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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2017	Feb. 21, 2018	Jun. 30, 2017
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	FY
Trading Symbol	MDRX
Entity Registrant Name	ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
Entity Central Index Key	0001124804
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		180,850,731
Entity Public Float			$ 2,265,556,247

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 155,839	$ 95,607
Restricted cash	6,659	1,003
Accounts receivable, net of allowance of $37,735 and $32,670 as of December 31, 2017 and December 31, 2016, respectively	567,873	405,172
Prepaid expenses and other current assets	115,463	102,551
Total current assets	845,834	604,333
Available for sale marketable securities	0	149,100
Fixed assets, net	165,603	148,810
Software development costs, net	222,189	163,879
Intangible assets, net	826,872	741,403
Goodwill	2,004,953	1,924,052
Deferred taxes, net	4,574	2,791
Other assets	148,849	97,791
Assets attributable to discontinued operations	11,276	0
Total assets	4,230,150	3,832,159
Current liabilities:
Accounts payable	97,583	126,144
Accrued expenses	85,915	86,135
Accrued compensation and benefits	99,632	64,291
Deferred revenue	546,830	363,772
Current maturities of long-term debt	27,687	15,158
Current maturities of non-recourse long-term debt - Netsmart	2,755	2,451
Current maturities of capital lease obligations	7,865	9,126
Total current liabilities	868,267	667,077
Long-term debt	906,725	717,853
Non-recourse long-term debt - Netsmart	625,193	576,918
Long-term capital lease obligations	7,105	9,877
Deferred revenue	24,047	18,009
Deferred taxes, net	93,643	141,752
Other liabilities	92,205	39,787
Liabilities attributable to discontinued operations	21,358	0
Total liabilities	2,638,543	2,171,273
Redeemable convertible non-controlling interest - Netsmart	431,535	387,685
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of December 31, 2017 and December 31, 2016	0	0
Common stock: $0.01 par value, 349,000 shares authorized as of December 31, 2017 and December 31, 2016; 269,335 and 180,832 shares issued and outstanding as of December 31, 2017, respectively; 267,997 and 180,510 shares issued and outstanding as of December 31, 2016, respectively	2,693	2,680
Treasury stock: at cost, 88,504 and 87,487 shares as of December 31, 2017 and December 31, 2016, respectively	(322,735)	(310,993)
Additional paid-in capital	1,781,059	1,789,959
Accumulated deficit	(338,150)	(187,351)
Accumulated other comprehensive loss	(1,985)	(61,829)
Total Allscripts Healthcare Solutions, Inc.'s stockholders' equity	1,120,882	1,232,466
Non-controlling interest	39,190	40,735
Total stockholders’ equity	1,160,072	1,273,201
Total liabilities and stockholders’ equity	$ 4,230,150	$ 3,832,159

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Statement Of Financial Position [Abstract]
Accounts receivable, allowance	$ 37,735	$ 32,670
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	349,000,000	349,000,000
Common stock, shares issued	269,335,000	267,997,000
Common stock, shares outstanding	180,832,000	180,510,000
Treasury stock at cost, shares	88,504,000	87,487,000

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Revenue:
Software delivery, support and maintenance	$ 1,174,722	$ 1,012,352	$ 918,430
Client services	631,620	537,547	467,963
Total revenue	1,806,342	1,549,899	1,386,393
Cost of revenue:
Software delivery, support and maintenance	368,192	331,055	291,804
Client services	541,388	459,174	432,038
Amortization of software development and acquisition-related assets	114,601	88,631	81,986
Total cost of revenue	1,024,181	878,860	805,828
Gross profit	782,161	671,039	580,565
Selling, general and administrative expenses	486,271	392,865	339,175
Research and development	220,219	187,906	184,791
Asset impairment charges	0	4,650	1,544
Amortization of intangible and acquisition-related assets	33,754	25,847	23,172
Income from operations	41,917	59,771	31,883
Interest expense	(87,479)	(68,141)	(31,396)
Other income, net	413	1,087	2,183
Impairment of and losses on long-term investments	(165,290)	0	0
Equity in net income (loss) of unconsolidated investments	821	(7,501)	(2,100)
(Loss) income from continuing operations before income taxes	(209,618)	(14,784)	570
Income tax benefit (provision)	50,767	17,814	(2,626)
(Loss) income from continuing operations, net of tax	(158,851)	3,030	(2,056)
Income from discontinued operations, net of tax	4,676	0	0
Net (loss) income	(154,175)	3,030	(2,056)
Less: Net loss (income) attributable to non-controlling interests	1,566	(146)	(170)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	(43,850)	(28,536)	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (196,459)	$ (25,652)	$ (2,226)
Basic
Continuing operations	$ (1.12)	$ (0.14)	$ (0.01)
Discontinued operations	0.03	0.00	0.00
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	(1.09)	(0.14)	(0.01)
Diluted
Continuing operations	(1.12)	(0.14)	(0.01)
Discontinued operations	0.03	0.00	0.00
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ (1.09)	$ (0.14)	$ (0.01)

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Statement Of Income And Comprehensive Income [Abstract]
Net (loss) income	$ (154,175)	$ 3,030	$ (2,056)
Other comprehensive income (loss):
Foreign currency translation adjustments	3,352	(1,528)	(2,381)
Change in unrealized gain (loss) on available for sale securities	56,359	(56,359)	(228)
Change in fair value of derivatives qualifying as cash flow hedges	114	597	424
Other comprehensive income (loss) before income tax benefit (expense)	59,825	(57,290)	(2,185)
Income tax benefit (expense) related to items in other comprehensive loss	19	(297)	(78)
Total other comprehensive income (loss)	59,844	(57,587)	(2,263)
Comprehensive loss	(94,331)	(54,557)	(4,319)
Less: Comprehensive loss (income) attributable to non-controlling interests	1,566	(146)	(170)
Comprehensive loss, net	$ (92,765)	$ (54,703)	$ (4,489)

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock Issued [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive (Loss) Income [Member]	Non-controlling interest [Member]
Beginning Balance, Shares at Dec. 31, 2014		265,138	(84,672)
Beginning Balance at Dec. 31, 2014	$ 1,284,220	$ 2,651	$ (278,036)	$ 1,749,593	$ (188,009)	$ (1,979)	$ 0
Stock-based compensation				31,961
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,407
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 14		(3,445)
Issuance of treasury stock, Shares			7,435
Issuance of treasury stock			$ 88,283	10,017
Tax deficiency realized upon exercise of stock-based awards				(2,920)
Accretion of redemption preference on redeemable convertible non-controlling interest in Netsmart				0
Purchase of treasury stock, Shares			0
Purchase of treasury stock			$ 0
Warrants issued				4,243
Net (loss) income less net income attributable to non-controlling interests					(2,226)
Foreign currency translation adjustments, net	(2,381)					(2,381)
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						258
Unrecognized gain (loss) on available for sale securities, net of tax						(140)
Acquisition of non-controlling interest							11,019
Net (loss) income attributable to non-controlling interests	170						170
Recognition of previously unrecognized excess tax benefits					0
Ending Balance, Shares at Dec. 31, 2015		266,545	(77,237)
Ending Balance at Dec. 31, 2015	1,419,073	$ 2,665	$ (189,753)	1,789,449	(190,235)	(4,242)	11,189
Stock-based compensation				34,544
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,452
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 15		(8,133)
Issuance of treasury stock, Shares			0
Issuance of treasury stock			$ 0	0
Tax deficiency realized upon exercise of stock-based awards				(1,280)
Accretion of redemption preference on redeemable convertible non-controlling interest in Netsmart				(28,536)
Purchase of treasury stock, Shares			(10,250)
Purchase of treasury stock			$ (121,240)
Warrants issued				3,915
Net (loss) income less net income attributable to non-controlling interests					2,884
Foreign currency translation adjustments, net	(1,528)					(1,528)
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						361
Unrecognized gain (loss) on available for sale securities, net of tax						(56,420)
Acquisition of non-controlling interest							29,400
Net (loss) income attributable to non-controlling interests	$ 146						146
Recognition of previously unrecognized excess tax benefits					0
Ending Balance, Shares at Dec. 31, 2016	267,997	267,997	(87,487)
Ending Balance at Dec. 31, 2016	$ 1,273,201	$ 2,680	$ (310,993)	1,789,959	(187,351)	(61,829)	40,735
Stock-based compensation				35,337
Common stock issued under stock compensation plans, net of shares withheld for employee taxes, Shares		1,338
Common stock issued under stock compensation plans, net of shares withheld for employee taxes		$ 13		(5,767)
Issuance of treasury stock, Shares			22
Issuance of treasury stock			$ 335	(76)
Tax deficiency realized upon exercise of stock-based awards				0
Accretion of redemption preference on redeemable convertible non-controlling interest in Netsmart				(43,850)
Subsidiary issuance of common stock				1,473
Purchase of treasury stock, Shares			(1,039)
Purchase of treasury stock			$ (12,077)
Warrants issued				3,983
Net (loss) income less net income attributable to non-controlling interests					(152,609)
Foreign currency translation adjustments, net	3,352					3,352
Unrecognized gain on derivatives qualifying as cash flow hedges, net of tax						72
Unrecognized gain (loss) on available for sale securities, net of tax						56,420
Acquisition of non-controlling interest							21
Net (loss) income attributable to non-controlling interests	$ (1,566)						(1,566)
Recognition of previously unrecognized excess tax benefits					1,810
Ending Balance, Shares at Dec. 31, 2017	269,335	269,335	(88,504)
Ending Balance at Dec. 31, 2017	$ 1,160,072	$ 2,693	$ (322,735)	$ 1,781,059	$ (338,150)	$ (1,985)	$ 39,190

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities:
Net (loss) income	$ (154,175)	$ 3,030	$ (2,056)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	218,537	172,390	161,011
Stock-based compensation expense	38,769	42,877	34,663
Excess tax benefits from stock-based compensation	0	(1,014)	(644)
Deferred taxes	(55,787)	(22,621)	(2,206)
Asset impairment charges	0	4,650	1,544
Impairment of and losses on long-term investments	165,290	0	0
Equity in net (income) loss of unconsolidated investments	(821)	7,501	2,100
Other losses, net	4,005	2,579	(614)
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable, net	(99,431)	(17,826)	3,215
Prepaid expenses and other assets	13,820	13,765	17,614
Accounts payable	(18,014)	40,456	(11,953)
Accrued expenses	4,631	1,490	(22,974)
Accrued compensation and benefits	22,006	(4,106)	10,257
Deferred revenue	126,041	21,722	20,372
Other liabilities	14,544	(1,113)	(183)
Net cash provided by operating activities	279,415	269,004	211,579
Write-off of unamortized deferred debt issuance costs	0	5,224	1,433
Cash flows from investing activities:
Capital expenditures	(46,376)	(35,510)	(18,322)
Capitalized software	(138,895)	(102,472)	(49,264)
Cash paid for business acquisitions, net of cash acquired	(222,310)	(994,876)	(9,372)
Purchases of equity securities, other investments and related intangible assets	(5,606)	(21,185)	(215,786)
Other proceeds from investing activities	215	37	3,778
Net cash used in investing activities	(412,972)	(1,154,006)	(288,966)
Cash flows from financing activities:
Proceeds from sale or issuance of common stock	1,568	84	103,631
Proceeds from issuance of redeemable convertible preferred stock - Netsmart	0	333,605	0
Excess tax benefits from stock-based compensation	0	1,014	644
Taxes paid related to net share settlement of equity awards	(7,269)	(8,204)	(7,062)
Payments of capital lease obligations	(12,203)	(6,277)	(598)
Credit facility payments	(142,748)	(157,245)	(238,511)
Credit facility borrowings, net of issuance costs	374,698	823,535	284,161
Repurchase of common stock	(12,077)	(121,241)	0
Payment of acquisition financing obligations	(4,878)	0	0
Proceeds from sales of subsidiary shares to non-controlling interest	1,494	0	0
Net cash provided by financing activities	198,585	865,271	142,265
Effect of exchange rate changes on cash and cash equivalents	860	(532)	(1,178)
Net increase (decrease) in cash and cash equivalents	65,888	(20,263)	63,700
Cash, cash equivalents and restricted cash, beginning of period	96,610	116,873	53,173
Cash, cash equivalents and restricted cash, end of period	$ 162,498	$ 96,610	$ 116,873

Basis of Presentation and Significant Accounting Policies

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Basis of Presentation and Significant Accounting Policies

1. Basis of Presentation and Significant Accounting Policies

Principles of Consolidation

The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned and controlled affiliates, unless otherwise stated.

Use of Estimates

The preparation of consolidated financial statements in accordance with generally accepted accounting principles in the United States (“GAAP”) requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Actual results could differ materially from these estimates.

Revenue Recognition

Revenue represents the fair value of consideration received or receivable from clients for goods and services provided by us. Software delivery revenue consists of all of our proprietary software sales (either as a perpetual license sale or under a subscription delivery model), transaction-related revenue and the resale of hardware. Support and maintenance revenue consists of revenue from post contract client support and maintenance services. Client services revenue consists of revenue from managed services solutions, such as private cloud hosting, outsourcing and revenue cycle management, as well as other client services or project-based revenue from implementation, training and consulting services. For some clients, we remotely host the software applications licensed from us using our own or third-party servers, which saves these clients the cost of procuring and maintaining hardware and related facilities. For other clients, we offer an outsourced solution in which we assume partial to total responsibility for a healthcare organization’s IT operations using our employees.

Revenue from software licensing arrangements where the service element is not considered essential to the functionality of the other elements of the arrangement is recognized upon delivery of the software or as services are performed, provided persuasive evidence of an arrangement exists, fees are considered fixed or determinable, and collection of the receivable is probable. The revenue recognized for each separate element of a multiple-element software contract is based upon vendor-specific objective evidence of fair value (“VSOE”), which is based upon the price the client is required to pay when the element is sold separately or renewed. For arrangements in which VSOE only exists for the undelivered elements, the delivered elements (generally software licenses) are accounted for using the residual method.

