Pediatrix Medical (MD) 10-Q 6 Nov 20 2020 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2020	Nov. 02, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Amendment Flag	false
Document Period End Date	Sep. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Entity Registrant Name	MEDNAX, INC.
Entity Central Index Key	0000893949
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Common Stock, Shares Outstanding		85,598,299
Title of 12(b) Security	Common Stock
Trading Symbol	MD
Security Exchange Name	NYSE
Entity 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

Consolidated Balance Sheets (Un

Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 294,512	$ 107,870
Short-term investments	81,574	74,510
Accounts receivable, net	267,125	434,266
Prepaid expenses	13,317	17,108
Income taxes receivable	22,797	0
Other current assets	20,287	11,837
Assets held for sale	951,548	85,916
Total current assets	1,651,160	731,507
Property and equipment, net	78,570	72,677
Goodwill	1,480,668	1,479,850
Intangible assets, net	27,665	28,587
Operating lease right-of-use assets	58,993	56,413
Deferred income tax assets	62,950	86,644
Other assets	64,820	48,643
Assets held for sale	0	1,641,580
Total assets	3,424,826	4,145,901
Current liabilities:
Accounts payable and accrued expenses	388,517	410,637
Current portion of finance lease liabilities	2,440	0
Current portion of operating lease liabilities	18,695	18,254
Income taxes payable	0	6,039
Liabilities held for sale	78,712	106,888
Total current liabilities	488,364	541,818
Long-term debt and finance lease liabilities, net	1,742,263	1,730,238
Long-term operating lease liabilities	40,220	44,643
Long-term professional liabilities	242,366	204,914
Deferred income tax liabilities	63,630	56,468
Other liabilities	42,977	22,819
Liabilities held for sale	0	46,005
Total liabilities	2,619,820	2,646,905
Shareholders' equity:
Preferred stock; $.01 par value; 1,000 shares authorized; none issued	0	0
Common stock; $.01 par value; 200,000 shares authorized; 85,504 and 84,248 shares issued and outstanding, respectively	855	842
Additional paid-in capital	1,023,974	987,942
Accumulated other comprehensive income	1,990	78
Retained (deficit) earnings	(222,058)	510,134
Total MEDNAX, Inc. shareholders' equity	804,761	1,498,996
Noncontrolling interest	245	0
Total equity	805,006	1,498,996
Total liabilities and equity	$ 3,424,826	$ 4,145,901

Consolidated Balance Sheets (_2

Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
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	85,504,000	84,248,000
Common stock, shares outstanding	85,504,000	84,248,000

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Statement [Abstract]
Net revenue		$ 460,635	$ 454,913	$ 1,317,321	$ 1,321,159
Operating expenses:
Practice salaries and benefits		309,904	301,306	909,168	880,686
Practice supplies and other operating expenses		22,440	22,581	66,455	72,688
General and administrative expenses		66,346	63,284	194,276	185,318
Depreciation and amortization		7,195	6,408	20,749	18,830
Transformational and restructuring related expenses		34,291	12,766	60,846	32,025
Total operating expenses		440,176	406,345	1,251,494	1,189,547
Income from operations		20,459	48,568	65,827	131,612
Investment and other income		10,534	802	13,064	2,777
Interest expense		(27,250)	(29,909)	(83,180)	(91,271)
Equity in earnings of unconsolidated affiliates		282	786	1,081	1,753
Total non-operating expenses		(16,434)	(28,321)	(69,035)	(86,741)
Income (loss) from continuing operations before income taxes		4,025	20,247	(3,208)	44,871
Income tax provision		(6,677)	(7,360)	(10,859)	(12,590)
(Loss) income from continuing operations		(2,652)	12,887	(14,067)	32,281
Loss from discontinued operations, net of tax		(38,392)	(1,268,803)	(718,125)	(1,539,314)
Net loss		$ (41,044)	$ (1,255,916)	$ (732,192)	$ (1,507,033)
(Loss) income from continuing operations:
Basic		$ (0.03)	$ 0.16	$ (0.17)	$ 0.39
Diluted		(0.03)	0.16	(0.17)	0.38
Loss from discontinued operations:
Basic		(0.46)	(15.39)	(8.62)	(18.36)
Diluted		(0.46)	(15.31)	(8.62)	(18.26)
Net loss:
Basic		(0.49)	(15.23)	(8.79)	(17.97)
Diluted		$ (0.49)	$ (15.15)	$ (8.79)	$ (17.88)
Weighted average common shares:
Basic		83,862	82,441	83,260	83,846
Diluted	[1]	83,862	82,883	83,260	84,302
[1]	Due to a loss from continuing operations for the three months and nine months ended September 30, 2020, no incremental shares are included because the effect would be antidilutive.

