Pediatrix Medical (MD) 10-Q 2 Nov 23 2023 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2023	Oct. 27, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Amendment Flag	false
Document Period End Date	Sep. 30, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Entity Registrant Name	Pediatrix Medical Group, Inc.
Entity Central Index Key	0000893949
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, par value $.01 per share
Trading Symbol	MD
Security Exchange Name	NYSE
Securities Act File Number	001-12111
Entity Incorporation, State or Country Code	FL
Entity Tax Identification Number	26-3667538
Entity Address, Address Line One	1301 Concord Terrace
Entity Address, City or Town	Sunrise
Entity Address, State or Province	FL
Entity Address, Postal Zip Code	33323
City Area Code	954
Local Phone Number	384-0175
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		84,023,916

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 21,179	$ 9,824
Short-term investments	103,541	93,239
Accounts receivable, net	277,352	296,787
Prepaid expenses	10,586	14,878
Other current assets	7,866	13,261
Total current assets	420,524	427,989
Property and equipment, net	75,146	73,290
Goodwill	1,532,092	1,532,092
Intangible assets, net	15,486	18,491
Operating and finance lease right-of-use assets	72,443	66,924
Deferred income tax assets	102,638	105,925
Other assets	108,010	123,176
Total assets	2,326,339	2,347,887
Current liabilities:
Accounts payable and accrued expenses	302,583	374,225
Current portion of debt and finance lease liabilities, net	14,929	14,898
Current portion of operating lease liabilities	21,814	21,589
Income taxes payable	11,118	16,271
Total current liabilities	350,444	426,983
Line of credit	0	4,000
Long-term debt and finance lease liabilities, net	621,691	632,381
Long-term operating lease liabilities	48,489	44,213
Long-term professional liabilities	265,523	275,629
Deferred income tax liabilities	41,018	33,638
Other liabilities	31,189	39,411
Total liabilities	1,358,354	1,456,255
Commitments and contingencies
Shareholders' equity:
Preferred stock; $.01 par value; 1,000 shares authorized; none issued	0	0
Common stock; $.01 par value; 200,000 shares authorized; 83,929 and 82,947 shares issued and outstanding, respectively	839	829
Additional paid-in capital	995,847	983,601
Accumulated other comprehensive loss	(3,517)	(3,735)
Retained deficit	(25,184)	(89,063)
Total shareholders' equity	967,985	891,632
Total liabilities and shareholders' equity	$ 2,326,339	$ 2,347,887

Consolidated Balance Sheets (_2

Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, issued	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	83,929,000	82,947,000
Common stock, shares outstanding	83,929,000	82,947,000

Consolidated Statements of Inco

Consolidated Statements of Income and Comprehensive Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Net revenue	$ 506,612	$ 489,915	$ 1,498,197	$ 1,458,177
Operating expenses:
Practice salaries and benefits	368,404	342,850	1,084,671	1,016,762
Practice supplies and other operating expenses	31,319	31,857	93,128	90,189
General and administrative expenses	57,406	57,888	174,478	180,340
Depreciation and amortization	9,211	8,956	27,109	26,500
Transformational and restructuring related expenses	0	977	0	7,736
Total operating expenses	466,340	442,528	1,379,386	1,321,527
Income from operations	40,272	47,387	118,811	136,650
Investment and other income	273	617	2,096	2,336
Interest expense	(10,374)	(9,516)	(31,994)	(29,743)
Loss on early extinguishment of debt	0	0	0	(57,016)
Equity in earnings of unconsolidated affiliate	661	371	1,578	1,319
Total non-operating expenses	(9,440)	(8,528)	(28,320)	(83,104)
Income from continuing operations before income taxes	30,832	38,859	90,491	53,546
Income tax provision	(9,441)	(10,051)	(26,612)	(14,982)
Income from continuing operations	21,391	28,808	63,879	38,564
Income (loss) from discontinued operations, net of tax	0	1,920	0	(1,892)
Net income	21,391	30,728	63,879	36,672
Net loss attributable to noncontrolling interest	0	0	0	4
Net income attributable to Pediatrix Medical Group, Inc.	21,391	30,728	63,879	36,676
Other comprehensive (loss) income, net of tax	1	(1,515)	218	(5,417)
Total comprehensive income attributable to Pediatrix Medical Group, Inc.	$ 21,392	$ 29,213	$ 64,097	$ 31,259
Net income attributable to Pediatrix Medical Group, Inc.:
Basic	$ 0.26	$ 0.37	$ 0.78	$ 0.44
Diluted	$ 0.26	$ 0.37	$ 0.77	$ 0.43
Weighted average common shares:
Basic	82,543	82,126	82,127	84,122
Diluted	82,950	82,776	82,492	84,821

Consolidated Statements of In_2

Consolidated Statements of Income and Comprehensive Income (Unaudited) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Other Comprehensive Income (Loss), Available-for-Sale Securities, Tax, Portion Attributable to Parent	$ 0	$ 508	$ 100	$ 1,816