Revenue from software licensing arrangements, where the service element is considered essential to the functionality of the other elements of the arrangement, is accounted for on an input basis under the percentage of completion accounting method using actual hours worked as a percentage of total expected hours required by the arrangement, provided that persuasive evidence of an arrangement exists, fees are considered fixed or determinable, and collection of the receivable is probable. Maintenance and support associated with these agreements is recognized over the term of the support agreement based on VSOE of the maintenance revenue, which is based upon contractual renewal rates. For presentation in the statement of operations, consideration from agreements accounted for under the percentage of completion accounting method is allocated between software delivery and client services revenue based on VSOE of our hourly services rate multiplied by the amount of hours performed with the residual amount allocated to the software license fee.

Fees related to software-as-a-service (“SaaS”) arrangements are recognized as revenue ratably over the contract terms beginning on the date our solutions are made available to clients. These arrangements include client services fees related to the implementation and set-up of our solutions and are typically billed upfront and recorded as deferred revenue until our solutions are made available to the client. The implementation and set-up fees are recognized as revenue ratably over the estimated client relationship period. The estimated length of a client relationship period is based on our experience with client contract renewals and consideration of the period over which such clients use our SaaS solutions.

Software private cloud hosting services are provided to clients that have purchased a perpetual license to our software solutions and contracted with us to host the software. These arrangements provide the client with a contractual right to take possession of the software at any time during the private cloud hosting period without significant penalty and it is feasible for the client to either use the software on its own equipment or to contract with an unrelated third party to host the software. Private cloud hosting services are not deemed to be essential to the functionality of the software or other elements of the arrangement; accordingly, for these arrangements, we recognize software license fees as software delivery revenue upon delivery, assuming all other revenue recognition criteria have been met, and separately recognize fees for the private cloud hosting services as client services revenue over the term of the private cloud hosting arrangement.

We also enter into multiple-element arrangements that may include a combination of various software-related and non-software-related products and services. Management applies judgment to ensure appropriate accounting for multiple deliverables, including the allocation of arrangement consideration among multiple units of accounting, the determination of whether undelivered elements are essential to the functionality of delivered elements, and the timing of revenue recognition, among others. In such arrangements, we first allocate the total arrangement consideration based on a selling price hierarchy at the inception of the arrangement. The selling price for each element is based upon the following selling price hierarchy: VSOE, if available, third-party evidence of fair value if VSOE is not available, or estimated selling price if neither VSOE nor third-party evidence of fair value is available (discussion as to how we determine VSOE, third-party evidence of fair value and estimated selling price is provided below). Upon allocation of the arrangement consideration to the software elements as a whole and to individual non-software elements, we then further allocate consideration within the software group to the respective elements following higher-level, industry-specific guidance and our policies described above. After the arrangement consideration has been allocated to the various elements, we account for each respective element in the arrangement as described above.

To determine the selling price in multiple-element arrangements, we establish VSOE using the price charged for a deliverable when sold separately and contractual renewal rates for maintenance fees. For non-software multiple element arrangements, third-party evidence of fair value is established by evaluating similar and interchangeable competitor products or services in standalone arrangements with similarly situated clients. If we are unable to determine the selling price because VSOE or third-party evidence of fair value does not exist, we determine an estimated selling price by considering several external and internal factors including, but not limited to, pricing practices, margin objectives, competition, client demand, internal costs and overall economic trends. The determination of an estimated selling price is made through consultation with and approval by our management, taking into consideration our go-to-market strategy. As our, or our competitors’, pricing and go-to-market strategies evolve, we may modify our pricing practices in the future. These events could result in changes to our determination of VSOE, third-party evidence of fair value and estimated selling price. Selling prices are analyzed on an annual basis or more frequently if we experience significant changes in our selling prices.

For those arrangements where the deliverables do not qualify as separate units of accounting, revenue recognition is evaluated for the combined deliverables as a single unit of accounting and the recognition pattern of the final deliverable will dictate the revenue recognition pattern for the single, combined unit of accounting. Changes in circumstances and client data may result in a requirement to either separate or combine deliverables, such that a delivered item could now meet the separation criteria and qualify as a separate unit of accounting, which may lead to an upward or downward adjustment to the amount of revenue recognized under the arrangement on a prospective basis.

We assess whether fees are considered fixed or determinable at the time of sale and recognize revenues if all other revenue recognition requirements are met. Our payment arrangements with clients typically include milestone-based software license fee payments and payments based upon delivery for services and hardware.

While most of our arrangements include short-term payment terms, we periodically provide extended payment terms to clients from the date of contract signing. We do not recognize revenue under extended payment term arrangements until such payments become due. In certain circumstances, where all other revenue recognition criteria have been met, we occasionally offer discounts to clients with extended payment terms to accelerate the timing of when payments are made. Changes to extended payment term arrangements have not had a material impact on our consolidated results of operations.

Maintenance fees are recognized ratably over the period of the contract based on VSOE, which is based upon contractual renewal rates. Revenue from electronic data interchange services is recognized as services are provided and is determined based on the volume of transactions processed or estimated selling price.

We provide managed services to our clients under arrangements that typically range from three to ten years in duration. Under these arrangements we assume full, partial or transitional responsibilities for a healthcare organization’s IT operations using our employees. Our managed services include facilities management, network outsourcing and transition management. Revenue from these arrangements is recognized subsequent to the transition period as services are performed.

Revenue is recognized net of any taxes collected from clients and subsequently remitted to governmental authorities. We record as revenue any amounts billed to clients for shipping and handling costs and record as cost of revenue the actual shipping costs incurred.

We record reimbursements for out-of-pocket expenses incurred as client services revenue in our consolidated statements of operations. These amounts totaled:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Reimbursements for out-of-pocket expenses incurred	$	10,276	$	9,528	$	12,873

The following table summarizes revenue earned on contracts in excess of billings, both the current and non-current portions, which are included in the balances of accounts receivable and other assets, respectively, in our consolidated balance sheets. Billings are expected to occur according to the contract terms.

	December 31,
(In thousands)	2017		2016
Revenue earned on contracts in excess of billings
Unbilled revenue (current)	$	133,368	$	98,917
Unbilled revenue (long-term)		0		0
Total revenue earned on contracts in excess of billings	$	133,368	$	98,917

Fair Value Measurements

Fair value measurements are based upon observable and unobservable inputs. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our view of market participant assumptions in the absence of observable market information. We utilize valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs. The fair values of assets and liabilities required to be measured at fair value are categorized based upon the level of judgment associated with the inputs used to measure their value in one of the following three categories:

Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities at the measurement date. Our Level 1 financial instruments included our investment in NantHealth common stock. Refer to Note 10, “Accumulated Other Comprehensive Loss” for further information regarding our available for sale marketable securities.

Level 2: Inputs, other than quoted prices included in Level 1, are observable for the asset or liability, either directly or indirectly. Our Level 2 derivative financial instruments include foreign currency forward contracts valued based upon observable values of spot and forward foreign currency exchange rates. Refer to Note 11, “Derivative Financial Instruments,” for further information regarding these derivative financial instruments.

Level 3: Unobservable inputs that are significant to the fair value of the asset or liability, and include situations where there is little, if any, market activity for the asset or liability. Our Level 3 financial instruments include derivative financial instruments comprising the 1.25% Call Option asset and the 1.25% embedded cash conversion option liability that are not actively traded. These derivative instruments were designed with the intent that changes in their fair values would substantially offset, with limited net impact to our earnings. Therefore, we believe the sensitivity of changes in the unobservable inputs to the option pricing model for these instruments is substantially mitigated. Refer to Note 11, “Derivative Financial Instruments,” for further information regarding these derivative financial instruments. The sensitivity of changes in the unobservable inputs to the valuation pricing model used to value these instruments is not material to our consolidated results of operations.

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	December 31, 2017										December 31, 2016
(In thousands)	Classifications	Level 1		Level 2		Level 3			Total			Level 1		Level 2		Level 3			Total
NantHealth Common Stock	Available for sale marketable securities	$	0	$	0	$	0		$	0		$	149,100	$	0	$	0		$	149,100
1.25% Call Option	Other assets		0		0		46,578			46,578			0		0		17,080			17,080
1.25% Embedded cash conversion option	Other liabilities		0		0		(47,777	)		(47,777	)		0		0		(17,659	)		(17,659	)
Foreign exchange derivative assets	Prepaid expenses and other current assets		0		1,136		0			1,136			0		1,021		0			1,021
Total		$	0	$	1,136	$	(1,199	)	$	(63	)	$	149,100	$	1,021	$	(579	)	$	149,542

As of December 31, 2017, it is not practicable to estimate the fair value of our non-marketable cost and equity method investments primarily because of their illiquidity and restricted marketability. The factors we considered in trying to determine fair value include, but are not limited to, available financial information, the issuer’s ability to meet its current obligations and the issuer’s subsequent or planned raises of capital. Refer to Note 2, “Business Combinations and Other Investments” for additional information about these investments.

Our long-term financial liabilities include borrowings outstanding under our Senior Secured Credit Facility and non-recourse borrowings outstanding under Netsmart’s Credit Agreements (both as defined in Note 6, “Debt”), with carrying values that approximate fair value since the variable interest rates approximate current market rates. In addition, as of December 31, 2017, the fair value of the 1.25% Notes (as defined in Note 6, “Debt”) exceeded the 1.25% Notes’ principal balance (or par) by approximately 7%. We utilized the 1.25% Notes’ market trading prices near December 31, 2017 in making this fair value assessment. See Note 6, “Debt,” for further information regarding our long-term financial liabilities.

Financial Instruments

We consider all highly liquid investments with an original maturity of three months or less, when purchased, to be cash equivalents. The fair values of these investments approximate their carrying values.

Other investments classified as long-term available for sale securities include certain debt and equity instruments. Debt securities are classified as available-for-sale and realized gains and losses are recorded using the specific identification method. Changes in market value, excluding other-than-temporary impairments, are reflected in other comprehensive income. We recognized other-than-temporary impairment charges of $142.2 million on available for sale marketable securities during the second quarter of 2017. During the third quarter of 2017, we recognized an additional $20.7 million loss upon the final disposition of these securities in connection with the NantHealth provider and patient engagement solutions business acquisition (refer to Note 2, “Business Combinations and Other Investments”). There were no other-than-temporary impairments related to our long-term available for sale securities for the years ended December 31, 2016 and 2015.

Derivative instruments are recognized as either assets or liabilities and are measured at fair value. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the resulting designation.

For derivative instruments designated as cash-flow hedges, the effective portion of the derivative’s gain (loss) is initially reported as a component of other comprehensive income and is subsequently recognized in earnings when the hedged exposure is recognized in earnings. Gains (losses) on derivatives representing either hedge components excluded from the assessment of effectiveness or hedge ineffectiveness are recognized in earnings. See Note 11, “Derivative Financial Instruments,” for information regarding gains and losses from derivative instruments during the years ended December 31, 2017, 2016 and 2015.

Allowance for Doubtful Accounts Receivable

Accounts receivable are recorded at the invoiced amounts and do not bear interest. An allowance for doubtful accounts is recorded to provide for estimated losses resulting from uncollectible accounts and is based principally on specifically identified amounts where collection is deemed doubtful. Additional non-specific allowances are recorded based on historical experience and management’s assessment of a variety of factors related to the general financial condition of our clients, the industry in which we operate and general economic conditions. We regularly review the collectability of individual accounts and assess the adequacy of the allowance for doubtful accounts. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. If the financial condition of our clients were to deteriorate, resulting in an impairment of their ability to make payments, additional allowance and related bad debt expense may be required.

Contingent Liabilities

A liability is contingent if the amount is not presently known, but may become known in the future as a result of the occurrence of some uncertain future event. We accrue a liability for an estimated loss if we determine that the potential loss is probable of occurring and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made.

The assessment of contingent liabilities, including legal and income tax contingencies, involves the use of estimates, assumptions and judgments. Our estimates are based on our belief that future events will validate the current assumptions regarding the ultimate outcome of these exposures. However, there can be no assurance that future events, such as court decisions or Internal Revenue Service (“IRS”) positions, will not differ from our assessments.

Fixed Assets

Fixed assets are stated at cost. Depreciation and amortization are computed on the straight-line method over the estimated useful lives of the related assets. The depreciable life of leasehold improvements is the shorter of the lease term or the useful life. Upon asset retirement or other disposition, the fixed asset cost and the related accumulated depreciation or amortization are removed from the accounts, and any gain or loss is included in the consolidated statements of operations. Amounts incurred for repairs and maintenance are expensed as incurred.

Business Combinations

Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions as a part of the purchase price allocation process to accurately value the assets acquired, including intangible assets, and the liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we may record adjustments to the fair values of the assets acquired and the liabilities assumed, with a corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or the liabilities assumed, whichever comes first, any subsequent adjustments are reflected in our consolidated statements of operations.

Goodwill and Intangible Assets

Goodwill and intangible assets acquired in a business combination and determined to have an indefinite useful life are not amortized but are tested for impairment annually or between annual tests when an impairment indicator exists. If an optional qualitative goodwill impairment assessment is not performed, we are required to determine the fair value of each reporting unit. If a reporting unit’s fair value is lower than its carrying value, we must determine the amount of implied goodwill that would be established if the reporting unit was hypothetically acquired on the impairment test date. If the carrying amount of a reporting unit’s goodwill exceeds the amount of implied goodwill, an impairment loss equal to the excess would be recorded. The recoverability of indefinite-lived intangible assets is assessed by comparison of the carrying value of the asset to its estimated fair value. If we determine that the carrying value of the asset exceeds its estimated fair value, an impairment loss equal to the excess would be recorded.

The determination of the fair value of our reporting units is based on a combination of a market approach, that considers benchmark company market multiples, and an income approach, that utilizes discounted cash flows for each reporting unit and other Level 3 inputs. Under the income approach, we determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. Additionally, the discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. As part of the goodwill impairment testing, we also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units.

