideration related to acquisition

200

$ 200

Pacific Cancer Institute Inc (PCI) | Minimum

Restructuring Cost and Reserve [Line Items]

Useful life

5 years

Pacific Cancer Institute Inc (PCI) | Maximum

Restructuring Cost and Reserve [Line Items]

Useful life

15 years

Pacific Cancer Institute Inc (PCI) | Physician Referral Network Intangible Assets

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

1,800

$ 1,800

Pacific Cancer Institute Inc (PCI) | Trademarks

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

950

950

Pacific Cancer Institute Inc (PCI) | Certificates of Need (CONs)

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

5,400

5,400

Pacific Cancer Institute Inc (PCI) | Non-Solicitation and Non-Competition Agreements

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

$ 650

$ 650

AHIP Florida LLC

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

60.00%

Payments to acquire businesses, net of cash

$ 15,014

Goodwill

8,234

Identifiable intangible assets

$ 15,600

Weighted average useful life

15 years

Net revenue generated from acquisition

3,150

6,597

Net income (loss) generated from acquisition

204

$ 746

Contingent consideration performance period (in months)

12 months

Contingent consideration related to acquisition

950

$ 950

Number of locations operated by entity | Location

8

Cash received

$ 264

Percentage of noncontrolling interest allowed to sell to the Company

10.00%

AHIP Florida LLC | Minimum

Restructuring Cost and Reserve [Line Items]

Useful life

5 years

AHIP Florida LLC | Maximum

Restructuring Cost and Reserve [Line Items]

Useful life

15 years

AHIP Florida LLC | Physician Referral Network Intangible Assets

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

$ 12,100

AHIP Florida LLC | Trademarks

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

1,700

AHIP Florida LLC | Non-Solicitation and Non-Competition Agreements

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

$ 1,800

Alliance HNI LLC

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

15.50%

Alliance HNI LLC and Subsidiaries

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

50.00%

Goodwill

$ 2,988

Identifiable intangible assets

$ 13,700

Useful life

15 years

Equity interest in acquiree, percentage

50.00%

50.00%

The Pain Center of Arizona

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

59.00%

Payments to acquire businesses, net of cash

$ 24,087

Goodwill

22,566

Identifiable intangible assets

$ 24,600

Useful life

20 years

Weighted average useful life

15 years

Net revenue generated from acquisition

7,961

8,167

$ 15,793

12,023

Net income (loss) generated from acquisition

(417)

$ 20

$ (1,056)

$ 291

Contingent consideration performance period (in months)

12 months

Contingent consideration related to acquisition

960

$ 960

Number of locations operated by entity | Location

12

Cash received

$ 234

Step acquisition, number of stages | Stage

2

Percentage of voting interests acquired before dilution

60.00%

Accounts receivable extinguishment, related parties

$ 3,071

Noncontrolling interest, fair value

20,598

The Pain Center of Arizona | Other Accrued Liabilities

Restructuring Cost and Reserve [Line Items]

Contingent consideration related to acquisition

$ 150

$ 150

The Pain Center of Arizona | Physician Referral Network Intangible Assets

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

13,500

The Pain Center of Arizona | Trademarks

Restructuring Cost and Reserve [Line Items]

Identifiable intangible assets

$ 11,100

Medical Practice Innovations, Inc.

Restructuring Cost and Reserve [Line Items]

Ownership interest, percentage acquired

50.00%

Thai Hot

Restructuring Cost and Reserve [Line Items]

Number of shares acquired | shares

5,537,945

Consideration transferred

$ 102,500

Stock price per share | $ / shares

$ 18.50

Percentage of fees and expenses incurred

100.00%

Fees and expenses incurred

$ 1,000

Issuance of cash-based awards under management incentive agreement

1,500

Capital contributions

$ 15,343

$ 13,500

Ownership interest, percentage acquired

51.50%

Ownership interest by parent

51.50%

Alliance HNI LLC | Alliance-HNI Leasing Co (AHNIL)

Restructuring Cost and Reserve [Line Items]

Equity interest in acquiree, percentage

98.00%

Alliance-HNV PET/CT Services, LLC (AHNVPS) Not Consolidate

Restructuring Cost and Reserve [Line Items]

Ownership interest by parent

53.40%

Alliance-HNV PET/CT Leasing, LLC (AHNVPL) Not Consolidate

Restructuring Cost and Reserve [Line Items]

Ownership interest by parent

53.30%

Acquisitions and Transactions36

Acquisitions and Transactions - Recognized Identifiable Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Goodwill	$ 106,129	$ 102,782	$ 63,864
American Health Centers, Inc. ("AHC")
Business Acquisition [Line Items]
Equipment, net	2,354
Goodwill	335
Identifiable intangible assets	1,940
Total consideration	$ 4,629

Acquisitions and Transactions37

Acquisitions and Transactions - Schedule of Pro Forma Operating Result of Acquisition (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Business Combinations [Abstract]
Revenues	$ 125,496	$ 126,116	$ 249,856	$ 246,766
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ 2,533	$ (978)	$ 1,612	$ 1,477
Basic earnings (loss) per share	$ 0.23	$ (0.09)	$ 0.15	$ 0.14
Diluted earnings (loss) per share	$ 0.23	$ (0.09)	$ 0.15	$ 0.14

