Annual report pursuant to Section 13 and 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
Dec. 31, 2015
Dec. 31, 2014
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Total nonamortizable and amortizable intangible assets, Gross Assets $ 51,317 $ 42,012
Total nonamortizable and amortizable intangible assets, Accumulated Amortization 19,783 16,940
Total nonamortizable and amortizable intangible assets, Net 31,534 25,073
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 23  
Amortizable intangible assets, Accumulated Amortization 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 16,946 14,755
Amortizable intangible assets, Net 15,919 18,111
Non-Compete Agreements [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 1,094 848
Amortizable intangible assets, Accumulated Amortization 930 778
Amortizable intangible assets, Net 164 70
Software [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 11,942 6,299
Amortizable intangible assets, Accumulated Amortization 1,789 1,407
Amortizable intangible assets, Net 10,153 4,892
Ciscura [Member] | Physician and Customer Relationships [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Amortizable intangible assets, Gross Assets 3,393  
Amortizable intangible assets, Accumulated Amortization 103  
Amortizable intangible assets, Net 3,290  
Trade Names [Member]    
Indefinite Lived And Finite Lived Intangible Assets [Line Items]    
Nonamortizable intangible assets $ 2,000 $ 2,000