Consolidated Statements of Equi

Consolidated Statements of Equity - USD ($) shares in Thousands, $ in Thousands		Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained (Deficit) Earnings [Member]
Balance at Dec. 31, 2018		$ 3,087,884	$ 878	$ 992,647	$ 2,094,359
Balance, Shares at Dec. 31, 2018			87,820
Net loss		(242,872)			(242,872)
Unrealized holding gain (loss) on investments, net of tax		(194)			(194)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		3,542	$ 1	3,541
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			140
Issuance of restricted stock and conversion of restricted stock units to common stock			$ 10	(10)
Issuance of restricted stock and conversion of restricted stock units to common stock, shares			978
Forfeitures of restricted stock, shares			(6)
Stock swaps		(666)		(666)
Stock swaps, shares			(20)
Stock-based compensation expense		11,100		11,100
Repurchased common stock		(78,982)	$ (25)	(28,740)	(50,217)
Repurchased common stock, shares			(2,525)
Balance at Mar. 31, 2019		2,779,812	$ 864	977,872	1,801,076
Balance, Shares at Mar. 31, 2019			86,387
Balance at Dec. 31, 2018		3,087,884	$ 878	992,647	2,094,359
Balance, Shares at Dec. 31, 2018			87,820
Net loss		(1,507,033)
Balance at Sep. 30, 2019		1,479,360	$ 842	977,709	500,809
Balance, Shares at Sep. 30, 2019			84,185
Balance at Mar. 31, 2019		2,779,812	$ 864	977,872	1,801,076
Balance, Shares at Mar. 31, 2019			86,387
Net loss		(8,245)			(8,245)
Unrealized holding gain (loss) on investments, net of tax		232			232
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		3,675	$ 2	3,673
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			155
Issuance of restricted stock and conversion of restricted stock units to common stock			$ 1	(1)
Issuance of restricted stock and conversion of restricted stock units to common stock, shares			123
Forfeitures of restricted stock			$ (1)	1
Forfeitures of restricted stock, shares			(61)
Stock-based compensation expense		15,080		15,080
Repurchased common stock		(65,527)	$ (25)	(29,196)	(36,306)
Repurchased common stock, shares			(2,508)
Balance at Jun. 30, 2019		2,725,027	$ 841	967,429	1,756,757
Balance, Shares at Jun. 30, 2019			84,096
Net loss		(1,255,916)			(1,255,916)
Unrealized holding gain (loss) on investments, net of tax		(32)			(32)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		2,606	$ 1	2,605
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			124
Issuance of restricted stock and conversion of restricted stock units to common stock, shares			12
Forfeitures of restricted stock, shares			(27)
Stock-based compensation expense		8,090		8,090
Repurchased common stock		(415)		(415)
Repurchased common stock, shares			(20)
Balance at Sep. 30, 2019		1,479,360	$ 842	977,709	500,809
Balance, Shares at Sep. 30, 2019			84,185
Balance at Dec. 31, 2019		1,498,996	$ 842	987,942	510,212
Balance, Shares at Dec. 31, 2019			84,248
Net loss		(18,712)			(18,712)
Unrealized holding gain (loss) on investments, net of tax	[1]	(213)			(213)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,832	$ 1	1,831
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			78
Issuance of restricted stock and conversion of restricted stock units to common stock			$ 10	(10)
Issuance of restricted stock and conversion of restricted stock units to common stock, shares			968
Forfeitures of restricted stock, shares			(19)
Stock-based compensation expense		8,035		8,035
Repurchased common stock		(2,542)	$ (1)	(2,541)
Repurchased common stock, shares			(125)
Balance at Mar. 31, 2020		1,487,396	$ 852	995,257	491,287
Balance, Shares at Mar. 31, 2020			85,150
Balance at Dec. 31, 2019		1,498,996	$ 842	987,942	510,212
Balance, Shares at Dec. 31, 2019			84,248
Net loss		(732,192)
Balance at Sep. 30, 2020		805,006	$ 855	1,023,974	(219,823)
Balance, Shares at Sep. 30, 2020			85,504
Balance at Mar. 31, 2020		1,487,396	$ 852	995,257	491,287
Balance, Shares at Mar. 31, 2020			85,150
Net loss		(672,436)			(672,436)
Unrealized holding gain (loss) on investments, net of tax	[1]	2,078			2,078
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		2,544	$ 3	2,541
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			277
Issuance of restricted stock and conversion of restricted stock units to common stock			$ 2	(2)
Issuance of restricted stock and conversion of restricted stock units to common stock, shares			200
Forfeitures of restricted stock			$ (1)	1
Forfeitures of restricted stock, shares			(57)
Stock-based compensation expense		7,489		7,489
Repurchased common stock		(501)	$ (1)	(500)
Repurchased common stock, shares			(34)
Balance at Jun. 30, 2020		826,570	$ 855	1,004,786	(179,071)
Balance, Shares at Jun. 30, 2020			85,536
Net loss		(41,044)			(41,044)
Contribution from noncontrolling Interests	[1]	245			245
Unrealized holding gain (loss) on investments, net of tax	[1]	47			47
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan		1,324	$ 1	1,323
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares			89
Issuance of restricted stock and conversion of restricted stock units to common stock			$ 3	(3)
Issuance of restricted stock and conversion of restricted stock units to common stock, shares			282
Forfeitures of restricted stock			$ (1)	1
Forfeitures of restricted stock, shares			(92)
Stock-based compensation expense		23,316		23,316
Repurchased common stock		(5,452)	$ (3)	(5,449)
Repurchased common stock, shares			(311)
Balance at Sep. 30, 2020		$ 805,006	$ 855	$ 1,023,974	$ (219,823)
Balance, Shares at Sep. 30, 2020			85,504
[1]	Presented within retained (deficit) earnings as the balance is immaterial.

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities:
Net loss	$ (732,192)	$ (1,507,033)
Loss from discontinued operations	718,125	1,539,314
Adjustments to reconcile net income to net cash from operating activities:
Depreciation and amortization	20,749	18,830
Amortization of premiums, discounts and issuance costs	4,076	4,293
Stock-based compensation expense	36,120	27,512
Deferred income taxes	30,214	(13,484)
Other	(30)	3,370
Changes in assets and liabilities:
Accounts receivable	30,006	7,491
Prepaid expenses and other current assets	(1,716)	(22,545)
Other long-term assets	7,703	21,825
Accounts payable and accrued expenses	(36,433)	(2,238)
Income taxes payable / receivable	(28,837)	(25,838)
Long-term professional liabilities	15,703	4,508
Other liabilities	8,157	(19,768)
Net cash provided by operating activities – continuing operations	71,645	36,237
Net cash provided by operating activities—discontinued operations	144,841	186,177
Net cash provided by operating activities	216,486	222,414
Cash flows from investing activities:
Acquisition payments, net of cash acquired	(2,225)	(31,200)
Purchases of investments	(36,090)	(13,907)
Proceeds from maturities or sales of investments	30,865	26,240
Purchases of property and equipment	(21,809)	(14,862)
Proceeds from sale of business, net of cash sold	1,080	0
Net cash used in investing activities – continuing operations	(28,179)	(33,729)
Net cash provided by (used in) investing activities—discontinued operations	3,079	(20,793)
Net cash used in investing activities	(25,100)	(54,522)
Cash flows from financing activities:
Borrowings on credit agreement	527,500	1,225,800
Payments on credit agreement	(527,500)	(1,755,500)
Proceeds from issuance of senior notes	0	500,000
Payments for credit facility amendment and financing costs	(510)	(9,194)
Payments on finance lease obligations	(433)	0
Proceeds from issuance of common stock	5,697	9,157
Contribution from noncontrolling interests	245	0
Repurchases of common stock	(8,495)	(144,925)
Net cash used in financing activities – continuing operations	(3,496)	(174,662)
Net cash used in financing activities—discontinued operations	(1,248)	(8,909)
Net cash used in financing activities	(4,744)	(183,571)
Net increase (decrease) in cash and cash equivalents	186,642	(15,679)
Cash and cash equivalents at beginning of period	107,870	40,774
Cash and cash equivalents at end of period	$ 294,512	$ 25,095