Share-Based Payment - Textual (

Share-Based Payment - Textual (Details) - USD ($)	3 Months Ended			6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Sep. 30, 2014	Jun. 30, 2016	Jun. 30, 2015	Mar. 31, 2016	Mar. 31, 2015	Nov. 30, 1999
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock shares available for options and awards (shares)	1,091,795			1,091,795				3,005,000
Options term				10 years
Options accelerated due to employment agreements vesting (shares)						71,057	0
Share-based related to stock options	$ 379,000	$ 430,000		$ 2,243,000	$ 819,000
Total unrecognized fair value related to unvested stock options	992,000			$ 992,000
Recognized weighted-average period				2 years 1 month 6 days
Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based related to stock options	174,000	257,000		$ 1,406,000	475,000
Number of awards, share				200,388
Restricted Stock Awards
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of awards, share				85,206
Share-based payment	205,000	172,000		$ 837,000	344,000
Restricted Stock Awards | Employees
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total unrecognized fair value related to unvested stock options	426,000	0		$ 426,000	$ 0
Recognized weighted-average period				2 years 8 months 12 days
Number of awards, share				85,206	0
Restricted Stock Awards | Unaffiliated directors
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total unrecognized fair value related to unvested stock options	$ 331,000	$ 345,000		$ 331,000	$ 345,000
Recognized weighted-average period				6 months
Restricted Stock Units (RSUs) | Executive Management
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of awards, share			25,000
Minimum market price that must be achieved				$ 40
Duration of minimum market price				10 days
Restricted Stock Units (RSUs) | Executive Management | Thai Hot
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Per share consideration received by the holders of the company's common stock upon the consummation of transactions	$ 18.50			$ 18.50
Cash right	$ 463,000			$ 463,000
Minimum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period				3 years
Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period				4 years

Share-Based Payment - Weighted

Share-Based Payment - Weighted Average Assumptions for Fair Value of Stock Options (Details)	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Weighted average assumptions for stock option awards
Risk free interest rate	1.53%	1.65%
Expected stock price volatility	66.50%	65.20%
Average expected life (in years)	6 years	6 years

Share-Based Payment - Stock Opt

Share-Based Payment - Stock Option Activity (Details) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2016USD ($)$ / sharesshares
Summary of stock option activity
Beginning balance (shares) | shares	646,290
Granted (shares) | shares	200,388
Exercised (shares) | shares	(121,667)
Canceled (shares) | shares	(27,431)
Ending balance (shares) | shares	697,580
Vested and expected to vest (shares) | shares	655,280
Vested and exercisable (shares) | shares	452,021
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Roll Forward]
Beginning balance, weighted-average exercise price (dollars per share) | $ / shares	$ 19.91
Granted, weighted-average exercise price (dollars per share) | $ / shares	7.16
Exercised, weighted-average exercise price (dollars per share) | $ / shares	5.05
Canceled, weighted-average exercise price (dollars per share) | $ / shares	19.15
Ending balance, weighted-average exercise price (dollars per share) | $ / shares	18.83
Vested and expected to vest, weighted-average exercise price (dollars per share) | $ / shares	19.53
Vested and exercisable, weighted-average exercise price (dollars per share) | $ / shares	$ 22.81
Share Based Compensation Arrangement By Share Based Payment Award Options Additional Disclosures [Abstract]
Outstanding, weighted-average remaining contractual term	6 years 6 months 22 days
Vested and expected to vest, weighted-average remaining contractual term	6 years 4 months 10 days
Vested and exercisable, weighted-average remaining contractual term	5 years 1 month 10 days
Share Based Compensation Arrangement By Share Based Payment Award Options Aggregate Intrinsic Value [Abstract]
Outstanding, aggregate intrinsic value | $	$ 35
Vested and expected to vest, aggregate intrinsic value | $	35
Vested and exercisable, aggregate intrinsic value | $	$ 35

Share-Based Payment - Unvested

Share-Based Payment - Unvested Stock Activity (Details) - Stock Options	6 Months Ended
	Jun. 30, 2016$ / sharesshares
Summary of unvested stock option activity
Beginning balance, unvested shares (shares) | shares	158,671
Granted, unvested share (shares) | shares	200,388
Vested, unvested share (shares) | shares	(107,613)
Canceled, unvested share (shares) | shares	(5,887)
Ending balance, unvested shares (shares) | shares	245,559
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Roll Forward]
Beginning balance, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	$ 15.01
Granted, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	4.32
Vested, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	14.01
Canceled, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	7.81
Ending balance, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	$ 6.90

Share-Based Payment - Cash Proc

Share-Based Payment - Cash Proceeds, Along with Fair Value Disclosures Related to Grants, Exercises, and Vesting Options (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended		6 Months Ended
		Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Share Based Compensation [Abstract]
Proceeds from stock options exercised		$ 129	$ 19	$ 614	$ 25
Intrinsic value of stock options exercised	[1]	$ 21	9	$ 1,386	$ 25
Weighted-average fair value of options granted (per share)				$ 4.32	$ 14.25
Total fair value of shares vested during the period			$ 107	$ 1,508	$ 479
[1]	The intrinsic value of stock options exercised is the amount by which the market price of the stock on the date of exercise exceeded the market price of the stock on the date of grant

Share-Based Payment - Restricte

Share-Based Payment - Restricted Stock Activity (Details) - Restricted stock	6 Months Ended
	Jun. 30, 2016$ / sharesshares
Summary of unvested stock option activity
Beginning balance, unvested shares (shares) | shares	74,413
Granted, unvested share (shares) | shares	85,206
Ending balance, unvested shares (shares) | shares	159,619
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Roll Forward]
Beginning balance, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	$ 9.18
Granted, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	6.93
Ending balance, unvested shares, weighted-average grant-date fair value (dollars per share) | $ / shares	$ 7.98

