Alliance HealthCare Services (AIQ) 10-Q 4 Nov 16 2016 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2016	Oct. 28, 2016
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q3
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	Sep. 30, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 19,608	$ 38,070
Accounts receivable, net of allowance for doubtful accounts of $4,307 in 2016 and $5,461 in 2015	74,605	73,208
Prepaid expenses	12,939	13,463
Other receivables	3,408	3,206
Total current assets	110,560	127,947
Plant, property and equipment, net	206,596	177,188
Goodwill	105,239	102,782
Other intangible assets, net	162,326	162,923
Other assets	22,794	32,820
Total assets	607,515	603,660
Current liabilities:
Accounts payable	29,982	20,796
Accrued compensation and related expenses	23,334	19,933
Accrued interest payable	3,254	3,323
Current portion of long-term debt	18,124	17,732
Current portion of obligations under capital leases	3,321	2,674
Other accrued liabilities	28,397	36,453
Total current liabilities	106,412	100,911
Long-term debt, net of current portion and deferred financing costs	498,885	540,353
Obligations under capital leases, net of current portion	13,541	10,332
Deferred income taxes	26,098	23,020
Other liabilities	7,526	6,664
Total liabilities	652,462	681,280
Commitments and contingencies (Note 12)	0	0
Stockholders’ deficit:
Preferred stock, $0.01 par value; 1,000,000 shares authorized and no shares issued and outstanding	0	0
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	60,815	29,297
Accumulated comprehensive loss	(293)	(511)
Accumulated deficit	(195,766)	(198,393)
Total stockholders’ deficit attributable to Alliance HealthCare Services, Inc.	(138,273)	(172,637)
Noncontrolling interest	93,326	95,017
Total stockholders’ deficit	(44,947)	(77,620)
Total liabilities and stockholders’ deficit	$ 607,515	$ 603,660

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Statement Of Financial Position [Abstract]
Allowance for doubtful accounts	$ 4,307	$ 5,461
Preferred stock, par value (dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized	100,000,000	100,000,000
Common stock, shares issued	10,896,524	10,774,857
Common stock, shares outstanding	10,738,551	10,616,884
Treasury stock, shares	157,973	157,973

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income and Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Income Statement [Abstract]
Revenues	$ 127,121	$ 120,784	$ 376,162	$ 348,717
Costs and expenses:
Cost of revenues, excluding depreciation and amortization	71,132	67,057	211,985	196,428
Selling, general and administrative expenses	23,061	24,543	71,501	66,298
Transaction costs	138	432	986	1,964
Shareholder transaction costs	1,009	0	3,516	0
Severance and related costs	762	277	3,186	731
Impairment charges	0	71	0	6,817
Depreciation expense	13,899	12,247	40,677	35,952
Amortization expense	2,556	2,377	7,493	6,907
Interest expense, net	9,072	6,660	25,439	19,582
Other income, net	(1,915)	(10,451)	(6,249)	(10,324)
Total costs and expenses	119,714	103,213	358,534	324,355
Income before income taxes, earnings from unconsolidated investees, and noncontrolling interest	7,407	17,571	17,628	24,362
Income tax expense	1,862	5,098	3,137	5,304
Earnings from unconsolidated investees	(282)	(592)	(927)	(3,047)
Net income	5,827	13,065	15,418	22,105
Less: Net income attributable to noncontrolling interest	(4,469)	(5,861)	(12,791)	(15,111)
Net income attributable to Alliance HealthCare Services, Inc.	1,358	7,204	2,627	6,994
Comprehensive income (loss), net of taxes:
Net income	5,827	13,065	15,418	22,105
Unrealized gain (loss) on hedging transactions, net of taxes of $15, $0, $17, and $0	24	(8)	(18)	(149)
Reclassification adjustment for losses included in net income, net of taxes of $89, $0, $226 and $0	148	0	236	0
Total comprehensive income, net of taxes	5,999	13,057	15,636	21,956
Comprehensive income attributable to noncontrolling interest	(4,469)	(5,861)	(12,791)	(15,111)
Comprehensive income attributable to Alliance HealthCare Services, Inc.	$ 1,530	$ 7,196	$ 2,845	$ 6,845
Income per common share attributable to Alliance HealthCare Services, Inc.:
Basic	$ 0.12	$ 0.67	$ 0.24	$ 0.65
Diluted	$ 0.12	$ 0.67	$ 0.24	$ 0.65
Weighted-average number of shares of common stock and common stock equivalents:
Basic	10,888	10,716	10,850	10,715
Diluted	10,963	10,815	10,953	10,832

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Income and Comprehensive Income (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Income Statement [Abstract]
Unrealized gain (loss) on hedging transactions, tax	$ 15	$ 0	$ 17	$ 0
Reclassification adjustment for losses included in net income, tax	$ 89	$ 0	$ 226	$ 0

Condensed Consolidated Stateme6

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Operating activities:
Net income	$ 15,418	$ 22,105
Adjustments to reconcile net income to net cash provided by operating activities:
Provision for doubtful accounts	1,663	2,373
Share-based payment	2,187	1,242
Depreciation and amortization	48,170	42,859
Amortization of deferred financing costs	5,690	2,602
Accretion of discount on long-term debt	383	357
Adjustment of derivatives to fair value	520	100
Distributions from unconsolidated investees	955	3,332
Earnings from unconsolidated investees	(927)	(3,047)
Deferred income taxes	2,413	4,043
Gain on sale of assets	(1,279)	(685)
Changes in fair value of contingent consideration related to acquisitions	(4,640)	0
Non-cash gain on step acquisition	0	(9,950)
Gain on acquisition	0	(209)
Other non-cash gain	(248)	0
Impairment charges	0	6,817
Excess tax benefit from share-based payment arrangements	(87)	5
Changes in operating assets and liabilities, net of the effects of acquisitions:
Accounts receivable	(2,787)	(2,674)
Prepaid expenses	220	(1,106)
Other receivables	1,392	451
Other assets	279	1,488
Accounts payable	8,026	(363)
Accrued compensation and related expenses	3,401	(968)
Accrued interest payable	(69)	116
Income taxes payable	551	55
Other accrued liabilities	864	(4,248)
Net cash provided by operating activities	82,095	64,695
Investing activities:
Equipment purchases	(52,977)	(39,382)
Increase in deposits on equipment	(8,122)	(13,024)
Acquisitions, net of cash received	(6,659)	(22,657)
Proceeds from sale of assets	1,663	868
Net cash used in investing activities	(66,095)	(74,195)
Financing activities:
Principal payments on equipment debt and capital lease obligations	(12,437)	(6,664)
Proceeds from equipment debt	11,793	23,295
Principal payments on term loan facility	(3,900)	(8,651)
Proceeds from term loan facility	0	29,850
Principal payments on revolving loan facility	(45,000)	(28,000)
Proceeds from revolving loan facility	29,000	26,000
Payments of debt issuance costs and deferred financing costs	(25,493)	(801)
Distributions to noncontrolling interest in subsidiaries	(18,045)	(13,734)
Contributions from noncontrolling interest in subsidiaries	1,113	0
Excess tax benefit from share-based payment arrangements	87	(5)
Issuance of common stock	1	0
Proceeds from exercise of stock options	614	25
Settlement of contingent consideration related to acquisitions	(825)	0
Proceeds from shareholder transaction	28,630	0
Net cash (used in) provided by financing activities	(34,462)	21,315
Net (decrease) increase in cash and cash equivalents	(18,462)	11,815
Cash and cash equivalents, beginning of period	38,070	33,033
Cash and cash equivalents, end of period	19,608	44,848
Supplemental disclosure of cash flow information:
Interest paid	19,100	16,973
Income taxes paid, net of refunds	102	327
Supplemental disclosure of non-cash investing and financing activities:
Capital lease obligations related to the purchase of equipment	1,499	1,294
Changes in equipment purchases in accounts payable and accrued equipment	(2,491)	2,417
Noncontrolling interest assumed in connection with acquisitions (Note 3)	2,948	30,417
Fair value of contingent consideration related to acquisitions (Note 3)	420	0
Extinguishment of note receivable	0	3,071
Transfer of equity investment as consideration in step acquisition (Note 3)	0	690
Transfer of equipment as consideration in step acquisition (Note 3)	0	477
Transfer of fair value of equity investment in step acquisition (Note 3)	$ 0	$ 13,645

Basis of Presentation, Principl

Basis of Presentation, Principles of Consolidation, and Use of Estimates	9 Months Ended
	Sep. 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 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 in the U.S. (“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 nine months ended September 30, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. The accompanying 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. For a complete summary Principles of Consolidation The accompanying 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 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.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	9 Months Ended
	Sep. 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 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 impact 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. Early adoption is not permitted. ASU 2014-09 will be effective for the Company beginning on January 1, 2018. Going Concern In August 2014, the FASB issued ASU 2014-15, “Presentation of Financial Statements—Going Concern (Subtopic 205-40).” Under 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. ASU 2014-15 will be effective for the Company beginning with the year ending December 31, 2016. 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. Other than the revised balance sheet presentation and related disclosures, t he adoption of the guidance on January 1, 2016 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 requires 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 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 offset long-term DTLs. Other than the revised balance sheet presentation and related disclosures, the adoption of ASU 2015-17 on January 1, 2016 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. ASU 2016-02 will be effective for the Company beginning on January 1, 2019. 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 entities, including the accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. 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. ASU 2016-09 will be effective for the Company beginning on January 1, 2017. The Company is assessing the impact, if any, that the adoption of ASU 2016-09 may have on the Company’s consolidated financial statements. Statement of Cash Flows In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments,” which is intended to reduce diversity in the classification of transactions related to debt prepayment or debt extinguishment costs, zero-coupon debt instruments settlement, contingent consideration payments made after a business combination, insurance claims settlement and corporate-owned life insurance settlement, distributions from equity method investments and beneficial interests in securitization transactions. This guidance is effective for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption is permitted. ASU 2016-15 will be effective for the Company beginning on January 1, 2018. The Company is assessing the impact, if any, that the adoption of ASU 2016-02 may have on the Company’s consolidated financial statements .

Acquisitions and Transactions

Acquisitions and Transactions	9 Months Ended
	Sep. 30, 2016
Business Combinations Restructuring And Related Activities [Abstract]
Acquisitions and Transactions	3. Acquisitions and Transactions Thai Hot Transaction On September 16, 2015, Fujian Thai Hot Investment Co., Ltd. (“Thai Hot”) agreed to purchase approximately 5,537,945 shares of the Company’s 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, owned 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 provided 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. (“AHC”), a provider of fixed and mobile radiology and nuclear medicine services in New Hampshire and Vermont. The Company acquired 8 mobile radiology sites, and 5 mobile nuclear medicine sites, effective May 19, 2016. The combined cash purchase price, net of related contingent consideration, totaled $4,209. The Company financed this acquisition using the revolving line of credit. . 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 5 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 nine months ended September 30, 2016 included $936 and $1,573, respectively, of net revenue and $382 and $651, respectively, of net income before income taxes generated by AHC. 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 and $405 as of the acquisition date and September 30, 2016, respectively, was estimated using the Company’s established fair value approach. For additional information, see Note 5. 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 stereotactic radiosurgery (“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. As a result of this acquisition, the Company recorded goodwill of $6,505, 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 $8,800, of which $1,800 was assigned to physician referral network, $5,400 was assigned to Certificates of Need (“CONs”), $650 was assigned to non-solicitation and non-competition agreements and $950 was assigned to trademarks, which are being amortized over 5 to 15 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 results for the three and nine months ended September 30, 2016 included $1,285 and $3,999 of net revenue, respectively, and $(21) and $198 of net (loss) 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. As of September 30, 2016, the Company did not record a liability related to these contingent consideration arrangements since it believes that the achievement of the future performance goals is unlikely. 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 8 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. For additional information, see Note 8. As a result of this acquisition, the Company recorded goodwill of $8,234, 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 $15,600, of which $12,100 was assigned to physician referral network, $1,800 was assigned to non-solicitation and non-competition agreements and $1,700 was assigned to trademarks, which are being amortized over 5 to 15 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 results for the three and nine months ended September 30, 2016 included $3,389 and $9,986 of net revenue, respectively, and $414 and $1,160 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 $150 was estimated using management’s estimates as of September 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 held a 98% interest in AHNIL, which AHNI consolidated, a 53.4% interest in AHNVPS, and effectively, a 53.3% interest in AHNVPL through its ownership in AHNVPS, both of which AHNI did not consolidate. In addition to the Company’s original 50% investment in AHNI, it also had a 46.6% direct interest in AHNVPS prior to the step acquisition and, accordingly, the Company has historically consolidated AHNVPS and AHNVPL. 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, which largely represents intangible assets that do not qualify for separate recognition. In addition, the Company recorded intangible assets of $13,700. The intangible assets consist primarily of physician referral networks, trademarks, and certificates of need, a portion of which is being amortized over 15 years. 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 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 nine months ended September 30, 2016 included $7,830 and $23,623 of net revenue, respectively, and $714 and $1,770 of net loss, respectively, generated by TPC. The results for the three and nine months ended September 30, 2015 included $8,957 and $20,980 of net revenue, respectively, and $804 and $1,095 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 Company paid $810 of the contingent consideration during the nine months ended September 30, 2016. Pro Forma Impact of Acquisitions The following table provides pro forma revenues and results of operations for the nine months ended September 30, 2016 and the three and nine months ended September 30, 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 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. Three Months Ended September 30, Nine Months Ended September 30, 2015 2016 2015 Revenues $ 127,078 $ 376,842 $ 373,844 Net income attributable to Alliance HealthCare Services, Inc. 8,168 2,914 9,629 Basic earnings per share 0.76 0.27 0.90 Diluted earnings per share 0.76 0.27 0.89 Restructuring Plan From time to time, the Company’s management implements immaterial restructuring plans, including the closure or consolidation of certain sites as a result of the loss of certain customers. The impact of the charges resulting from restructuring plans are summarized below: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Cost of revenues, excluding depreciation and amortization $ 172 $ 176 $ 925 $ 572 Selling, general and administrative expenses 45 40 143 135 Other expense, net 67 — 567 — Total restructuring charges $ 284 $ 216 $ 1,635 $ 707