Consolidated Statements of Equi

Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands		Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Loss [Member]	Retained Deficit [Member]
Balance at Dec. 31, 2021		$ 896,692	$ 864	$ 1,049,696	$ 1,317	$ (155,185)
Balance, Shares at Dec. 31, 2021			86,423,000
Net Income (Loss)		(21,188)				(21,188)
Dissolution of and net loss attributable to noncontrolling interest	[1]	(203)		10		(213)
Unrealized holding gain (loss) on investments, net of tax		(2,668)			(2,668)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,174		1,174
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			50,000
Issuance of restricted stock			$ 8	(8)
Issuance of restricted stock, shares			766,000
Forfeitures of restricted stock, shares			(5,000)
Stock-based compensation expense		4,435		4,435
Repurchased common stock		(1,166)		(1,166)
Repurchased common stock, shares			(50,000)
Balance at Mar. 31, 2022		877,076	$ 872	1,054,141	(1,351)	(176,586)
Balance, Shares at Mar. 31, 2022			87,184,000
Balance at Dec. 31, 2021		896,692	$ 864	1,049,696	1,317	(155,185)
Balance, Shares at Dec. 31, 2021			86,423,000
Net Income (Loss)		36,676
Balance at Sep. 30, 2022		858,667	$ 830	980,659	(4,100)	(118,722)
Balance, Shares at Sep. 30, 2022			83,006,000
Balance at Mar. 31, 2022		877,076	$ 872	1,054,141	(1,351)	(176,586)
Balance, Shares at Mar. 31, 2022			87,184,000
Net Income (Loss)		27,136				27,136
Unrealized holding gain (loss) on investments, net of tax		(1,234)			(1,234)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,664	$ 1	1,663
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			82,000
Issuance of restricted stock			$ 1	(1)
Issuance of restricted stock, shares			74,000
Forfeitures of restricted stock, shares			(5,000)
Stock-based compensation expense		5,186		5,186
Repurchased common stock		(64,398)	$ (33)	(64,365)
Repurchased common stock, shares			(3,275,000)
Balance at Jun. 30, 2022		845,430	$ 841	996,624	(2,585)	(149,450)
Balance, Shares at Jun. 30, 2022			84,060,000
Net Income (Loss)		30,728				30,728
Unrealized holding gain (loss) on investments, net of tax		(1,515)			(1,515)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,381	$ 1	1,380
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			74,000
Issuance of restricted stock, shares			1,000
Forfeitures of restricted stock			$ (1)	1
Forfeitures of restricted stock, shares			(8,000)
Stock-based compensation expense		4,120		4,120
Repurchased common stock		(21,477)	$ (11)	(21,466)
Repurchased common stock, shares			(1,121,000)
Balance at Sep. 30, 2022		858,667	$ 830	980,659	(4,100)	(118,722)
Balance, Shares at Sep. 30, 2022			83,006,000
Balance at Dec. 31, 2022		891,632	$ 829	983,601	(3,735)	(89,063)
Balance, Shares at Dec. 31, 2022			82,947,000
Net Income (Loss)		14,206				14,206
Unrealized holding gain (loss) on investments, net of tax		604			604
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,095		1,095
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			86,000
Issuance of restricted stock			$ 9	(9)
Issuance of restricted stock, shares			871,000
Forfeitures of restricted stock			$ (2)	2
Forfeitures of restricted stock, shares			(221,000)
Stock-based compensation expense		3,009		3,009
Repurchased common stock		(775)		(775)
Repurchased common stock, shares			(49,000)
Balance at Mar. 31, 2023		909,771	$ 836	986,923	(3,131)	(74,857)
Balance, Shares at Mar. 31, 2023			83,634,000
Balance at Dec. 31, 2022		891,632	$ 829	983,601	(3,735)	(89,063)
Balance, Shares at Dec. 31, 2022			82,947,000
Net Income (Loss)		$ 63,879
Repurchased common stock, shares		0
Balance at Sep. 30, 2023		$ 967,985	$ 839	995,847	(3,517)	(25,184)
Balance, Shares at Sep. 30, 2023			83,929,000
Balance at Mar. 31, 2023		909,771	$ 836	986,923	(3,131)	(74,857)
Balance, Shares at Mar. 31, 2023			83,634,000
Net Income (Loss)		28,282				28,282
Unrealized holding gain (loss) on investments, net of tax		(387)			(387)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,594	$ 1	1,593
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			126,000
Issuance of restricted stock			$ 1	(1)
Issuance of restricted stock, shares			93,000
Forfeitures of restricted stock, shares			(11,000)
Stock-based compensation expense		3,126		3,126
Repurchased common stock		(11)		(11)
Repurchased common stock, shares			(1,000)
Balance at Jun. 30, 2023		942,375	$ 838	991,630	(3,518)	(46,575)
Balance, Shares at Jun. 30, 2023			83,841,000
Net Income (Loss)		21,391				21,391
Unrealized holding gain (loss) on investments, net of tax		1			1
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,187	$ 1	1,186
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			100,000
Forfeitures of restricted stock, shares			(1,000)
Stock-based compensation expense		3,164		3,164
Repurchased common stock		(133)		(133)
Repurchased common stock, shares			(11,000)
Balance at Sep. 30, 2023		$ 967,985	$ 839	$ 995,847	$ (3,517)	$ (25,184)
Balance, Shares at Sep. 30, 2023			83,929,000
[1] Net loss component is presented within retained deficit on the consolidated balance sheet as the balance is immaterial.

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities:
Net income	$ 63,879	$ 36,676
Loss from discontinued operations	0	1,892
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization	27,109	26,500
Amortization of premiums, discounts and issuance costs	1,015	1,346
Loss on early extinguishment of debt	0	57,016
Stock-based compensation expense	9,299	12,891
Deferred income taxes	10,589	(8,702)
Other	(1,607)	(2,379)
Changes in assets and liabilities:
Accounts receivable	22,095	(501)
Prepaid expenses and other current assets	4,290	22,709
Other long-term assets	13,343	11,160
Accounts payable and accrued expenses	(56,118)	(76,439)
Income taxes payable	(5,154)	799
Long-term professional liabilities	838	7,360
Other liabilities	(16,500)	(10,309)
Net cash provided by operating activities - continuing operations	73,078	80,019
Net cash used in operating activities - discontinued operations	(5,003)	(11,764)
Net cash provided by operating activities	68,075	68,255
Cash flows from investing activities:
Acquisition payments, net of cash acquired	(1,667)	(28,167)
Purchases of investments	(26,477)	(14,938)
Proceeds from maturities or sales of investments	16,560	15,889
Purchases of property and equipment	(24,284)	(20,650)
Other	116	2,153
Net cash used in investing activities	(35,752)	(45,713)
Cash flows from financing activities:
Borrowings on credit agreement	470,000	674,500
Payments on credit agreement	(474,000)	(579,500)
Payments on term loan	(9,375)	(6,250)
Redemption of senior notes, including call premium	0	(1,046,880)
Proceeds from senior notes and term loan	0	650,000
Payments for financing costs	0	(8,621)
Payment on finance lease obligation	(2,105)	(2,176)
Proceeds from issuance of common stock	3,876	4,220
Repurchases of common stock	(919)	(87,041)
Other	(8,445)	483
Net cash used in financing activities	(20,968)	(401,265)
Net increase (decrease) in cash and cash equivalents	11,355	(378,723)
Cash and cash equivalents at beginning of period	9,824	387,391
Cash and cash equivalents at end of period	$ 21,179	$ 8,668