Basis of Presentation and New A

Basis of Presentation and New Accounting Pronouncements	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation and New Accounting Pronouncements	1. Basis of Presentation and New Accounting Pronouncements: The accompanying unaudited Consolidated Financial Statements of the Company and the notes thereto presented in this Form 10-Q r The Company 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. In August 2020, the Company entered into a joint venture in which it owns a 51% economic interest and for which it is deemed the primary beneficiary. The equity interests of the outside investor in the equity of this consolidated entity is accounted for and presented as noncontrolling interests on the Company’s Consolidated Balance Sheets. Although the joint venture was formed the will be accounted for and presented as such 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 In October 2019, the Company divested its management services organization, which operated as MedData, to allow the Company to focus on its core physician services business. The operating results of MedData are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and nine months ended September 30, 2019. In May 2020, the Company divested its anesthesiology services medical group. The operating results of this medical group are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and nine months ended September 30, 2020 and 2019. On September 9, entered into a definitive agreement to divest its radiology services medical group. The operating results of this medical group are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and nine months ended September 30, 2020 and 2019. Reclassifications have been made to certain prior period financial statements and footnote disclosures to reflect the impact of discontinued operations. See Note 6 – Assets Held for Sale and Discontinued Operations for additional information. New Accounting Pronouncements In December 2019, accounting guidance related to income taxes was issued with the goal of enhancing and simplifying various aspects of the income tax accounting guidance, including requirements related to hybrid tax regimes, deferred taxes on step-up year-to-date

Coronavirus Pandemic ("COVID-19

Coronavirus Pandemic ("COVID-19")	9 Months Ended
	Sep. 30, 2020
Extraordinary Items [Abstract]
Coronavirus Pandemic ("COVID-19")	2. Coronavirus Pandemic (“COVID-19”): COVID-19 mid-March non-urgent with much of this reduction focused in non-urgent COVID-19. COVID-19 mid-March The Company implemented a number of actions to preserve financial flexibility and partially mitigate the significant anticipated impact of COVID-19. COVID-19. non-clinical COVID-19. In response to the anticipated impact of COVID-19 CARES Act On March 27, 2020, President Trump signed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) into law. The CARES Act is a relief package intended to assist many aspects of the American economy, including providing up to $100 billion in aid to the healthcare industry to reimburse healthcare providers for lost revenue and expenses attributable to COVID-19. COVID-19, within continuing operations In addition, the CARES Act also provides for deferred payment of the employer portion of social security taxes through the end of 2020, with 50% of the deferred amount due December 31, 2021 and the remaining 50% due December 31, 2022. The Company intends to utilize this deferral option throughout 2020. The COVID-19 pandemic has impacted the Company’s

Cash Equivalents and Investment

Cash Equivalents and Investments	9 Months Ended
	Sep. 30, 2020
Investments, Debt and Equity Securities [Abstract]
Cash Equivalents and Investments	3. Cash Equivalents and Investments: As of September 30, 2020 and December 31, 2019, the Company’s cash equivalents consisted entirely of money market funds totaling $2.4 million and $16.8 million, respectively. Investments consisted of corporate securities, municipal debt securities, federal home loan securities and certificates of deposit. All investments are classified as current. Investments held at September 30, 2020 and December 31, 2019 are summarized as follows (in thousands): September 30, 2020 December 31, 2019 Corporate securities $ 56,680 $ 32,962 Municipal debt securities 13,523 29,066 Federal home loan securities 6,529 8,013 Certificates of deposit 4,842 4,469 $ 81,574 $ 74,510

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Disclosures	4. Fair Value Measurements: The accounting guidance establishes a fair value hierarchy that prioritizes valuati o 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, 2020 and December 31, 2019 (in thousands): Fair Value Fair Value September 30, 2020 December 31, 2019 Assets: Money market funds Level 1 $ 2,411 $ 16,775 Short-term investments Level 2 81,574 74,510 Mutual Funds Level 1 14,446 14,264 The following table presents information about the Company’s financial instruments that are not carried at fair value at September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Carrying Fair Value Carrying Fair Value Liabilities: 2023 Notes 750,000 759,375 750,000 766,875 2027 Notes 1,000,000 1,035,000 1,000,000 1,025,600 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 Company’s 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, 2020
Text Block [Abstract]
Accounts Receivable and Net Revenue	5. Accounts Receivable and Net Revenue: Accounts receivable, net consists of the following (in thousands): September 30, 2020 December 31, 2019 Gross accounts receivable $ 1,119,171 $ 1,750,264 Allowance for contractual adjustments and uncollectibles (852,046 ) (1,315,998 ) $ 267,125 $ 434,266 Patient service 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 September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net patient service revenue $ 382,936 $ 400,330 $ 1,133,313 $ 1,159,363 Hospital contract administrative fees 61,186 51,149 154,840 149,407 Other revenue 16,513 3,434 29,168 12,389 $ 460,635 $ 454,913 $ 1,317,321 $ 1,321,159 The approximate percentage of net patient service revenue by type of payor was as follows: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Contracted managed care 69 % 68 % 69 % 68 % Government 26 26 26 26 Other third-parties 4 5 4 5 Private-pay 1 1 1 1 100 % 100 % 100 % 100 %