Share-Based Payment

Share-Based Payment	9 Months Ended
	Sep. 30, 2016
Share Based Compensation [Abstract]
Share-Based Payment	4. Share-Based Payment 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 September 30, 2016, a total of 1,024,866 shares remained available for grant under the 1999 Equity Plan. During the first quarter of 2016, the vesting for 71,057 options was accelerated due to a change in control in connection with the closing of the Thai Hot Transaction. There were no options for which vesting was accelerated during 2015. The following weighted average assumptions were used in the estimated grant date fair value calculations for stock option awards: Nine Months Ended September 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 Weighted average fair value on grant date $ 4.32 $ 14.25 The following table summarizes the Company’s stock option activity: Number of Shares Weighted- Average Exercise Price Weighted-Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (1) Outstanding at December 31, 2015 646,290 $ 19.91 Granted 200,388 7.16 Exercised (121,667 ) 5.05 $ 1,386 Canceled/forfeited (64,798 ) 24.00 Outstanding at September 30, 2016 660,213 18.37 6.43 $ 114 Vested and expected to vest in the future at September 30, 2016 618,096 19.08 6.23 $ 114 Vested and exercisable at September 30, 2016 415,540 22.41 4.93 $ 114 (1) Represents the difference between the exercise price and the value of the Company’s stock at the time of exercise, for exercised grants. For outstanding awards, represents the difference between the exercise price and the value of the Company’s stock at fiscal quarter-end. The following table summarizes the Company’s unvested stock option activity: Shares Weighted- Average Grant-Date Fair Value Aggregate Unrecognized Compensation Weighted Average Period Over Which Expected to be Recognized (in years) Total Fair Value Unvested at December 31, 2015 158,671 $ 15.01 Granted 200,388 4.32 Vested (107,613 ) 14.01 $ 1,508 Forfeited (6,773 ) 7.34 Unvested at September 30, 2016 244,673 $ 6.91 $ 786 2.0 Stock Awards The 1999 Equity Plan permits the award of restricted stock, restricted stock units, stock bonus awards and performance-based stock awards (collectively referred to as “stock awards”). In the third quarter of 2014, 25,000 restricted stock units (“RSU”), which vest based upon achieving certain market performance conditions, were granted to executive management. 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 agreement 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 of the board of directors 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 was paid during the three months ended September 30, 2016. For additional information on the Thai Hot Transaction, see Note 3. The following table summarizes the Company’s restricted stock unit activity: Shares Weighted- Average Grant-Date Fair Value Aggregate Unrecognized Compensation Weighted Average Period Over Which Expected to be Recognized (in years) Unvested at December 31, 2015 74,413 $ 9.18 Granted 85,206 6.93 Vested — — Forfeited (2,577 ) 6.93 Unvested at September 30, 2016 157,042 $ 7.85 $ 540 2.5 Share-based compensation expense The following table summarizes pre-tax, share-based compensation expense included within selling, general and administrative expenses in the condensed consolidated statements of income: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Share-based compensation expense $ 407 $ 423 $ 2,650 (1) $ 1,242 (1) Includes Cash Right of $463.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2016
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	5. Fair Value of Financial Instruments Instruments Measured at Fair Value on a Recurring Basis The following table summarizes the valuation of the Company’s financial instruments that are reported at fair value on a recurring basis as of September 30, 2016 and December 31, 2015: Fair Value as of September 30, 2016 Fair Value as of December 31, 2015 Total Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Financial liabilities: Contingent consideration related to acquisitions $ 705 $ — $ — $ 705 $ 5,750 $ — $ — $ 5,750 Mandatorily redeemable noncontrolling interest 2,386 — — 2,386 2,386 — — 2,386 Interest rate contracts - liability position 180 — 180 — 86 — 86 — Total financial liabilities $ 3,271 $ — $ 180 $ 3,091 $ 8,222 $ — $ 86 $ 8,136 The Company’s derivative instruments are primarily pay-fixed, receive-variable interest rate swaps and caps based on the London interbank offered rate (“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. The fair value of the liability for contingent consideration related to acquisitions was estimated using probability-adjusted performance estimates (Level 3 inputs) over the performance periods following the transaction dates (see Note 3). These estimates represent inputs for which market data are not available and are developed using the best information available about the assumptions that market participants would use when pricing the liability. Significant increases or decreases to either of these inputs in isolation would result in a significantly higher or lower liability. Ultimately, the liability will be equivalent to the amount paid, and the difference between the fair value estimate and amount paid will be recorded in earnings. Changes in the fair value of the Company’s Level 3 liabilities for the nine months ended September 30, 2016 were as follows: Contingent consideration related to acquisitions Mandatorily redeemable noncontrolling interest Balance at December 31, 2015 $ 5,750 $ 2,386 Additions to earn-out obligations (1) 420 — Settlement of contingent consideration related to acquisitions (825 ) — Fair value adjustment (2) (4,640 ) — Balance at September 30, 2016 $ 705 $ 2,386 (1) See Note 3. (2) Adjustments to the estimated fair value of the contingent consideration is related to the actual versus expected performance of acquisitions and are reported in Other income, net. Financial instruments measured and recorded at fair value on a recurring basis were presented on the Company’s consolidated balance sheets as follows: Fair Value as of September 30, 2016 Fair Value as of December 31, 2015 Total Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Financial liabilities: Other accrued liabilities $ 3,189 $ — $ 98 $ 3,091 $ 8,139 $ — 3 $ 8,136 Other liabilities 82 — 82 — 83 — 83 — Total financial liabilities $ 3,271 $ — $ 180 $ 3,091 $ 8,222 $ — 86 $ 8,136 During the nine months ended September 30, 2016, there were no transfers in or out of Level 1, Level 2 or Level 3 financial instruments. Instruments Not Recorded at Fair Value on a Recurring Basis The Company’s fixed and variable-rate debt represent Level 2 liabilities not measured at fair value on a recurring basis. On September 30, 2016 and December, 31, 2015, the fair values of the Company’s fixed and variable-rate debt were $41,954 and $521,337, respectively, and $40,262 and $538,520, respectively. On September 30, 2016 and December, 31, 2015, the book values of the Company’s fixed and variable-rate debt were $40,919 and $519,618, respectively, and $40,667 and $537,018, respectively. The fair value of long-term debt is estimated using Level 2 inputs based on quoted market prices or pricing models using current market rates. Assets and Liabilities Recorded at Fair Value on a Non-Recurring Basis The Company also measures the fair value of certain assets on a non-recurring basis (utilizing Level 3 inputs), generally on an annual basis, in connection with acquisitions, or when events or changes in circumstances indicate that the carrying amount of the assets may not be recoverable. These assets include goodwill, intangible assets, long-lived assets and investments in unconsolidated investees. See Note 6 for a discussion of the Company’s annual impairment test for goodwill and indefinite-lived intangible assets.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 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: Radiology Oncology Interventional Total Balance at December 31, 2015 $ 44,822 $ 27,589 $ 30,371 $ 102,782 Goodwill acquired during the period 335 225 854 1,414 Adjustments to goodwill during the period — 615 428 1,043 Balance at September 30, 2016 $ 45,157 $ 28,429 $ 31,653 $ 105,239 Gross goodwill $ 199,499 $ 48,331 $ 31,653 $ 279,483 Accumulated impairment charges (154,342 ) (19,902 ) — (174,244 ) Balance at September 30, 2016 $ 45,157 $ 28,429 $ 31,653 $ 105,239 Intangible assets consisted of the following: September 30, 2016 December 31, 2015 Estimated Useful Life Gross Carrying Amount Accumulated Amortization Intangible Assets, net Gross Carrying Amount Accumulated Amortization Intangible Assets, net Amortizing intangible assets: Customer contracts 15 years $ 192,720 $ (98,561 ) $ 94,159 $ 186,316 $ (92,280 ) $ 94,036 Other 11 years 39,014 (21,752 ) 17,262 38,522 (20,540 ) 17,982 Total amortizing intangible assets $ 231,734 $ (120,313 ) $ 111,421 $ 224,838 $ (112,820 ) $ 112,018 Intangible assets not subject to amortization 50,905 50,905 Total other intangible assets $ 162,326 $ 162,923 In 2016, the Company intends to perform its annual impairment test for goodwill and indefinite-lived intangible assets in the fourth quarter, 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 September 30, 2016, impairment testing was not required during the nine months then ended. Although the Company concluded that no impairment was present in its intangible assets during the nine 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. Amortization expense for intangible assets subject to amortization was $2,556 and $2,377 for the three months ended September 30, 2016 and 2015, respectively, and $7,493 and $6,907 for the nine months ended September 30, 2016 and 2015, respectively As of September 30, 2016, estimated future amortization expense for each of the fiscal years ending December 31, is presented below: Remainder of 2016 $ 2,517 2017 9,798 2018 9,420 2019 8,931 2020 8,415 Thereafter 72,340 $ 111,421

Supplemental Balance Sheet Info

Supplemental Balance Sheet Information	9 Months Ended
	Sep. 30, 2016
Supplemental Balance Sheet Information [Abstract]
Supplemental Balance Sheet Information	7. Supplemental Balance Sheet Information Other accrued liabilities consisted of the following: September 30, 2016 December 31, 2015 Systems rental and maintenance costs $ 1,522 $ 1,808 Site rental fees 1,177 1,121 Property and sales taxes payable 7,895 8,695 Self-insurance accrual 2,426 2,037 Legal fees 1,346 1,971 Deferred gain on sale of equipment 87 312 Equipment purchases 1,137 4,756 Contingent consideration related to acquisitions 705 5,750 Mandatorily redeemable noncontrolling interest 2,386 2,386 Other accrued liabilities 9,716 7,617 Total $ 28,397 $ 36,453 A summary of plant, property and equipment, net is presented below: September 30, 2016 December 31, 2015 Furniture and fixtures $ 4,852 $ 4,825 Office equipment 78,542 71,245 Transportation and service equipment 15,323 5,884 Major equipment 789,684 758,718 Tenant improvements 44,062 42,792 Buildings and land 340 340 932,803 883,804 Accumulated depreciation (726,207 ) (706,616 ) Plant, property and equipment, net $ 206,596 $ 177,188

Long-Term Debt and Senior Subor

Long-Term Debt and Senior Subordinated Credit Facility	9 Months Ended
	Sep. 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: September 30, 2016 December 31, 2015 Term loan facility $ 498,974 $ 502,874 Discount on term loan facility (1,440 ) (1,823 ) Revolving credit facility 3,500 19,500 Equipment under capital leases 16,862 13,006 Equipment debt 42,641 44,128 Deferred financing costs, net (26,666 ) (6,594 ) Long-term debt, including current portion 533,871 571,091 Less current portion (21,445 ) (20,406 ) Long-term debt $ 512,426 $ 550,685 Equipment debt, collateralized by equipment, has interest rates ranging from 1.93% to 9.00% 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) a $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 and 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 from 3.00% to 3.25% per annum, based on the applicable leverage ratio, and 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 from 2.00% to 2.25% per annum, based on the applicable leverage ratio. 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 from 0.38% to 0.50% per annum, based on the applicable leverage ratio, 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, as defined in the Credit Agreement, that ranges from 4.95 to 1.00 to 4.30 to 1.00. At September 30, 2016, the Credit Agreement required 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 $25,000, which were capitalized and amortized on a straight-line basis as interest expense over the term of the Credit Agreement. As of September 30, 2016, the Company’s ratio of consolidated total debt to Consolidated Adjusted EBITDA calculated pursuant to the Credit Agreement was 4.13 to 1.00. As of September 30, 2016, the Company had $42,100 of available borrowings under the revolving line of credit, net of $3,500 outstanding on the revolving line of credit and $4,400 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 described in Note 3, the Company had notes payable to PNC Equipment Finance, LLC (“PNC”) totaling $9,438 at September 30, 2016. The notes payable are due in various installments through December 2020 at interest rates between 1.93% and 2.05% 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 September 30, 2016, there was $0 amount outstanding on the line of credit.