Accounting guidance also requires that definite-lived intangible assets be amortized over their respective estimated useful lives and reviewed for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We estimate the useful lives of our intangible assets and ratably amortize the value over the estimated useful lives of those assets. If the estimates of the useful lives should change, we will amortize the remaining book value over the remaining useful lives or, if an asset is deemed to be impaired, a write-down of the value of the asset may be required at such time.

Long-Lived Assets and Long-Lived Assets to Be Disposed Of

We review our long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the fair value of the assets.

Software Development Costs

We capitalize purchased software upon acquisition if it is accounted for as internal-use or if it meets the future alternative use criteria. We capitalize incurred labor costs for software development from the time technological feasibility of the software is established, or when the preliminary project phase is completed in the case of internal use software, until the software is available for general release. Research and development costs and other computer software maintenance costs related to software development are expensed as incurred. We estimate the useful life of our capitalized software and amortize its value over that estimated life. If the actual useful life is shorter than our estimated useful life, we will amortize the remaining book value over the remaining useful life or the asset may be deemed to be impaired and, accordingly, a write-down of the value of the asset may be recorded as a charge to earnings. Upon the availability for general release, we commence amortization of the capitalized software costs on a product by product basis. Amortization of capitalized software is recorded using the greater of (i) the ratio of current revenues to total and anticipated future revenues for the applicable product or (ii) the straight-line method over the remaining estimated economic life, which is estimated to be three to five years.

At each balance sheet date, the unamortized capitalized costs of a software product are compared with the net realizable value of that product. The net realizable value is the estimated future gross revenues from that product reduced by the estimated future costs of completing and disposing of that product, including the costs of performing maintenance and client support required to satisfy our responsibility set forth at the time of sale. The amount by which the unamortized capitalized costs of a software product exceed the net realizable value of that asset is written off. If we determine in the future that the value of the capitalized software could not be recovered, a write-down of the value of the capitalized software to its recoverable value may be recorded as a charge to earnings.

The unamortized balances of capitalized software were as follows:

	December 31,
(In thousands)	2017			2016
Software development costs	$	318,824		$	321,265
Less: accumulated amortization		(96,635	)		(157,386	)
Software development costs, net	$	222,189		$	163,879

Capitalized software development costs, write-offs included in asset impairment changes and amortization of capitalized software development costs included in cost of revenue are shown in the table below. Capitalized software development costs for the year ended December 31, 2016 include $44 million of third-party software purchases to supplement our internal software development efforts, of which $24 million was accrued as of December 31, 2016 and paid during 2017.

	Year Ended December 31,
(In thousands)	2017		2016		2015
Capitalized software development costs	$	115,394	$	126,003	$	46,464
Write-offs of capitalized software development costs	$	0	$	4,625	$	0
Amortization of capitalized software development costs	$	57,084	$	43,274	$	46,842

Redeemable Convertible Non-Controlling Interest – Netsmart

The redeemable convertible non-controlling interest reported in the mezzanine equity section of the accompanying consolidated balance sheet as of December 31, 2017 and 2016 represents the redemption value of the Class A Preferred Units issued as part of the formation of Nathan Holding LLC in April 2016. Refer to Note 2, “Business Combinations and Other Investments” for additional information about the formation of this joint business entity and the redemption terms of the Class A Preferred Units.

The Class A Preferred Units do not have a mandatory redemption date and, with certain exceptions, can be redeemed no earlier than five years from their issuance date. They also contain a minimum liquidation preference feature and the value of such feature is accreted using the effective interest method. The Class A Preferred Units were not redeemable as of December 31, 2017.

A rollforward of the balance of redeemable convertible non-controlling interest for the year ended December 31, 2017 follows:

(In thousands)
Balance as of December 31, 2016	$	387,685
Issuance of redeemable convertible non-controlling interest		0
Accretion of redemption preference on redeemable convertible non-controlling interest		43,850
Balance as of December 31, 2017	$	431,535

Income Taxes

We account for income taxes using the liability method, which requires the recognition of deferred tax assets or liabilities for the tax-effected temporary differences between the financial reporting and tax bases of our assets and liabilities and for net operating loss and tax credit carryforwards. The objectives of accounting for income taxes are to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in an entity’s financial statements or tax returns. Judgment is required in addressing the future tax consequences of events that have been recognized in our consolidated financial statements or tax returns. The deferred tax assets are recorded net of a valuation allowance when, based on the weight of available evidence, we believe it is more likely than not that some portion or all of the recorded deferred tax assets will not be realized in future periods. We consider many factors when assessing the likelihood of future realization of our deferred tax assets, including recent cumulative earnings experience, expectations of future taxable income, the ability to carryback losses and other relevant factors.

In addition, we are subject to the continuous examination of our income tax returns by the Internal Revenue Service and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements.

The calculation of tax liabilities involves dealing with uncertainties in the application of complex tax regulations. We recognize liabilities for anticipated tax audit issues based on our estimate of whether, and the extent to which, additional taxes may be required. If we ultimately determine that payment of these amounts is unnecessary, then we reverse the liability and recognize a tax benefit during the period in which we determine that the liability is no longer necessary. We also recognize tax benefits to the extent that it is more likely than not that our positions will be sustained if challenged by the taxing authorities. To the extent we prevail in matters for which liabilities have been established, or are required to pay amounts in excess of our liabilities, our effective tax rate in a given period may be materially affected. An unfavorable tax settlement would require cash payments and may result in an increase in our effective tax rate in the year of resolution. A favorable tax settlement would be recognized as a reduction in our effective tax rate in the year of resolution. We report interest and penalties related to uncertain income tax positions in the income tax (provision) benefit line of our consolidated statements of operations.

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States.

Earnings (Loss) Per Share

Basic earnings (loss) per share is computed by dividing net income (loss) by the weighted-average shares of common stock outstanding. For purposes of calculating diluted earnings per share, the denominator includes both the weighted average shares of common stock outstanding and dilutive common stock equivalents. Dilutive common stock equivalents consist of stock options, restricted stock unit awards and warrants calculated under the treasury stock method.

The calculations of earnings (loss) per share are as follows:

	Year Ended December 31,
(In thousands, except per share amounts)	2017			2016			2015
Basic Loss per Common Share:
(Loss) income from continuing operations, net of tax	$	(158,851	)	$	3,030		$	(2,056	)
Less: Net income attributable to non-controlling interests	$	1,566		$	(146	)	$	(170	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	(43,850	)	$	(28,536	)	$	0
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(201,135	)	$	(25,652	)	$	(2,226	)
Net income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	4,676		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(196,459	)	$	(25,652	)	$	(2,226	)

Weighted-average common shares outstanding		180,830			186,188			185,082

Basic Loss from continuing operations per Common Share	$	(1.12	)	$	(0.14	)	$	(0.01	)
Basic Income from discontinued operations per Common Share	$	0.03		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.09	)	$	(0.14	)	$	(0.01	)

Diluted Loss per Common Share:
(Loss) income from continuing operations, net of tax	$	(158,851	)	$	3,030		$	(2,056	)
Less: Net income attributable to non-controlling interests	$	1,566		$	(146	)	$	(170	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	(43,850	)	$	(28,536	)	$	0
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(201,135	)	$	(25,652	)	$	(2,226	)
Net income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	4,676		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(196,459	)	$	(25,652	)	$	(2,226	)

Weighted-average common shares outstanding		180,830			186,188			185,082
Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0
Weighted-average common shares outstanding assuming dilution		180,830			186,188			185,082

Diluted Loss from continuing operations per Common Share	$	(1.12	)	$	(0.14	)	$	(0.01	)
Diluted Income from discontinued operations per Common Share	$	0.03		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.09	)	$	(0.14	)	$	(0.01	)

As a result of the net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders for the years ended December 31, 2017, 2016 and 2015, we used basic weighted-average common shares outstanding in the calculation of diluted loss per share for each of these years, since the inclusion of any stock equivalents would be anti-dilutive.

The following stock options, restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such stock options, restricted stock unit awards and warrants in the computation would be anti-dilutive:

Year Ended December 31,

(In thousands)

2017

2016

2015

Shares subject to anti-dilutive stock options, restricted stock unit awards and

warrants excluded from calculation

26,515

25,277

25,063

Stock-Based Compensation

We account for stock-based compensation in accordance with GAAP, which requires the measurement and recognition of compensation expense for all share-based payment awards made to employees and non-employee directors based on their estimated fair value. With the exception of Netsmart, we measure stock-based compensation cost at the grant date based on the fair value of the award and recognize the expense over the requisite service period typically on a straight-line basis, net of estimated forfeitures. Netsmart’s stock-based option awards are liability-classified due to the option to call and cash settle such awards. We recognize stock-based compensation cost for awards with performance conditions if and when we conclude that it is probable that the performance conditions will be achieved. With the exception of Netsmart, whose awards are marked-to-market each reporting period, the fair value of service-based restricted stock units and restricted stock awards is measured at their underlying closing share price on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. The net proceeds from stock-based compensation activities are reflected as a financing activity within the accompanying consolidated statements of cash flows. We settle employee stock option exercises and stock awards with newly issued common shares.

Employee Benefit Plans

We provide employees with defined contribution savings plans. We recognize expense for our contributions to the savings plans at the time employees make contributions to the plans and we contributed the following amounts to these plans:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Company contributions to employee benefit plans	$	18,861	$	18,329	$	16,397

Foreign Currency

The determination of the functional currency of our foreign subsidiaries is made based on the appropriate economic and management indicators. Our foreign subsidiaries use the local currency of their respective countries as the functional currency, with the exception of our operating subsidiaries in India and Israel which use the United States dollar as a functional currency. The assets and liabilities of foreign subsidiaries whose functional currency is the local currency are translated into United States dollars at the exchange rates in effect at the consolidated balance sheet date, while revenues and expenses are translated at the average rates of exchange during the year. Translation gains and losses are not included in determining net income or loss but are included as a separate component of accumulated other comprehensive loss. Gains and losses resulting from foreign currency transactions are included in determining net income or loss and have not been material in any years presented in the accompanying consolidated statements of operations. We periodically enter into non-deliverable forward foreign currency exchange contracts in order to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. See Note 11, “Derivative Financial Instruments,” for information regarding these foreign currency exchange contracts.

Concentrations of Credit Risk

Financial instruments that potentially subject us to a concentration of credit risk consist of cash, cash equivalents, marketable securities and trade receivables. We primarily maintain our cash balances with one major commercial bank domestically and several commercial banks internationally.

We sell our products and services to healthcare providers. Credit risk with respect to trade receivables is generally diversified due to the large number of clients and their geographic dispersion. To reduce credit risk, we perform ongoing credit evaluations of significant clients and their payment histories. In general, we do not require collateral from our clients, but we do enter into advance deposit agreements, if appropriate.

The majority of our revenue is derived from clients located in the United States. The majority of long-lived assets are also located in the United States. No single client accounted for more than 10% of our revenue in the years ended December 31, 2017, 2016 and 2015. No client represented more than 10% of accounts receivable as of December 31, 2017 or 2016.

Recently Adopted Accounting Pronouncements

In March 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2016-07, Investments – Equity Method and Joint Ventures (Topic 323): Simplifying the Transition to the Equity Method of Accounting (“ASU 2016-07”). The guidance in ASU 2016-07 eliminates the requirement that, when an investment qualifies for use of the equity method as a result of an increase in the level of ownership interest or degree of influence, an investor must adjust the investment, results of operations, and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect during all previous periods that the investment had been held. The amendments require that the equity method investor add the cost of acquiring the additional interest in the investee to the current basis of the investor’s previously held interest and adopt the equity method of accounting as of the date the investment becomes qualified for equity method accounting. The amendments also require that an entity that has an available-for-sale equity security that becomes qualified for the equity method of accounting recognize through earnings the unrealized holding gain or loss in accumulated other comprehensive income at the date the investment becomes qualified for use of the equity method. ASU 2016-07 is effective for interim and annual periods beginning after December 15, 2016, and should be applied prospectively. Early application is permitted. We adopted this new guidance effective January 1, 2017 and the adoption did not have any impact on our consolidated financial statements.

In March 2016, the FASB issued Accounting Standards Update No. 2016-09, Compensation – Stock Compensation (Topic 718): Improvements to Share-Based Payment Accounting (“ASU 2016-09”). The Company adopted ASU 2016-09 effective January 1, 2017, which requires that tax effects related to employee share-based payments be recorded prospectively as a component of the provision for income taxes, thus potentially increasing the volatility in our effective tax rate (see Note 7, “Income Taxes”). Additionally, we prospectively adopted the requirement to present recognized excess tax benefits related to employee share-based payments as an operating activity in the accompanying Consolidated Statements of Cash Flows. ASU 2016-09 also eliminates prospectively the requirement to consider anticipated tax windfalls and shortfalls in the calculation of assumed proceeds under the treasury stock method used for computing the dilutive effect of share-based payment awards in the calculation of diluted earnings per share. Finally, ASU 2016-09 requires the recognition of excess tax benefits related to employee share-based payments, regardless of whether the tax deduction reduces taxes payable. As part of the adoption of this requirement, we decreased the opening balance of accumulated deficit by $1.8 million to recognize excess tax benefits not previously recorded since they did not reduce taxes payable. The adoption of the remaining requirements of ASU 2016-09 did not have a material impact on our financial position or results of operation.

In August 2016, the FASB issued Accounting Standards Update No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments (“ASU 2016-15”). The guidance in ASU 2016-15 eliminates the diversity in practice related to the classification of certain cash receipts and payments in the statement of cash flows, by adding or clarifying guidance on eight specific cash flow issues. ASU 2016-15 is effective for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted. We early adopted this new guidance effective January 1, 2017 and the adoption did not have any impact on our consolidated financial statements.