Business Combinations, Assets H

Business Combinations, Assets Held for Sale and Discontinued Operations	9 Months Ended
	Sep. 30, 2020
Business Combinations Assets Held For Sale And Discontinued Operations Disclosure [Abstract]
Business Combinations, Assets Held for Sale and Discontinued Operations	6. Business Combinations, Assets Held for Sale and Discontinued Operations: Business Combinations During the nine months ended September 30, 2020, the Company completed the acquisition of one pediatric subspecialty practice for total consideration of $2.1 million, of which $1.9 million was paid in cash and $0.2 million was recorded as a contingent consideration liability. This acquisition expanded the Company’s national network of physician practices. In connection with this acquisition, the Company recorded non-deductible Divestiture of the On September 9 , securities purchase agreement with Radiology Partners, Inc., pursuant to which Radiology Partners, Inc. will acquire the Company’s radiology services medical group for $885 million cash, subject to certain customary adjustments. This divestiture will allow the Company to focus solely on its Pediatrix and Obstetrix medical groups. The Company determined that the criterion to classify the radiology services medical group as assets held for sale within the Company’s Consolidated Balance Sheets effective September 30, 2020 were met. Accordingly, the assets and liabilities of the radiology services medical group were classified as current assets and current liabilities held for sale at September 30, 2020 as the Company expects to divest of the radiology services medical group within the next twelve months. The classification to assets held for sale impacted the net book value of the assets and liabilities expected to be transferred upon sale. The estimated fair value of the radiology services medical group was determined using the purchase price in the purchase agreement along with estimated broker, accounting, legal and other selling expenses. The Company deemed the carrying amount of other within the medical group, specifically accounts receivable and property and equipment, to represent fair value and therefore recorded a non-cash generated an additional $4.0 million deferred tax asset that increased the fair value of the medical group. An incremental non-cash radiology services non-cash non-cash In addition, in accordance with accounting guidance for discontinued operations, the expected divestiture of the radiology services medical group was deemed to represent a fundamental strategic shift that will have a major effect on the Company’s operations, and accordingly, the operating results of the radiology services medical group were reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and nine months ended September 30, 2020 with prior periods recast to conform with the current period presentation. The following table represents the major classes of assets and liabilities of the radiology services medical group that are included as assets and liabilities held for sale in the accompanying Consolidated Balance Sheets as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Assets Accounts receivable, net $ 54,284 $ 64,603 Prepaid expenses and other current 9,819 9,744 Property and equipment, net 20,078 19,204 Operating leases right-of-use 14,165 15,008 Goodwill 640,818 685,170 Intangible assets, net 170,059 180,978 Deferred income tax assets 6,020 18,183 Other assets 36,305 40,724 $ 951,548 $ 1,033,614 Liabilities Accounts payable and accrued expenses $ 39,505 $ 42,474 Operating and finance leases 13,619 14,355 Long-term professional liabilities 23,744 21,978 Other liabilities 1,844 81 $ 78,712 $ 78,888 The following table summarizes the results of discontinued operations related to the radiology services medical group for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net revenue $ 125,765 $ 125,650 $ 340,133 $ 366,678 Operating expenses: Cost of service salaries and benefits 84,718 80,336 234,169 238,402 Cost of service supplies and other operating expenses 1,449 1,532 4,273 (1,468 ) General and administrative expenses 19,876 20,734 57,178 64,490 Depreciation and amortization 5,090 7,595 20,328 22,757 Transformational and restructuring related expenses 2,491 441 6,517 1,487 Goodwill impairment 46,963 117,924 46,963 117,924 Total operating expenses 160,587 228,562 369,428 443,592 Loss from operations (34,822 ) (102,912 ) (29,295 ) (76,914 ) Non-operating 1,369 2,059 3,035 4,768 Loss before income taxes (33,453 ) (100,853 ) (26,260 ) (72,146 ) Income tax (provision) benefit (62 ) 3,907 (1,988 ) (3,687 ) Net loss $ (33,515 ) $ (96,946 ) $ (28,248 ) $ (75,833 ) Divestiture of the Anesthesiology Services Medical Group On May 6, 2020, the Company entered into a securities purchase agreement with an affiliate of North American Partners in Anesthesia (“NAPA”) to divest the Company’s anesthesiology services medical group, and the transaction closed on May 6, 2020. Pursuant to the terms and conditions of the agreement, at the closing of the transaction, the Company received a cash payment of $50.0 million, subject to certain customary adjustments, as well as a contingent economic interest in NAPA with a value ranging from $0 to $250 million based upon the multiple of invested capital returned to NAPA’s owners upon exit of the investment. The Company will begin to receive a payment on its economic interest at an exit multiple of 2.0, with such payment reaching $250 million at an exit multiple of 5.0. In addition, the Company retained the accounts receivable of the anesthesiology services medical group, which net of various other working capital items, approximated $110.0 million at March 31, 2020. operating results of the anesthesiology services medical group service line were reported as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and nine months ended September 30, 2020 and 2019. A single anesthesiology practice was not included in the divestiture of the anesthesiology services medical group, and continues to operate as an affiliate of the Company. Its results of operations are reflected in the three months ended September 30, 2020 while the incremental loss on sale of the anesthesiology services medical group recorded during the three months ended September 30, 2020 reflects a true up of various divested account balances during the third quarter of 2020. The total preliminary loss on sale of the anesthesiology services medical group true-up, that will expire The following table summarizes the results of discontinued operations related to the anesthesiology services medical group for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net revenue $ 2,700 $ 309,602 $ 377,661 $ 924,845 Operating expenses: Cost of service salaries and benefits 2,746 250,157 351,408 746,237 Cost of service supplies and other operating expenses 38 2,837 5,254 9,537 General and administrative expenses 215 18,338 31,179 57,909 Depreciation and amortization — 5,605 6,308 17,863 Transformational and restructuring related expenses — 6,785 28,634 17,506 Goodwill impairment — 1,331,291 — 1,331,291 Loss on sale, net 4,499 — 644,653 — Total operating expenses 7,498 1,615,013 1,067,436 2,180,343 Loss from operations (4,798 ) (1,305,411 ) (689,775 ) (1,255,498 ) Non-operating — (17 ) 51 (14 ) Loss before income taxes (4,798 ) (1,305,428 ) (689,724 ) (1,255,512 ) Income tax benefit 100 129,241 5,661 115,987 Net loss $ (4,698 ) $ (1,176,187 ) $ (684,063 ) $ (1,139,525 ) Divestiture of MedData The Company divested of its true-up