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ 21,391	$ 28,282	$ 14,206	$ 30,728	$ 27,136	$ (21,188)	$ 63,879	$ 36,676

Insider Trading Arrangements

Insider Trading Arrangements	9 Months Ended
	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	1. Basis of Presentation: On July 1, 2022, effective after the close of the market, the Company changed its corporate name from "Mednax, Inc." to “Pediatrix Medical Group, Inc." signifying the Company's return to its core focus in caring for women, babies and children. The Company’s common stock continues to trade on the New York Stock Exchange under the ticker symbol “MD.” The accompanying unaudited Consolidated Financial Statements of the Company and the notes thereto presented in this Form 10-Q have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission ("SEC") applicable to interim financial statements, and do not include all disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for complete financial statements. In the opinion of management, these financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair statement of the results of interim periods. The financial statements include all the accounts of Pediatrix Medical Group, Inc. and its consolidated subsidiaries (collectively, “PMG”) together with the accounts of PMG’s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (the “affiliated professional contractors”). Certain subsidiaries of PMG have contractual management arrangements with its affiliated professional contractors, which are separate legal entities that provide physician services in certain states. The Company ceased providing services in Puerto Rico effective December 31, 2022. The terms “Pediatrix” and the “Company” refer collectively to Pediatrix Medical Group Inc., its subsidiaries and the affiliated professional contractors. The Compan y is a party to a joint venture in which it owns a 37.5 % economic interest. The Company accounts for this joint venture under the equity method of accounting because the Company exercises significant influence over, but does not control, this entity. The Company was also a party to another joint venture in which it owned a 51 % economic interest and for which it was deemed the primary beneficiary. This joint venture was dissolved in February 2022. The operating results related to this joint venture prior to the dissolution and impacts from such dissolution were not material. The consolidated results of operations for the interim periods presented are not necessarily indicative of the results to be experienced for the entire fiscal year. In addition, the accompanying unaudited Consolidated Financial Statements and the notes thereto should be read in conjunction with the Consolidated Financial Statements and the notes thereto included in the Company’s most recent Annual Report on Form 10-K (the “Form 10-K”).

Cash Equivalents and Investment

Cash Equivalents and Investments	9 Months Ended
	Sep. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Cash Equivalents and Investments	2. Cash Equivalents and Investments: As of September 30, 2023 and December 31, 2022, the Company's cash equivalents consisted entirely of money market funds totaling $ 1.2 million and $ 1.4 million, respectively. Investments held are all classified as current and at September 30, 2023 and December 31, 2022 are summarized as follows (in thousands): September 30, 2023 December 31, 2022 Corporate securities $ 58,830 $ 61,385 Municipal debt securities 13,419 14,377 U.S. Treasury securities 21,888 10,205 Certificates of deposit 3,906 3,710 Federal home loan securities 5,498 3,562 $ 103,541 $ 93,239

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	3. Fair Value Measurements: The accounting guidance establishes a fair value hierarchy that prioritizes valuation inputs into three levels based on the extent to which inputs used in measuring fair value are observable in the market. Each fair value measurement is reported in one of three levels: Level 1 – inputs are based upon unadjusted quoted prices for identical instruments traded in active markets. Level 2 – inputs are based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-based valuation techniques for which all significant assumptions are observable in the market or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 – inputs are generally unobservable and typically reflect management’s estimates of assumptions that market participants would use in pricing the asset or liability. The fair values are therefore determined using model-based techniques that include option pricing models, discounted cash flow models, and similar techniques. The following table presents information about the Company’s financial instruments that are accounted for at fair value on a recurring basis at September 30, 2023 and December 31, 2022 (in thousands): Fair Value Fair Value September 30, 2023 December 31, 2022 Assets: Money market funds Level 1 $ 1,201 $ 1,415 Short-term investments Level 2 103,541 93,239 Mutual Funds Level 1 15,851 14,544 The following table presents information about the Company’s financial instruments that are not carried at fair value at September 30, 2023 and December 31, 2022 (in thousands): September 30, 2023 December 31, 2022 Carrying Fair Carrying Fair Liabilities: 2030 Notes $ 400,000 $ 352,680 $ 400,000 $ 344,000 The carrying amounts of cash equivalents, accounts receivable and accounts payable and accrued expenses approximate fair value due to the short maturities of the respective instruments. The carrying value of the line of credit approximates fair value. If the Company’s line of credit was measured at fair value, it would be categorized as Level 2 in the fair value hierarchy.