In May 2017, the FASB issued Accounting Standards Update No. 2017-09, Compensation – Stock Compensation (Topic 718): Scope of Modification Accounting (“ASU 2017-09”). The guidance in ASU 2017-09 clarifies when to account for a change to the terms or conditions of a share-based payment award as a modification. ASU 2017-09 is effective prospectively for annual periods beginning after December 15, 2017, and interim periods within those annual periods. Early adoption is permitted, including adoption in an interim period. We early adopted this new guidance effective June 1, 2017 and the adoption did not have any impact on our consolidated financial statements.

Accounting Pronouncements Not Yet Adopted

In May 2014, the FASB issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers: Topic 606 (“ASU 2014-09”), to supersede nearly all existing revenue recognition guidance under GAAP. The core principle of ASU 2014-09 is to recognize revenue when promised goods or services are transferred to customers in an amount that reflects the consideration that is expected to be received for those goods or services. ASU 2014-09 defines a five-step process to achieve this principle and, in doing so, it is possible more judgment and estimates may be required within the revenue recognition process than required under existing GAAP, including identifying performance obligations in the contract, estimating the amount of variable consideration to include in the transaction price and allocating the transaction price to each separate performance obligation. As issued, ASU 2014-09 was effective for us for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period. On August 12, 2015, the FASB issued ASU 2015-14, which deferred the effective date of ASU 2014-09 by one year to annual reporting periods beginning after December 15, 2017, while also permitting companies to voluntarily adopt the new revenue standard as of the original effective date. In addition, during 2016, the FASB issued ASU 2016-08, ASU 2016-10, 2016-11, 2016-12 and 2016-20, all of which clarify certain implementation guidance within ASU 2014-09.

The new revenue recognition guidance permits two methods of adoption: retrospectively to each prior reporting period presented (full retrospective method), or retrospectively with the cumulative effect of initially applying the guidance recognized at the date of initial application (modified retrospective method). We have decided to adopt the standard effective January 1, 2018 using the modified retrospective method.

We have completed our assessment of our systems, available data and processes that will be affected by the implementation of this new guidance. The Company’s formal accounting policies have been established along with updates to our processes as well as implementing necessary changes to be able to comply with the new requirements. Evaluation of the enactment of such policies and necessary changes is ongoing from both a financial statement as well as from an internal control perspective. Through evaluation of the standard’s requirements, the Company plans to utilize several practical expedients including (i) viewing shipping and handling as a fulfillment cost versus a distinct performance obligation, and (ii) the right to invoice expedient as it relates to transaction-related revenue activities. Based on the results of our assessment to date, we anticipate this standard will have an impact, which could be significant, on our consolidated financial statements. While we are continuing to assess all potential impacts of the standard we remain convinced the most significant impact relates to our accounting for software license revenue. We expect revenue related to hardware sales, software-as-a-service-based offerings, client services, electronic data interchange services, and managed services to remain substantially unchanged. We expect to recognize a significant portion of license revenue upfront rather than be restricted to payment amounts due under extended payment term contracts as required under the current guidance. We also expect to recognize license revenue at a point in time rather than over the subscription period from certain multi-year software subscription contracts that include both software licenses and software support and maintenance. Due to the complexity of certain of our license subscription contracts, the actual revenue license recognition treatment required under the new standard will be dependent on contract-specific terms and may vary in some instances from upfront recognition. However, at the current time, we cannot reasonably estimate a specific dollar impact relating to this change in software license revenue recognition.

Additionally, we currently only capitalize direct sales commissions that are specifically associated with new or renewal contracts. The new revenue recognition guidance requires the capitalization of all incremental costs of obtaining a contract with a customer that an entity expects to recover. As part of our implementation efforts, we have identified certain indirect commissions and other payments that would be eligible for capitalization under the new guidance because they are also incremental costs solely associated with new or renewal contracts that we expect to recover. In addition, there are certain costs related to the fulfilment of contracts which will be capitalized. As result, we expect to record a deferral for such costs of approximately $11 million upon adoption of the new guidance on January 1, 2018.

In January 2016, the FASB issued Accounting Standards Update No. 2016-01, “Recognition and Measurement of Financial Assets and Financial Liabilities” (“ASU 2016-01”). The amendments in ASU 2016-01 modify the requirements related to the measurement of certain financial instruments in the statement of financial condition and results of operation. Equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee), are required to be measured at fair value with changes in fair value recognized in net income. An entity may continue to elect to measure equity investments which do not have a readily determinable fair value at cost with adjustments for impairment, if any, and observable changes in price. In addition, for a liability (other than a derivative liability) that an entity measures at fair value, any change in fair value related to the instrument-specific credit risk, that is the entity’s own-credit, should be presented separately in other comprehensive income and not as a component of net income. ASU 2016-01 also clarifies that an entity should evaluate the need for a valuation allowance on a deferred tax asset related to available-for sale securities in combination with the entity’s other deferred tax assets. ASU 2016-01 is effective for interim and annual periods beginning after December 15, 2017 with early adoption permitted solely for the instrument-instrument specific credit risk for liabilities measured at fair value. The amendments should be applied by means of a cumulative-effect adjustment to the balance sheet as of the beginning of the fiscal year of adoption. The amendments related to equity securities without readily determinable fair values (including disclosure requirements) should be applied prospectively to equity investments that exist as of the date of adoption. We plan to adopt ASU 2016-01 effective January 1, 2018 and do not expect any immediate impact upon adoption.

In February 2016, the FASB issued Accounting Standards Update No. 2016-02, “Leases (Topic 842)” (“ASU 2016-02”) intended to improve financial reporting about leasing transactions. The new guidance will require entities that lease assets to recognize on their balance sheets the assets and liabilities for the rights and obligations created by those leases and to disclose key information about the leasing arrangements. ASU 2016-02 is effective for interim and annual periods beginning after December 15, 2018 with early adoption permitted. We are currently evaluating the impact of this accounting guidance, including the timing of adoption.

In June 2016, the FASB issued Accounting Standards Update No. 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). The guidance in ASU 2016-13 replaces the incurred loss impairment methodology under current GAAP. The new impairment model requires immediate recognition of estimated credit losses expected to occur for most financial assets and certain other instruments. For available-for-sale debt securities with unrealized losses, the losses will be recognized as allowances rather than reductions in the amortized cost of the securities. ASU 2016-13 is effective for annual periods beginning after December 15, 2019, and interim periods within those annual periods. Early adoption is permitted for fiscal years beginning after December 15, 2018. We are currently in the process of evaluating this new guidance, which we expect to have an impact on our consolidated financial statements and results of operations.

In January 2017, the FASB issued Accounting Standards Update No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business (“ASU 2017-01”). ASU 2017-01 provides new accounting guidance to assist an entity in evaluating when a set of transferred assets and activities is a business. The guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2017, and should be applied prospectively to any transactions occurring within the period of adoption. Early adoption is permitted, including for interim or annual periods in which the financial statements have not been issued or made available for issuance. We plan to adopt ASU 2017-01 effective January 1, 2018 and do not expect any immediate impact upon adoption.

In January 2017, the FASB issued Accounting Standards Update No. 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment (“ASU 2017-04”), which provides new accounting guidance to simplify the accounting for goodwill impairment. ASU 2017-04 removes Step Two of the goodwill impairment test, which requires a hypothetical purchase price allocation. Under the new guidance, a goodwill impairment will equal the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill assigned to the reporting unit. All other goodwill impairment guidance will remain largely unchanged. Entities will continue to have the option to perform a qualitative assessment to determine if a quantitative impairment test is necessary. ASU 2017-04 is effective for annual and interim periods in fiscal years beginning after December 15, 2019 with early adoption permitted for any goodwill impairment tests performed after January 1, 2017. The new guidance is to be applied prospectively. We are currently evaluating the impact of this accounting guidance, including the timing of adoption.

In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities (“ASU 2017-12”), which provides new accounting guidance to simplify and improve the reporting of hedging relationships to better portray the economic results of an entity’s risk management activities in its financial statements. In addition to that main objective, the amendments in this Update make certain targeted improvements to simplify the application of the hedge accounting guidance in current GAAP. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early application is permitted in any interim period after the issuance of this Update. We are currently evaluating the impact of this accounting guidance, including the timing of adoption.

We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

Business Combinations and Other Investments

12 Months Ended

Dec. 31, 2017

Business Combinations [Abstract]

Business Combinations and Other Investments

2. Business Combinations and Other Investments

2017 Business Combinations

Acquisition of DeVero

On July 17, 2017, Netsmart (as defined below) completed the acquisition of DeVero, Inc. (“DeVero”), a healthcare technology company that develops electronic medical record solutions for home healthcare and hospice, for an aggregate purchase price of $50.5 million in cash. The purchase price was funded through incremental borrowings under Netsmart’s credit facilities. The allocation of the aggregate consideration is as follows: $32.4 million of goodwill; $19.0 million of intangible assets related to customer relationships; $6.9 million of intangible assets related to technology; $0.5 million of intangible assets related to product trademarks; $2.0 million of cash; other assets of $0.8 million; accounts payable and accrued expenses of $2.6 million; deferred revenue of $0.9 million; and deferred income taxes of $7.6 million. This allocation is preliminary and subject to changes, which could be significant, as appraisals of tangible and intangible assets are finalized, and additional information becomes available. The acquired intangible assets related to technology and customer relationships will be amortized over their estimated useful lives of 7-20 years using a method that approximates the pattern of economic benefits to be gained by the intangible assets. The goodwill is not deductible for tax purposes. We incurred $0.4 million of acquisition costs which are included in selling, general and administrative expenses in the accompanying consolidated statement of operations for the year ended December 31, 2017. The results of operations of DeVero were not material to our consolidated results of operations for the year ended December 31, 2017.

Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc.

On August 25, 2017, the Company completed the acquisition of substantially all of the assets relating to the provider/patient engagement solutions business of NantHealth, Inc. (“NantHealth”). The consideration for the transaction included the 15,000,000 shares of common stock of NantHealth that had been held by the Company as available for sale securities and which had a fair value of $42.8 million at the time of the transaction. The transaction also includes adjustments for working capital and deferred revenue obligations, as well as a modification of the commercial agreement between the parties. Total consideration for the transaction was as follows:

	(In thousands)
Cash	$	1,742
Add: Final net working capital surplus		906
Add: NantHealth common stock		42,750
Less: Value assigned to modification of existing commercial agreement with NantHealth		(22,900	)
Total consideration for NantHealth provider/patient solutions business	$	22,498

The allocation of the fair value of the consideration transferred as of the acquisition date of August 25, 2017 is shown in the table below. This allocation is preliminary and subject to changes, which could be significant, as appraisals of tangible and intangible assets are finalized, and additional information becomes available. The goodwill is expected to be deductible for tax purposes.

	(In thousands)
Cash and cash equivalents	$	21
Accounts receivable, net		2,069
Prepaid expenses and other current assets		1,735
Fixed assets		3,401
Intangible assets		12,442
Goodwill		13,350
Other assets		204
Accounts payable and accrued expenses		(1,519	)
Deferred revenue		(9,205	)
Net assets acquired	$	22,498

The following table summarizes the estimated fair values of the most significant identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	19	$	9,200
Technology	5		3,000
Tradenames	5		200
		$	12,400

Acquisition of the Enterprise Information Solutions Business from McKesson Corporation

On October 2, 2017, Allscripts Healthcare, LLC, a wholly-owned subsidiary of the Company (“Healthcare LLC”), completed the transactions contemplated by a purchase agreement (the “Purchase Agreement”) with McKesson Corporation (“McKesson”), pursuant to which Healthcare LLC purchased McKesson’s Enterprise Information Solutions Business division (the “EIS Business”), which provides certain software solutions and services to hospitals and health systems, by acquiring all of the outstanding equity interests of two indirect, wholly-owned subsidiaries of McKesson. The acquisition of the EIS Business was based on a total enterprise value of $185 million as shown in the table below. The net consideration paid was funded through incremental borrowings under our debt facilities.

	(In thousands)
Aggregate purchase price	$	185,000
Add: Final net working capital surplus		1,331
Less: Assumption of restructuring indebtedness		(16,834	)
Net consideration paid in cash for the EIS Business	$	169,497

The EIS Business acquisition is being accounted for under the acquisition method of accounting in accordance with Accounting Standards Codification Topic 805, Business Combinations. Under the acquisition method of accounting, the fair value of consideration transferred for the EIS Business was allocated to the tangible and intangible assets acquired and the liabilities assumed based on their estimated fair values as of the acquisition date with the remaining unallocated amount recorded as goodwill. We have performed a preliminary valuation analysis as of the acquisition date of October 2, 2017 of the fair value of the EIS Business’ assets and liabilities. Our estimates and assumptions are subject to change, which could be significant, as appraisals of intangible assets are finalized, and as additional information becomes available during the measurement period (up to one year from the acquisition date). The goodwill is expected to be deductible for tax purposes. Among the factors that contributed to a purchase price resulting in the recognition of goodwill were the expected growth and synergies that we believe will result from the integration of the EIS business with our software solutions and services to hospitals and health systems. The following table summarizes the preliminary allocation of the purchase consideration as of the acquisition date:

	(In thousands)
Cash and cash equivalents	$	1,068
Accounts receivable, net		65,632
Prepaid expenses and other current assets		19,633
Fixed assets		9,808
Intangible assets		136,200
Goodwill		29,227
Other assets		1,601
Accounts payable and accrued expenses		(32,497	)
Deferred revenue		(58,490	)
Other liabilities		(2,685	)
Net assets acquired	$	169,497

The acquired intangible assets are being amortized over their useful lives, using a method that approximates the pattern of economic benefits to be gained by the intangible asset and consist of the following amounts for each class of acquired intangible asset:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	10	$	75,200
Technology	7		57,200
Tradenames	7		3,800
		$	136,200

Acquisition costs related to the EIS Business acquisition totaled $4.8 million and are included in selling, general and administrative expenses in the accompanying consolidated statement of operations for the year ended December 31, 2017.