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2016
Summary Of Derivative Instruments [Abstract]
Derivatives	9. Derivatives Cash Flow Hedges Interest Rate Cash Flow Hedges The Company 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 nine months ended September 30, 2016 and December 31, 2015, the Company had interest rate swap and cap agreements to hedge approximately $266,975 and $265,879 of its variable rate bank debt, respectively, or 47.6% and 46.0% of total debt, respectively. Over the next twelve months, the Company expects to reclassify $300 from unrealized gain (loss) on hedging transactions, net of taxes to interest expense, net. The Company’s interest rate cash flow hedges consist of: Fair Value Asset (Liability) (1) Notional Amount Fixed Payment Rate Strike Rate Maturity Date September 30, 2016 December 31, 2015 Asset Derivatives Derivatives designated as cash flow hedging instruments: Interest rate cap on LIBOR, effective December 2013 (2) $ 250,000 N/A 2.50% December 2016 $ — $ — Total asset derivatives $ 250,000 $ — $ — Liability Derivatives Derivatives designated as cash flow hedging instruments: One-month LIBOR plus 2.50% interest rate swap, effective December 2012 $ 1,389 3.75% N/A December 2017 $ (6 ) $ (11 ) One-month LIBOR plus 2.00% interest rate swap, effective March 2013 1,392 2.87% N/A April 2018 (3 ) (2 ) One-month LIBOR interest rate swap, effective December 2014 1,089 1.34% N/A November 2019 (10 ) (7 ) One-month LIBOR plus 2.00% interest rate swap, effective December 2015 4,896 3.69% N/A December 2021 (102 ) (54 ) One-month LIBOR interest rate swap, effective December 2015 1,242 1.37% N/A December 2020 (14 ) (5 ) One-month LIBOR interest rate swap, effective September 2016 4,672 1.17% N/A September 2021 (35 ) — Derivatives not designated as cash flow hedging instruments: One-month LIBOR interest rate swap (3) 2,295 0.75% - 1.68% N/A April 2017 - April 2020 (10 ) (7 ) Total liability derivatives $ 16,975 $ (180 ) $ (86 ) (1) The fair values of the interest rate cap asset and interest rate swap liabilities are included in Other assets and Other accrued liabilities and Other liabilities, respectively, in the condensed consolidated balance sheets. (2) The Company paid $815 to enter into five interest rate cap agreements. The Company is amortizing the payment through Interest expense, net over the life of the agreements. (3) The Company acquired eight non-designated interest rate swaps (the “AHNI Swaps”) as a result of the step acquisition of AHNI. The changes in fair market value of the AHNI Swaps are recorded in Interest expense, net as incurred. The following tables summarize the amount of income recognized from derivative instruments for the periods indicated and the line items in the accompanying condensed consolidated statements of income and comprehensive income where the results are recorded for cash flow hedges: Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Loss Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Loss (Gain) 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 Income (Ineffective Portion) Three Months Ended September 30, Three Months Ended September 30, Three Months Ended September 30, 2016 2015 2016 2015 2016 2015 Interest rate contracts $ 24 $ (11 ) Interest expense, net $ 148 $ (7 ) Interest expense, net $ — $ — Total $ 24 $ (11 ) $ 148 $ (7 ) $ — $ — Amount of Loss Recognized in OCI on Derivatives (Effective Portion) Location of Loss Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Loss Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of (Loss) Gain Recognized in Income on Derivatives Income (Ineffective Portion) Nine Months Ended September 30, Nine Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 2016 2015 Interest rate contracts $ (18 ) $ (219 ) Interest expense, net $ 236 $ 9 Interest expense, net $ (1 ) $ 1 Total $ (18 ) $ (219 ) $ 236 $ 9 $ (1 ) $ 1 The effect of non-designated derivative instruments on the condensed consolidated statements of income and comprehensive income for the three and nine months ended September 30, 2016 and 2015 was immaterial.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2016
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes For the three and nine months ended September 30, 2016, the Company recorded income tax expense of $1,862 and $3,137 million, respectively, or 57.8% and 54.4%, respectively, of the Company’s pretax income. For the three and nine months ended September 30, 2015, the Company recorded income tax expense of $5,098 and $5,304, respectively, or 41.4% and 43.1%, 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 nine months ended September 30, 2016 and 2015 differed from the federal statutory rate principally as a result of state income taxes and permanent non-deductible tax items, which include share-based payments, unrecognized tax benefits and other permanent differences. As of September 30, 2016, the Company has provided a liability for $239 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 $195. 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 September 30, 2016 and December 31, 2015, the Company had approximately $9 and $10, respectively, in accrued interest and penalties related to unrecognized tax benefits. The Company is subject to U.S. 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, 2013 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	9 Months Ended
	Sep. 30, 2016
Earnings Per Share [Abstract]
Earnings Per Common Share	11. Earnings Per Common Share The following table sets forth the computation of basic and diluted net income per share (amounts in thousands, except per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Numerator: Net income attributable to Alliance HealthCare Services, Inc. $ 1,358 $ 7,204 $ 2,627 $ 6,994 Denominator: Weighted-average shares-basic 10,888 10,716 10,850 10,715 Effect of dilutive securities: Stock options and RSUs 75 99 103 117 Weighted-average shares-diluted 10,963 10,815 10,953 10,832 Net income per common share attributable to Alliance HealthCare Services, Inc.: Basic $ 0.12 $ 0.67 $ 0.24 $ 0.65 Diluted $ 0.12 $ 0.67 $ 0.24 $ 0.65 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 553 392 513 379 Average exercise price per share that exceeds average market price of common stock $ 21.62 $ 30.07 $ 23.26 $ 30.35

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 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 1 to 7 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 were $10,041 and $30,303 for the three and nine months ended September 30, 2016, respectively, and $10,046 and $29,825 for the three and nine months ended September 30, 2015, respectively. At September 30, 2016, the Company had binding equipment purchase commitments totaling $15,699. 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 September 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. The Company intends to vigorously defend itself against the lawsuit and currently believes the ultimate disposition of these matters will not have a material adverse effect on its consolidated financial statements. Other Matters From time to time, the Company 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	9 Months Ended
	Sep. 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, Thai Hot agreed to purchase approximately 5,537,945 shares of the Company’s common stock from funds managed by the Selling Stockholders for approximately $102,500 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 $1,000. In addition, subject to the approval of the Company’s board of directors or an authorized special committee of the Company’s board of directors, Thai Hot agreed to fund a new management incentive arrangement which involves the issuance of $1,500 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 of $15,343 received prior to the Thai Hot Transaction close from the Selling Stockholders as capital contributions and reimbursements of $13,500 received subsequent to the Thai Hot Transaction close from Thai Hot as capital contributions. In addition, the Selling Stockholders provided $1,500 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 per the agreement. 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 September 30, 2016 and December 31, 2015. The following table summarizes revenues from management agreements with unconsolidated equity investees: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Revenue from management agreements 348 1,191 1,053 5,778 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 income and comprehensive income. The following table summarizes the revenue and reimbursed expenses related to the Company’s unconsolidated equity investees: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Revenue and reimbursed expenses 234 978 719 4,707

Investments in Unconsolidated I

Investments in Unconsolidated Investees	9 Months Ended
	Sep. 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 September 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, accordingly, the Company accounted for the investment using the equity method. Set forth below are certain balance sheet data and operating results for the aggregate of the Company’s unconsolidated investees for the three and nine months ended September 30, 2016 and 2015. Operating results for AHNI are included for the three and nine months ended September 30, 2015: September 30, 2016 December 31, 2015 Balance sheet data: Current assets $ 2,777 $ 2,644 Noncurrent assets 124 273 Current liabilities 628 676 Noncurrent liabilities 33 35 Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Operating results: Revenues $ 2,558 $ 3,788 $ 7,521 $ 16,894 Expenses 655 1,648 2,215 7,904 Net income 1,902 2,140 5,305 8,990 Earnings from unconsolidated investees 282 592 927 3,047

Stockholders' Deficit

Stockholders' Deficit	9 Months Ended
	Sep. 30, 2016
Stockholders Equity Note [Abstract]
Stockholders' Deficit	15. Stockholders’ Deficit The following table summarizes consolidated stockholders’ deficit, including noncontrolling interest. Stockholders’ (Deficit) Equity Attributable to Common Stock Treasury Stock Additional Paid-In Accumulated Comprehensive (Accumulated Deficit) Retained Alliance HealthCare Non-controlling Total Stockholders’ (Deficit) Shares Amount Shares Amount Capital (Loss) Income Earnings Services, Inc. Interest Equity 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 — — — — 28,630 — — 28,630 — 28,630 Share-based payment — — — — 2,187 — — 2,187 — 2,187 Share-based payment income tax benefit — — — — 87 — — 87 — 87 Unrealized gain on hedging transaction, net of tax — — — — — 218 — 218 — 218 Noncontrolling interest assumed in connection with acquisitions (Note 3) — — — — — — — — 2,450 2,450 Distributions to noncontrolling interest in subsidiaries — — — — — — — — (18,045 ) (18,045 ) Contributions from noncontrolling interest in subsidiaries — — — — — — — — 1,113 1,113 Net income — — — — — — 2,627 2,627 12,791 15,418 Balance at September 30, 2016 10,896,524 $ 109 (157,973 ) $ (3,138 ) $ 60,815 $ (293 ) $ (195,766 ) $ (138,273 ) $ 93,326 $ (44,947 )

Segment Information

Segment Information	9 Months Ended
	Sep. 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 Division and Oncology Division). 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 (loss) and net income (loss). The following table summarizes the Company’s revenue by segment: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Revenue: MRI revenue $ 49,887 $ 47,603 $ 146,212 $ 135,739 PET/CT revenue 31,936 32,248 95,701 96,392 Other radiology 6,904 6,433 19,999 20,534 Radiology 88,727 86,284 261,912 252,665 Oncology 26,271 25,224 78,162 74,740 Interventional 11,511 8,957 34,572 20,980 Corporate / Other 612 319 1,516 332 Total $ 127,121 $ 120,784 $ 376,162 $ 348,717 Segment income represents net income (loss) before: income tax expense (benefit); noncontrolling interest in subsidiaries; interest expense, net; depreciation expense; amortization expense; share-based payment; severance and related costs; restructuring charges; transaction costs; shareholder transaction costs; impairment charges; legal matters expense, net; changes in fair value of contingent consideration related to acquisitions; other non-cash charges, net; and non-cash gain on step acquisition. 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 September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Segment income: Radiology $ 30,310 $ 28,526 $ 85,556 $ 83,319 Oncology 13,307 12,661 38,024 37,005 Interventional 1,162 1,461 4,204 2,835 Corporate / Other (9,666 ) (8,786 ) (27,857 ) (25,166 ) Total $ 35,113 $ 33,862 $ 99,927 $ 97,993 The reconciliation of income before income taxes, earnings from unconsolidated investees, and noncontrolling interest to total segment income is shown below: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Income before income taxes, earnings from unconsolidated investees, and noncontrolling interest $ 7,407 $ 17,571 $ 17,628 $ 24,362 Earnings from unconsolidated investees 282 592 927 3,047 Interest expense, net 9,072 6,660 25,439 19,582 Depreciation expense 13,899 12,247 40,677 35,952 Amortization expense 2,556 2,377 7,493 6,907 Share-based payment (included in selling, general and administrative expenses) 407 423 2,650 1,242 Severance and related costs 762 277 3,186 731 Restructuring charges (Note 3) 284 216 1,635 707 Transaction costs 138 432 986 1,964 Shareholder transaction costs 1,009 — 3,516 — Impairment charges — 71 — 6,817 Legal matters expense, net (included in selling, general and administrative expenses) (88 ) 2,924 106 5,827 Changes in fair value of contingent consideration related to acquisitions (1,000 ) — (4,640 ) — Other non-cash charges, net (included in other income, net) 385 22 324 805 Non-cash gain on step acquisition (included in other income, net) — (9,950 ) — (9,950 ) Total segment income $ 35,113 $ 33,862 $ 99,927 $ 97,993 Net income (loss) for the Radiology, Oncology and Interventional segments does not include charges for interest expense, net, 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 September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Net income (loss): Radiology $ 19,172 $ 20,100 $ 53,998 $ 55,034 Oncology 3,814 4,047 15,335 7,442 Interventional 894 611 2,482 1,033 Corporate / Other (22,522 ) (17,554 ) (69,188 ) (56,515 ) Total $ 1,358 $ 7,204 $ 2,627 $ 6,994 The following table summarizes the Company’s identifiable assets by segment: September 30, December 31, 2016 2015 Identifiable assets: Radiology $ 292,236 $ 280,497 Oncology 202,121 213,698 Interventional 82,924 83,480 Corporate / Other 30,234 25,985 Total $ 607,515 $ 603,660 The following table summarizes the Company’s equipment capital expenditures by segment: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Capital expenditures: Radiology $ 18,200 $ 10,075 $ 48,875 $ 25,734 Oncology 400 1,183 2,838 10,394 Interventional 58 183 111 183 Corporate / Other 344 267 1,153 3,071 Total $ 19,002 $ 11,708 $ 52,977 $ 39,382

Basis of Presentation, Princi23

Basis of Presentation, Principles of Consolidation, and Use of Estimates (Policies)	9 Months Ended
	Sep. 30, 2016
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying 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 in the U.S. (“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 nine months ended September 30, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016. The accompanying 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. For a complete summary
Principles of Consolidation	Principles of Consolidation The accompanying 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	Use of Estimates The preparation of condensed consolidated financial statements in conformity with 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.
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 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 impact 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. Early adoption is not permitted. ASU 2014-09 will be effective for the Company beginning on January 1, 2018. Going Concern In August 2014, the FASB issued ASU 2014-15, “Presentation of Financial Statements—Going Concern (Subtopic 205-40).” Under 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. ASU 2014-15 will be effective for the Company beginning with the year ending December 31, 2016. 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. Other than the revised balance sheet presentation and related disclosures, t he adoption of the guidance on January 1, 2016 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 requires 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 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 offset long-term DTLs. Other than the revised balance sheet presentation and related disclosures, the adoption of ASU 2015-17 on January 1, 2016 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. ASU 2016-02 will be effective for the Company beginning on January 1, 2019. 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 entities, including the accounting for income taxes, forfeitures, and statutory tax withholding requirements, as well as classification in the statement of cash flows. 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. ASU 2016-09 will be effective for the Company beginning on January 1, 2017. The Company is assessing the impact, if any, that the adoption of ASU 2016-09 may have on the Company’s consolidated financial statements. Statement of Cash Flows In August 2016, the FASB issued ASU 2016-15, “Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments,” which is intended to reduce diversity in the classification of transactions related to debt prepayment or debt extinguishment costs, zero-coupon debt instruments settlement, contingent consideration payments made after a business combination, insurance claims settlement and corporate-owned life insurance settlement, distributions from equity method investments and beneficial interests in securitization transactions. This guidance is effective for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. Early adoption is permitted. ASU 2016-15 will be effective for the Company beginning on January 1, 2018. The Company is assessing the impact, if any, that the adoption of ASU 2016-02 may have on the Company’s consolidated financial statements .