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	9 Months Ended
	Sep. 30, 2020
Payables and Accruals [Abstract]
Accounts Payable and Accrued Expenses	7. Accounts Payable and Accrued Expenses: Accounts payable and accrued expenses consist of the following (in thousands): September 30, December 31, Accounts payable $ 60,956 $ 35,410 Accrued salaries and bonuses 158,579 193,631 Accrued payroll taxes and benefits 48,474 54,768 Accrued professional liabilities 55,469 44,699 Accrued interest 26,940 32,910 Other accrued expenses 38,099 49,219 $ 388,517 $ 410,637 The net decrease in accrued salaries and bonuses of $35.1 million, from December 31, 2019 to September 30, 2020, 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, 2020. A majority of the Company’s payments for performance-based incentive compensation is paid annually during the first quarter.

Common and Common Equivalent Sh

Common and Common Equivalent Shares	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Common and Common Equivalent Shares	8. 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, deferred 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, 2020 and 2019 is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Weighted average number of common shares outstanding 83,862 82,441 83,260 83,846 Weighted average number of dilutive common share equivalents — 442 — 456 Weighted average number of common and common equivalent shares outstanding (a) 83,862 82,883 83,260 84,302 Antidilutive securities not included in the diluted net income per common share calculation 829 962 1,004 796 (a) Due to a loss from continuing operations for the three months and nine months ended September 30, 2020, no incremental shares are included because the effect wou l

Stock Incentive Plans and Stock

Stock Incentive Plans and Stock Purchase Plans	9 Months Ended
	Sep. 30, 2020
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Incentive Plans and Stock Purchase Plans	9. Stock Incentive Plans and Stock Purchase Plans: The Company’s Amended and Restated 2008 Incentive Compensation Plan (the “A&R 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 A&R 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, deferred stock awards and stock options ratably over the corresponding vesting periods. During the nine months ended September 30, 2020, the Company granted 1.4 million shares of restricted stock and 1.0 million shares of stock underlying non-qualified non-employee Under the Company’s 1996 Non-Qualified Non-Qualified non-employee Each of the ESPP and the SPP provide for the issuance of an aggregate of 2.6 million shares of the Company’s common stock less the number of shares of common stock purchased under the other plan. The Company recognizes stock-based compensation expense for the discount received by participating employees and non-employee During the three and nine months ended September 30, 2020 and 2019, the Company recognized stock-based compensation expense of $4.5 million and $18.2 million, and $7.6 million and $27.6 million, respectively.

Common Stock Repurchase Program

Common Stock Repurchase Programs	9 Months Ended
	Sep. 30, 2020
Text Block [Abstract]
Common Stock Repurchase Programs	10. 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 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 $107.2 million remained available for repurchase as of December 31, 2019. Under this share repurchase program, during the nine months ended September 30, 2020, the Company withheld approximately 0.5 million shares of its common stock to satisfy minimum statutory withholding obligations of $8.5 million in connection with the vesting of restricted stock and deferred stock. 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.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
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, 2020 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.

Basis of Presentation and New_2

Basis of Presentation and New Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements In December 2019, accounting guidance related to income taxes was issued with the goal of enhancing and simplifying various aspects of the income tax accounting guidance, including requirements related to hybrid tax regimes, deferred taxes on step-up year-to-date

Cash Equivalents and Investme_2

Cash Equivalents and Investments (Tables)	9 Months Ended
	Sep. 30, 2020
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	Investments held at September 30, 2020 and December 31, 2019 are summarized as follows (in thousands): September 30, 2020 December 31, 2019 Corporate securities $ 56,680 $ 32,962 Municipal debt securities 13,523 29,066 Federal home loan securities 6,529 8,013 Certificates of deposit 4,842 4,469 $ 81,574 $ 74,510

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2020
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, 2020 and December 31, 2019 (in thousands): Fair Value Fair Value September 30, 2020 December 31, 2019 Assets: Money market funds Level 1 $ 2,411 $ 16,775 Short-term investments Level 2 81,574 74,510 Mutual Funds Level 1 14,446 14,264
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, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Carrying Fair Value Carrying Fair Value Liabilities: 2023 Notes 750,000 759,375 750,000 766,875 2027 Notes 1,000,000 1,035,000 1,000,000 1,025,600