Accounts Receivable and Net Rev

Accounts Receivable and Net Revenue	9 Months Ended
	Sep. 30, 2023
Text Block [Abstract]
Accounts Receivable and Net Revenue	4. Accounts Receivable and Net Revenue: Accounts receivable, net consists of the following (in thousands): September 30, 2023 December 31, 2022 Gross accounts receivable $ 1,448,620 $ 1,548,492 Allowance for contractual adjustments and uncollectibles ( 1,171,268 ) ( 1,251,705 ) $ 277,352 $ 296,787 Patient service revenue is recognized at the time services are provided by the Company’s affiliated physicians. The Company’s performance obligations related to the delivery of services to patients are satisfied at the time of service. Accordingly, there are no performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period with respect to patient service revenue. Almost all of the Company’s patient service revenue is reimbursed by government-sponsored healthcare programs (“GHC Programs”) and third-party insurance payors. Payments for services rendered to the Company’s patients are generally less than billed charges. The Company monitors its revenue and receivables from these sources and records an estimated contractual allowance to properly account for the anticipated differences between billed and reimbursed amounts. Accordingly, patient service revenue is presented net of an estimated provision for contractual adjustments and uncollectibles. The Company estimates allowances for contractual adjustments and uncollectibles on accounts receivable based upon historical experience and other factors, including days sales outstanding (“DSO”) for accounts receivable, evaluation of expected adjustments and delinquency rates, past adjustments and collection experience in relation to amounts billed, an aging of accounts receivable, current contract and reimbursement terms, changes in payor mix and other relevant information. Contractual adjustments result from the difference between the physician rates for services performed and the reimbursements by GHC Programs and third-party insurance payors for such services. Collection of patient service revenue the Company expects to receive is normally a function of providing complete and correct billing information to the GHC Programs and third-party insurance payors within the various filing deadlines and typically occurs within 30 to 60 days of billing. Some of the Company’s hospital agreements require hospitals to pay the Company administrative fees. Some agreements provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that the Company receives a specified minimum revenue level. The Company also receives fees from hospitals for administrative services performed by its affiliated physicians providing medical director or other services at the hospital. The following table summarizes the Company’s net revenue by category (in thousands): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Net patient service revenue $ 437,321 $ 421,085 $ 1,290,888 $ 1,245,627 Hospital contract administrative fees 68,712 67,418 204,286 196,425 Other revenue 579 1,412 3,023 16,125 $ 506,612 $ 489,915 $ 1,498,197 $ 1,458,177 The approximate percentage of net patient service revenue by type of payor was as follows: Three Months Ended Nine Months Ended 2023 2022 2023 2022 Contracted managed care 67 % 65 % 67 % 67 % Government 25 28 25 26 Other third-parties 5 5 6 5 Private-pay patients 3 2 2 2 100 % 100 % 100 % 100 %

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	9 Months Ended
	Sep. 30, 2023
Payables and Accruals [Abstract]
Accounts Payable and Accrued Expenses	5. Accounts Payable and Accrued Expenses: Accounts payable and accrued expenses consist of the following (in thousands): September 30, 2023 December 31, 2022 Accounts payable $ 31,696 $ 31,857 Accrued salaries and incentive compensation 150,014 197,831 Accrued payroll taxes and benefits 35,366 34,983 Accrued professional liabilities 30,169 32,232 Accrued interest 3,204 8,921 Other accrued expenses 52,134 68,401 $ 302,583 $ 374,225 The net decrease in accrued salaries and incentive compensation of $ 47.8 million, from December 31, 2022 to September 30, 2023, is primarily due to the payment of performance-based incentive compensation, principally to the Company’s affiliated physicians, partially offset by performance-based incentive compensation accrued during the nine months ended September 30, 2023 . A majority of the Company’s payments for performance-based incentive compensation is paid annually during the first quarter.

Line of Credit and Long Term De

Line of Credit and Long Term Debt	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Line of Credit and Long Term Debt	6. Line of Credit and Long-Term Debt: On February 11, 2022, the Company issued $ 400.0 million of 5.375 % unsecured senior notes due 2030 (the “2030 Notes”). The Company used the net proceeds from the issuance of the 2030 Notes, together with $ 100.0 million drawn under the Revolving Credit Line (as defined below), $ 250.0 million of Term A Loan (as defined below) and approximately $ 308.0 million of cash on hand, to redeem (the “Redemption”) the 6.25 % senior unsecured notes due 2027, which had an outstanding principal balance of $ 1.0 billion, and to pay costs, fees and expenses associated with the Redemption and the Credit Agreement Amendment (as defined below). Interest on the 2030 Notes accrues at the rate of 5.375 % per annum, or $ 21.5 million, and is payable semi-annually in arrears on February 15 and August 15, beginning on August 15, 2022 . The Company's obligations under the 2030 Notes are guaranteed on an unsecured senior basis by the same subsidiaries and affiliated professional contractors that guarantee the Amended Credit Agreement (as defined below). The indenture under which the 2030 Notes are issued, among other things, limits the Company's ability to (1) incur liens and (2) enter into sale and lease-back transactions, and also limits the Company's ability to merge or dispose of all or substantially all of its assets, in all cases, subject to a number of customary exceptions . Although the Company is not required to make mandatory redemption or sinking fund payments with respect to the 2030 Notes, upon the occurrence of a change in control, the Company may be required to repurchase the 2030 Notes at a purchase price equal to 101 % of the aggregate principal amount of the 2030 Notes repurchased plus accrued and unpaid interest. Also in connection with the Redemption, the Company amended its credit agreement (the “Credit Agreement”, and such amendment, the "Credit Agreement Amendment"), concurrently with the issuance of the 2030 Notes. The Credit Agreement Amendment, among other things, (i) refinanced the prior unsecured revolving credit facility with a $ 450 million unsecured revolving credit facility, including a $ 37.5 million sub-facility for the issuance of letters of credit (the “Revolving Credit Line”), and a $ 250 million term A loan facility (“Term A Loan”) and (ii) removed JPMorgan Chase Bank, N.A., as the administrative agent under the Credit Agreement and appointed Bank of America, N.A. as the administrative agent for the lenders. The Credit Agreement, as amended by the Credit Agreement Amendment (the “Amended Credit Agreement”) matures on February 11, 2027 and is guaranteed on an unsecured basis by substantially all of the Company's subsidiaries and affiliated professional contractors. At the Company's option, borrowings under the Amended Credit Agreement bear interest at (i) the Alternate Base Rate (defined as the highest of (a) the prime rate as announced by Bank of America, N.A., (b) the Federal Funds Rate plus 0.50% and (c) Term Secured Overnight Financing Rate ("SOFR") for an interest period of one month plus 1.00% with a 1.00% floor) plus an applicable margin rate of 0.50% for the first two fiscal quarters after the date of the Credit Agreement Amendment, and thereafter at an applicable margin rate ranging from 0.125% to 0.750% based on the Company's consolidated net leverage ratio or (ii) Term SOFR rate (calculated as the Secured Overnight Financing Rate published on the applicable Reuters screen page plus a spread adjustment of 0.10%, 0.15% or 0.25% depending on if the Company selects a one-month, three-month or six-month interest period, respectively, for the applicable loan with a 0% floor), plus an applicable margin rate of 1.50% for the first two full fiscal quarters after the date of the Credit Agreement Amendment, and thereafter at an applicable margin rate ranging from 1.125% to 1.750% based on the Company's consolidated net leverage ratio. The Amended Credit Agreement also provides for other customary fees and charges, including an unused commitment fee with respect to the Revolving Credit Line ranging from 0.150% to 0.200% of the unused lending commitments under the Revolving Credit Line , based on the Company's consolidated net leverage ratio. The Amended Credit Agreement contains customary covenants and restrictions, including covenants that require the Company to maintain a minimum interest coverage ratio, a maximum consolidated net leverage ratio and to comply with laws, and restrictions on the ability to pay dividends, incur indebtedness or liens and make certain other distributions subject to baskets and exceptions, in each case, as specified therein. Failure to comply with these covenants would constitute an event of default under the Amended Credit Agreement, notwithstanding the ability of the Company to meet its debt service obligations. The Amended Credit Agreement includes various customary remedies for the lenders following an event of default, including the acceleration of repayment of outstanding amounts under the Amended Credit Agreement. In addition, the Company may increase the principal amount of the Revolving Credit Line or incur additional term loans under the Amended Credit Agreement in an aggregate principal amount such that on a pro forma basis after giving effect to such increase or additional term loans, the Company would be in compliance with the financial covenants, subject to the satisfaction of specified conditions and additional caps in the event that the Amended Credit Agreement is secured. At September 30, 2023, the Company had an outstanding principal balance on the Amended Credit Agreement of $ 231.3 million, comprised solely of the Term A Loan. The Company had $ 450.0 million available on its Amended Credit Agreement at September 30, 2023. At September 30, 2023 , the Company had an outstanding principal balance of $ 400.0 million on the 2030 Notes.