Asset Purchase Agreement with Third Party

On March 31, 2017, Netsmart entered into an Asset Purchase Agreement with a third party, for an aggregate cash consideration of $4.0 million, to acquire intellectual property, certain contractual relationships and certain associates. This transaction has been accounted for as a business combination. The Asset Purchase Agreement provides for contingent consideration to be paid to the third party based on the number of customers of the third party that migrate to Netsmart’s electronic health record product. The value of the contingent consideration has been estimated to be $0.5 million at March 31, 2017. Netsmart accrued $0.6 million at December 31, 2017 within other liabilities. This amount represents the discounted fair value of the contingent consideration. This transaction resulted in the recognition of goodwill of $4.4 million. The goodwill is expected to be deductible for tax purposes. We have finalized the allocation of the fair value of the consideration transferred as of December 31, 2017.

2016 Business Combinations

Formation of Joint Business Entity and Acquisition of Netsmart, Inc.

On March 20, 2016, we entered into a Contribution and Investment Agreement (the “Contribution Agreement”) with GI Netsmart Holdings LLC, a Delaware limited liability company (“GI Partners”) to form a joint business entity, Nathan Holding LLC, a Delaware limited liability company (“Nathan”). The formation of Nathan was completed on April 19, 2016. As a result, pursuant to, and subject to the terms and conditions of, the Contribution Agreement, Nathan issued to Allscripts Class A Common Units in exchange for Allscripts contributing its Homecare^TM business and cash to Nathan and issued to GI Partners Class A Preferred Units in exchange for cash.

The Nathan operating agreement provides that the Class A Preferred Units entitle the owners at any time and from time to time following the later of (A) the earlier of (I) the fifth anniversary of the effective date and (II) a change in control of Allscripts, and (B) the earlier of (I) the payment in full of the obligations under the Netsmart Credit Agreements and the termination of any commitments thereunder or (II) with respect to any proposed redemption, such earlier date for such redemption consented to in writing by the required lenders under each of the credit facilities under which obligations remain unpaid or under which commitments continue, to redeem all or any portion of their Class A Preferred Units for cash at a price per Unit equal to the Class A Preferred liquidation preference for each such Class A Preferred Unit as of the date of such redemption. The liquidation preference is equal to the greater of (i) a return of the original issue price plus a preferred return (accruing on a daily basis at the rate of 11% per annum and compounding annually on the last day of each calendar year) or (ii) the as-converted value of Class A Common Units in Nathan. The consolidated statement of operations for the year ended December 31, 2016 gives effect to the accretion of the 11% redemption preference as part of the calculation of net income (loss) attributable to Allscripts stockholders.

Also on April 19, 2016, Nathan acquired Netsmart, Inc., a Delaware corporation, pursuant to the Agreement and Plan of Merger, dated as of March 20, 2016 (the “Merger Agreement”), by and among Nathan Intermediate LLC, a Delaware limited liability company and a wholly-owned subsidiary of Nathan (“Intermediate”), Nathan Merger Co., a Delaware corporation and a wholly-owned subsidiary of Intermediate (“Merger Sub”), Netsmart, Inc. and Genstar Capital Partners V, L.P., as the equityholders’ representative. Pursuant to the Merger Agreement, on April 19, 2016, Merger Sub was merged with and into Netsmart, Inc., with Netsmart, Inc. surviving as a wholly-owned subsidiary of Intermediate (the “Merger”). As a result of these transactions (the “Netsmart Transaction” or “Netsmart Acquisition”), the establishment of Nathan combined the Allscripts Homecare^TM business with Netsmart, Inc. In September 2016, Nathan amended its certificate of incorporation with the State of Delaware and changed its name from Nathan Holding LLC to Netsmart LLC. Throughout the rest of this Form 10-K, Netsmart LLC is referred to as “Netsmart”.

At the effective time of the Merger, shares of Netsmart, Inc.’s common stock issued and outstanding immediately prior to the effective time were converted into the right to receive a pro rata share of $950 million, reduced by net debt and subject to working capital and other adjustments (the “Purchase Price”). Each vested outstanding option to acquire shares of Netsmart, Inc.’s common stock became entitled to receive a pro rata share of the Purchase Price, less applicable exercise prices of the options. Certain holders of shares of Netsmart, Inc.’s common stock, who were members of Netsmart, Inc.’s management, exchanged a portion of such shares for equity interests in Nathan, in lieu of receiving their pro rata share of the Purchase Price, and certain holders of options to purchase shares of Netsmart, Inc.’s common stock, who were also members of Netsmart, Inc.’s management, invested a portion of such holder’s proceeds from the Merger in equity interests in Nathan (collectively, the “Rollover”). After the completion of the Merger and the Rollover, Allscripts owned 49.1%, GI Partners owned 47.2% and Netsmart’s management owned 3.7% of the outstanding equity interests in Netsmart, in each case on an as-converted basis. As part of the Netsmart Transaction, we deposited $15 million in an escrow account to be used by Netsmart to facilitate the integration of our Homecare^TM business within Netsmart over the next 4 years, at which time the restriction on any unused funds will lapse. As of December 31, 2017, there is $10.0 million remaining in the escrow account.

The acquisition of Netsmart, Inc. by Nathan was completed for an aggregate consideration of $937 million. The consideration was funded by the sources of funds as described in the table below. The new Netsmart term loans are non-recourse to Allscripts and its wholly-owned subsidiaries. A portion of the debt proceeds were used to extinguish Netsmart, Inc.’s existing debt of $325 million, including accrued interest and fees of $2 million.

	(In thousands)
Cash contribution for redeemable convertible non-controlling interest in Netsmart - GI Partners	$	333,606
Exchange of Netsmart, Inc.'s common stock for redeemable convertible non-controlling interest in Netsmart - Netsmart, Inc. management		25,543
Cash contribution from borrowings under revolver in exchange for common stock in Netsmart - Allscripts		43,782
Net borrowings under new term loans - Netsmart		534,135
Total consideration for Netsmart, Inc.	$	937,066

Under the acquisition method of accounting, the fair value of consideration transferred for Netsmart, Inc. was allocated to the tangible and intangible assets acquired and the liabilities assumed based on their estimated fair values as of the acquisition date with the remaining unallocated amount recorded as goodwill. During the year ended December 31, 2016, we recorded several measurement period adjustments, which included $3.6 million decrease in accounts receivable, net, $0.3 million increase in prepaid expenses and other assets, $0.3 million decrease in other assets, $0.7 million increase in deferred taxes, net, $0.6 million decrease in other liabilities and $3.7 million increase in the residual allocation to goodwill.

The final allocation of the fair value of the consideration transferred, including measurement period adjustments through December 31, 2017, is shown in the table below.

	(In thousands)
Cash and cash equivalents	$	5,982
Accounts receivable, net		50,472
Prepaid expenses and other current assets		9,667
Fixed assets		26,829
Intangible assets		409,500
Goodwill		619,283
Other assets		6,540
Accounts payable		(14,151	)
Accrued expenses		(9,595	)
Deferred revenue		(18,843	)
Capital lease obligations		(17,833	)
Deferred taxes, net		(127,729	)
Other liabilities		(3,056	)
Net assets acquired	$	937,066

Allscripts’ contribution of its Homecare^TM business to Nathan was deemed to be a transaction between entities under common control and the net assets of the Homecare^TM business were contributed at carryover basis.

As noted above, the formation of Netsmart resulted in the merger of our Homecare^TM business with Netsmart, Inc.’s behavioral health technology business. As a result, Netsmart became one of the largest healthcare IT companies serving the health and human services sector, which includes behavioral health, public health and child and family services. Among the factors that contributed to a purchase price resulting in the recognition of goodwill were the expected growth and synergies that we believe will result from the integration of our Homecare^TM business with Netsmart, Inc.’s product offerings. The goodwill is not deductible for tax purposes.

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Technology	10	$	144,000
Corporate Trademark	indefinite		27,000
Product Trademarks	10		8,500
Customer Relationships	12-20		230,000
		$	409,500

Acquisition costs related to the Netsmart Acquisition totaled $4.1 million and are included in selling, general and administrative expenses in the accompanying consolidated statement of operations for the year ended December 31, 2016. No acquisition costs related to the Netsmart Acquisition were recognized during the year ended December 31, 2017.

Acquisition of HealthMEDX

On October 27, 2016, Netsmart completed the acquisition of HealthMEDX, LLC, a Delaware limited liability company (“HealthMEDX”), for an aggregate consideration of $39.2 million. HealthMEDX is a provider of electronic medical record solutions for long-term and post-acute care including continuing care retirement communities, assisted living, independent living, skilled nursing and home care providers.

The aggregate consideration was funded by the sources of funds as shown in the table below and includes a contingent consideration payable to the HealthMEDX unitholders in the first half of 2018 of up to $3.5 million based on HealthMEDX achieving certain recurring revenue milestones in 2017. The fair value of such contingent consideration shown in the table below represents the maximum pay-out amount discounted at the weighted-average cost of capital rate used as part of the HealthMEDX valuation. The outstanding contingent consideration of $0.9 million is included in accrued expenses in the accompanying consolidated balance sheet as of December 31, 2017. The decrease in value of the contingent consideration was the result of a revised estimate of the liability due. The portion of the aggregate consideration that was paid in cash at closing was funded with borrowings under the Netsmart Credit Agreements.

	(In thousands)
Incremental term loan - Netsmart	$	36,195
Contingent consideration payable to former HealthMEDX owners		2,888
Deferred cash consideration		100
Total consideration for HealthMEDX, LLC	$	39,183

The final allocation of the fair value of the consideration transferred is shown in the table below:

	(In thousands)
Cash and cash equivalents	$	489
Accounts receivable, net		3,109
Prepaid expenses and other current assets		773
Fixed assets		603
Intangible assets		20,940
Goodwill		18,568
Other assets		45
Accounts payable		(768	)
Accrued expenses		(1,427	)
Deferred revenue		(1,838	)
Current maturities of capital lease obligations		(808	)
Long-term maturities of debt and capital lease obligations		(503	)
Net assets acquired	$	39,183

We believe that the HealthMEDX acquisition will complement the existing Homecare^TM business and result in higher future revenue and operating synergies. These factors contributed to a purchase price resulting in the recognition of goodwill. The goodwill is expected to be deductible for tax purposes.

The following table summarizes the estimated fair values of HealthMEDX’s identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Technology	10	$	11,410
Product Trademarks	10		680
Customer Relationships	15		8,850
		$	20,940

Supplemental Information

The supplemental pro forma results below were calculated after applying our accounting policies and adjusting the results of the EIS Business to reflect (i) the additional amortization that would have been charged resulting from the fair value adjustments to intangible assets and (ii) the additional interest expense associated with Allscripts’ borrowings under its revolving facility, and (iii) the additional amortization of the estimated adjustment to decrease the assumed deferred revenue obligations to fair value that would have been charged assuming the acquisition occurred on January 1, 2016, together with the consequential tax effects. Supplemental pro forma results for the year ended December 31, 2017 were also adjusted to exclude acquisition-related and transaction costs incurred during this period. Supplemental pro forma results for the year ended December 31, 2016 were adjusted to include these items.

We also acquired the provider/patient engagement solutions business of NantHealth, Inc. (the “NantHealth business”) on August 25, 2017, Netsmart, Inc. (“Netsmart”) on April 19, 2016 and HealthMEDX, LLC (“HealthMEDX”) on October 27, 2016. The pro forma results below give effect to (i) the NantHealth business acquisition as if it had occurred on January 1, 2016 and (ii) the Netsmart and HealthMEDX acquisitions as if they had occurred on January 1, 2015, by applying pro forma adjustments attributable to these acquisitions to our historical financial results.

The supplemental pro forma results below were calculated after applying our accounting policies and adjusting the results of Netsmart and HealthMEDX to reflect (i) the additional depreciation and amortization that would have been charged resulting from the fair value adjustments to property, plant and equipment and intangible assets, (ii) the additional interest expense associated with Netsmart’s borrowings under the new term loans, and (iii) the additional amortization of the estimated adjustment to decrease the assumed deferred revenue obligations to fair value that would have been charged assuming both acquisitions occurred on January 1, 2015, together with the consequential tax effects. Supplemental pro forma results for the year ended December 31, 2016 were also adjusted to exclude acquisition-related and transaction costs incurred during this period. The supplemental pro forma results for the year ended December 31, 2016 exclude expenses incurred by Netsmart immediately prior to the Netsmart Transaction related to the accelerated pay-out of outstanding equity awards and the payment of seller costs. The effects of transactions between Allscripts and Netsmart during the periods presented have been eliminated in the supplemental pro forma data.

The revenue and earnings of Netsmart, since April 19, 2016, and HealthMEDX, since October 27, 2016, are included in our consolidated statement of operations for the years ended December 31, 2016 and 2017, and the supplemental pro forma revenue and net loss of the combined entity is presented as if the acquisitions of both entities had occurred on January 1, 2015. The revenue and earnings of the NantHealth provider and patient engagement solutions business, since August 25, 2017, and the EIS Business, since October 2, 2017, are included in our consolidated statement of operations for the year ended December 31, 2017 and the supplemental pro forma revenue and net loss of the combined entity is presented as if the acquisitions of both entities had occurred on January 1, 2016.

	(Unaudited) Year Ended December 31,
(In thousands, except per share amounts)	2017			2016
Actual from Netsmart since acquisition date of April 19, 2016:
Revenue	$	0		$	173,361
Net loss	$	0		$	(27,709	)

Actual from HealthMEDX since acquisition date of October 27, 2016:
Revenue	$	0		$	4,725
Net income	$	0		$	602

Actual from NantHealth since acquisition date of August 25, 2017:
Revenue	$	6,268		$	0
Net loss	$	(4,393	)	$	0

Actual from EIS Business since acquisition date of October 2, 2017: ⁽¹⁾
Revenue	$	77,046		$	0
Net loss	$	(15,160	)	$	0

Supplemental pro forma data for combined entity:
Revenue	$	2,113,761		$	2,002,253
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(192,653	)	$	(477,744	)
Loss per share, basic and diluted	$	(1.07	)	$	(2.57	)

______________________

(1)	Revenue and Net loss from the EIS Business excludes revenue and income from discontinued operations. Refer to Note 13, “Discontinued Operations”.