Fair Value of Financial Instr44

Fair Value of Financial Instruments - Estimated Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Contingent consideration related to acquisition	$ 1,720	$ 5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Fair Value, Measurements, Recurring
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Cash and cash equivalents	24,319	38,070
Contingent consideration related to acquisition	1,720	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Fair Value, Measurements, Recurring | Carrying Value
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Cash and cash equivalents	24,319	38,070
Fixed-rate capital leases and debt	40,116	40,667
Variable-rate debt	532,007	537,018
Contingent consideration related to acquisition	1,720	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Derivative instruments - liability position	205	86
Fair Value, Measurements, Recurring | Fair Value
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Cash and cash equivalents	24,319	38,070
Fixed-rate capital leases and debt	39,242	40,262
Variable-rate debt	531,254	538,520
Contingent consideration related to acquisition	1,720	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Derivative instruments - liability position	$ 205	$ 86

Fair Value of Financial Instr45

Fair Value of Financial Instruments - Summary of Valuation of Financial Instruments Reported at Fair Value on a Recurring Basis by Pricing Level (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Contingent consideration related to acquisition	$ 1,720	$ 5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Recurring basis
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash and cash equivalents	24,319	38,070
Contingent consideration related to acquisition	1,720	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Recurring basis | Quoted market prices in active markets (Level 1)
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash and cash equivalents	24,319	38,070
Recurring basis | Significant unobservable inputs (Level 3)
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Contingent consideration related to acquisition	1,720	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Recurring basis | Interest rate contracts
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate contracts - liability position	205	86
Recurring basis | Interest rate contracts | Significant other observable inputs (Level 2)
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate contracts - liability position	$ 205	$ 86

Goodwill and Intangible Asset46

Goodwill and Intangible Assets - Changes in the Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Changes in the Carrying Amount of Goodwill
Beginning balance	$ 102,782	$ 63,864
Goodwill acquired during the period	2,379	38,918
Impairment charges	0	0
Adjustments to goodwill during the period	968
Ending balance	106,129	$ 102,782
Gross goodwill	280,373
Accumulated impairment charges	$ (174,244)

Goodwill and Intangible Asset47

Goodwill and Intangible Assets - Components of Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Amortizing intangible assets:
Gross Carrying Amount	$ 231,440	$ 224,838
Accumulated Amortization	(117,758)	(112,820)
Intangible Assets, net	113,682	112,018
Intangible assets not subject to amortization	50,905	50,905
Total other intangible assets	164,587	162,923
Customer contracts
Amortizing intangible assets:
Gross Carrying Amount	192,431	186,316
Accumulated Amortization	(96,399)	(92,280)
Intangible Assets, net	96,032	94,036
Other
Amortizing intangible assets:
Gross Carrying Amount	39,009	38,522
Accumulated Amortization	(21,359)	(20,540)
Intangible Assets, net	$ 17,650	$ 17,982

Goodwill and Intangible Asset48

Goodwill and Intangible Assets - Textual (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Finite Lived Intangible Assets [Line Items]
Impairment of intangible assets		$ 6,670	$ 0	$ 6,746
Amortization expense	$ 2,494	$ 2,495	$ 4,937	$ 4,530
Customer contracts
Finite Lived Intangible Assets [Line Items]
Weighted-average estimated useful life of amortization intangible assets			15 years
Other intangible assets
Finite Lived Intangible Assets [Line Items]
Weighted-average estimated useful life of amortization intangible assets			11 years

Goodwill and Intangible Asset49

Goodwill and Intangible Assets - Estimated Annual Amortization Expense (Details) $ in Thousands	Jun. 30, 2016USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Remainder of 2016	$ 5,050
2,017	9,751
2,018	9,378
2,019	8,889
2,020	8,374
Thereafter	$ 72,240

Supplemental Balance Sheet Info

Supplemental Balance Sheet Information- Components of Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Components of other accrued liabilities
Systems rental and maintenance costs	$ 1,599	$ 1,808
Site rental fees	1,661	1,121
Property and sales taxes payable	8,352	8,695
Self-insurance accrual	2,376	2,037
Legal fees	1,673	1,971
Deferred gain on sale of equipment	87	312
Equipment purchases	3,541	4,756
Contingent consideration related to acquisition	1,720	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Other accrued liabilities	11,388	7,617
Total	$ 34,783	$ 36,453

Supplemental Balance Sheet In51

Supplemental Balance Sheet Information - Plant ,Property and Equipment Net of Depreciation (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	$ 927,458	$ 883,804
Accumulated depreciation	(723,011)	(706,616)
Plant, property and equipment, net	204,447	177,188
Furniture and fixtures
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	4,979	4,825
Office equipment
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	77,904	71,245
Transportation and service equipment
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	14,052	5,884
Major equipment
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	786,581	758,718
Tenant improvements
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	43,600	42,792
Buildings and land
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	$ 342	$ 340