Acquisitions and Transactions (

Acquisitions and Transactions (Tables)	9 Months Ended
	Sep. 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 results 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. Three Months Ended September 30, Nine Months Ended September 30, 2015 2016 2015 Revenues $ 127,078 $ 376,842 $ 373,844 Net income attributable to Alliance HealthCare Services, Inc. 8,168 2,914 9,629 Basic earnings per share 0.76 0.27 0.90 Diluted earnings per share 0.76 0.27 0.89
Restructuring Charges	From time to time, the Company’s management implements immaterial restructuring plans, including the closure or consolidation of certain sites as a result of the loss of certain customers. The impact of the charges resulting from restructuring plans are summarized below: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Cost of revenues, excluding depreciation and amortization $ 172 $ 176 $ 925 $ 572 Selling, general and administrative expenses 45 40 143 135 Other expense, net 67 — 567 — Total restructuring charges $ 284 $ 216 $ 1,635 $ 707

Share-Based Payment (Tables)

Share-Based Payment (Tables)	9 Months Ended
	Sep. 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: Nine Months Ended September 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 Weighted average fair value on grant date $ 4.32 $ 14.25
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 (in years) Aggregate Intrinsic Value (1) Outstanding at December 31, 2015 646,290 $ 19.91 Granted 200,388 7.16 Exercised (121,667 ) 5.05 $ 1,386 Canceled/forfeited (64,798 ) 24.00 Outstanding at September 30, 2016 660,213 18.37 6.43 $ 114 Vested and expected to vest in the future at September 30, 2016 618,096 19.08 6.23 $ 114 Vested and exercisable at September 30, 2016 415,540 22.41 4.93 $ 114 (1) Represents the difference between the exercise price and the value of the Company’s stock at the time of exercise, for exercised grants. For outstanding awards, represents the difference between the exercise price and the value of the Company’s stock at fiscal quarter-end.
Summary of unvested stock option activity	The following table summarizes the Company’s unvested stock option activity: Shares Weighted- Average Grant-Date Fair Value Aggregate Unrecognized Compensation Weighted Average Period Over Which Expected to be Recognized (in years) Total Fair Value Unvested at December 31, 2015 158,671 $ 15.01 Granted 200,388 4.32 Vested (107,613 ) 14.01 $ 1,508 Forfeited (6,773 ) 7.34 Unvested at September 30, 2016 244,673 $ 6.91 $ 786 2.0
Summary of restricted stock unit activity	The following table summarizes the Company’s restricted stock unit activity: Shares Weighted- Average Grant-Date Fair Value Aggregate Unrecognized Compensation Weighted Average Period Over Which Expected to be Recognized (in years) Unvested at December 31, 2015 74,413 $ 9.18 Granted 85,206 6.93 Vested — — Forfeited (2,577 ) 6.93 Unvested at September 30, 2016 157,042 $ 7.85 $ 540 2.5
Summary of pre-tax, share-based compensation expense	The following table summarizes pre-tax, share-based compensation expense included within selling, general and administrative expenses in the condensed consolidated statements of income: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Share-based compensation expense $ 407 $ 423 $ 2,650 (1) $ 1,242 (1) Includes Cash Right of $463.

Fair Value of Financial Instr26

Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2016
Fair Value Disclosures [Abstract]
Summary of valuation of financial instruments reported at fair value on a recurring basis	The following table summarizes the valuation of the Company’s financial instruments that are reported at fair value on a recurring basis as of September 30, 2016 and December 31, 2015: Fair Value as of September 30, 2016 Fair Value as of December 31, 2015 Total Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Financial liabilities: Contingent consideration related to acquisitions $ 705 $ — $ — $ 705 $ 5,750 $ — $ — $ 5,750 Mandatorily redeemable noncontrolling interest 2,386 — — 2,386 2,386 — — 2,386 Interest rate contracts - liability position 180 — 180 — 86 — 86 — Total financial liabilities $ 3,271 $ — $ 180 $ 3,091 $ 8,222 $ — $ 86 $ 8,136 Financial instruments measured and recorded at fair value on a recurring basis were presented on the Company’s consolidated balance sheets as follows: Fair Value as of September 30, 2016 Fair Value as of December 31, 2015 Total Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Financial liabilities: Other accrued liabilities $ 3,189 $ — $ 98 $ 3,091 $ 8,139 $ — 3 $ 8,136 Other liabilities 82 — 82 — 83 — 83 — Total financial liabilities $ 3,271 $ — $ 180 $ 3,091 $ 8,222 $ — 86 $ 8,136
Schedule of changes in fair value of level 3 liabilities	Changes in the fair value of the Company’s Level 3 liabilities for the nine months ended September 30, 2016 were as follows: Contingent consideration related to acquisitions Mandatorily redeemable noncontrolling interest Balance at December 31, 2015 $ 5,750 $ 2,386 Additions to earn-out obligations (1) 420 — Settlement of contingent consideration related to acquisitions (825 ) — Fair value adjustment (2) (4,640 ) — Balance at September 30, 2016 $ 705 $ 2,386 (1) See Note 3. (2) Adjustments to the estimated fair value of the contingent consideration is related to the actual versus expected performance of acquisitions and are reported in Other income, net.

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 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: Radiology Oncology Interventional Total Balance at December 31, 2015 $ 44,822 $ 27,589 $ 30,371 $ 102,782 Goodwill acquired during the period 335 225 854 1,414 Adjustments to goodwill during the period — 615 428 1,043 Balance at September 30, 2016 $ 45,157 $ 28,429 $ 31,653 $ 105,239 Gross goodwill $ 199,499 $ 48,331 $ 31,653 $ 279,483 Accumulated impairment charges (154,342 ) (19,902 ) — (174,244 ) Balance at September 30, 2016 $ 45,157 $ 28,429 $ 31,653 $ 105,239
Components of intangible assets	Intangible assets consisted of the following: September 30, 2016 December 31, 2015 Estimated Useful Life Gross Carrying Amount Accumulated Amortization Intangible Assets, net Gross Carrying Amount Accumulated Amortization Intangible Assets, net Amortizing intangible assets: Customer contracts 15 years $ 192,720 $ (98,561 ) $ 94,159 $ 186,316 $ (92,280 ) $ 94,036 Other 11 years 39,014 (21,752 ) 17,262 38,522 (20,540 ) 17,982 Total amortizing intangible assets $ 231,734 $ (120,313 ) $ 111,421 $ 224,838 $ (112,820 ) $ 112,018 Intangible assets not subject to amortization 50,905 50,905 Total other intangible assets $ 162,326 $ 162,923
Estimated Future amortization expense	As of September 30, 2016, estimated future amortization expense for each of the fiscal years ending December 31, is presented below: Remainder of 2016 $ 2,517 2017 9,798 2018 9,420 2019 8,931 2020 8,415 Thereafter 72,340 $ 111,421

Supplemental Balance Sheet In28

Supplemental Balance Sheet Information (Tables)	9 Months Ended
	Sep. 30, 2016
Supplemental Balance Sheet Information [Abstract]
Components of other accrued liabilities	Other accrued liabilities consisted of the following: September 30, 2016 December 31, 2015 Systems rental and maintenance costs $ 1,522 $ 1,808 Site rental fees 1,177 1,121 Property and sales taxes payable 7,895 8,695 Self-insurance accrual 2,426 2,037 Legal fees 1,346 1,971 Deferred gain on sale of equipment 87 312 Equipment purchases 1,137 4,756 Contingent consideration related to acquisitions 705 5,750 Mandatorily redeemable noncontrolling interest 2,386 2,386 Other accrued liabilities 9,716 7,617 Total $ 28,397 $ 36,453
Plant, property and equipment, net	A summary of plant, property and equipment, net is presented below: September 30, 2016 December 31, 2015 Furniture and fixtures $ 4,852 $ 4,825 Office equipment 78,542 71,245 Transportation and service equipment 15,323 5,884 Major equipment 789,684 758,718 Tenant improvements 44,062 42,792 Buildings and land 340 340 932,803 883,804 Accumulated depreciation (726,207 ) (706,616 ) Plant, property and equipment, net $ 206,596 $ 177,188

Long-Term Debt and Senior Sub29

Long-Term Debt and Senior Subordinated Credit Facility (Tables)	9 Months Ended
	Sep. 30, 2016
Debt Disclosure [Abstract]
Components of long-term debt	Long-term debt consisted of the following: September 30, 2016 December 31, 2015 Term loan facility $ 498,974 $ 502,874 Discount on term loan facility (1,440 ) (1,823 ) Revolving credit facility 3,500 19,500 Equipment under capital leases 16,862 13,006 Equipment debt 42,641 44,128 Deferred financing costs, net (26,666 ) (6,594 ) Long-term debt, including current portion 533,871 571,091 Less current portion (21,445 ) (20,406 ) Long-term debt $ 512,426 $ 550,685

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2016
Summary Of Derivative Instruments [Abstract]
Summary of Interest Rate Cash Flow Hedges	The Company’s interest rate cash flow hedges consist of: Fair Value Asset (Liability) (1) Notional Amount Fixed Payment Rate Strike Rate Maturity Date September 30, 2016 December 31, 2015 Asset Derivatives Derivatives designated as cash flow hedging instruments: Interest rate cap on LIBOR, effective December 2013 (2) $ 250,000 N/A 2.50% December 2016 $ — $ — Total asset derivatives $ 250,000 $ — $ — Liability Derivatives Derivatives designated as cash flow hedging instruments: One-month LIBOR plus 2.50% interest rate swap, effective December 2012 $ 1,389 3.75% N/A December 2017 $ (6 ) $ (11 ) One-month LIBOR plus 2.00% interest rate swap, effective March 2013 1,392 2.87% N/A April 2018 (3 ) (2 ) One-month LIBOR interest rate swap, effective December 2014 1,089 1.34% N/A November 2019 (10 ) (7 ) One-month LIBOR plus 2.00% interest rate swap, effective December 2015 4,896 3.69% N/A December 2021 (102 ) (54 ) One-month LIBOR interest rate swap, effective December 2015 1,242 1.37% N/A December 2020 (14 ) (5 ) One-month LIBOR interest rate swap, effective September 2016 4,672 1.17% N/A September 2021 (35 ) — Derivatives not designated as cash flow hedging instruments: One-month LIBOR interest rate swap (3) 2,295 0.75% - 1.68% N/A April 2017 - April 2020 (10 ) (7 ) Total liability derivatives $ 16,975 $ (180 ) $ (86 ) (1) The fair values of the interest rate cap asset and interest rate swap liabilities are included in Other assets and Other accrued liabilities and Other liabilities, respectively, in the condensed consolidated balance sheets. (2) The Company paid $815 to enter into five interest rate cap agreements. The Company is amortizing the payment through Interest expense, net over the life of the agreements. (3) The Company acquired eight non-designated interest rate swaps (the “AHNI Swaps”) as a result of the step acquisition of AHNI. The changes in fair market value of the AHNI Swaps are recorded in Interest expense, net as incurred.
Effect of Designated Derivative Instruments on the Condensed Consolidated Statements of Income and Comprehensive Income	The following tables summarize the amount of income recognized from derivative instruments for the periods indicated and the line items in the accompanying condensed consolidated statements of income and comprehensive income where the results are recorded for cash flow hedges: Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion) Location of Loss Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Loss (Gain) 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 Income (Ineffective Portion) Three Months Ended September 30, Three Months Ended September 30, Three Months Ended September 30, 2016 2015 2016 2015 2016 2015 Interest rate contracts $ 24 $ (11 ) Interest expense, net $ 148 $ (7 ) Interest expense, net $ — $ — Total $ 24 $ (11 ) $ 148 $ (7 ) $ — $ — Amount of Loss Recognized in OCI on Derivatives (Effective Portion) Location of Loss Reclassified from Accumulated OCI into Income (Effective Portion) Amount of Loss Reclassified from Accumulated OCI into Income (Effective Portion) Location of Gain (Loss) Recognized in Income on Derivatives (Ineffective Portion) Amount of (Loss) Gain Recognized in Income on Derivatives Income (Ineffective Portion) Nine Months Ended September 30, Nine Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 2016 2015 Interest rate contracts $ (18 ) $ (219 ) Interest expense, net $ 236 $ 9 Interest expense, net $ (1 ) $ 1 Total $ (18 ) $ (219 ) $ 236 $ 9 $ (1 ) $ 1

Earnings Per Common Share (Tabl

Earnings Per Common Share (Tables)	9 Months Ended
	Sep. 30, 2016
Earnings Per Share [Abstract]
Computation of basic and diluted net income per share	The following table sets forth the computation of basic and diluted net income per share (amounts in thousands, except per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Numerator: Net income attributable to Alliance HealthCare Services, Inc. $ 1,358 $ 7,204 $ 2,627 $ 6,994 Denominator: Weighted-average shares-basic 10,888 10,716 10,850 10,715 Effect of dilutive securities: Stock options and RSUs 75 99 103 117 Weighted-average shares-diluted 10,963 10,815 10,953 10,832 Net income per common share attributable to Alliance HealthCare Services, Inc.: Basic $ 0.12 $ 0.67 $ 0.24 $ 0.65 Diluted $ 0.12 $ 0.67 $ 0.24 $ 0.65 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 553 392 513 379 Average exercise price per share that exceeds average market price of common stock $ 21.62 $ 30.07 $ 23.26 $ 30.35