Accounts Receivable and Net R_2

Accounts Receivable and Net Revenue (Tables)	9 Months Ended
	Sep. 30, 2020
Text Block [Abstract]
Schedule of Accounts Receivable, Net	Accounts receivable, net consists of the following (in thousands): September 30, 2020 December 31, 2019 Gross accounts receivable $ 1,119,171 $ 1,750,264 Allowance for contractual adjustments and uncollectibles (852,046 ) (1,315,998 ) $ 267,125 $ 434,266
Schedule of Net Revenue	The following table summarizes the Company’s net revenue by category (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net patient service revenue $ 382,936 $ 400,330 $ 1,133,313 $ 1,159,363 Hospital contract administrative fees 61,186 51,149 154,840 149,407 Other revenue 16,513 3,434 29,168 12,389 $ 460,635 $ 454,913 $ 1,317,321 $ 1,321,159
Schedule of Percentage of Net Revenue	The approximate percentage of net patient service revenue by type of payor was as follows: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Contracted managed care 69 % 68 % 69 % 68 % Government 26 26 26 26 Other third-parties 4 5 4 5 Private-pay 1 1 1 1 100 % 100 % 100 % 100 %

Business Combinations, Assets_2

Business Combinations, Assets Held for Sale and Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2020
Radiology Partners Inc [Member]
Disposal Groups, Including Discontinued Operations	The following table represents the major classes of assets and liabilities of the radiology services medical group that are included as assets and liabilities held for sale in the accompanying Consolidated Balance Sheets as of September 30, 2020 and December 31, 2019 (in thousands): September 30, 2020 December 31, 2019 Assets Accounts receivable, net $ 54,284 $ 64,603 Prepaid expenses and other current 9,819 9,744 Property and equipment, net 20,078 19,204 Operating leases right-of-use 14,165 15,008 Goodwill 640,818 685,170 Intangible assets, net 170,059 180,978 Deferred income tax assets 6,020 18,183 Other assets 36,305 40,724 $ 951,548 $ 1,033,614 Liabilities Accounts payable and accrued expenses $ 39,505 $ 42,474 Operating and finance leases 13,619 14,355 Long-term professional liabilities 23,744 21,978 Other liabilities 1,844 81 $ 78,712 $ 78,888 The following table summarizes the results of discontinued operations related to the radiology services medical group for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net revenue $ 125,765 $ 125,650 $ 340,133 $ 366,678 Operating expenses: Cost of service salaries and benefits 84,718 80,336 234,169 238,402 Cost of service supplies and other operating expenses 1,449 1,532 4,273 (1,468 ) General and administrative expenses 19,876 20,734 57,178 64,490 Depreciation and amortization 5,090 7,595 20,328 22,757 Transformational and restructuring related expenses 2,491 441 6,517 1,487 Goodwill impairment 46,963 117,924 46,963 117,924 Total operating expenses 160,587 228,562 369,428 443,592 Loss from operations (34,822 ) (102,912 ) (29,295 ) (76,914 ) Non-operating 1,369 2,059 3,035 4,768 Loss before income taxes (33,453 ) (100,853 ) (26,260 ) (72,146 ) Income tax (provision) benefit (62 ) 3,907 (1,988 ) (3,687 ) Net loss $ (33,515 ) $ (96,946 ) $ (28,248 ) $ (75,833 )
North American Partners In Anesthesia [Member]
Disposal Groups, Including Discontinued Operations	The following table summarizes the results of discontinued operations related to the anesthesiology services medical group for the three and nine months ended September 30, 2020 and 2019 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Net revenue $ 2,700 $ 309,602 $ 377,661 $ 924,845 Operating expenses: Cost of service salaries and benefits 2,746 250,157 351,408 746,237 Cost of service supplies and other operating expenses 38 2,837 5,254 9,537 General and administrative expenses 215 18,338 31,179 57,909 Depreciation and amortization — 5,605 6,308 17,863 Transformational and restructuring related expenses — 6,785 28,634 17,506 Goodwill impairment — 1,331,291 — 1,331,291 Loss on sale, net 4,499 — 644,653 — Total operating expenses 7,498 1,615,013 1,067,436 2,180,343 Loss from operations (4,798 ) (1,305,411 ) (689,775 ) (1,255,498 ) Non-operating — (17 ) 51 (14 ) Loss before income taxes (4,798 ) (1,305,428 ) (689,724 ) (1,255,512 ) Income tax benefit 100 129,241 5,661 115,987 Net loss $ (4,698 ) $ (1,176,187 ) $ (684,063 ) $ (1,139,525 )

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2020
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Expenses	Accounts payable and accrued expenses consist of the following (in thousands): September 30, December 31, Accounts payable $ 60,956 $ 35,410 Accrued salaries and bonuses 158,579 193,631 Accrued payroll taxes and benefits 48,474 54,768 Accrued professional liabilities 55,469 44,699 Accrued interest 26,940 32,910 Other accrued expenses 38,099 49,219 $ 388,517 $ 410,637

Common and Common Equivalent _2

Common and Common Equivalent Shares (Tables)	9 Months Ended
	Sep. 30, 2020
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, 2020 and 2019 is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Weighted average number of common shares outstanding 83,862 82,441 83,260 83,846 Weighted average number of dilutive common share equivalents — 442 — 456 Weighted average number of common and common equivalent shares outstanding (a) 83,862 82,883 83,260 84,302 Antidilutive securities not included in the diluted net income per common share calculation 829 962 1,004 796 (a) Due to a loss from continuing operations for the three months and nine months ended September 30, 2020, no incremental shares are included because the effect wou l

Basis of Presentation and New_3

Basis of Presentation and New Accounting Pronouncements - Additional Information (Detail)	Sep. 30, 2020	Aug. 31, 2020
Corporate Joint Venture [Member]
Basis Of Presentation [Line Items]
Equity method ownership percentage in joint venture		51.00%
Unnamed Corporate Joint Venture One [Member]
Basis Of Presentation [Line Items]
Equity method ownership percentage in joint venture	37.50%