Common and Common Equivalent Sh

Common and Common Equivalent Shares	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Common and Common Equivalent Shares	7. Common and Common Equivalent Shares: Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the period. Diluted net income per common share is calculated by dividing net income by the weighted average number of common and potential common shares outstanding during the period. Potential common shares consist of outstanding restricted stock and stock options and is calculated using the treasury stock method. The calculation of shares used in the basic and diluted net income per common share calculation for the three and nine months ended September 30, 2023 and 2022 is as follows (in thousands): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Weighted average number of common shares outstanding 82,543 82,126 82,127 84,122 Weighted average number of dilutive common share 407 650 365 699 Weighted average number of common and common 82,950 82,776 82,492 84,821 Antidilutive securities (restricted stock and stock options) not included in the diluted net income per common share calculation 888 1 1,201 273

Stock Incentive Plans and Stock

Stock Incentive Plans and Stock Purchase Plans	9 Months Ended
	Sep. 30, 2023
Share-Based Payment Arrangement [Abstract]
Stock Incentive Plans and Stock Purchase Plans	8. Stock Incentive Plans and Stock Purchase Plans: The Company’s Amended and Restated 2008 Incentive Compensation Plan (the “Amended and Restated 2008 Incentive Plan”) provides for grants of stock options, stock appreciation rights, restricted stock, deferred stock, and other stock-related awards and performance awards that may be settled in cash, stock or other property. Under the Amended and Restated 2008 Incentive Plan, options to purchase shares of common stock may be granted at a price not less than the fair market value of the shares on the date of grant. The options must be exercised within 10 years from the date of grant and generally become exercisable on a pro rata basis over a three-year period from the date of grant. The Company issues new shares of its common stock upon exercise of its stock options. Restricted stock awards generally vest over periods of three years upon the fulfillment of specified service-based conditions and in certain instances performance-based conditions. Deferred stock awards generally vest upon the satisfaction of specified performance-based conditions and service-based conditions. The Company recognizes compensation expense related to its restricted stock and deferred stock awards ratably over the corresponding vesting periods. During the nine months ended September 30, 2023, the Company granted 0.8 million shares of restricted stock to its employees and non-employee directors under the Amended and Restated 2008 Incentive Plan. At September 30, 2023, the Company had 8.1 million shares available for future grants and awards under the Amended and Restated 2008 Incentive Plan. Under the Company’s Amended and Restated 1996 Non-Qualified Employee Stock Purchase Plan, as amended (the “ESPP”), employees are permitted to purchase the Company's common stock at 85 % of market value on January 1st, April 1st, July 1st and October 1st of each year. Under the Company’s 2015 Non-Qualified Stock Purchase Plan (the “SPP”), certain eligible non-employee service providers are permitted to purchase the Company’s common stock at 90 % of market value on January 1st, April 1st, July 1st and October 1st of each year. The Company recognizes stock-based compensation expense for the discount received by participating employees and non-employee service providers. During the nine months ended September 30, 2023, approximately 0.3 million shares were issued under the ESPP. At September 30, 2023, the Company had approximately 2.2 million shares reserved for issuance under the ESPP. At September 30, 2023, the Company had approximately 61,000 shares in the aggregate reserved for issuance under the SPP. No shares have been issued under the SPP since 2020. During the three and nine months ended September 30, 2023 and 2022, the Company recognized stock-based compensation expense of $ 3.2 million and $ 9.3 million and $ 4.1 million and $ 12.9 million, respectively.

