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
Jun. 30, 2016
Dec. 31, 2015
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 52,038 $ 51,317
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 20,183 19,783
Total nonamortizable and amortizable intangible assets, Net 31,855 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 23 15
Amortizable intangible assets, Net   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 18,041 16,946
Amortizable intangible assets, Net 14,824 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 992 930
Amortizable intangible assets, Net 102 164
Software [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 12,663 11,942
Amortizable intangible assets, Accumulated Amortization 929 1,789
Amortizable intangible assets, Net 11,734 10,153
Ciscura [Member] | Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 3,393 3,393
Amortizable intangible assets, Accumulated Amortization 198 103
Amortizable intangible assets, Net 3,195 3,290
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000