Coronavirus Pandemic ("COVID-_2

Coronavirus Pandemic ("COVID-19") - Additional Information (Detail) - USD ($) $ in Millions	Mar. 27, 2020	Mar. 25, 2020	Sep. 30, 2020
Line of credit remaining borrowing capacity			$ 899.8
Senior Unsecurd Notes 2023 [Member]
Debt Instrument Interest Rate			5.25%
Senior Unsecurd Notes 2027 [Member]
Debt Instrument Interest Rate			6.25%
Letters of Credit [Member]
Line of credit outstanding			$ 0.2
Forecast For Second And Third Quarters Of 2020 [Member] | Credit Agreement [Member]
Estimated EBITDA		$ 139.2
Forecast For Second And Third Quarters Of 2020 [Member] | Credit Agreement [Member] | Maximum [Member]
Leverage ratio		5.00:1:00
Forecast For Second And Third Quarters Of 2020 [Member] | Credit Agreement [Member] | Minimum [Member]
Leverage ratio		4.50:1:00
Forecast For Fourth Quarter Of 2020 [Member] | Credit Agreement [Member]
Leverage ratio		4.75:1:00
Forecast For First Quarter Of 2021 [Member] | Credit Agreement [Member]
Leverage ratio		2020
Forecast For Second Quarter Of 2021 [Member] | Credit Agreement [Member]
Credit Facility Borrowing Capacity		$ 300
COVID-19 [Member]
Reimbursement of Lost Revenue	$ 100
Proceeds From Contribution In Aid Of Reimbursement of Lost Revenue			$ 20
Deferred Payment Of Social Security Taxes | %	50.00%
COVID-19 [Member] | Rural Area [Member]
Reimbursement of Lost Revenue	$ 70
COVID-19 [Member] | Executive Officer [Member]
Decrease In Salary | %			50.00%

Cash Equivalents and Investme_3

Cash Equivalents and Investments - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Cash Equivalents [Member]
Cash Equivalents And Investments [Line Items]
Cash equivalents	$ 2.4	$ 16.8

Cash Equivalents and Investme_4

Cash Equivalents and Investments - Schedule of Investments (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Available-for-sale [Line Items]
Available-for-sale Securities	$ 81,574	$ 74,510
Corporate Securities [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	56,680	32,962
Municipal Debt Securities [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	13,523	29,066
Federal Home Loan Securities [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	6,529	8,013
Certificates of Deposit [Member]
Available-for-sale [Line Items]
Available-for-sale Securities	$ 4,842	$ 4,469

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of fair value on a recurring basis (Details) - Fair Value, Measurements, Recurring [Member] - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Fair Value, Inputs, Level 1 [Member]
Assets:
Money market funds	$ 2,411	$ 16,775
Mutual Funds	14,446	14,264
Fair Value, Inputs, Level 2 [Member]
Assets:
Short-term investments	$ 81,574	$ 74,510

Fair Value Measurements - Sch_2

Fair Value Measurements - Schedule of financial instruments that are not carried at fair value (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
2023 Notes [Member]
Liabilities:
Notes Payable	$ 750,000	$ 750,000
Liabilities:
Notes Payable Fair Value Disclosure	759,375	766,875
2027 Notes [Member]
Liabilities:
Notes Payable	1,000,000	1,000,000
Liabilities:
Notes Payable Fair Value Disclosure	$ 1,035,000	$ 1,025,600

Accounts Receivable and Net R_3

Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Receivables [Abstract]
Gross accounts receivable	$ 1,119,171	$ 1,750,264
Allowance for contractual adjustments and uncollectibles	(852,046)	(1,315,998)
Accounts receivable, net	$ 267,125	$ 434,266

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, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Disaggregation of Revenue [Abstract]
Net revenue	$ 460,635	$ 454,913	$ 1,317,321	$ 1,321,159
Net patient service revenue [Member]
Disaggregation of Revenue [Abstract]
Net revenue	382,936	400,330	1,133,313	1,159,363
Hospital contract administrative fees [Member]
Disaggregation of Revenue [Abstract]
Net revenue	61,186	51,149	154,840	149,407
Other revenue [Member]
Disaggregation of Revenue [Abstract]
Net revenue	$ 16,513	$ 3,434	$ 29,168	$ 12,389

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, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	100.00%	100.00%	100.00%	100.00%
Contracted Managed Care [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	69.00%	68.00%	69.00%	68.00%
Government [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	26.00%	26.00%	26.00%	26.00%
Other Third-Parties [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	4.00%	5.00%	4.00%	5.00%
Private-Pay Patients [Member]
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Percentage of net patient service revenue	1.00%	1.00%	1.00%	1.00%

Business Combinations, Assets_3

Business Combinations, Assets Held for Sale and Discontinued Operations - Additional information (Detail) $ in Thousands	May 06, 2020USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Net incremental loss on the sale of MedData		$ (38,392)	$ (1,268,803)	$ (718,125)	$ (1,539,314)
Goodwill		1,480,668		1,480,668			$ 1,479,850
Pediatric Subspecialty Practice [Member]
Business acquisition total consideration				2,100
Business acquisition consideration paid in cash				1,900
Goodwill		800		800
Other intangible assets		1,300		$ 1,300
Number of other pediatric subspecialty practices acquired				1
Business acquisition contingent consideration liability		200		$ 200
Deferred Tax Assets, Goodwill and Intangible Assets		4,000		4,000
North American Partners In Anesthesia [Member]
Preliminary and incremental gain loss on sale				648,700
Increase decrease in valuation allowance deferred tax assets				419,000
Net incremental loss on the sale of MedData		(4,698)	$ (1,176,187)	(684,063)	$ (1,139,525)
Proceeds from Divestiture of Businesses	$ 50,000
Maximum consideration receivable	250,000
Accounts receivable retained						$ 110,000
North American Partners In Anesthesia [Member] | Tax Year Two Thousand and Twenty Five [Member]
Capital loss carry forward		1,680,000		1,680,000
North American Partners In Anesthesia [Member] | Maximum [Member]
Maximum consideration receivable	250,000
North American Partners In Anesthesia [Member] | Minimum [Member]
Maximum consideration receivable	$ 0
Divestiture of MedData [Member]
Net incremental loss on the sale of MedData				5,800
Radiology Services Medical Group [Member]
Maximum consideration receivable		$ 885,000		885,000
Non-cash charge against goodwill				43,000
Deferred Tax Assets Goodwill [Member] | Pediatric Subspecialty Practice [Member]
Non-cash charge against goodwill				$ 47,000