Common Stock Repurchase Program

Common Stock Repurchase Programs	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Common Stock Repurchase Programs	9. Common Stock Repurchase Programs: In July 2013, the Company’s Board of Directors authorized the repurchase of shares of the Company’s common stock up to an amount sufficient to offset the dilutive impact from the issuance of shares under the Company’s equity compensation programs. The share repurchase program allows the Company to make open market purchases from time-to-time based on general economic and market conditions and trading restrictions. The repurchase program also allows for the repurchase of shares of the Company’s common stock to offset the dilutive impact from the issuance of shares, if any, related to the Company’s acquisition program. No shares were purchased under this program during the nine months ended September 30, 2023. In August 2018, the Company announced that its Board of Directors had authorized the repurchase of up to $ 500.0 million of the Company’s common stock in addition to its existing share repurchase program, of which $ 5.5 million remained available for repurchase as of December 31, 2022. Under this share repurchase program, during the nine months ended September 30, 2023, the Company purchased a nominal number of shares of its common stock for $ 0.9 million representing shares withheld to satisfy minimum statutory withholding obligations in connection with the vesting of restricted stock, resulting in $ 4.6 million remaining available for repurchase under this authorization as of September 30, 2023. The Company intends to utilize various methods to effect any future share repurchases, including, among others, open market purchases and accelerated share repurchase programs. The amount and timing of repurchases will depend upon several factors, including general economic and market conditions and trading restrictions.

Coronavirus Pandemic (COVID-19)

Coronavirus Pandemic (COVID-19)	9 Months Ended
	Sep. 30, 2023
Extraordinary Items [Abstract]
Coronavirus Pandemic (COVID-19)	10. Coronavirus Pandemic (“COVID-19”): COVID-19 has had an impact on the demand for medical services provided by the Company's affiliated clinicians. Beginning in mid-March 2020 and throughout the second quarter of 2020, the Company's operating results were significantly impacted by COVID-19, but volumes began to normalize in mid-2020 and substantially recovered throughout 2020 with no material impacts from COVID-19 or its variants since that time. However, due to the continued uncertainties surrounding the timeline of and impacts from COVID-19 and with multiple variant strains still circulating, the Company is unable to predict the ultimate impact of COVID-19 on its business, financial condition, results of operations, cash flows and the trading price of its securities at this time. CARES Act In March 2020, the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") was signed into law. The CARES Act is a relief package intended to assist many aspects of the American economy, including providing financial aid to the healthcare industry to reimburse healthcare providers for lost revenue and expenses attributable to COVID-19. The Department of Health and Human Services is administering this program and began disbursing funds in April 2020, of which the Company’s affiliated physician practices within continuing operations recognized an aggregate of $ 0.3 million and $ 11.4 million during the three and nine months ended September 30, 2022 , respectively.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	11. Commitments and Contingencies: The Company expects that audits, inquiries and investigations from government authorities and agencies will occur in the ordinary course of business. Such audits, inquiries and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on the Company's business, financial condition, results of operations, cash flows and the trading price of its securities. The Company has not included an accrual for these matters as of September 30, 2023 in its Consolidated Financial Statements, as the variables affecting any potential eventual liability depend on the currently unknown facts and circumstances that arise out of, and are specific to, any particular future audit, inquiry and investigation and cannot be reasonably estimated at this time. In the ordinary course of business, the Company becomes involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services provided by the Company's affiliated physicians. The Company's contracts with hospitals generally require the Company to indemnify them and their affiliates for losses resulting from the negligence of the Company's affiliated physicians. The Company may also become subject to other lawsuits which could involve large claims and significant costs. The Company believes, based upon a review of pending actions and proceedings, that the outcome of such legal actions and proceedings will not have a material adverse effect on its business, financial condition, results of operations, cash flows and the trading price of its securities. The outcome of such actions and proceedings, however, cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on the Company's business, financial condition, results of operations, cash flows and the trading price of its securities. Although the Company currently maintains liability insurance coverage intended to cover professional liability and certain other claims, the Company cannot assure that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against it in the future where the outcomes of such claims are unfavorable. With respect to professional liability risk, the Company generally self-insures a portion of this risk through its wholly owned captive insurance subsidiary. Liabilities in excess of the Company's insurance coverage, including coverage for professional liability and certain other claims, could have a material adverse effect on the Company's business, financial condition, results of operations, cash flows and the trading price of its securities.

Cash Equivalents and Investme_2

Cash Equivalents and Investments (Tables)	9 Months Ended
	Sep. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	Investments held are all classified as current and at September 30, 2023 and December 31, 2022 are summarized as follows (in thousands): September 30, 2023 December 31, 2022 Corporate securities $ 58,830 $ 61,385 Municipal debt securities 13,419 14,377 U.S. Treasury securities 21,888 10,205 Certificates of deposit 3,906 3,710 Federal home loan securities 5,498 3,562 $ 103,541 $ 93,239

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	The following table presents information about the Company’s financial instruments that are accounted for at fair value on a recurring basis at September 30, 2023 and December 31, 2022 (in thousands): Fair Value Fair Value September 30, 2023 December 31, 2022 Assets: Money market funds Level 1 $ 1,201 $ 1,415 Short-term investments Level 2 103,541 93,239 Mutual Funds Level 1 15,851 14,544
Financial Instruments Measured At Carrying Amount	The following table presents information about the Company’s financial instruments that are not carried at fair value at September 30, 2023 and December 31, 2022 (in thousands): September 30, 2023 December 31, 2022 Carrying Fair Carrying Fair Liabilities: 2030 Notes $ 400,000 $ 352,680 $ 400,000 $ 344,000