Related-Party Transactions (Tab

Related-Party Transactions (Tables)	9 Months Ended
	Sep. 30, 2016
Related Party Transactions [Abstract]
Summary of Revenue and Reimbursed Expenses with Unconsolidated Equity Investees	The following table summarizes revenues from management agreements with unconsolidated equity investees: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Revenue from management agreements 348 1,191 1,053 5,778 The following table summarizes the revenue and reimbursed expenses related to the Company’s unconsolidated equity investees: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Revenue and reimbursed expenses 234 978 719 4,707

Investments in Unconsolidated33

Investments in Unconsolidated Investees (Tables)	9 Months Ended
	Sep. 30, 2016
Equity Method Investments And Joint Ventures [Abstract]
Schedule of financial data of unconsolidated investees, Balance Sheet Data	Set forth below are certain balance sheet data and operating results for the aggregate of the Company’s unconsolidated investees for the three and nine months ended September 30, 2016 and 2015. Operating results for AHNI are included for the three and nine months ended September 30, 2015: September 30, 2016 December 31, 2015 Balance sheet data: Current assets $ 2,777 $ 2,644 Noncurrent assets 124 273 Current liabilities 628 676 Noncurrent liabilities 33 35
Schedule of financial data of unconsolidated investees, Combined Operating Results	Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Operating results: Revenues $ 2,558 $ 3,788 $ 7,521 $ 16,894 Expenses 655 1,648 2,215 7,904 Net income 1,902 2,140 5,305 8,990 Earnings from unconsolidated investees 282 592 927 3,047

Stockholders' Deficit (Tables)

Stockholders' Deficit (Tables)	9 Months Ended
	Sep. 30, 2016
Stockholders Equity Note [Abstract]
Summary of stockholders' deficit, including noncontrolling interest	The following table summarizes consolidated stockholders’ deficit, including noncontrolling interest. Stockholders’ (Deficit) Equity Attributable to Common Stock Treasury Stock Additional Paid-In Accumulated Comprehensive (Accumulated Deficit) Retained Alliance HealthCare Non-controlling Total Stockholders’ (Deficit) Shares Amount Shares Amount Capital (Loss) Income Earnings Services, Inc. Interest Equity 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 — — — — 28,630 — — 28,630 — 28,630 Share-based payment — — — — 2,187 — — 2,187 — 2,187 Share-based payment income tax benefit — — — — 87 — — 87 — 87 Unrealized gain on hedging transaction, net of tax — — — — — 218 — 218 — 218 Noncontrolling interest assumed in connection with acquisitions (Note 3) — — — — — — — — 2,450 2,450 Distributions to noncontrolling interest in subsidiaries — — — — — — — — (18,045 ) (18,045 ) Contributions from noncontrolling interest in subsidiaries — — — — — — — — 1,113 1,113 Net income — — — — — — 2,627 2,627 12,791 15,418 Balance at September 30, 2016 10,896,524 $ 109 (157,973 ) $ (3,138 ) $ 60,815 $ (293 ) $ (195,766 ) $ (138,273 ) $ 93,326 $ (44,947 )

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2016
Segment Reporting [Abstract]
Summary of revenue by segment	The following table summarizes the Company’s revenue by segment: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Revenue: MRI revenue $ 49,887 $ 47,603 $ 146,212 $ 135,739 PET/CT revenue 31,936 32,248 95,701 96,392 Other radiology 6,904 6,433 19,999 20,534 Radiology 88,727 86,284 261,912 252,665 Oncology 26,271 25,224 78,162 74,740 Interventional 11,511 8,957 34,572 20,980 Corporate / Other 612 319 1,516 332 Total $ 127,121 $ 120,784 $ 376,162 $ 348,717
Summary of segment income	The following table summarizes the Company’s segment income: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Segment income: Radiology $ 30,310 $ 28,526 $ 85,556 $ 83,319 Oncology 13,307 12,661 38,024 37,005 Interventional 1,162 1,461 4,204 2,835 Corporate / Other (9,666 ) (8,786 ) (27,857 ) (25,166 ) Total $ 35,113 $ 33,862 $ 99,927 $ 97,993
Reconciliation of income before income taxes, earnings from unconsolidated investees, and noncontrolling interest to total segment income	The reconciliation of income before income taxes, earnings from unconsolidated investees, and noncontrolling interest to total segment income is shown below: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Income before income taxes, earnings from unconsolidated investees, and noncontrolling interest $ 7,407 $ 17,571 $ 17,628 $ 24,362 Earnings from unconsolidated investees 282 592 927 3,047 Interest expense, net 9,072 6,660 25,439 19,582 Depreciation expense 13,899 12,247 40,677 35,952 Amortization expense 2,556 2,377 7,493 6,907 Share-based payment (included in selling, general and administrative expenses) 407 423 2,650 1,242 Severance and related costs 762 277 3,186 731 Restructuring charges (Note 3) 284 216 1,635 707 Transaction costs 138 432 986 1,964 Shareholder transaction costs 1,009 — 3,516 — Impairment charges — 71 — 6,817 Legal matters expense, net (included in selling, general and administrative expenses) (88 ) 2,924 106 5,827 Changes in fair value of contingent consideration related to acquisitions (1,000 ) — (4,640 ) — Other non-cash charges, net (included in other income, net) 385 22 324 805 Non-cash gain on step acquisition (included in other income, net) — (9,950 ) — (9,950 ) Total segment income $ 35,113 $ 33,862 $ 99,927 $ 97,993
Summary of net income (loss) by segment	The following table summarizes the Company’s net income (loss) by segment: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Net income (loss): Radiology $ 19,172 $ 20,100 $ 53,998 $ 55,034 Oncology 3,814 4,047 15,335 7,442 Interventional 894 611 2,482 1,033 Corporate / Other (22,522 ) (17,554 ) (69,188 ) (56,515 ) Total $ 1,358 $ 7,204 $ 2,627 $ 6,994
Summary of identifiable assets by segment	The following table summarizes the Company’s identifiable assets by segment: September 30, December 31, 2016 2015 Identifiable assets: Radiology $ 292,236 $ 280,497 Oncology 202,121 213,698 Interventional 82,924 83,480 Corporate / Other 30,234 25,985 Total $ 607,515 $ 603,660
Summary of capital expenditures by segment	The following table summarizes the Company’s equipment capital expenditures by segment: Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Capital expenditures: Radiology $ 18,200 $ 10,075 $ 48,875 $ 25,734 Oncology 400 1,183 2,838 10,394 Interventional 58 183 111 183 Corporate / Other 344 267 1,153 3,071 Total $ 19,002 $ 11,708 $ 52,977 $ 39,382

Recent Accounting Pronounceme36

Recent Accounting Pronouncements - Additional Information (Details) $ in Thousands	Dec. 31, 2015USD ($)
Accounting Standards Update 201503 | Offset Long-term Debt, Net of Current Portion
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Impact of reclassification due to adoption of new accounting pronouncement	$ 6,594
Accounting Standards Update 201503 | Deferred Financing Costs Net
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Impact of reclassification due to adoption of new accounting pronouncement	(6,594)
Accounting Standards Update 201517 | Long Term Deferred Tax Liabilities
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Impact of reclassification due to adoption of new accounting pronouncement	6,496
Accounting Standards Update 201517 | Deferred Tax Assets
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Impact of reclassification due to adoption of new accounting pronouncement	$ (6,496)

Acquisitions and Transactions -

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

May 19, 2016USD ($)Site

Dec. 31, 2015USD ($)

Oct. 14, 2015USD ($)Location

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

Aug. 01, 2015USD ($)

Feb. 17, 2015USD ($)Location

Sep. 30, 2016USD ($)

Sep. 30, 2015USD ($)

Sep. 30, 2016USD ($)

Sep. 30, 2015USD ($)

Dec. 31, 2015USD ($)

Mar. 29, 2016

Jul. 31, 2015

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Payments to acquire businesses, net of cash

$ 6,659

$ 22,657

Goodwill

$ 102,782

$ 105,239

105,239

$ 102,782

Contingent consideration related to acquisition

5,750

705

705

5,750

Contingent consideration paid

$ 825

0

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Percentage of ownership from investees (percent)

46.60%

American Health Centers, Inc. ("AHC")

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Sites acquired, effective date

May 19, 2016

Payments to acquire businesses, net of cash

$ 4,209

Goodwill

335

Identifiable intangible assets

$ 1,940

Goodwill and intangible assets tax amortization period

15 years

Net revenue generated from acquisition

936

$ 1,573

Net income (loss) generated from acquisition

382

651

Contingent consideration performance period (in months)

18 months

Contingent consideration related to acquisition

$ 420

405

405

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Identifiable intangible assets

$ 1,600

Useful life

15 years

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Identifiable intangible assets

$ 340

Useful life

5 years

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Number of sites acquired | Site

8

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Number of sites acquired | Site

5

Pacific Cancer Institute Inc (PCI)

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Payments to acquire businesses, net of cash

11,013

Goodwill

$ 6,505

$ 6,505

Goodwill and intangible assets tax amortization period

15 years

Net revenue generated from acquisition

1,285

3,999

Net income (loss) generated from acquisition

(21)

198

Contingent consideration performance period (in months)

12 months

Ownership interest, percentage acquired

95.00%

95.00%

Intangible assets

$ 8,800

$ 8,800

Pacific Cancer Institute Inc (PCI) | Minimum

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Useful life

5 years

Pacific Cancer Institute Inc (PCI) | Maximum

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Useful life

15 years

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

1,800

$ 1,800

Pacific Cancer Institute Inc (PCI) | Trademarks

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

950

950

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

5,400

5,400

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

$ 650

$ 650

AHIP Florida LLC

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Payments to acquire businesses, net of cash

$ 15,014

Goodwill

$ 8,234

Goodwill and intangible assets tax amortization period

15 years

Net revenue generated from acquisition

3,389

9,986

Net income (loss) generated from acquisition

414

1,160

Contingent consideration performance period (in months)

12 months

Contingent consideration related to acquisition

150

150

Ownership interest, percentage acquired

60.00%

Intangible assets

$ 15,600

Number of locations operated by entity | Location

8

Cash acquired

$ 264

Percentage of noncontrolling interest allowed to sell to the Company

10.00%

AHIP Florida LLC | Minimum

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Useful life

5 years

AHIP Florida LLC | Maximum

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Useful life

15 years

AHIP Florida LLC | Physician Referral Network Intangible Assets

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

$ 12,100

AHIP Florida LLC | Trademarks

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

1,700

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

$ 1,800

Alliance HNI LLC

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Goodwill

$ 2,988

Useful life

15 years

Intangible assets

$ 13,700

Ownership interest, percentage acquired

15.50%

Equity interest in acquiree, percentage

50.00%

50.00%

50.00%

Ownership interest by parent

65.50%

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Equity interest in acquiree, percentage

98.00%

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Equity interest in acquiree, percentage

53.40%

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

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Equity interest in acquiree, percentage

53.30%

The Pain Center of Arizona

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Payments to acquire businesses, net of cash

$ 24,087

Goodwill

$ 22,566

Useful life

20 years

Goodwill and intangible assets tax amortization period

15 years

Net revenue generated from acquisition

7,830

$ 8,957

23,623

20,980

Net income (loss) generated from acquisition

$ (714)

$ 804

(1,770)

$ 1,095

Contingent consideration performance period (in months)

12 months

Ownership interest, percentage acquired

59.00%

Intangible assets

$ 24,600

Number of locations operated by entity | Location

12

Cash acquired

$ 234

Accounts receivable extinguishment, related parties

3,071

Noncontrolling interest, fair value

20,598

Contingent consideration paid

$ 810

The Pain Center of Arizona | Physician Referral Network Intangible Assets

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

13,500

The Pain Center of Arizona | Trademarks

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Intangible assets

$ 11,100

Fujian Thai Hot Oaktree M T S And Larry C Buckelew

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Percentage of fees and expenses incurred by the Company in connection with the credit agreement that are attributable to Thai Hot and Selling Stockholders

100.00%

Threshold above which reasonable and documented fees and expenses are attributable to Thai Hot and Selling Stockholders

$ 1,000

Oaktree M T S And Larry C Buckelew

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Capital contributions

15,343

Capital contributions, taxes

$ 213

Fujian Thai Hot Investment Co Ltd

Schedule of Business Acquisitions and Restructuring Transactions [Line Items]

Number of shares acquired from Selling Stockholders | shares

5,537,945

Consideration transferred

$ 102,500

Stock price per share | $ / shares

$ 18.50

Issuance of cash-based awards under management incentive agreement

$ 1,500

Capital contributions

$ 13,500

Ownership interest, percentage acquired

51.50%

Acquisitions and Transactions38

Acquisitions and Transactions - Recognized Identifiable Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2016	May 19, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 105,239		$ 102,782
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 Transactions39

Acquisitions and Transactions - Schedule of Pro Forma Operating Result of Acquisition (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Acquisitions And Transactions [Abstract]
Revenues	$ 127,078	$ 376,842	$ 373,844
Net income attributable to Alliance HealthCare Services, Inc.	$ 8,168	$ 2,914	$ 9,629
Basic earnings per share	$ 0.76	$ 0.27	$ 0.90
Diluted earnings per share	$ 0.76	$ 0.27	$ 0.89