Long-Term Debt and Senior Sub52

Long-Term Debt and Senior Subordinated Credit Facility - Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Deferred financing costs, net	$ (29,019)	$ (6,594)
Long-term debt, including current portion	543,104	571,091
Less current portion	21,780	20,406
Long-term debt	521,324	550,685
Term Loan Facility
Debt Instrument [Line Items]
Long-term debt, gross	500,274	502,874
Discount on term loan facility	(1,569)	(1,823)
Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt, gross	16,500	19,500
Equipment Under Capital Leases
Debt Instrument [Line Items]
Long-term debt, gross	14,131	13,006
Equipment Debt
Debt Instrument [Line Items]
Long-term debt, gross	$ 42,787	$ 44,128

Long-Term Debt and Senior Sub53

Long-Term Debt and Senior Subordinated Credit Facility - Long-term Debt - Additional Information (Details)	Dec. 31, 2015
Minimum | Equipment Debt
Debt Instrument [Line Items]
Stated percentage rate range	1.93%
Minimum | Capital Leases
Debt Instrument [Line Items]
Stated percentage rate range	4.00%
Maximum | Equipment Debt
Debt Instrument [Line Items]
Stated percentage rate range	7.50%
Maximum | Capital Leases
Debt Instrument [Line Items]
Stated percentage rate range	13.97%

Long-Term Debt and Senior Sub54

Long-Term Debt and Senior Subordinated Credit Facility - Credit Facility and Senior Secured Term Loan Refinancing - Additional Information (Details) - USD ($)	Jun. 03, 2013	Jun. 01, 2013	Jun. 30, 2016	Jul. 03, 2013
Term Loan Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate		4.25%
Senior Notes
Debt Instrument [Line Items]
Principal amount of debt repurchased				$ 80,000,000
New Credit Agreement
Debt Instrument [Line Items]
Ownership percentage of subsidiaries	50.00%
New Credit Agreement | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	1.00%
Debt description of variable rate basis	one-month LIBOR
New Credit Agreement | Term Loan Facility
Debt Instrument [Line Items]
Original debt amount	$ 340,000,000			$ 340,000,000
Debt term	6 years
New Credit Agreement | Term Loan Facility | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	3.25%
New Credit Agreement | Term Loan Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	2.25%
New Credit Agreement | Term Loan Facility | Maximum
Debt Instrument [Line Items]
Debt, leverage ratio	325.00%		455.00%
Covenant ratio of consolidated total debt to Consolidated Adjusted EBITDA, current year			495.00%
New Credit Agreement | Term Loan Facility | Minimum
Debt Instrument [Line Items]
Covenant ratio of consolidated total debt to Consolidated Adjusted EBITDA, current year			430.00%
New Credit Agreement | Uncommitted Incremental Loan Facility
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 100,000,000
New Credit Agreement | Delayed Draw
Debt Instrument [Line Items]
Original debt amount	$ 80,000,000
Required draw period	30 days
Period quarterly amortization payments required	5 years 6 months
Debt instrument, periodic payment	$ 1,050,000
New Credit Agreement | Senior Notes
Debt Instrument [Line Items]
Extinguishment of debt, amount	$ 190,000,000
Stated percentage rate range	8.00%
New Revolving Credit Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate		5.25%
New Revolving Credit Facility | Maximum
Debt Instrument [Line Items]
Debt, leverage ratio	0.50%
New Revolving Credit Facility | Minimum
Debt Instrument [Line Items]
Debt, leverage ratio	0.38%
New Revolving Credit Facility | Minimum | LIBOR
Debt Instrument [Line Items]
LIBOR floor		2.00%
New Revolving Credit Facility | New Credit Agreement
Debt Instrument [Line Items]
Debt term	5 years
Credit facility borrowing capacity	$ 50,000,000
New Revolving Credit Facility | New Credit Agreement | Maximum | LIBOR
Debt Instrument [Line Items]
Debt, leverage ratio	3.25%
New Revolving Credit Facility | New Credit Agreement | Maximum | Base Rate
Debt Instrument [Line Items]
Debt, leverage ratio	2.25%
New Revolving Credit Facility | New Credit Agreement | Minimum | LIBOR
Debt Instrument [Line Items]
Debt, leverage ratio	3.00%
LIBOR floor	1.00%
New Revolving Credit Facility | New Credit Agreement | Minimum | Base Rate
Debt Instrument [Line Items]
Debt, leverage ratio	2.00%
Letter of Credit | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 20,000,000