Accounts Receivable and Net R_2

Accounts Receivable and Net Revenue (Tables)	9 Months Ended
	Sep. 30, 2023
Text Block [Abstract]
Schedule of Accounts Receivable, Net	Accounts receivable, net consists of the following (in thousands): September 30, 2023 December 31, 2022 Gross accounts receivable $ 1,448,620 $ 1,548,492 Allowance for contractual adjustments and uncollectibles ( 1,171,268 ) ( 1,251,705 ) $ 277,352 $ 296,787
Schedule of Net Revenue	The following table summarizes the Company’s net revenue by category (in thousands): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Net patient service revenue $ 437,321 $ 421,085 $ 1,290,888 $ 1,245,627 Hospital contract administrative fees 68,712 67,418 204,286 196,425 Other revenue 579 1,412 3,023 16,125 $ 506,612 $ 489,915 $ 1,498,197 $ 1,458,177
Schedule of Percentage of Net Revenue	The approximate percentage of net patient service revenue by type of payor was as follows: Three Months Ended Nine Months Ended 2023 2022 2023 2022 Contracted managed care 67 % 65 % 67 % 67 % Government 25 28 25 26 Other third-parties 5 5 6 5 Private-pay patients 3 2 2 2 100 % 100 % 100 % 100 %

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2023
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Expenses	Accounts payable and accrued expenses consist of the following (in thousands): September 30, 2023 December 31, 2022 Accounts payable $ 31,696 $ 31,857 Accrued salaries and incentive compensation 150,014 197,831 Accrued payroll taxes and benefits 35,366 34,983 Accrued professional liabilities 30,169 32,232 Accrued interest 3,204 8,921 Other accrued expenses 52,134 68,401 $ 302,583 $ 374,225

Common and Common Equivalent _2

Common and Common Equivalent Shares (Tables)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share	The calculation of shares used in the basic and diluted net income per common share calculation for the three and nine months ended September 30, 2023 and 2022 is as follows (in thousands): Three Months Ended Nine Months Ended 2023 2022 2023 2022 Weighted average number of common shares outstanding 82,543 82,126 82,127 84,122 Weighted average number of dilutive common share 407 650 365 699 Weighted average number of common and common 82,950 82,776 82,492 84,821 Antidilutive securities (restricted stock and stock options) not included in the diluted net income per common share calculation 888 1 1,201 273

Basis of Presentation - Additio

Basis of Presentation - Additional Information (Detail)	Sep. 30, 2023
Unnamed Corporate Joint Venture One [Member]
Basis Of Presentation [Line Items]
Equity method ownership percentage in joint venture	37.50%
Unnamed Corporate Joint Venture Two [Member]
Basis Of Presentation [Line Items]
Equity method ownership percentage in joint venture	51%

Cash Equivalents and Investme_3

Cash Equivalents and Investments - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Cash Equivalents [Member]
Cash Equivalents And Investments [Line Items]
Cash equivalents	$ 1.2	$ 1.4

Cash Equivalents and Investme_4

Cash Equivalents and Investments - Schedule of Investments (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Available-for-sale [Line Items]
Available-for-sale Securities	$ 103,541	$ 93,239
Corporate securities
Available-for-sale [Line Items]
Available-for-sale Securities	58,830	61,385
Municipal Debt Securities [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	13,419	14,377
U.S. Treasury securities [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	21,888	10,205
Certificates of Deposit [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	3,906	3,710
Federal Home Loan Securities [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	$ 5,498	$ 3,562

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of fair value on a recurring basis (Details) - Fair Value, Recurring [Member] - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Fair Value, Inputs, Level 1 [Member]
Assets:
Money market funds	$ 1,201	$ 1,415
Mutual funds	15,851	14,544
Fair Value, Inputs, Level 2 [Member]
Assets:
Short-term investments	$ 103,541	$ 93,239

Fair Value Measurements - Sch_2

Fair Value Measurements - Schedule of financial instruments that are not carried at fair value (Details) - 2030 Notes [Member] - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Liabilities:
Notes Payable	$ 400,000	$ 400,000
Liabilities:
Notes Payable Fair Value Disclosure	$ 352,680	$ 344,000

Accounts Receivable and Net R_3

Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Receivables [Abstract]
Gross accounts receivable	$ 1,448,620	$ 1,548,492
Allowance for contractual adjustments and uncollectibles	(1,171,268)	(1,251,705)
Accounts receivable, net	$ 277,352	$ 296,787

Accounts Receivable and Net R_4

Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue [Abstract]
Net revenue	$ 506,612	$ 489,915	$ 1,498,197	$ 1,458,177
Net patient service revenue [Member]
Disaggregation of Revenue [Abstract]
Net revenue	437,321	421,085	1,290,888	1,245,627
Hospital contract administrative fees [Member]
Disaggregation of Revenue [Abstract]
Net revenue	68,712	67,418	204,286	196,425
Other revenue [Member]
Disaggregation of Revenue [Abstract]
Net revenue	$ 579	$ 1,412	$ 3,023	$ 16,125

Accounts Receivable and Net R_5

Accounts Receivable and Net Revenue - Schedule of Net Patient Service Revenue by Type of Payor (Detail)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	100%	100%	100%	100%
Contracted Managed Care [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	67%	65%	67%	67%
Government [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	25%	28%	25%	26%
Other Third-Parties [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	5%	5%	6%	5%
Private-Pay Patients [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	3%	2%	2%	2%

Business Combinations and Disco

Business Combinations and Discontinued Operations - Additional information (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Other non-current assets	$ 108,010	$ 123,176

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Accounts payable	$ 31,696	$ 31,857
Accrued salaries and incentive compensation	150,014	197,831
Accrued payroll taxes and benefits	35,366	34,983
Accrued professional liabilities	30,169	32,232
Accrued interest	3,204	8,921
Other accrued expenses	52,134	68,401
Accounts payable and accrued expenses, total	$ 302,583	$ 374,225

Accounts Payable and Accrued _4

Accounts Payable and Accrued Expenses - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Net decrease in accrued salaries and bonuses	$ 47.8