Business Combinations, Assets_4

Business Combinations, Assets Held for Sale and Discontinued Operations - Schedule of Management Services Service Line (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Assets
Other assets	$ 0	$ 1,641,580
Radiology Services Medical Group [Member]
Assets
Accounts receivable, net	54,284	64,603
Prepaid expenses and other current assets	9,819	9,744
Property and equipment, net	20,078	19,204
Operating leases right-of-use assets	14,165	15,008
Goodwill	640,818	685,170
Intangible assets, net	170,059	180,978
Deferred income tax assets	6,020	18,183
Other assets	36,305	40,724
Total Assets	951,548	1,033,614
Liabilities
Accounts payable and accrued expenses	39,505	42,474
Operating and finance leases	13,619	14,355
Long-term professional liabilities	23,744	21,978
Other liabilities	1,844	81
Total Liabilities	$ 78,712	$ 78,888

Business Combinations, Assets_5

Business Combinations, Assets Held for Sale and Discontinued Operations - Schedule of Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Operating expenses:
Net loss	$ (38,392)	$ (1,268,803)	$ (718,125)	$ (1,539,314)
Radiology Partners Inc [Member]
Net revenue	125,765	125,650	340,133	366,678
Operating expenses:
Cost of service salaries and benefits	84,718	80,336	234,169	238,402
Cost of service supplies and other operating expenses	1,449	1,532	4,273	(1,468)
General and administrative expenses	19,876	20,734	57,178	64,490
Depreciation and amortization	5,090	7,595	20,328	22,757
Transformational and restructuring related expenses	2,491	441	6,517	1,487
Goodwill impairment	46,963	117,924	46,963	117,924
Total operating expenses	160,587	228,562	369,428	443,592
Loss from operations	(34,822)	(102,912)	(29,295)	(76,914)
Non-operating (expense) income, net	1,369	2,059	3,035	4,768
Loss before income taxes	(33,453)	(100,853)	(26,260)	(72,146)
Income tax (provision) benefit	(62)	3,907	(1,988)	(3,687)
Net loss	(33,515)	(96,946)	(28,248)	(75,833)
North American Partners In Anesthesia [Member]
Net revenue	2,700	309,602	377,661	924,845
Operating expenses:
Cost of service salaries and benefits	2,746	250,157	351,408	746,237
Cost of service supplies and other operating expenses	38	2,837	5,254	9,537
General and administrative expenses	215	18,338	31,179	57,909
Depreciation and amortization		5,605	6,308	17,863
Transformational and restructuring related expenses		6,785	28,634	17,506
Goodwill impairment		1,331,291		1,331,291
Loss on sale, net	4,499		644,653
Total operating expenses	7,498	1,615,013	1,067,436	2,180,343
Loss from operations	(4,798)	(1,305,411)	(689,775)	(1,255,498)
Non-operating (expense) income, net		(17)	51	(14)
Loss before income taxes	(4,798)	(1,305,428)	(689,724)	(1,255,512)
Income tax (provision) benefit	100	129,241	5,661	115,987
Net loss	$ (4,698)	$ (1,176,187)	$ (684,063)	$ (1,139,525)

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Accounts payable	$ 60,956	$ 35,410
Accrued salaries and bonuses	158,579	193,631
Accrued payroll taxes and benefits	48,474	54,768
Accrued professional liabilities	55,469	44,699
Accrued interest	26,940	32,910
Other accrued expenses	38,099	49,219
Accounts payable and accrued expenses, total	$ 388,517	$ 410,637

Accounts Payable and Accrued _4

Accounts Payable and Accrued Expenses - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2020USD ($)
Net decrease in accrued salaries and bonuses	$ 35.1

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 shares in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Earnings Per Share [Abstract]
Weighted average number of common shares outstanding		83,862	82,441	83,260	83,846
Weighted average number of dilutive common share equivalents			442		456
Weighted average number of common and common equivalent shares outstanding	[1]	83,862	82,883	83,260	84,302
Antidilutive securities not included in the diluted net income per common share calculation		829	962	1,004	796
[1]	Due to a loss from continuing operations for the three months and nine months ended September 30, 2020, no incremental shares are included because the effect would be antidilutive.

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, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock, aggregate shares authorized	200,000,000		200,000,000		200,000,000
Stock-based compensation expense	$ 4.5	$ 7.6	$ 18.2	$ 27.6
Stock Option [Member] | 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]
Percentage of market value of common stock at which employees are permitted to purchase			85.00%
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			90.00%
Amended and Restated 2008 Plan [Member] | Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants and awards under Stock Incentive Plans	5,000,000		5,000,000
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			1,400,000
Amended and Restated 2008 Plan [Member] | Non Qualified Stock Options [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			1,000,000
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]
Common stock, aggregate shares authorized	2,600,000		2,600,000
Aggregate number Shares issued under Stock Purchase Plans			400,000
Common stock, reserved for issuance	600,000		600,000

Common Stock Repurchase Progr_2

Common Stock Repurchase Programs - Additional Information (Detail) - USD ($) shares in Millions, $ in Millions	9 Months Ended
	Sep. 30, 2020	Dec. 31, 2019	Aug. 31, 2018
Common Stock [Line Items]
Common stock authorized for repurchase			$ 500
Company's Common stock repurchased		$ 107.2
Restricted Stock [Member]
Common Stock [Line Items]
Number of shares withheld to satisfy minimum statutory tax withholding obligations	0.5
Amount withheld to satisfy minimum statutory tax withholding obligations	$ 8.5