Long-Term Debt and Senior Sub55

Long-Term Debt and Senior Subordinated Credit Facility - Amendments to the Credit Agreement - Additional Information (Details) - USD ($)	Mar. 29, 2016	Jun. 19, 2015	Jun. 03, 2013	Jun. 01, 2013	Jun. 30, 2015	Jun. 30, 2016	Dec. 31, 2015	Dec. 02, 2013	Oct. 11, 2013
Term Loan Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate				4.25%
First Amendment to New Credit Agreement | Committed Incremental Term Loan
Debt Instrument [Line Items]
Credit facility borrowing capacity								$ 70,000,000	$ 70,000,000
Second Amendment to New Credit Agreement | Committed Incremental Term Loan
Debt Instrument [Line Items]
Credit facility borrowing capacity		$ 30,000,000
Principal amount funded (percent)		99.50%
Debt instrument, periodic payment					$ 1,300,000
New Credit Agreement | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate			1.00%
New Credit Agreement | Committed Incremental Term Loan
Debt Instrument [Line Items]
Debt instrument, periodic payment						$ 1,050,000
New Credit Agreement | Committed Incremental Term Loan | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate		2.25%
New Credit Agreement | Committed Incremental Term Loan | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate		3.25%
LIBOR floor		1.00%
New Credit Agreement | Term Loan Facility
Debt Instrument [Line Items]
Actual ratio of consolidated total debt to Consolidated Adjusted EBITDA						415.00%
New Credit Agreement | Term Loan Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate			2.25%
New Credit Agreement | Term Loan Facility | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate			3.25%
Third Amendment to New Credit Agreement
Debt Instrument [Line Items]
Percentage of premium on prepayment of term loan	1.00%
Fees that capitalized and amortized as interest expense	$ 25,000,000
New Revolving Credit Facility
Debt Instrument [Line Items]
Maturity date						Jun. 3, 2018
Credit facility, available borrowings						$ 29,100,000
Long-term debt, gross						$ 16,500,000	$ 19,500,000
New Revolving Credit Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate				5.25%
New Revolving Credit Facility | Second Amendment to New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity		$ 50,000,000
New Revolving Credit Facility | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity			$ 50,000,000
Term Loan Facility
Debt Instrument [Line Items]
Maturity date						Jun. 3, 2019
Long-term debt, gross						$ 500,274,000	$ 502,874,000
Letter of Credit
Debt Instrument [Line Items]
Long-term debt, gross						$ 4,400,000
Letter of Credit | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity			$ 20,000,000

Long-Term Debt and Senior Sub56

Long-Term Debt and Senior Subordinated Credit Facility - Notes Payable and Line of Credit - Additional Information (Details) - Debt Assumed from Acquisition of Alliance HNI, LLC and Subsidiaries	6 Months Ended
	Jun. 30, 2016USD ($)
Debt Instrument [Line Items]
Notes payable	$ 6,746,000
Minimum
Debt Instrument [Line Items]
Stated percentage rate range	1.83%
Maximum
Debt Instrument [Line Items]
Stated percentage rate range	1.95%
Line of Credit [Member]
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 4,700,000
Long-term debt, gross	$ 1,389,000
Line of Credit [Member] | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	1.40%

Derivatives - Textual (Details)

Derivatives - Textual (Details)	3 Months Ended	6 Months Ended
	Dec. 31, 2013USD ($)Aggrement	Jun. 30, 2016USD ($)	Jun. 30, 2015USD ($)	Dec. 31, 2015Aggrement	Sep. 30, 2015interest_swaps	Dec. 31, 2014	Mar. 31, 2013	Dec. 31, 2012
Interest rate swap, maturing December 2017
Derivative [Line Items]
Derivative, notional amount		$ 1,658,000
Interest rate agreement, basis spread on variable rate (percent)								2.50%
Fixed rate of interest paid by the Company (percent)								3.75%
Recorded interest expense rate								3.75%
Interest rate swap, maturing December 2017 | LIBOR
Derivative [Line Items]
Interest rate agreement, basis spread on variable rate (percent)								2.50%
Interest rate swap, maturing April 2018
Derivative [Line Items]
Derivative, notional amount		1,612,000
Interest rate agreement, basis spread on variable rate (percent)							2.00%
Fixed rate of interest paid by the Company (percent)							2.87%
Recorded interest expense rate							2.87%
Interest rate swap, maturing April 2018 | LIBOR
Derivative [Line Items]
Interest rate agreement, basis spread on variable rate (percent)							2.00%
Interest Rate Cap
Derivative [Line Items]
Derivative, notional amount	$ 250,000,000
Interest rate agreement, basis spread on variable rate (percent)	2.50%
Paid for cap purchase amortized as interest expense	$ 815,000
Interest rate swap
Derivative [Line Items]
Derivative, notional amount		1,175,000
Interest rate agreement, basis spread on variable rate (percent)						1.34%
AHNI swaps
Derivative [Line Items]
Derivative, notional amount		2,631,000
Number of interest swaps | interest_swaps					8
AHNI swaps | Minimum
Derivative [Line Items]
Fixed rate of interest paid by the Company (percent)					0.75%
AHNI swaps | Maximum
Derivative [Line Items]
Fixed rate of interest paid by the Company (percent)					1.68%
Interest rate swap mature dates ranging from December 2020 through December 2021
Derivative [Line Items]
Derivative, notional amount		6,445,000
Interest rate agreement, basis spread on variable rate (percent)				2.00%
Number of agreements | Aggrement				2
Interest rate swap mature dates ranging from December 2020 through December 2021 | Minimum
Derivative [Line Items]
Fixed rate of interest paid by the Company (percent)				1.37%
Recorded interest expense rate				1.37%
Interest rate swap mature dates ranging from December 2020 through December 2021 | Maximum
Derivative [Line Items]
Fixed rate of interest paid by the Company (percent)				3.69%
Recorded interest expense rate				3.69%
Interest rate swap mature dates ranging from December 2020 through December 2021 | LIBOR
Derivative [Line Items]
Interest rate agreement, basis spread on variable rate (percent)				2.00%
Interest Rate Cash Flow Hedges
Derivative [Line Items]
Variable bank rate debt		$ 263,520,000	$ 257,057,000
Variable rate debt as a percent of total debt (percent)		46.10%	47.30%
Expected reclassification from unrealized gain (loss) on hedging transactions net of taxes to interest expense and other, net		$ 563,000
Interest Rate Cash Flow Hedges | Interest Rate Cap
Derivative [Line Items]
Number of agreements | Aggrement	5