Line of Credit and Long Term _2

Line of Credit and Long Term Debt (Additional Information) (Details) - USD ($) $ in Thousands		9 Months Ended
	Feb. 11, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Debt Instrument [Line Items]
Debt instrument interest rate		5.375%
Debt Instrument, Frequency of Periodic Payment		payable semi-annually in arrears on February 15 and August 15, beginning on August 15, 2022
Debt Instrument, Description		Notes are guaranteed on an unsecured senior basis by the same subsidiaries and affiliated professional contractors that guarantee the Amended Credit Agreement (as defined below). The indenture under which the 2030 Notes are issued, among other things, limits the Company's ability to (1) incur liens and (2) enter into sale and lease-back transactions, and also limits the Company's ability to merge or dispose of all or substantially all of its assets, in all cases, subject to a number of customary exceptions
Purchase price		101%
Borrowings on revolving credit line		$ 470,000	$ 674,500
Line of credit		0		$ 4,000
Long-Term Debt
Debt Instrument [Line Items]
Proceeds from issuance of unsecured debt	$ 250,000
Cash on hand	308,000
Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit facility, available balance		450,000
Long term debt		231,300
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Proceeds from issuance of unsecured debt	100,000
Borrowings on revolving credit line		37,500
Revolving Credit Facility [Member] | Long-Term Debt
Debt Instrument [Line Items]
Proceeds from issuance of unsecured debt		250,000
Revolving Credit Facility [Member] | Credit Agreement [Member]
Debt Instrument [Line Items]
Unsecured note issued		$ 450,000
Interest Rate, description		(i) the Alternate Base Rate (defined as the highest of (a) the prime rate as announced by Bank of America, N.A., (b) the Federal Funds Rate plus 0.50% and (c) Term Secured Overnight Financing Rate ("SOFR") for an interest period of one month plus 1.00% with a 1.00% floor) plus an applicable margin rate of 0.50% for the first two fiscal quarters after the date of the Credit Agreement Amendment, and thereafter at an applicable margin rate ranging from 0.125% to 0.750% based on the Company's consolidated net leverage ratio or (ii) Term SOFR rate (calculated as the Secured Overnight Financing Rate published on the applicable Reuters screen page plus a spread adjustment of 0.10%, 0.15% or 0.25% depending on if the Company selects a one-month, three-month or six-month interest period, respectively, for the applicable loan with a 0% floor), plus an applicable margin rate of 1.50% for the first two full fiscal quarters after the date of the Credit Agreement Amendment, and thereafter at an applicable margin rate ranging from 1.125% to 1.750% based on the Company's consolidated net leverage ratio. The Amended Credit Agreement also provides for other customary fees and charges, including an unused commitment fee with respect to the Revolving Credit Line ranging from 0.150% to 0.200% of the unused lending commitments under the Revolving Credit Line
5.375% Unsecured Senior Notes Due 2030 [Member]
Debt Instrument [Line Items]
Senior notes	$ 400,000
Debt instrument interest rate	5.375%
Debt instrument, maturity year	2030
Interest accrued periodically		$ 21,500
Long term debt		$ 400,000
6.25% senior unsecured notes due 2027
Debt Instrument [Line Items]
Debt instrument, interest rate, effective percentage	6.25%
2027 Notes
Debt Instrument [Line Items]
Long term debt	$ 1,000,000

Common and Common Equivalent _3

Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Weighted average number of common shares outstanding	82,543,000	82,126,000	82,127,000	84,122,000
Weighted average number of dilutive common share equivalents	407,000	650,000	365,000	699,000
Weighted average number of common and common equivalent shares outstanding	82,950,000	82,776,000	82,492,000	84,821,000
Antidilutive securities (restricted stock and stock options) not included in the diluted net income per common share calculation	888,000	1,000	1,201,000	273,000

Stock Incentive Plans and Sto_2

Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 3.2	$ 4.1	$ 9.3	$ 12.9
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			3 years
Employee Stock Option | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period of options, maximum years			10 years
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			3 years
1996 Non-Qualified Employee Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate number Shares issued under Stock Purchase Plans			0
2015 Non-Qualified Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of market value of common stock at which employees are permitted to purchase			90%
Amended and Restated 2008 Plan [Member] | Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants and awards under Stock Incentive Plans	8,100,000		8,100,000
Amended and Restated 2008 Plan [Member] | Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-Based Compensation Arrangement by Share-Based Payment Award, Equity Instruments Other than Options, Grants in Period			800,000
1996 Non-Qualified Employee Stock Purchase Plan and 2015 Non-Qualified Stock Purchase Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of market value of common stock at which employees are permitted to purchase			85%
Aggregate number Shares issued under Stock Purchase Plans			300,000
Common stock, reserved for issuance	2,200,000		2,200,000
1996 Non-Qualified Employee Stock Purchase Plan and 2015 Non-Qualified Stock Purchase Plan [Member] | Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock, reserved for issuance	61,000		61,000

Common Stock Repurchase Progr_2

Common Stock Repurchase Programs - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022	Aug. 31, 2018
Common Stock [Line Items]
Repurchased common stock, shares							0
Common stock authorized for repurchase									$ 500,000
Company's Common stock repurchased									$ 5,500
Payments for repurchase of common stock							$ 919	$ 87,041
Common Stock [Member]
Common Stock [Line Items]
Repurchased common stock, shares	(11,000)	(1,000)	(49,000)	(1,121,000)	(3,275,000)	(50,000)
Payments for repurchase of common stock							$ 900
Stock Repurchase Program, Number of Shares Authorized to be Repurchased	4,600,000						4,600,000

Coronavirus Pandemic (COVID-1_2

Coronavirus Pandemic (COVID-19) - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Sep. 30, 2022
COVID-19 [Member]
Proceeds From Contribution In Aid Of Reimbursement of Lost Revenue	$ 0.3	$ 11.4