Other Acquisitions and Investments

On December 2, 2016, we acquired a 100% interest in a third party based in Australia for an aggregate consideration of $5.1 million, net of cash acquired. The acquisition will broaden our clinical solutions portfolio. The financial results of this third party were consolidated with our financial results starting on the date of the transaction. The allocation of the estimated fair value of the aggregate consideration is as follows: $2.9 million of goodwill; $3.4 million of intangible assets related to customer relationships, $0.6 million of intangible assets related to technology; $1.2 million of deferred tax liabilities; and $0.6 million of net working capital and deferred revenue. The goodwill is not deductible for tax purposes. The acquired intangible assets relating to technology and customer relationships will be amortized on a straight-line basis over estimated lives of 8 years. The aggregate consideration included a contingent consideration payable to the third-party owners of up to $2.5 million based on the achievement of certain profitability targets by 2018 and 2019. The fair value of $2.0 million accrued at December 31, 2016 was calculated based on probability-weighted simulations of potential target achievements. All amounts are based on the exchange rate between the United States dollar and the Australian dollar as of December 31, 2016. The results of operations of this third party were not material to our consolidated results of operations for the year ended December 31, 2016.

On October 14, 2016, we acquired a 100% interest in a third party for an aggregate consideration $24.0 million, net of cash acquired. The acquisition will broaden our population health solutions portfolio. The financial results of this third party were consolidated with our financial results starting on the date of the transaction. The allocation of the aggregate consideration is as follows: $16.2 million of goodwill; $11.5 million of intangibles assets related to technology, $0.2 million of intangible assets related to customer relationships; $3.7 million of deferred tax liabilities and $0.2 million of net working capital and deferred revenue. The goodwill is not deductible for tax purposes. The acquired intangible assets relating to technology and customer relationships will be amortized on a straight-line basis over estimated lives of 8 years. The results of operations of this third party were not material to our consolidated results of operations for the year ended December 31, 2016.

On September 8, 2016, we acquired a 51% interest in a third party for $29.7 million, net of cash acquired. This acquisition broadens our financial analytics solutions portfolio. The financial results of this third party were consolidated with our financial results starting on the date of the transaction and were not material to our consolidated results of operations for the year ended December 31, 2016. The allocation of the fair value of the consideration transferred is as follows: $46.2 million in goodwill; $8.3 million intangible assets related to customer relationships, $10.3 million of intangible assets related to technology; $1.6 million related to tradename; $5.9 million of accounts receivable and other current assets; $0.6 million of deferred tax assets; $1.5 million of fixed assets; $6.0 million of accounts payable, deferred revenue and accruals; $8.5 million of deferred tax liabilities; $0.8 million of other long-term liabilities, and $29.4 million of non-controlling interest. The value of the non-controlling interest was based on its proportionate share of the implied total enterprise value of the third party at the time of the transaction. The goodwill is not deductible for tax purposes. The acquired intangible assets relating to technology, customer relationships and tradename will be amortized on a straight-line basis over estimated lives of 10 years, 13 years and 10 years, respectively. During the three months ended December 31, 2016, we recorded several measurement period adjustments, which included $1.2 million decrease in the value of customer relationship intangibles, $0.2 million decrease in deferred tax liability and $1.0 million increase in the residual allocation to goodwill. As part of this acquisition, Allscripts also obtained a call option to purchase all, but not less than all, of the remaining 49% equity share of the third party after the second and third anniversaries of the transaction date at pre-defined future enterprise values of the third party. Additionally, as part of this acquisition, the minority owners of the third party were granted a call option to repurchase the 51% equity share owned by Allscripts at the same pre-defined future enterprise value applicable to Allscripts call option for a period of 9 months after the third anniversary of the transaction date. Such call option can only be exercised in the event that Allscripts chooses not to exercise its call option after the third anniversary of the transaction date.

On April 17, 2015, we acquired a majority interest in a third party for $11.1 million and provided a loan to the third party of $9.3 million to refinance its outstanding indebtedness. The financial results of this third party were consolidated with our financial results starting on the date of the transaction, with a proportionate share allocated to non-controlling interest. The allocations of the estimated fair value of the net assets of the third party to goodwill, intangibles and non-controlling interest were $22.3 million, $4.3 million and $11.0 million, respectively. The value of the non-controlling interest was based on its proportionate share of the implied total enterprise value of the third party at the time of the transaction. The goodwill is not deductible for tax purposes. The results of operations of this third party were not material to our consolidated results of operations for the year ended December 31, 2015.

The following table summarizes our other equity investments which are included in other assets in the accompanying consolidated balance sheets:

	Number of
	Investees		Original		Carrying Value at
(In thousands, except # of investees)	at December 31, 2017		Investment		December 31, 2017		December 31, 2016
Equity method investments ⁽¹⁾		3	$	1,658	$	3,258	$	2,436
Cost method investments		7		32,784		26,755		26,041
Total equity investments		10	$	34,442	$	30,013	$	28,477

(1)

Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

During 2016, we acquired a $1.0 million non-marketable convertible note of a third party with which we have an existing license and distribution agreement. This investment is accounted for under the cost method. The carrying value of the convertible note was $1.0 million and was included in other assets in the accompanying consolidated balance sheets as of December 31, 2017 and December 31, 2016. During 2017, we acquired a $2.6 million non-marketable convertible note of a third party with which we have an existing investment accounted for under the equity method. The carrying value of the convertible note was $2.6 million and was included in other assets in the accompanying consolidated balance sheet as of December 31, 2017.

During 2016, we also acquired certain non-marketable equity securities of two third parties and entered into new commercial agreements with each of those third parties to license and distribute their products and services, for a total consideration of $10.2 million. Both of these equity investments are accounted for under the cost method. The carrying value of these investments was $10.2 million and is included in other assets in the accompanying consolidated balance sheets as of December 31, 2017 and December 31, 2016. During 2017, we acquired certain non-marketable equity securities of two third parties and entered into new commercial agreements with one of these third parties to license and distribute their products and services, for a total consideration of $2.8 million. Both of these investments are accounted for under the cost method. The carrying value of these investments was $2.8 million and is included in other assets in the accompanying consolidated balance sheet as of December 31, 2017.

As of December 31, 2017, it is not practicable to estimate the fair value of our equity investments primarily because of their illiquidity and restricted marketability. The factors we considered in trying to determine fair value include, but are not limited to, available financial information, the issuer’s ability to meet its current obligations and the issuer’s subsequent or planned raises of capital.

Impairment of and Losses on Long-term Investments

Each quarter, management performs an assessment of each of our investments on an individual basis to determine if any declines in fair value are other-than-temporary. Based on management's assessment during the second quarter of 2017, the Company determined that the decline in fair value of our available for sale marketable securities was other-than-temporary based on a number of factors, including, but not limited to, uncertainty regarding our intent to hold these investments for a period of time that would be sufficient to recover our cost basis in the event of a market recovery, the fact that the fair value of each investment had continued to decline below cost over the period held, and the Company's uncertainty around the near-term prospects for certain of the investments. As a result, the Company recognized other-than-temporary impairment charges of $142.2 million on available for sale marketable securities during the second quarter of 2017. The cost basis of these marketable securities prior to recognizing the impairment charges was approximately $205.6 million. The Company determined the fair value of these securities based on Level 1 inputs. During the three months ended September 30, 2017, the Company recognized an additional $20.7 million loss upon the final disposition of these securities in connection with the NantHealth provider/patient solutions business acquisition. In addition, the Company recognized other-than-temporary impairment charges of $2.1 million on a cost method equity investment during the nine months ended September 30, 2017. The aggregate carrying value of this equity investment prior to recognizing the impairment charge was $2.1 million. These impairment charges are included in impairment of and losses on long-term investments line in our consolidated statement of operations for the year ended December 31, 2017.

Fixed Assets

12 Months Ended

Dec. 31, 2017

Property Plant And Equipment [Abstract]

Fixed Assets

3. Fixed Assets

Fixed assets consist of the following:

	Estimated	December 31,			December 31,
(Dollar amounts in thousands)	Useful Life	2017			2016
Computer equipment and software	3 to 10 years	$	332,640		$	336,784
Facility furniture, fixtures and equipment	5 to 7 years		28,705			23,398
Leasehold improvements	Shorter of 7 years or life of lease		37,735			36,600
Assets under capital lease	3 to 5 years		28,132			23,204
Fixed assets, gross			427,212			419,986
Less: Accumulated depreciation and amortization			(261,609	)		(271,176	)
Fixed assets, net		$	165,603		$	148,810

Accumulated amortization for assets under capital lease amounted to $13.7 million and $5.6 million as of December 31, 2017 and 2016, respectively.

Fixed assets depreciation and amortization expense were as follows:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Fixed assets depreciation and amortization expense, including capital leases	$	52,152	$	40,315	$	42,153

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2017

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

4. Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	December 31, 2017							December 31, 2016
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	695,354	$	(405,114	)	$	290,240	$	627,819	$	(347,477	)	$	280,342
Customer contracts and relationships		922,492		(464,860	)		457,632		813,021		(430,960	)		382,061
Total	$	1,617,846	$	(869,974	)	$	747,872	$	1,440,840	$	(778,437	)	$	662,403

Intangibles not subject to amortization:
Registered trademarks						$	79,000						$	79,000
Goodwill							2,004,953							1,924,052
Total						$	2,083,953						$	2,003,052

We performed our annual impairment tests of our reporting units as of October 1, 2017. During the year ended December 31, 2017, the annual impairment testing date of the Netsmart reporting unit was changed to October 1, 2017 to coincide with Allscripts annual testing date. The prior annual impairment testing date for the Netsmart unit was December 31, 2016. The fair value of each reporting unit substantially exceeded its carrying value and no indicators of impairment were identified. All of the impairment tests performed during 2017 consisted of quantitative analyses.

We determined the fair value of each of our reporting units using both a discounted cash flow analysis and a market approach considering benchmark company market multiples. A discount rate of 9% was applied to the cash flows used in the discounted cash flow analysis. We also considered our market capitalization as of the date of each test.

There were no accumulated impairment losses associated with our goodwill as of December 31, 2017 or 2016, and no impairments were recorded during the years ended December 31, 2017, 2016 and 2015. Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2017 and 2016 were as follows:

	Clinical and			Population
(In thousands)	Financial Solutions			Health			Netsmart		Total
Balance as of December 31, 2015	$	796,367		$	426,234		$	0	$	1,222,601
Additions arising from business acquisitions:
Netsmart		0			0			619,283		619,283
HealthMEDX		0			0			18,457		18,457
Other additions		49,093			16,241			0		65,334
Total additions to goodwill		49,093			16,241			637,740		703,074
Reallocation		0			(37,600	)		37,600		0
Foreign exchange translation		(1,623	)		0			0		(1,623	)
Balance as of December 31, 2016	$	843,837		$	404,875		$	675,340	$	1,924,052
Additions arising from business acquisitions:
DeVero acquisition		0			0			32,363		32,363
Nanthealth provider/patient solutions business		0			13,350			0		13,350
Enterprise Information Solutions business		16,367			12,860			0		29,227
Other additions		420			47			4,503		4,970
Total additions to goodwill		16,787			26,257			36,866		79,910
Foreign exchange translation		991			0			0		991
Balance as of December 31, 2017	$	861,615		$	431,132		$	712,206	$	2,004,953

Other additions during the years ended December 31, 2017 and 2016 relate to goodwill arising from our acquisition of several third parties in late 2016, including measurement period adjustments, and Netsmart’s Asset Purchase Agreement with a third party during March 2017. The goodwill reallocation during the year ended December 31, 2016 relates to the allocation of goodwill associated with our Homecare^TM business during the second quarter of 2016 as a result of the Netsmart Transaction. Refer to Note 2, “Business Combinations and Other Investments,” for additional information regarding these acquisitions.

Intangible assets are being amortized over their estimated useful lives and amortization expense related to intangible assets was as follows:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Proprietary technology amortization included in cost of revenue	$	57,517	$	45,357	$	35,144
Intangible amortization included in operating expenses		33,754		25,847		23,172
Total intangible amortization expense	$	91,271	$	71,204	$	58,316

The increase in amortization expense for the year ended December 31, 2017 compared with the year ended December 31, 2016 was primarily driven by acquisitions completed during 2017. The increase in amortization expense for the year ended December 31, 2016 compared with the year ended December 31, 2015 was primarily driven by acquisitions completed during 2016, partly offset by amortization associated with intangible assets that were fully amortized in the second half of 2015. Estimated future amortization expense for the intangible assets that exist as of December 31, 2017, based on foreign currency exchange rates in effect as of such date, is as follows:


Year Ended December 31,	(In thousands)
2018	$	106,859
2019		105,191
2020		100,509
2021		91,428
2022		79,315
Thereafter		264,570
Total	$	747,872

- Definition

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References + Details

Asset Impairment Charges

12 Months Ended

Dec. 31, 2017

Asset Impairment Charges [Abstract]

Asset Impairment Charges

5. Asset Impairment Charges

During the year ended December 31, 2017, we recognized non-cash charges of $165.3 million including other-than-temporary impairment charges of $144.6 million during the second quarter of 2017 associated with two of the Company’s long-term investments based on management’s assessment of the likelihood of near-term recovery of the investments’ value. The majority of the impairment charges relate to our investment in NantHealth common stock. During the three months ended September 30, 2017, we realized an additional $20.7 million loss upon the final disposition of the NantHealth common stock in connection with our acquisition of certain assets related to NantHealth’s provider/patient engagement solutions business. Refer to Note 2, “Business Combinations and Other Investments” and Note 10, “Accumulated Other Comprehensive Loss,” for further information regarding these impairments.