Derivatives - Impact on Stateme

Derivatives - Impact on Statement of Operations and Comprehensive Income (Loss) (Details) - Derivatives designated as hedging instruments - Derivatives in Cash Flow Hedging Relationships - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Effect of Derivative Instruments on Statement of Operations
Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion)	$ 6	$ (19)	$ (74)	$ (208)
Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion)	(140)	5	(223)	16
Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion)			(1)	1
Interest rate contracts
Effect of Derivative Instruments on Statement of Operations
Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion)	6	(19)	(74)	(208)
Interest rate contracts | Interest expense and other, net
Effect of Derivative Instruments on Statement of Operations
Amount of Gain (Loss) Reclassified from Accumulated OCI into Income (Effective Portion)	$ (140)	$ 5	(223)	16
Amount of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion)			$ (1)	$ 1

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income tax (benefit) expense	$ 2,221	$ (1,366)	$ 1,275	$ 206
Income tax expense benefit (percentage)	47.40%	41.00%	50.10%	5275.00%
Unrecognized tax benefits related to various federal and state income tax matters	$ 263		$ 263		$ 229
Tax-effected amount that would reduce the company's effective income tax rate if recognized	221		221		$ 192
Accrued interest and penalties related to unrecognized tax benefits	$ 13	$ 16	$ 13	$ 16

Earnings Per Common Share (Deta

Earnings Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Numerator:
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ 2,459	$ (1,961)	$ 1,269	$ (210)
Denominator:
Weighted-average shares-basic (shares)	10,882	10,715	10,771	10,714
Effect of dilutive securities:
Employee stock options (shares)	11	121	25	125
Weighted-average shares-diluted (shares)	10,893	10,836	10,796	10,839
Net income (loss) per common share attributable to Alliance HealthCare Services, Inc.:
Basic (dollars per share)	$ 0.23	$ (0.18)	$ 0.12	$ (0.02)
Diluted (dollars per share)	$ 0.23	$ (0.18)	$ 0.12	$ (0.02)
Stock options excluded from the computation of diluted per share amounts:
Weighted-average shares for which the exercise price exceeds average market price of common stock	776	394	478	335
Average exercise price per share that exceeds average market price of common stock (dollars per share)	$ 17.89	$ 30.15	$ 24.79	$ 31.57

Commitments and Contingencies -

Commitments and Contingencies - Textual (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Commitments and Contingencies [Line Items]
Maintenance contracts with equipment vendors, expiration year			2,022
Equipment maintenance contract payments	$ 9,978,000	$ 20,262,000	$ 9,893,000	$ 19,780,000
Liability related to guarantees and indemnities	0		$ 0
Minimum
Commitments and Contingencies [Line Items]
Period since inception of equipment maintenance contract (years)			1 year
Maximum
Commitments and Contingencies [Line Items]
Period since inception of equipment maintenance contract (years)			7 years
Equipment Purchase Commitments
Commitments and Contingencies [Line Items]
Equipment purchase commitment	$ 17,745,000		$ 17,745,000

Related-Party Transactions (Det

Related-Party Transactions (Details) $ / shares in Units, $ in Thousands	Sep. 16, 2015USD ($)$ / sharesshares	Jun. 30, 2016USD ($)unconsolidated_investee	Jun. 30, 2015USD ($)	Jun. 30, 2016USD ($)unconsolidated_investee	Jun. 30, 2015USD ($)	Mar. 29, 2016USD ($)	Dec. 31, 2015unconsolidated_investee	Aug. 01, 2015unconsolidated_investee	Apr. 16, 2007shares
Related Party Transaction [Line Items]
Ownership interest, percentage acquired		15.50%		15.50%
Ownership interest by parent								65.50%
Number of unconsolidated entities with direct ownership (investee) | unconsolidated_investee		2		2			2
Revenues from management agreements with unconsolidated equity investees		$ 352	$ 2,209	$ 705	$ 4,587
Alliance HNI LLC
Related Party Transaction [Line Items]
Number of unconsolidated entities with direct ownership (investee) | unconsolidated_investee								1
Percentage of ownership in unconsolidated investees after step acquisition (percent)		65.50%		65.50%
Unconsolidated Equity Method Investees | Revenues
Related Party Transaction [Line Items]
Reimbursement of expenses from related parties		$ 233	$ 1,782	$ 485	$ 3,729
Oaktree and MTS
Related Party Transaction [Line Items]
Shares purchased by Oaktree and MTS (shares) | shares									4,900,301
Ownership interest, percentage acquired									50.00%
Ownership interest by parent							51.00%
Thai Hot
Related Party Transaction [Line Items]
Ownership interest, percentage acquired						51.50%
Ownership interest by parent						51.50%
Number of shares acquired | shares	5,537,945
Consideration transferred	$ 102,500
Stock price per share | $ / shares	$ 18.50
Percentage of fees and expenses incurred	100.00%
Fees and expenses incurred	$ 1,000
Issuance of cash-based awards under management incentive agreement	1,500
Capital contributions	15,343					$ 13,500
Contributions received in relation to potential tax impact credit amendment costs incurred	$ 1,500