Acquisitions and Transactions40

Acquisitions and Transactions - Restructuring Charges (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Restructuring Cost And Reserve [Line Items]
Restructuring charges	$ 284	$ 216	$ 1,635	$ 707
Cost of Revenues Excluding Depreciation and Amortization
Restructuring Cost And Reserve [Line Items]
Restructuring charges	172	176	925	572
Selling, General and Administrative Expenses
Restructuring Cost And Reserve [Line Items]
Restructuring charges	45	40	143	135
Other Expense, Net
Restructuring Cost And Reserve [Line Items]
Restructuring charges	$ 67	$ 0	$ 567	$ 0

Share-Based Payment - Textual (

Share-Based Payment - Textual (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended			9 Months Ended	12 Months Ended
	Sep. 30, 2016	Mar. 31, 2016	Sep. 30, 2014	Sep. 30, 2016	Dec. 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)	1,024,866			1,024,866		3,005,000
Options accelerated due to employment agreements vesting (shares)		71,057			0
Cash right paid				$ 463
Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of awards granted, in shares				85,206
Restricted Stock Units (RSUs) | Executive Management
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of awards granted, in shares			25,000
Minimum market price that must be achieved (per share)				$ 40
Duration of minimum market price				10 days
Fujian Thai Hot Investment Co Ltd | Restricted Stock Units (RSUs) | Executive Management
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 the transaction	$ 18.50			$ 18.50
Cash right paid	$ 463

Share-Based Payment - Weighted

Share-Based Payment - Weighted Average Assumptions for Fair Value of Stock Options (Details) - $ / shares	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Weighted average assumptions for stock option awards
Risk free interest rate	1.53%	1.65%
Expected dividend yield	0.00%	0.00%
Expected stock price volatility	66.50%	65.20%
Average expected life (in years)	6 years	6 years
Weighted average fair value on grant date	$ 4.32	$ 14.25

Share-Based Payment - Stock Opt

Share-Based Payment - Stock Option Activity (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)$ / sharesshares
Number of Shares
Beginning balance | shares	646,290
Granted | shares	200,388
Exercised | shares	(121,667)
Canceled/forfeited | shares	(64,798)
Ending balance | shares	660,213
Vested and expected to vest in the future | shares	618,096
Vested and exercisable | shares	415,540
Weighted - Average Exercise Price
Beginning balance | $ / shares	$ 19.91
Granted | $ / shares	7.16
Exercised | $ / shares	5.05
Canceled | $ / shares	24
Ending balance | $ / shares	18.37
Vested and expected to vest in the future | $ / shares	19.08
Vested and exercisable | $ / shares	$ 22.41
Weighted - Average Remaining Contractual Term
Outstanding	6 years 5 months 5 days
Vested and expected to vest in the future	6 years 2 months 23 days
Vested and exercisable	4 years 11 months 5 days
Aggregate Intrinsic Value
Exercised | $	$ 1,386	[1]
Outstanding | $	114	[1]
Vested and expected to vest in the future | $	114	[1]
Vested and exercisable | $	$ 114	[1]
[1]	Represents the difference between the exercise price and the value of the Company’s stock at the time of exercise, for exercised grants. For outstanding awards, represents the difference between the exercise price and the value of the Company’s stock at fiscal quarter-end.

Share-Based Payment - Unvested

Share-Based Payment - Unvested Stock Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Shares
Beginning balance	158,671
Granted	200,388
Vested	(107,613)
Forfeited	(6,773)
Ending balance	244,673
Weighted Average Grant - Date Fair Value
Beginning balance	$ 15.01
Granted	4.32	$ 14.25
Vested	14.01
Forfeited	7.34
Ending balance	$ 6.91
Total fair value - vested	$ 1,508
Employee Stock Option
Weighted Average Grant - Date Fair Value
Aggregate unrecognized compensation	$ 786
Weighted average period over which expected to be recognized (in years)	2 years

Share-Based Payment - Restricte

Share-Based Payment - Restricted Stock Unit Activity (Details) - Restricted stock units $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)$ / sharesshares
Summary of restricted stock unit activity
Beginning balance, unvested (shares) | shares	74,413
Granted (shares) | shares	85,206
Vested (shares) | shares	0
Forfeited (shares) | shares	(2,577)
Ending balance, unvested (shares) | shares	157,042
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, weighted-average grant-date fair value (dollars per share) | $ / shares	$ 9.18
Granted, weighted-average grant-date fair value (dollars per share) | $ / shares	6.93
Vested, weighted-average grant-date fair value (dollars per share) | $ / shares	0
Forfeited, weighted-average grant-date fair value (dollars per share) | $ / shares	6.93
Ending balance, unvested, weighted-average grant-date fair value (dollars per share) | $ / shares	$ 7.85
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized [Abstract]
Aggregate unrecognized compensation | $	$ 540
Unvested, weighted average period over which expected to be recognized	2 years 6 months

Share-Based Payments - Summary

Share-Based Payments - Summary of Pre-Tax, Share-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016		Sep. 30, 2015
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 407	$ 423	$ 2,650		$ 1,242
Selling, General and Administrative Expenses
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 407	$ 423	$ 2,650	[1]	$ 1,242
[1]	Includes Cash Right of $463.

Share-Based Payments - Summar47

Share-Based Payments - Summary of Pre-Tax, Share-Based Compensation Expense (Parenthetical) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)
Share Based Compensation [Abstract]
Cash right paid	$ 463

Fair Value of Financial Instr48

Fair Value of Financial Instruments - Summary of Valuation of Financial Instruments Reported at Fair Value on a Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Financial liabilities:
Contingent consideration related to acquisitions	$ 705	$ 5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Recurring basis
Financial liabilities:
Contingent consideration related to acquisitions	705	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Total financial liabilities	3,271	8,222
Recurring basis | Level 1
Financial liabilities:
Contingent consideration related to acquisitions	0	0
Mandatorily redeemable noncontrolling interest	0	0
Total financial liabilities	0	0
Recurring basis | Level 2
Financial liabilities:
Contingent consideration related to acquisitions	0	0
Mandatorily redeemable noncontrolling interest	0	0
Total financial liabilities	180	86
Recurring basis | Level 3
Financial liabilities:
Contingent consideration related to acquisitions	705	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Total financial liabilities	3,091	8,136
Recurring basis | Interest rate contracts
Financial liabilities:
Interest rate contracts - liability position	180	86
Recurring basis | Interest rate contracts | Level 1
Financial liabilities:
Interest rate contracts - liability position	0	0
Recurring basis | Interest rate contracts | Level 2
Financial liabilities:
Interest rate contracts - liability position	180	86
Recurring basis | Interest rate contracts | Level 3
Financial liabilities:
Interest rate contracts - liability position	$ 0	$ 0

Fair Value of Financial Instr49

Fair Value of Financial Instruments - Schedule of Changes in Fair Value of Level 3 Liabilities (Details) - Level 3 $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)
Contingent Consideration Related to Acquisitions
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Balance at December 31, 2015	$ 5,750
Additions to earn-out obligations	420	[1]
Settlement of contingent consideration related to acquisitions	(825)
Fair value adjustment	(4,640)	[2]
Balance at September 30, 2016	705
Mandatorily Redeemable Noncontrolling Interest
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Balance at December 31, 2015	2,386
Additions to earn-out obligations	0	[1]
Settlement of contingent consideration related to acquisitions	0
Fair value adjustment	0	[2]
Balance at September 30, 2016	$ 2,386
[1]	See Note 3.
[2]	Adjustments to the estimated fair value of the contingent consideration is related to the actual versus expected performance of acquisitions and are reported in Other income, net.

Fair Value of Financial Instr50

Fair Value of Financial Instruments - Summary of Financial Instruments Measured and Recorded at Fair Value on a Recurring Basis (Details) - Recurring basis - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Financial liabilities:
Other accrued liabilities	$ 3,189	$ 8,139
Other liabilities	82	83
Total financial liabilities	3,271	8,222
Level 1
Financial liabilities:
Other accrued liabilities	0	0
Other liabilities	0	0
Total financial liabilities	0	0
Level 2
Financial liabilities:
Other accrued liabilities	98	3
Other liabilities	82	83
Total financial liabilities	180	86
Level 3
Financial liabilities:
Other accrued liabilities	3,091	8,136
Other liabilities	0	0
Total financial liabilities	$ 3,091	$ 8,136

Fair Value of Financial Instr51

Fair Value of Financial Instruments - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Transfers in or out of Level 1, Level 2 or Level 3 financial instruments	$ 0
Level 2 | Fixed Rate Debt
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fixed-rate debt, fair value	41,954	$ 40,262
Fixed-rate debt, book value	40,919	40,667
Level 2 | Variable Rate Debt
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fixed-rate debt, fair value	521,337	538,520
Fixed-rate debt, book value	$ 519,618	$ 537,018

Goodwill and Intangible Asset52

Goodwill and Intangible Assets - Changes in the Carrying Amount of Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2016USD ($)
Goodwill [Line Items]
Balance at December 31, 2015	$ 102,782
Goodwill acquired during the period	1,414
Adjustments to goodwill during the period	1,043
Balance at September 30, 2016	105,239
Gross goodwill	279,483
Accumulated impairment charges	(174,244)
Radiology
Goodwill [Line Items]
Balance at December 31, 2015	44,822
Goodwill acquired during the period	335
Balance at September 30, 2016	45,157
Gross goodwill	199,499
Accumulated impairment charges	(154,342)
Oncology
Goodwill [Line Items]
Balance at December 31, 2015	27,589
Goodwill acquired during the period	225
Adjustments to goodwill during the period	615
Balance at September 30, 2016	28,429
Gross goodwill	48,331
Accumulated impairment charges	(19,902)
Interventional
Goodwill [Line Items]
Balance at December 31, 2015	30,371
Goodwill acquired during the period	854
Adjustments to goodwill during the period	428
Balance at September 30, 2016	31,653
Gross goodwill	31,653
Accumulated impairment charges	$ 0

Goodwill and Intangible Asset53

Goodwill and Intangible Assets - Components of Intangible Assets (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Amortizing intangible assets:
Gross carrying amount	$ 231,734	$ 224,838
Accumulated amortization	(120,313)	(112,820)
Amortizing intangible assets, net	111,421	112,018
Intangible assets not subject to amortization	50,905	50,905
Total other intangible assets	$ 162,326	162,923
Customer contracts
Amortizing intangible assets:
Estimated useful life	15 years
Gross carrying amount	$ 192,720	186,316
Accumulated amortization	(98,561)	(92,280)
Amortizing intangible assets, net	$ 94,159	94,036
Other
Amortizing intangible assets:
Estimated useful life	11 years
Gross carrying amount	$ 39,014	38,522
Accumulated amortization	(21,752)	(20,540)
Amortizing intangible assets, net	$ 17,262	$ 17,982

Goodwill and Intangible Asset54

Goodwill and Intangible Assets - Textual (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Goodwill And Intangible Assets Disclosure [Abstract]
Impairment of intangible assets	$ 0	$ 71	$ 0	$ 6,817
Amortization expense	$ 2,556	$ 2,377	$ 7,493	$ 6,907

Goodwill and Intangible Asset55

Goodwill and Intangible Assets - Estimated Future Amortization Expense (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Finite-Lived Intangible Assets, Net [Abstract]
Remainder of 2016	$ 2,517
2,017	9,798
2,018	9,420
2,019	8,931
2,020	8,415
Thereafter	72,340
Amortizing intangible assets, net	$ 111,421	$ 112,018

Supplemental Balance Sheet In56

Supplemental Balance Sheet Information- Components of Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Components of other accrued liabilities
Systems rental and maintenance costs	$ 1,522	$ 1,808
Site rental fees	1,177	1,121
Property and sales taxes payable	7,895	8,695
Self-insurance accrual	2,426	2,037
Legal fees	1,346	1,971
Deferred gain on sale of equipment	87	312
Equipment purchases	1,137	4,756
Contingent consideration related to acquisitions	705	5,750
Mandatorily redeemable noncontrolling interest	2,386	2,386
Other accrued liabilities	9,716	7,617
Total	$ 28,397	$ 36,453

Supplemental Balance Sheet In57

Supplemental Balance Sheet Information - Plant ,Property and Equipment Net (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	$ 932,803	$ 883,804
Accumulated depreciation	(726,207)	(706,616)
Plant, property and equipment, net	206,596	177,188
Furniture and fixtures
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	4,852	4,825
Office equipment
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	78,542	71,245
Transportation and service equipment
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	15,323	5,884
Major equipment
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	789,684	758,718
Tenant improvements
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	44,062	42,792
Buildings and land
Property Plant And Equipment [Line Items]
Plant, property and equipment, gross	$ 340	$ 340

Long-Term Debt and Senior Sub58

Long-Term Debt and Senior Subordinated Credit Facility - Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Deferred financing costs, net	$ (26,666)	$ (6,594)
Long-term debt, including current portion	533,871	571,091
Less current portion	(21,445)	(20,406)
Long-term debt	512,426	550,685
Term Loan Facility
Debt Instrument [Line Items]
Long-term debt, gross	498,974	502,874
Discount on term loan facility	(1,440)	(1,823)
Revolving Credit Facility
Debt Instrument [Line Items]
Revolving credit facility	3,500	19,500
Equipment Under Capital Leases
Debt Instrument [Line Items]
Long-term debt, gross	16,862	13,006
Equipment Debt
Debt Instrument [Line Items]
Long-term debt, gross	$ 42,641	$ 44,128