During the year ended December 31, 2016, we incurred non-cash asset impairment charges totaling $4.7 million. These charges included $2.2 million for the impairment of capitalized software as a result of our decision to discontinue several software development projects, $2.1 million for the impairment of one of our cost method equity investments, and other charges of $0.4 million to write down a long-term asset to its estimated net realizable value.

During the year ended December 31, 2015, we recorded non-cash asset impairment charges of $1.2 million associated with a decline in the value of a commercial agreement and wrote-off $0.3 million of certain deferred costs that were determined to be unrealizable.

	Year Ended December 31,
(In thousands)	2017		2016		2015
Asset impairment charges	$	0	$	4,650	$	1,544
Impairment of and losses on long-term investments	$	165,290	$	0	$	0

Debt

12 Months Ended

Dec. 31, 2017

Debt Disclosure [Abstract]

Debt

6. Debt

Debt outstanding, excluding capital lease obligations, consisted of the following:

	December 31, 2017						December 31, 2016
(In thousands)	Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount		Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount
1.25% Cash Convertible Senior Notes	$	345,000	$	35,978	$	309,022	$	345,000	$	49,186	$	295,814
Senior Secured Credit Facility		628,750		3,360		625,390		441,875		4,691		437,184
Netsmart Non-Recourse Debt:
First Lien Term Loan		479,316		10,950		468,366		432,925		11,655		421,270
Second Lien Term Loan		167,000		7,418		159,582		167,000		8,901		158,099
Other debt		0		0		0		13		0		13
Total debt	$	1,620,066	$	57,706	$	1,562,360	$	1,386,813	$	74,433	$	1,312,380
Less: Debt payable within one year - excluding Netsmart		28,125		438		27,687		15,638		480		15,158
Less: Debt payable within one year - Netsmart		4,866		2,111		2,755		4,351		1,900		2,451
Total long-term debt, less current maturities	$	1,587,075	$	55,157	$	1,531,918	$	1,366,824	$	72,053	$	1,294,771

Interest expense consisted of the following:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Interest expense	$	23,001	$	15,556	$	16,284
Amortization of discounts and debt issuance costs		14,539		13,922		13,679
Write off of unamortized deferred debt issuance costs		0		0		1,433

Netsmart:
Interest expense ⁽¹⁾		46,449		30,820		0
Amortization of discounts and debt issuance costs		3,490		2,619		0
Write off of unamortized deferred debt issuance costs		0		5,224		0
Total interest expense	$	87,479	$	68,141	$	31,396

⁽¹⁾	Includes interest expense related to capital leases.

Interest expense related to the 1.25% Cash Convertible Senior Notes was comprised of the following:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Coupon interest at 1.25%	$	4,312	$	4,312	$	4,312
Amortization of discounts and debt issuance costs		13,208		12,585		11,994
Total interest expense related to the 1.25% Notes	$	17,520	$	16,897	$	16,306

1.25% Cash Convertible Senior Notes due 2020

On June 18, 2013, we issued $345.0 million aggregate principal amount of the 1.25% Cash Convertible Senior Notes due 2020 (the “1.25% Notes”). The aggregate net proceeds of the 1.25% Notes were $305.1 million, after payment of the net cost of the 1.25% Notes Call Spread Overlay (as described below) and transaction costs.

Interest on the 1.25% Notes is payable semiannually in arrears on January 1 and July 1 of each year, at a fixed annual rate of 1.25% commencing on January 1, 2014. The 1.25% Notes will mature on July 1, 2020 unless repurchased or converted in accordance with their terms prior to such date.

The 1.25% Notes are convertible only into cash, and not into shares of our common stock or any other securities. Holders may convert their 1.25% Notes solely into cash at their option at any time prior to the close of business on the business day immediately preceding January 1, 2020 only under the following circumstances: (1) during any calendar quarter (and only during such calendar quarter), if the last reported sale price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; (2) during the five business day period immediately after any five consecutive trading day period in which the trading price per $1,000 principal amount of the 1.25% Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day; or (3) upon the occurrence of specified corporate events. On or after January 1, 2020 until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their 1.25% Notes solely into cash at any time, regardless of the foregoing circumstances. Upon conversion, in lieu of receiving shares of our common stock, a holder will receive an amount in cash, per $1,000 principal amount of the 1.25% Notes, equal to the settlement amount, determined in the manner set forth in the Indenture.

The initial conversion rate will be 58.1869 shares of our common stock per $1,000 principal amount of the 1.25% Notes (equivalent to an initial conversion price of approximately $17.19 per share of common stock). The conversion rate will be subject to adjustment in some events but will not be adjusted for any accrued and unpaid interest. In addition, following certain corporate events that occur prior to the maturity date, we will pay a cash make-whole premium by increasing the conversion rate for a holder who elects to convert such holder’s 1.25% Notes in connection with such a corporate event in certain circumstances. We may not redeem the 1.25% Notes prior to the maturity date, and no sinking fund is provided for the 1.25% Notes.

If we undergo a fundamental change (as defined in the Indenture), holders may require us to repurchase for cash all or part of their 1.25% Notes at a repurchase price equal to 100% of the principal amount of the 1.25% Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date. The Indenture provides for customary events of default, including cross acceleration to certain other indebtedness of ours, and our subsidiaries.

The 1.25% Notes are senior unsecured obligations, and rank senior in right of payment to any of our indebtedness that is expressly subordinated in right of payment to the 1.25% Notes; equal in right of payment to any of our unsecured indebtedness that is not so subordinated; effectively junior in right of payment to any of our secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities (including trade payables) of our subsidiaries.

The 1.25% Notes contain an embedded cash conversion option. We have determined that the embedded cash conversion option is a derivative financial instrument, required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of operations until the cash conversion option transaction settles or expires. The initial fair value liability of the embedded cash conversion option was $82.8 million, which simultaneously reduced the carrying value of the 1.25% Notes (effectively an original issuance discount). For further discussion of the derivative financial instruments relating to the 1.25% Notes, refer to Note 11, “Derivative Financial Instruments.”

The reduced carrying value of the 1.25% Notes resulted in a debt discount that is amortized to the 1.25% Notes’ principal amount through the recognition of non-cash interest expense over the expected term of the 1.25% Notes, which extends through their maturity date of July 1, 2020. This has resulted in our recognition of interest expense on the 1.25% Notes at an effective rate approximating what we would have incurred had nonconvertible debt with otherwise similar terms been issued. The effective interest rate of the 1.25% Notes at issuance was 5.4%, which was imputed based on the amortization of the fair value of the embedded cash conversion option over the remaining term of the 1.25% Notes. As of December 31, 2017, we expect the 1.25% Notes to be outstanding until their July 1, 2020 maturity date, for a remaining amortization period of approximately two and a half years. As of December 31, 2017, the if-converted value of the 1.25% Notes did not exceed the 1.25% Notes’ principal amount.

In connection with the settlement of the 1.25% Notes, we paid $8.4 million in transaction costs. Such costs have been allocated to the 1.25% Notes, the 1.25% Call Option (as defined below) and the 1.25% Warrants (as defined below). The amount allocated to the 1.25% Notes, or $8.3 million, was capitalized and is being amortized over the expected term of the 1.25% Notes. The remaining aggregate amounts allocated to the 1.25% Call Option and 1.25% Warrants were not significant. The outstanding capitalized amount of transaction costs related to the 1.25% Notes was $2.9 million and is reported as a reduction of long-term debt on our consolidated balance sheet as of December 31, 2017.

Accrued and unpaid interest on the 1.25% Notes of $2.2 million is included in accrued expenses in the accompanying consolidated balance sheet as of December 31, 2017.

1.25% Notes Call Spread Overlay

Also in June 2013, concurrent with the issuance of the 1.25% Notes, we entered into privately negotiated hedge transactions (collectively, the “1.25% Call Option”) and warrant transactions (collectively, the “1.25% Warrants”), with certain of the initial purchasers of the 1.25% Notes (collectively, the “Call Spread Overlay”). Assuming full performance by the counterparties, the 1.25% Call Option is intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes. We used $82.8 million of the proceeds from the settlement of the 1.25% Notes to pay for the 1.25% Call Option, and simultaneously received $51.2 million from the sale of the 1.25% Warrants, for a net cash outlay of $31.6 million for the Call Spread Overlay. The 1.25% Call Option is a derivative financial instrument and is discussed further in Note 11, “Derivative Financial Instruments.” The 1.25% Warrants are equity instruments and are further discussed in Note 9, “Stockholders’ Equity.”

Senior Secured Credit Facility Amendment

On September 30, 2015, we entered into a Replacement Facility Amendment (the “2015 Credit Agreement”) to our existing Credit Agreement, dated as of June 28, 2013, as amended on June 8, 2015, with a syndicate of financial institutions and JPMorgan Chase Bank, N.A., as administrative agent. The 2015 Credit Agreement provides for a $250 million senior secured term loan (the “Term Loan”) and a $550 million senior secured revolving facility (the “Revolving Facility”), each with a five year term (collectively the “Senior Secured Credit Facility”). These amounts represent increases in total borrowing limits of $25 million and $125 million, respectively, compared with our existing Credit Agreement. The Term Loan is repayable in quarterly installments, which commenced on December 31, 2015 and end on September 30, 2020. A total of up to $50 million of the Revolving Facility is available for the issuance of letters of credit, up to $10 million of the Revolving Facility is available for swingline loans, and up to $100 million of the Revolving Facility could be borrowed under certain foreign currencies.

Proceeds from the borrowings under the 2015 Credit Agreement were used for the refinancing of the term loan and revolving facility under our existing Credit Agreement. The proceeds of the Revolving Facility can be used to finance our working capital needs and for general corporate purposes, including financing of permitted acquisitions, share repurchases, and other investments. We may also request to add one or more incremental revolving and/or term loan facilities in an aggregate amount of up to $300 million, subject to certain conditions.

Borrowings under the Senior Secured Credit Facility bear interest, at our option, at a rate per annum equal to either (1) the rate (adjusted for statutory reserve requirements for eurocurrency liabilities and mandatory costs, if any) for deposits in the applicable currency for a period equal to one, two, three or six months or, with respect to loans under the Revolving Facility denominated in United States dollars, subject to availability to all affected lenders, 7 days (as selected by us), appearing on pages LIBOR01, LIBOR02, EURIBOR01, as applicable, or other page displaying such rate for such currency of the Reuters Screen (the “Eurocurrency Rate”) plus the applicable margin or (2) the highest of (a) the rate of interest publicly announced by JPMorgan Chase Bank, N.A. as its prime rate in effect at its principal office in New York City, (b) the federal funds effective rate from time to time plus 0.5%, and (c) the Eurocurrency Rate for United States dollars for a one month interest period plus 1.0% (the “Base Rate”), plus, in each case, the applicable margin. The initial applicable interest rate margin for Base Rate borrowings was 1.25%, and for Eurocurrency Rate borrowings was 2.25%. Future applicable interest rate margins will be determined from a pricing table and will depend upon our total leverage ratio. The applicable interest rate margins under the 2015 Credit Agreement for Base Rate borrowings range from 0.00% to 1.25% and for Eurocurrency Rate loans range from 1.00% to 2.25%. These ranges are 50 basis points lower at each level of the leverage-based pricing grid compared with our existing Credit Agreement.

Subject to certain agreed upon exceptions, all obligations under the Senior Secured Credit Facility remain guaranteed by each of our existing and future direct and indirect material domestic subsidiaries other than Coniston Exchange LLC and certain domestic subsidiaries owned by our foreign subsidiaries (the “Guarantors”) pursuant to a related Guarantee and Collateral Agreement, dated as of June 28, 2013, among Allscripts Healthcare Solutions, Inc., Allscripts Healthcare, LLC, certain of our other subsidiaries, and JPMorgan Chase Bank, N.A., as administrative agent. Our obligations under the Senior Secured Credit Facility, any swap agreements and any cash management arrangements provided by any lender, remain secured, subject to permitted liens and other agreed upon exceptions, by a perfected first priority security interest in all of the tangible and intangible assets (including, without limitation, intellectual property, material owned real property and all of the capital stock of each Guarantor and, in the case of foreign subsidiaries, up to 65% of the capital stock of first tier material foreign subsidiaries) of Allscripts Healthcare Solutions, Inc. and certain of our subsidiary guarantors.

The Senior Secured Credit Facility requires us to maintain a minimum interest coverage ratio of 4.0 to 1.0, a maximum total leverage ratio of 4.0 to 1.0 and a maximum senior secured leverage ratio of 3.0 to 1.0. The minimum interest coverage ratio is calculated by dividing earnings before interest expense, income tax expense, depreciation and amortization expense by cash interest expense, subject to various agreed upon adjustments. The total leverage ratio is calculated by dividing total indebtedness by earnings before interest expense, income tax expense, depreciation and amortization expense, subject to various agreed upon adjustments. The senior secured leverage ratio is calculated by dividing senior secured indebtedness by earnings before interest expense, income tax expense, depreciation and amortization expense, subject to various agreed upon adjustments. The 2015 Credit Agreement also provides that during the four-quarter period following permitted acquisitions that are financed in whole or in part with indebtedness and the consideration paid by us is $100 million or more, we are required to maintain a maximum total leverage ratio of 4.5 to 1.0 and a maximum senior secured leverage ratio of 3.25 to 1.0. In addition, the 2015 Credit Agreement requires mandatory prepayments of the debt outstanding under the Senior Secured Credit Facility in certain specific circumstances, and contains a number of covenants which, among other things, restrict our ability to incur additional indebtedness, engage in mergers, or declare dividends or other payments in respect of our capital stock.

The Senior Secured Credit Facility also contains certain customary events of default, including relating to non-payment, breach of covenants, cross-default, bankruptcy and change of control.