Investments in Unconsolidated63

Investments in Unconsolidated Investees - Textual (Details) - unconsolidated_investee	6 Months Ended
	Jun. 30, 2016	Dec. 31, 2015	Aug. 01, 2015
Schedule Of Equity Method Investments [Line Items]
Number of unconsolidated entities with direct ownership (investee)	2	2
Management services agreements expiration period	2,025
Ownership interest, percentage acquired	15.50%
HNI L.L.C.
Schedule Of Equity Method Investments [Line Items]
Ownership interest, percentage acquired			15.50%
Percentage of ownership in unconsolidated investees after step acquisition (percent)			65.50%
Minimum
Schedule Of Equity Method Investments [Line Items]
Percentage of ownership from investees (percent)	15.00%
Maximum
Schedule Of Equity Method Investments [Line Items]
Percentage of ownership from investees (percent)	50.00%

Investments in Unconsolidated64

Investments in Unconsolidated Investees - Balance Sheet Data (Details) - Investments - Equity Method and Joint Ventures - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Schedule of financial data of unconsolidated investees, Balance Sheet Data
Current assets	$ 2,254	$ 2,644
Noncurrent assets	143	273
Current liabilities	646	676
Noncurrent liabilities	$ 34	$ 35

Investments in Unconsolidated65

Investments in Unconsolidated Investees - Combined Operating Results (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Schedule of financial data of unconsolidated investees, Combined Operating Results
Earnings from unconsolidated investees	$ 393	$ 1,292	$ 645	$ 2,455
Investments - Equity Method and Joint Ventures
Schedule of financial data of unconsolidated investees, Combined Operating Results
Revenues	2,662	6,469	4,963	13,106
Expenses	782	2,920	1,560	6,256
Net income	1,880	3,549	3,403	6,850
Earnings from unconsolidated investees	$ 393	$ 1,292	$ 645	$ 2,455

Stockholders' Deficit (Details)

Stockholders' Deficit (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Class Of Stock [Line Items]
Beginning balance			$ (77,620)
Exercise of stock options			$ 615
Exercise of common stock options, shares			121,667
Shareholder transaction			$ 28,629
Share-based payment			1,780
Share-based payment income tax benefit			315
Unrealized loss on hedging transaction, net of tax			46
Net investments in subsidiaries			(8,754)
Net income	$ 6,188	$ 2,942	9,591	$ 9,040
Ending balance	(45,398)		(45,398)
Common Stock
Class Of Stock [Line Items]
Beginning balance			$ 108
Beginning balance, shares			10,774,857
Exercise of stock options			$ 1
Exercise of common stock options, shares			121,667
Ending balance	$ 109		$ 109
Ending balance, shares	10,896,524		10,896,524
Treasury Stock
Class Of Stock [Line Items]
Beginning balance			$ (3,138)
Beginning balance, shares			(157,973)
Ending balance	$ (3,138)		$ (3,138)
Ending balance, shares	(157,973)		(157,973)
Additional Paid-In Capital
Class Of Stock [Line Items]
Beginning balance			$ 29,297
Exercise of stock options			614
Shareholder transaction			28,629
Share-based payment			1,780
Share-based payment income tax benefit			315
Ending balance	$ 60,635		60,635
Accumulated Comprehensive Income (Loss)
Class Of Stock [Line Items]
Beginning balance			(511)
Unrealized loss on hedging transaction, net of tax			46
Ending balance	(465)		(465)
Retained Earnings (Accumulated Deficit)
Class Of Stock [Line Items]
Beginning balance			(198,393)
Net income			1,269
Ending balance	(197,124)		(197,124)
Alliance HealthCare Services, Inc.
Class Of Stock [Line Items]
Beginning balance			(172,637)
Exercise of stock options			615
Shareholder transaction			28,629
Share-based payment			1,780
Share-based payment income tax benefit			315
Unrealized loss on hedging transaction, net of tax			46
Net income			1,269
Ending balance	(139,983)		(139,983)
Noncontrolling Interest
Class Of Stock [Line Items]
Beginning balance			95,017
Net investments in subsidiaries			(8,754)
Net income			8,322
Ending balance	$ 94,585		$ 94,585

Segment Information - Textual (

Segment Information - Textual (Details) $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2016USD ($)	Jun. 30, 2015USD ($)	Jun. 30, 2016USD ($)segment	Jun. 30, 2015USD ($)	Dec. 31, 2015segment
Segment Reporting Information [Line Items]
Number of operating segments (segment) | segment			3
Number of reportable segments (segment) | segment					2
Payments to acquire property, plant, and equipment			$ 33,975	$ 26,382
Operating Segment | Radiology
Segment Reporting Information [Line Items]
Payments to acquire property, plant, and equipment	$ 13,749	$ 5,865	30,675	12,695
Operating Segment | Oncology
Segment Reporting Information [Line Items]
Payments to acquire property, plant, and equipment	1,954	3,022	2,438	3,757
Operating Segment | Interventional
Segment Reporting Information [Line Items]
Payments to acquire property, plant, and equipment	20	0	53	0
Corporate / Other
Segment Reporting Information [Line Items]
Payments to acquire property, plant, and equipment	$ 576	$ 2,806	$ 809	$ 2,806

Segment Information - Revenue b

Segment Information - Revenue by Segment (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Summary of revenue by segment
Revenue	$ 125,317	$ 118,504	$ 249,041	$ 227,933
Operating Segment | Radiology
Summary of revenue by segment
Revenue	87,546	84,994	173,185	166,381
Operating Segment | Oncology
Summary of revenue by segment
Revenue	25,829	25,330	51,891	49,516
Operating Segment | Interventional
Summary of revenue by segment
Revenue	11,398	8,167	23,061	12,023
Corporate / Other
Summary of revenue by segment
Revenue	$ 544	$ 13	$ 904	$ 13