Long-Term Debt and Senior Sub59

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	9.00%
Maximum | Capital Leases
Debt Instrument [Line Items]
Stated percentage rate range	13.97%

Long-Term Debt and Senior Sub60

Long-Term Debt and Senior Subordinated Credit Facility - Credit Facility and Senior Secured Term Loan Refinancing - Additional Information (Details)	Jun. 03, 2013USD ($)	Jun. 01, 2013	Sep. 30, 2016	Jul. 03, 2013USD ($)
Debt Instrument [Line Items]
Debt instrument, interest rate terms			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.
Senior Notes
Debt Instrument [Line Items]
Senior Notes, face amount	$ 190,000,000
Stated percentage rate range	8.00%
Principal amount of debt repurchased				$ 80,000,000
New Credit Agreement
Debt Instrument [Line Items]
Ownership percentage of subsidiaries	50.00%
New Credit Agreement | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	1.00%
Debt description of variable rate basis			one-month LIBOR
New Credit Agreement | Maximum
Debt Instrument [Line Items]
Debt, leverage ratio	3.25
New Credit Agreement | Term Loan Facility
Debt Instrument [Line Items]
Period of initial quarterly amortization payments required	5 years 6 months
Quarterly amortization payments	$ 1,050,000
New Credit Agreement | Term Loan Facility | Maximum
Debt Instrument [Line Items]
Debt, leverage ratio			4.55
Covenant ratio of consolidated total debt to Consolidated Adjusted EBITDA			4.95%
New Credit Agreement | Term Loan Facility | Minimum
Debt Instrument [Line Items]
Covenant ratio of consolidated total debt to Consolidated Adjusted EBITDA			4.30%
Term Loan Facility | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity				$ 340,000,000
Term Loan Facility | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 340,000,000
Debt term	6 years
Covenant ratio of consolidated total debt to Consolidated Adjusted EBITDA			4.13%
Term Loan Facility | New Credit Agreement | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	2.25%
Term Loan Facility | New Credit Agreement | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	3.25%
Term Loan Facility | New Credit Agreement | Minimum | LIBOR
Debt Instrument [Line Items]
LIBOR floor	1.00%
New Revolving Credit Facility | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 50,000,000
Debt term	5 years
New Revolving Credit Facility | New Credit Agreement | Maximum
Debt Instrument [Line Items]
Commitment fee, percentage	0.50%
New Revolving Credit Facility | New Credit Agreement | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	2.25%
New Revolving Credit Facility | New Credit Agreement | Maximum | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	3.25%
New Revolving Credit Facility | New Credit Agreement | Minimum
Debt Instrument [Line Items]
Commitment fee, percentage	0.38%
New Revolving Credit Facility | New Credit Agreement | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate	2.00%
New Revolving Credit Facility | New Credit Agreement | Minimum | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	3.00%
LIBOR floor	1.00%
Letter of Credit | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 20,000,000
Uncommitted Incremental Loan Facility | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity	100,000,000
Delayed Draw | New Credit Agreement
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 80,000,000
Required draw period	30 days
Prior Credit Facility | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate		4.25%
Prior Credit Facility | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate		5.25%
Prior Credit Facility | Minimum | LIBOR
Debt Instrument [Line Items]
LIBOR floor		2.00%

Long-Term Debt and Senior Sub61

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. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015	Dec. 02, 2013	Oct. 11, 2013
Debt Instrument [Line Items]
Amount of fees paid, which were capitalized and amortized as interest expense					$ 25,493,000	$ 801,000
Committed Incremental Term Loan
Debt Instrument [Line Items]
Credit facility borrowing capacity		$ 30,000,000
New Revolving Credit Facility
Debt Instrument [Line Items]
Maturity date					Jun. 3, 2018
Credit facility, available borrowings					$ 42,100,000
Revolving credit facility					3,500,000		$ 19,500,000
Term Loan Facility
Debt Instrument [Line Items]
Debt, carrying value					$ 498,974,000		$ 502,874,000
Maturity date					Jun. 3, 2019
Letter of Credit
Debt Instrument [Line Items]
Debt, carrying value					$ 4,400,000
First Amendment to New Credit Agreement | Committed Incremental Term Loan
Debt Instrument [Line Items]
Credit facility borrowing capacity									$ 70,000,000
Debt, carrying value								$ 70,000,000
Second Amendment to New Credit Agreement | Committed Incremental Term Loan
Debt Instrument [Line Items]
Principal amount funded (percent)		99.50%
Second Amendment to New Credit Agreement | Term Loan Facility
Debt Instrument [Line Items]
Quarterly amortization payments				$ 1,300,000
New Credit Agreement | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate			1.00%
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%
New Credit Agreement | Committed Incremental Term Loan | Minimum | LIBOR
Debt Instrument [Line Items]
LIBOR floor		1.00%
New Credit Agreement | New Revolving Credit Facility
Debt Instrument [Line Items]
Credit facility borrowing capacity			$ 50,000,000
New Credit Agreement | New Revolving Credit Facility | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate			2.00%
New Credit Agreement | New Revolving Credit Facility | Minimum | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate			3.00%
LIBOR floor			1.00%
New Credit Agreement | Term Loan Facility
Debt Instrument [Line Items]
Credit facility borrowing capacity			$ 340,000,000
Covenant ratio of consolidated total debt to Consolidated Adjusted EBITDA					4.13%
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%
New Credit Agreement | Term Loan Facility | Minimum | LIBOR
Debt Instrument [Line Items]
LIBOR floor			1.00%
New Credit Agreement | Letter of Credit
Debt Instrument [Line Items]
Credit facility borrowing capacity			$ 20,000,000
Third Amendment to New Credit Agreement
Debt Instrument [Line Items]
Percentage of premium on prepayment of term loan	1.00%
Amount of fees paid, which were capitalized and amortized as interest expense	$ 25,000,000

Long-Term Debt and Senior Sub62

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	9 Months Ended
	Sep. 30, 2016USD ($)
Debt Instrument [Line Items]
Notes payable	$ 9,438,000
Minimum
Debt Instrument [Line Items]
Stated percentage rate range	1.93%
Maximum
Debt Instrument [Line Items]
Stated percentage rate range	2.05%
Line of Credit [Member]
Debt Instrument [Line Items]
Credit facility borrowing capacity	$ 4,700,000
Revolving credit facility	$ 0
Line of Credit [Member] | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	1.40%

Derivatives - Textual (Details)

Derivatives - Textual (Details) - Interest Rate Cash Flow Hedges - Variable Rate Debt - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Derivative [Line Items]
Amount of hedged debt	$ 266,975	$ 265,879
Hedged debt as a percent of total debt (percent)	47.60%	46.00%
Expected reclassification from unrealized gain (loss) on hedging transactions net of taxes to interest expense, net	$ 300

Derivatives - Summary of Intere

Derivatives - Summary of Interest Rate Cash Flow Hedges (Details) - USD ($)		9 Months Ended
		Sep. 30, 2016	Dec. 31, 2015
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount		$ 16,975,000
Fair Value Asset (Liability)	[1]	(180,000)	$ (86,000)
Derivatives designated as hedging instruments
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Notional Amount		250,000,000
Fair Value Asset (Liability)	[1]	0	0
Derivatives designated as hedging instruments | Interest Rate Cap
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Notional Amount	[2]	$ 250,000,000
Derivative, Strike Rate	[2]	2.50%
Derivative, Maturity Date	[2]	Dec. 31, 2016
Fair Value Asset (Liability)	[1],[2]	$ 0	0
Derivatives designated as hedging instruments | Interest Rate Swap Effective December2012
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date		Dec. 14, 2017
Derivative Liability, Notional Amount		$ 1,389,000
Derivative, Fixed Payment Rate		3.75%
Fair Value Asset (Liability)	[1]	$ (6,000)	(11,000)
Derivatives designated as hedging instruments | Interest Rate Swap Effective March2013
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date		Apr. 1, 2018
Derivative Liability, Notional Amount		$ 1,392,000
Derivative, Fixed Payment Rate		2.87%
Fair Value Asset (Liability)	[1]	$ (3,000)	(2,000)
Derivatives designated as hedging instruments | Interest Rate Swap Effective December2014
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date		Nov. 30, 2019
Derivative Liability, Notional Amount		$ 1,089,000
Derivative, Fixed Payment Rate		1.34%
Fair Value Asset (Liability)	[1]	$ (10,000)	(7,000)
Derivatives designated as hedging instruments | Interest Rate Swap Effective December2015
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date		Dec. 1, 2021
Derivative Liability, Notional Amount		$ 4,896,000
Derivative, Fixed Payment Rate		3.69%
Fair Value Asset (Liability)	[1]	$ (102,000)	(54,000)
Derivatives designated as hedging instruments | Interest Rate Swap Two Effective December2015
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date		Dec. 15, 2020
Derivative Liability, Notional Amount		$ 1,242,000
Derivative, Fixed Payment Rate		1.37%
Fair Value Asset (Liability)	[1]	$ (14,000)	(5,000)
Derivatives designated as hedging instruments | Interest Rate Swap Effective September2016
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date		Sep. 30, 2021
Derivative Liability, Notional Amount		$ 4,672,000
Derivative, Fixed Payment Rate		1.17%
Fair Value Asset (Liability)	[1]	$ (35,000)	0
Derivatives not designated hedging instruments | Interest Rate Swap
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount	[3]	2,295,000
Fair Value Asset (Liability)	[1],[3]	$ (10,000)	$ (7,000)
Derivatives not designated hedging instruments | Interest Rate Swap | Minimum
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date	[3]	Apr. 7, 2017
Derivative, Fixed Payment Rate	[3]	0.75%
Derivatives not designated hedging instruments | Interest Rate Swap | Maximum
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Derivative, Maturity Date	[3]	Apr. 23, 2020
Derivative, Fixed Payment Rate	[3]	1.68%
[1]	The fair values of the interest rate cap asset and interest rate swap liabilities are included in Other assets and Other accrued liabilities and Other liabilities, respectively, in the condensed consolidated balance sheets.
[2]	The Company paid $815 to enter into five interest rate cap agreements. The Company is amortizing the payment through Interest expense, net over the life of the agreements.
[3]	The Company acquired eight non-designated interest rate swaps (the “AHNI Swaps”) as a result of the step acquisition of AHNI. The changes in fair market value of the AHNI Swaps are recorded in Interest expense, net as incurred.

Derivatives - Summary of Inte65

Derivatives - Summary of Interest Rate Cash Flow Hedges (Parenthetical) (Details) $ in Thousands	3 Months Ended
	Dec. 31, 2013USD ($)	Sep. 30, 2016Agreementinterest_swaps
Interest Rate Cap
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Paid for cap purchase amortized as interest expense | $	$ 815
Interest Rate Cap | Interest Rate Cash Flow Hedges
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Number of agreements | Agreement		5
Derivatives designated as hedging instruments | LIBOR | Interest Rate Swap Effective December2012
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Interest rate agreement, basis spread on variable rate (percent)		2.50%
Derivatives designated as hedging instruments | LIBOR | Interest Rate Swap Effective March2013
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Interest rate agreement, basis spread on variable rate (percent)		2.00%
Derivatives designated as hedging instruments | LIBOR | Interest Rate Swap One Effective December2015
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Interest rate agreement, basis spread on variable rate (percent)		2.00%
Derivatives not designated hedging instruments | AHNI swaps
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Number of interest swaps | interest_swaps		8

Derivatives - Impact on Stateme

Derivatives - Impact on Statement of Income and Comprehensive Income (Details) - Derivatives designated as hedging instruments - Derivatives in Cash Flow Hedging Relationships - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion)	$ 24	$ (11)	$ (18)	$ (219)
Amount of Loss (Gain) Reclassified from Accumulated OCI into Income (Effective Portion)	148	(7)	236	9
Amount of Gain (Loss) Recognized in Income on Derivatives Income (Ineffective Portion)			(1)	1
Interest rate contracts
Derivative Instruments Gain Loss [Line Items]
Amount of Gain (Loss) Recognized in OCI on Derivatives (Effective Portion)	24	(11)	(18)	(219)
Interest rate contracts | Interest expense, net
Derivative Instruments Gain Loss [Line Items]
Amount of Loss (Gain) Reclassified from Accumulated OCI into Income (Effective Portion)	148	(7)	236	9
Amount of Gain (Loss) Recognized in Income on Derivatives Income (Ineffective Portion)	$ 0	$ 0	$ (1)	$ 1

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income tax expense	$ 1,862	$ 5,098	$ 3,137	$ 5,304
Income tax expense (percentage)	57.80%	41.40%	54.40%	43.10%
Unrecognized tax benefits related to various federal and state income tax matters	$ 239		$ 239		$ 229
Tax-effected amount that would reduce the Company's effective income tax rate if recognized	195		195		192
Accrued interest and penalties related to unrecognized tax benefits	$ 9		$ 9		$ 10

Earnings Per Common Share (Deta

Earnings Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Numerator:
Net income attributable to Alliance HealthCare Services, Inc.	$ 1,358	$ 7,204	$ 2,627	$ 6,994
Denominator:
Weighted-average shares-basic (shares)	10,888	10,716	10,850	10,715
Effect of dilutive securities:
Stock options and RSUs (shares)	75	99	103	117
Weighted-average shares-diluted (shares)	10,963	10,815	10,953	10,832
Net income per common share attributable to Alliance HealthCare Services, Inc.:
Basic (dollars per share)	$ 0.12	$ 0.67	$ 0.24	$ 0.65
Diluted (dollars per share)	$ 0.12	$ 0.67	$ 0.24	$ 0.65
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	553	392	513	379
Average exercise price per share that exceeds average market price of common stock (dollars per share)	$ 21.62	$ 30.07	$ 23.26	$ 30.35

