Quarterly report pursuant to Section 13 or 15(d)

Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail)

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Intangible Assets - Summary of Carrying Amount and Accumulated Amortization of Identifiable Intangible Assets (Detail) - USD ($)
$ in Thousands
Mar. 31, 2016
Dec. 31, 2015
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 51,093 $ 51,317
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 19,260 19,783
Total nonamortizable and amortizable intangible assets, Net 31,833 31,534
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 23 23
Amortizable intangible assets, Accumulated Amortization 21 15
Amortizable intangible assets, Net 2 8
Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 32,865 32,865
Amortizable intangible assets, Accumulated Amortization 17,493 16,946
Amortizable intangible assets, Net 15,372 15,919
Non-Compete Agreements [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 1,094 1,094
Amortizable intangible assets, Accumulated Amortization 961 930
Amortizable intangible assets, Net 133 164
Software [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 11,717 11,942
Amortizable intangible assets, Accumulated Amortization 629 1,789
Amortizable intangible assets, Net 11,088 10,153
Ciscura [Member] | Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 3,394 3,393
Amortizable intangible assets, Accumulated Amortization 156 103
Amortizable intangible assets, Net 3,238 3,290
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000