Segment Information - Component

Segment Information - Components of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Summary of components of revenue
Revenue	$ 125,317	$ 118,504	$ 249,041	$ 227,933
Operating Segment | Radiology
Summary of components of revenue
Revenue	87,546	84,994	173,185	166,381
Operating Segment | Oncology
Summary of components of revenue
Revenue	25,829	25,330	51,891	49,516
Operating Segment | Interventional
Summary of components of revenue
Revenue	11,398	8,167	23,061	12,023
Operating Segment | MRI | Radiology
Summary of components of revenue
Revenue	48,755	45,249	96,325	88,136
Operating Segment | PET/CT | Radiology
Summary of components of revenue
Revenue	32,099	32,594	63,765	64,144
Operating Segment | Other Radiology | Radiology
Summary of components of revenue
Revenue	6,692	7,151	13,095	14,101
Corporate / Other
Summary of components of revenue
Revenue	$ 544	$ 13	$ 904	$ 13

Segment Information - Summary o

Segment Information - Summary of Segment Income (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Summary of segment income
Segment income (loss)	$ 34,442	$ 34,015	$ 64,814	$ 64,131
Segment Continuing Operations
Summary of segment income
Segment income (loss)	34,442	34,015	64,814	64,131
Segment Continuing Operations | Operating Segment | Radiology
Summary of segment income
Segment income (loss)	28,802	28,419	55,246	54,793
Segment Continuing Operations | Operating Segment | Oncology
Summary of segment income
Segment income (loss)	12,559	12,581	24,717	24,344
Segment Continuing Operations | Operating Segment | Interventional
Summary of segment income
Segment income (loss)	1,787	990	3,042	1,374
Segment Continuing Operations | Corporate / Other
Summary of segment income
Segment income (loss)	$ (8,706)	$ (7,975)	$ (18,191)	$ (16,380)

Segment Information - Reconcili

Segment Information - Reconciliation of Net Income (Loss) to Total Segment Income (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Reconciliation of net (loss) income to total segment income
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ 2,459	$ (1,961)	$ 1,269	$ (210)
Income tax (benefit) expense	2,221	(1,366)	1,275	206
Interest expense and other, net	8,872	6,904	16,367	12,922
Amortization expense	2,494	2,495	4,937	4,530
Depreciation expense	13,730	12,072	26,778	23,705
Share-based payment (included in selling, general and administrative expenses)	379	430	2,243	819
Severance and related costs	708	195	2,424	454
Noncontrolling interest in subsidiaries	3,729	4,903	8,322	9,250
Restructuring charges	1,120	236	1,351	491
Transaction costs	431	1,113	848	1,532
Shareholder transaction costs	1,498		2,507
Impairment charges		6,670	0	6,746
Legal matters expense (included in selling, general and administrative expenses)	39	1,543	194	2,903
Other non-cash (gains) charges (included in other (income) and expense, net)	(3,238)	781	(3,701)	783
Total segment income	$ 34,442	$ 34,015	$ 64,814	$ 64,131

Segment Information - Summary72

Segment Information - Summary of Net Income (Loss) by Segment (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ 2,459	$ (1,961)	$ 1,269	$ (210)
Operating Segment | Radiology
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	19,173	17,937	34,826	34,934
Operating Segment | Oncology
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	7,334	(1,629)	11,521	3,395
Operating Segment | Interventional
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	1,401	253	1,588	422
Corporate / Other
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ (25,449)	$ (18,522)	$ (46,666)	$ (38,961)

Segment Information - Summary73

Segment Information - Summary of Identifiable Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Summary of Company's identifiable assets by segment
Identifiable assets	$ 614,577	$ 603,660
Operating Segment | Radiology
Summary of Company's identifiable assets by segment
Identifiable assets	298,655	280,497
Operating Segment | Oncology
Summary of Company's identifiable assets by segment
Identifiable assets	208,222	213,698
Operating Segment | Interventional
Summary of Company's identifiable assets by segment
Identifiable assets	82,460	83,480
Corporate / Other
Summary of Company's identifiable assets by segment
Identifiable assets	$ 25,240	$ 25,985

Segment Information - Summary74

Segment Information - Summary of Goodwill by Segment (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2016	Dec. 31, 2015
Summary of goodwill by segment
Beginning balance	$ 102,782	$ 63,864
Goodwill acquired during the period	2,379	38,918
Impairment charges	0	0
Adjustments to goodwill during the period	968
Ending balance	106,129	102,782
Gross goodwill	280,373
Accumulated impairment charges	(174,244)
Radiology
Summary of goodwill by segment
Beginning balance	44,822	42,166
Goodwill acquired during the period	335	2,656
Impairment charges	0	0
Ending balance	45,157	44,822
Gross goodwill	199,499
Accumulated impairment charges	(154,342)
Oncology
Summary of goodwill by segment
Beginning balance	27,589	21,698
Goodwill acquired during the period	1,115	5,891
Impairment charges	0	0
Adjustments to goodwill during the period	615
Ending balance	29,319	27,589
Gross goodwill	49,221
Accumulated impairment charges	(19,902)
Interventional
Summary of goodwill by segment
Beginning balance	30,371	0
Goodwill acquired during the period	929	30,371
Impairment charges	0	0
Adjustments to goodwill during the period	353
Ending balance	31,653	$ 30,371
Gross goodwill	31,653
Accumulated impairment charges	$ 0