Commitments and Contingencies -

Commitments and Contingencies - Textual (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Commitments and Contingencies [Line Items]
Maintenance contracts with equipment vendors, expiration year			2,022
Equipment maintenance contract payments	$ 10,041,000	$ 10,046,000	$ 30,303,000	$ 29,825,000
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	$ 15,699,000		$ 15,699,000

Related-Party Transactions - Ad

Related-Party Transactions - Additional Information (Details) $ / shares in Units, $ in Thousands	Sep. 16, 2015USD ($)$ / sharesshares	Sep. 30, 2016unconsolidated_investee	Mar. 29, 2016	Dec. 31, 2015unconsolidated_investee	Apr. 16, 2007shares
Related Party Transaction [Line Items]
Number of unconsolidated entities with direct ownership (investee) | unconsolidated_investee		2		2
Oaktree and MTS
Related Party Transaction [Line Items]
Shares purchased by Oaktree and MTS (shares) | shares					4,900,301
Ownership interest, percentage acquired				51.00%	50.00%
Thai Hot
Related Party Transaction [Line Items]
Shares purchased by Oaktree and MTS (shares) | shares	5,537,945
Ownership interest, percentage acquired			51.50%
Consideration transferred	$ 102,500
Stock price per share | $ / shares	$ 18.50
Issuance of cash-based awards under management incentive agreement	$ 1,500
Capital contributions	$ 13,500
Fujian Thai Hot Oaktree M T S And Larry C Buckelew
Related Party Transaction [Line Items]
Percentage of fees and expenses incurred by the Company in connection with the credit agreement that are attributable to Thai Hot and Selling Stockholders	100.00%
Threshold above which reasonable and documented fees and expenses are attributable to Thai Hot and Selling Stockholders	$ 1,000
Oaktree M T S And Larry C Buckelew
Related Party Transaction [Line Items]
Capital contributions	15,343
Potential tax impact of the credit amendment costs incurred by the Company and reimbursed by the Selling Stockholders	$ 1,500
Potential tax impact of the credit amendment costs incurred by the Company and reimbursed by the Selling Stockholders, description		In addition, the Selling Stockholders provided $1,500 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 per the agreement.

Related-Party Transactions - Su

Related-Party Transactions - Summary of Revenue and Reimbursed Expenses with Unconsolidated Equity Investees (Details) - Equity Method Investee - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Related Party Transaction [Line Items]
Revenue from management agreements	$ 348	$ 1,191	$ 1,053	$ 5,778
Revenue and reimbursed expenses	$ 234	$ 978	$ 719	$ 4,707

Investments in Unconsolidated72

Investments in Unconsolidated Investees - Textual (Details) - unconsolidated_investee	9 Months Ended
	Sep. 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
Alliance HNI LLC
Schedule Of Equity Method Investments [Line Items]
Ownership interest, percentage acquired			15.50%
Percentage of ownership in unconsolidated investee after step acquisition (percent)			65.50%
Unconsolidated Subsidiary One
Schedule Of Equity Method Investments [Line Items]
Percentage of ownership from investees (percent)	15.00%
Unconsolidated Subsidiary Two
Schedule Of Equity Method Investments [Line Items]
Percentage of ownership from investees (percent)	50.00%

Investments in Unconsolidated73

Investments in Unconsolidated Investees - Balance Sheet Data (Details) - Investments - Equity Method and Joint Ventures - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Balance sheet data:
Current assets	$ 2,777	$ 2,644
Noncurrent assets	124	273
Current liabilities	628	676
Noncurrent liabilities	$ 33	$ 35

Investments in Unconsolidated74

Investments in Unconsolidated Investees - Combined Operating Results (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Operating results:
Earnings from unconsolidated investees	$ 282	$ 592	$ 927	$ 3,047
Investments - Equity Method and Joint Ventures
Operating results:
Revenues	2,558	3,788	7,521	16,894
Expenses	655	1,648	2,215	7,904
Net income	1,902	2,140	5,305	8,990
Earnings from unconsolidated investees	$ 282	$ 592	$ 927	$ 3,047

Stockholders' Deficit (Details)

Stockholders' Deficit (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 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			$ 28,630
Share-based payment			2,187
Share-based payment income tax benefit			87
Unrealized gain on hedging transaction, net of tax			218
Noncontrolling interest assumed in connection with acquisitions			2,450
Distributions to noncontrolling interest in subsidiaries			(18,045)
Contributions from noncontrolling interest in subsidiaries			1,113
Net income	$ 5,827	$ 13,065	15,418	$ 22,105
Ending balance	(44,947)		(44,947)
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
Shareholder transaction			$ 0
Share-based payment			0
Share-based payment income tax benefit			0
Unrealized gain on hedging transaction, net of tax			0
Noncontrolling interest assumed in connection with acquisitions			0
Distributions to noncontrolling interest in subsidiaries			0
Contributions from noncontrolling interest in subsidiaries			0
Net income			0
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)
Exercise of stock options			$ 0
Shareholder transaction			0
Share-based payment			0
Share-based payment income tax benefit			0
Unrealized gain on hedging transaction, net of tax			0
Noncontrolling interest assumed in connection with acquisitions			0
Distributions to noncontrolling interest in subsidiaries			0
Contributions from noncontrolling interest in subsidiaries			0
Net income			0
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			28,630
Share-based payment			2,187
Share-based payment income tax benefit			87
Unrealized gain on hedging transaction, net of tax			0
Noncontrolling interest assumed in connection with acquisitions			0
Distributions to noncontrolling interest in subsidiaries			0
Contributions from noncontrolling interest in subsidiaries			0
Net income			0
Ending balance	$ 60,815		60,815
Accumulated Comprehensive (Loss) Income
Class Of Stock [Line Items]
Beginning balance			(511)
Exercise of stock options			0
Shareholder transaction			0
Share-based payment			0
Share-based payment income tax benefit			0
Unrealized gain on hedging transaction, net of tax			218
Noncontrolling interest assumed in connection with acquisitions			0
Distributions to noncontrolling interest in subsidiaries			0
Contributions from noncontrolling interest in subsidiaries			0
Net income			0
Ending balance	(293)		(293)
(Accumulated Deficit) Retained Earnings
Class Of Stock [Line Items]
Beginning balance			(198,393)
Exercise of stock options			0
Shareholder transaction			0
Share-based payment			0
Share-based payment income tax benefit			0
Unrealized gain on hedging transaction, net of tax			0
Noncontrolling interest assumed in connection with acquisitions			0
Distributions to noncontrolling interest in subsidiaries			0
Contributions from noncontrolling interest in subsidiaries			0
Net income			2,627
Ending balance	(195,766)		(195,766)
Alliance HealthCare Services, Inc.
Class Of Stock [Line Items]
Beginning balance			(172,637)
Exercise of stock options			615
Shareholder transaction			28,630
Share-based payment			2,187
Share-based payment income tax benefit			87
Unrealized gain on hedging transaction, net of tax			218
Noncontrolling interest assumed in connection with acquisitions			0
Distributions to noncontrolling interest in subsidiaries			0
Contributions from noncontrolling interest in subsidiaries			0
Net income			2,627
Ending balance	(138,273)		(138,273)
Noncontrolling Interest
Class Of Stock [Line Items]
Beginning balance			95,017
Exercise of stock options			0
Shareholder transaction			0
Share-based payment			0
Share-based payment income tax benefit			0
Unrealized gain on hedging transaction, net of tax			0
Noncontrolling interest assumed in connection with acquisitions			2,450
Distributions to noncontrolling interest in subsidiaries			(18,045)
Contributions from noncontrolling interest in subsidiaries			1,113
Net income			12,791
Ending balance	$ 93,326		$ 93,326

Segment Information - Textual (

Segment Information - Textual (Details) - segment	9 Months Ended	12 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Segment Reporting [Abstract]
Number of operating segments (segment)	3
Number of reportable segments (segment)		2
Reconciliation of operating profit (Loss) from segments to consolidated	Segment income represents net income (loss) before: income tax expense (benefit); noncontrolling interest in subsidiaries; interest expense, net; depreciation expense; amortization expense; share-based payment; severance and related costs; restructuring charges; transaction costs; shareholder transaction costs; impairment charges; legal matters expense, net; changes in fair value of contingent consideration related to acquisitions; other non-cash charges, net; and non-cash gain on step acquisition. Segment income is the most frequently used measure of each segment’s performance and is commonly used in setting performance goals.

Segment Information - Revenue b

Segment Information - Revenue by Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Summary of revenue by segment
Revenue	$ 127,121	$ 120,784	$ 376,162	$ 348,717
Operating Segments | Radiology
Summary of revenue by segment
Revenue	88,727	86,284	261,912	252,665
Operating Segments | Oncology
Summary of revenue by segment
Revenue	26,271	25,224	78,162	74,740
Operating Segments | Interventional
Summary of revenue by segment
Revenue	11,511	8,957	34,572	20,980
Operating Segments | MRI | Radiology
Summary of revenue by segment
Revenue	49,887	47,603	146,212	135,739
Operating Segments | PET/CT | Radiology
Summary of revenue by segment
Revenue	31,936	32,248	95,701	96,392
Operating Segments | Other Radiology | Radiology
Summary of revenue by segment
Revenue	6,904	6,433	19,999	20,534
Corporate / Other
Summary of revenue by segment
Revenue	$ 612	$ 319	$ 1,516	$ 332

Segment Information - Summary o

Segment Information - Summary of Segment Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Summary of segment income
Segment income (loss)	$ 35,113	$ 33,862	$ 99,927	$ 97,993
Segment Continuing Operations
Summary of segment income
Segment income (loss)	35,113	33,862	99,927	97,993
Segment Continuing Operations | Operating Segments | Radiology
Summary of segment income
Segment income (loss)	30,310	28,526	85,556	83,319
Segment Continuing Operations | Operating Segments | Oncology
Summary of segment income
Segment income (loss)	13,307	12,661	38,024	37,005
Segment Continuing Operations | Operating Segments | Interventional
Summary of segment income
Segment income (loss)	1,162	1,461	4,204	2,835
Segment Continuing Operations | Corporate / Other
Summary of segment income
Segment income (loss)	$ (9,666)	$ (8,786)	$ (27,857)	$ (25,166)

Segment Information - Reconcili

Segment Information - Reconciliation of Income Before Income Taxes, Earnings from Unconsolidated Investees, and Noncontrolling Interest to Total Segment Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Reconciliation of net (loss) income to total segment income
Income before income taxes, earnings from unconsolidated investees, and noncontrolling interest	$ 7,407	$ 17,571	$ 17,628	$ 24,362
Earnings from unconsolidated investees	282	592	927	3,047
Interest expense, net	9,072	6,660	25,439	19,582
Depreciation expense	13,899	12,247	40,677	35,952
Amortization expense	2,556	2,377	7,493	6,907
Share-based payment (included in selling, general and administrative expenses)	407	423	2,650	1,242
Severance and related costs	762	277	3,186	731
Restructuring charges	284	216	1,635	707
Transaction costs	138	432	986	1,964
Shareholder transaction costs	1,009	0	3,516	0
Impairment charges	0	71	0	6,817
Legal matters expense, net (included in selling, general and administrative expenses)	(88)	2,924	106	5,827
Changes in fair value of contingent consideration related to acquisitions	(1,000)	0	(4,640)	0
Other non-cash charges, net (included in other income, net)	385	22	324	805
Non-cash gain on step acquisition	0	(9,950)	0	(9,950)
Total segment income	$ 35,113	$ 33,862	$ 99,927	$ 97,993

Segment Information - Summary80

Segment Information - Summary of Net Income (Loss) by Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ 1,358	$ 7,204	$ 2,627	$ 6,994
Operating Segments | Radiology
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	19,172	20,100	53,998	55,034
Operating Segments | Oncology
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	3,814	4,047	15,335	7,442
Operating Segments | Interventional
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	894	611	2,482	1,033
Corporate / Other
Segment Reporting Information [Line Items]
Net income (loss) attributable to Alliance HealthCare Services, Inc.	$ (22,522)	$ (17,554)	$ (69,188)	$ (56,515)

Segment Information - Summary81

Segment Information - Summary of Identifiable Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Summary of Company's identifiable assets by segment
Identifiable assets	$ 607,515	$ 603,660
Operating Segments | Radiology
Summary of Company's identifiable assets by segment
Identifiable assets	292,236	280,497
Operating Segments | Oncology
Summary of Company's identifiable assets by segment
Identifiable assets	202,121	213,698
Operating Segments | Interventional
Summary of Company's identifiable assets by segment
Identifiable assets	82,924	83,480
Corporate / Other
Summary of Company's identifiable assets by segment
Identifiable assets	$ 30,234	$ 25,985

Segment Information - Summary82

Segment Information - Summary of Capital Expenditures (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Summary of Company's capital expenditures by segment
Capital expenditures	$ 19,002	$ 11,708	$ 52,977	$ 39,382
Operating Segments | Radiology
Summary of Company's capital expenditures by segment
Capital expenditures	18,200	10,075	48,875	25,734
Operating Segments | Oncology
Summary of Company's capital expenditures by segment
Capital expenditures	400	1,183	2,838	10,394
Operating Segments | Interventional
Summary of Company's capital expenditures by segment
Capital expenditures	58	183	111	183
Corporate / Other
Summary of Company's capital expenditures by segment
Capital expenditures	$ 344	$ 267	$ 1,153	$ 3,071