In connection with our entry into the 2015 Credit Agreement, during the year ended December 31, 2015, we incurred fees and other costs totaling $3.0 million, of which $2.7 million were capitalized and included in the net carrying amounts outstanding under the Senior Secured Credit Facility as of December 31, 2015. In addition, $3.3 million of deferred costs associated with our existing Credit Facility carried over to the 2015 Credit Agreement. Also, in connection with our entry into the 2015 Credit Agreement, $1.1 million of deferred costs associated with our existing Credit Agreement and $0.3 million of fees and other costs associated with the 2015 Credit Agreement were written off to interest expense and are included in other losses, net in the accompanying consolidated statement of cash flows for the year ended December 31, 2015.

As of December 31, 2017, $218.8 million under the Term Loan, $410.0 million under the Revolving Facility, and $0.8 million in letters of credit were outstanding under the 2015 Credit Agreement.

As of December 31, 2017, the interest rate on the Senior Secured Credit Facility was LIBOR plus 2.25%, which totaled 3.82%. We were in compliance with all financial covenants under the 2015 Credit Agreement as of December 31, 2017.

As of December 31, 2017, we had $139.2 million available borrowing capacity, net of outstanding letters of credit, under the Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of the Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings.

Subsequent to December 31, 2017, we amended and restated our Senior Secured Credit Facility on February 15, 2018. The Second Amended and Restated Credit Agreement provides for a $400 million senior secured term loan and a $900 million senior secured revolving facility, which represent increases from the $250 million term loan and $550 million revolving facility provided under our existing 2015 Credit Agreement, respectively, each with a five-year term. Refer to Note 19, “Subsequent Events,” for further information regarding the Second Amended and Restated Credit Agreement.

Netsmart Non-Recourse Debt

On April 19, 2016, Netsmart entered into a First and Second Lien Credit Agreement (the “Netsmart First Lien Credit Agreement” and the “Netsmart Second Lien Credit Agreement”, respectively), with a syndicate of financial institutions and UBS AG, Stamford Branch, as administrative agent. The Netsmart First Lien Credit Agreement provides for a $395 million senior secured 7‑year term loan credit facility (the “Netsmart First Lien Term Loan”) and a $50 million senior secured 5-year revolving loan credit facility (the “Netsmart Revolving Facility”). The Netsmart Second Lien Credit Agreement provides for a $167 million senior secured 7.5-year term loan credit facility (the “Netsmart Second Lien Term Loan,” and, together with the Netsmart First Lien Credit Agreement, the “Netsmart Credit Agreements”). Each of Netsmart’s obligations under the Netsmart Credit Agreements are guaranteed by Netsmart’s wholly-owned subsidiaries, under an unconditional guaranty. Netsmart’s debt under the Netsmart Credit Agreements is non-recourse to Allscripts and its wholly-owned subsidiaries. In connection with the Netsmart Credit Agreements, during the second quarter of 2016, Netsmart incurred fees and other costs totaling $27.9 million, which were capitalized and included in the net borrowings outstanding under Netsmart’s Credit Agreements as of December 31, 2016.

On October 27, 2016, Netsmart signed a definitive agreement to acquire HealthMEDX, LLC. The acquisition agreement resulted in Netsmart issuing additional first lien debt under the new facility of $40 million. In connection with this additional first lien debt, Netsmart incurred debt issuance costs of $0.6 million.

On November 10, 2016, Netsmart amended its First Lien Credit Agreement to reduce the effective interest rate by 25 basis points. No other terms or conditions were impacted by this amendment. The Netsmart Revolving Facility and the Netsmart Second Lien Term Loan were not impacted by the amendment. There were no debt issuance costs associated with the amendment. Debt issuance costs of $5.2 million were written off to interest expense in connection with this amendment due to the changes in members of the lending bank syndicate.

On July 17, 2017, Netsmart signed a definitive agreement to acquire DeVero. The acquisition agreement resulted in Netsmart issuing additional first lien debt under the new facility of $51 million. In connection with this additional first lien debt, Netsmart incurred debt issuance costs of $1.3 million.

The Netsmart Revolving Facility will terminate on April 19, 2021 and the Netsmart First Lien Term Loan matures on April 19, 2023. The Netsmart Second Lien Term Loan matures on October 19, 2023. All unpaid principal of, and interest accrued on, such loans must be repaid on their respective maturity dates. The outstanding principal amount of the Netsmart First Lien Term Loan bears interest at a rate equal to (a) with respect to LIBO Rate Loans, Adjusted LIBO Rate plus 4.50% and (b) with respect to ABR Loans, 3.50%. The outstanding principal amount of the Netsmart Revolving Facility bears interest at a rate equal to (a) with respect to LIBO Rate Loans, Adjusted LIBO Rate plus 4.75% and (b) with respect to ABR Loans, 3.75% (provided, however, such rate may step-down to 4.25% and 3.25%, respectively, depending on the then-applicable leverage ratio). The outstanding principal amount of the Netsmart Second Lien Term Loan bears interest at a rate equal to (a) with respect to LIBO Rate Loans, Adjusted LIBO Rate plus 9.50% and (b) with respect to ABR Loans, 8.50%. The proceeds from the funding of the Netsmart Credit Agreements were used to, among other things, finance a portion of the Netsmart aggregate consideration and to pay fees and expenses in connection therewith.

The Netsmart Credit Agreements contain a financial covenant that Intermediate and its subsidiaries maintain a maximum ratio of total debt to Consolidated Adjusted EBITDA. The entire principal amount of the Netsmart Credit Agreements and any accrued but unpaid interest may be declared immediately due and payable if an event of default occurs. Events of default under the Netsmart Credit Agreements include (but are not limited to) failure to make payments when due, a default in the performance of any covenants in the Netsmart Credit Agreements or related documents or certain changes of control of Intermediate and/or of Netsmart.

The Netsmart First Lien Credit Agreement requires Netsmart to maintain a total net leverage ratio of not more than 7.50 to 1.00 at December 31, 2017, with gradual step‑downs to 6.75 to 1.00 for the quarter ending March 31, 2019 and each three-month period ending thereafter. The Netsmart Second Lien Credit Agreement requires Netsmart to maintain a total net leverage ratio of not more than 8.50 to 1.00 at December 31, 2017, with gradual step‑downs to 7.75 to 1.00 for the quarter ending March 31, 2019 and each three-month period ending thereafter. Netsmart was in compliance with all covenants under its Credit Agreements as of December 31, 2017.

As of December 31, 2017, $479.3 million under the Netsmart First Lien Term Loan and $167.0 million under the Netsmart Second Lien Term Loan were outstanding.

As of December 31, 2017 and 2016, the interest rate on the borrowings under the Netsmart First Lien Term Loan was Adjusted LIBO plus 4.50%, which totaled 6.19% and 5.50%, respectively. The interest rate applicable to the Netsmart Revolving Facility was Adjusted LIBO plus 4.75%, which totaled 6.44% as of December 31, 2017, however, there have been no borrowings under the Netsmart Revolving Facility since its inception. As of December 31, 2017 and 2016, the interest rate on the borrowings under the Netsmart Second Lien Term Loan was Adjusted LIBO plus 9.5%, which totaled 10.98% and 10.5%, respectively.

As of December 31, 2017, Netsmart had $50.0 million available borrowing capacity, net of outstanding letters of credit, under the Netsmart Revolving Facility. Additional amounts of up to $200.2 million as of December 31, 2017 are available under Netsmart’s Credit Agreements based upon Netsmart’s net leverage ratio at the time of the request. There can be no assurance that Netsmart will be able to draw on the full available balance of the Netsmart Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings.

The following table summarizes future debt payments as of December 31, 2017:

(In thousands)	Total		2018		2019		2020		2021		2022		Thereafter
1.25% Cash Convertible Senior Notes ⁽¹⁾	$	345,000	$	0	$	0	$	345,000	$	0	$	0	$	0
Term Loan		218,750		28,125		40,625		150,000		0		0		0
Revolving Facility ⁽²⁾		410,000		0		0		410,000		0		0		0
Netsmart Non-Recourse Debt ⁽²⁾
First Lien Term Loan ⁽³⁾		479,316		4,866		4,866		4,866		4,866		4,866		454,986
Second Lien Term Loan		167,000		0		0		0		0		0		167,000
Total debt	$	1,620,066	$	32,991	$	45,491	$	909,866	$	4,866	$	4,866	$	621,986

⁽¹⁾

Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

⁽²⁾

Assumes no additional borrowings after December 31, 2017 and that all drawn amounts are repaid upon maturity.

⁽³⁾

Starting with the year ended December 31, 2017, additional amounts may be due within 125 days after year-end if Netsmart has “excess cash” as defined in the Netsmart First Lien Credit Agreement. For the year ended December 31, 2017, no additional amounts will be due as a result of this provision.

Income Taxes

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Income Taxes

7. Income Taxes

The following is a geographic breakdown of income (loss) before income tax benefits:


	Year Ended December 31,
(In thousands)	2017			2016			2015
United States	$	(209,634	)	$	(13,317	)	$	(5,357	)
Foreign		16			(1,467	)		5,927
(Loss) income from continuing operations before income taxes	$	(209,618	)	$	(14,784	)	$	570

The following is a summary of the components of the provision (benefit) for income taxes:


	Year Ended December 31,
(In thousands)	2017			2016			2016
Current tax provision
Federal	$	407		$	323		$	570
State		1,770			606			658
Foreign		5,091			3,857			4,083
		7,268			4,786			5,311
Deferred tax provision
Federal		(39,237	)		(18,369	)		(2,928	)
State		(15,885	)		(3,354	)		898
Foreign		(2,913	)		(877	)		(655	)
		(58,035	)		(22,600	)		(2,685	)
Income tax (benefit) provision	$	(50,767	)	$	(17,814	)	$	2,626

Taxes computed at the statutory federal income tax rate of 35% are reconciled to the provision for income taxes as follows:


	Year Ended December 31,
(In thousands)	2017			2016			2015
United States federal tax at statutory rate	$	(73,171	)	$	(4,714	)	$	200
Items affecting federal income tax rate
Non-deductible acquisition and reorganization expenses		169			1,400			(2	)
Research credits		(4,476	)		(3,360	)		(3,000	)
Change in unrecognized tax benefits		686			(545	)		(208	)
State income taxes, net of federal benefit		(9,244	)		(371	)		182
Compensation		2,950			651			765
Meals and entertainment		1,358			1,341			1,023
Impact of foreign operations		730			2,847			1,848
Provision-to-Return adjustments		(1,413	)		(1,116	)		(136	)
Settlements with taxing authorities		0			0			(4,218	)
Deemed Dividends		1,289			887			1,408
Dividends Accrued		0			2,198			1,190
Federal, state and local rate changes		185			344			1,104
US Tax reform impact		(26,016	)		0			0
One time Mandatory Repatriation Toll Charge		5,155			0			0
Bilateral Advance Pricing Agreement impact		0			0			524
Non-deductible items		64			70			(5	)
Valuation allowance		47,959			(17,504	)		1,816
Other		3,008			58			135
Income tax provision (benefit)	$	(50,767	)	$	(17,814	)	$	2,626

Significant components of our deferred tax assets and liabilities consist of the following:


	December 31,
(In thousands)	2017			2016
Deferred tax assets
Accruals and reserves, net	$	26,126		$	22,305
Allowance for doubtful accounts		7,741			12,386
Stock-based compensation, net		12,654			15,939
Deferred revenue		12,466			15,092
Net operating loss carryforwards		67,677			91,859
Capital loss carryforwards		42,702			0
Research and development tax credit		38,310			32,952
AMT credits		7,901			7,085
State tax credits		3,795			2,911
Other		11,106			15,065
Less: Valuation Allowance		(79,732	)		(23,761	)
Total deferred tax assets		150,746			191,833

Deferred tax liabilities
Prepaid expense		(6,407	)		(9,532	)
Property and equipment, net		(13,201	)		(15,879	)
Acquired intangibles, net		(219,559	)		(305,361	)
Other		(648	)		(22	)
Total deferred tax liabilities		(239,815	)		(330,794	)
Net deferred tax liabilities	$	(89,069	)	$	(138,961	)

The deferred tax assets (liabilities) are classified in the consolidated balance sheets as follows:


	December 31,
(In thousands)	2017			2016
Non-current deferred tax assets, net	$	4,574		$	2,791
Non-current deferred tax liabilities, net		(93,643	)		(141,752	)
Non-current deferred tax liabilities, net	$	(89,069	)	$	(138,961	)

Allscripts Income Taxes

The United States Tax Cuts and Jobs Act (the “Tax Act”) was enacted on December 22, 2017 and introduced significant changes to the income tax law in the United States. Effective in 2018, the Tax Act reduces the United States statutory tax rate from 35% to 21% and creates new taxes on certain foreign-sourced earnings and certain related-party payments, which are referred to as the global intangible low-taxed income tax and the base erosion tax, respectively. In addition, in 2017 we were subject to a one-time transition tax on accumulated foreign subsidiary earnings not previously subject to income tax in the United States.

Due to the timing of the enactment and the complexity involved in applying the provisions of the Tax Act, we made reasonable estimates of the effects and recorded provisional amounts in our financial statements for the year ended December 31, 2017 in accordance with guidance in Staff Accounting Bulletin No. 118 which provided guidance for companies that had not completed their accounting for the income tax effects of the Tax Act in the period of enactment and allowed for a measurement period of up to one year after the enactment date to finalize the recording of the related tax impacts. As of December 31, 2017, we had not completed our accounting for the tax effects of the enactment of the Tax Act, however, we made a reasonable estimate of the effects on our deferred tax balances and in relation to the transition tax. The remeasurement of our deferred tax balances to reflect the reduced federal rate resulted in tax expense of $10.2 million. In addition, we have estimated and recorded tax expense of $5.2 million in our tax provision for the year ended December 31, 2017 related to the one-time transition tax on accumulated foreign subsidiary earnings not previously subject to income tax in the United States. The Tax Act creates new global intangible low-taxed income ("GILTI") tax provisions. The GILTI provisions require us to include in our future U.S. taxable income, the earnings of foreign subsidiaries in excess of an allowable return on the foreign subsidiaries' tangible assets. We have elected to account for GILTI tax in the period in which it is incurred, and therefore have not provided any deferred tax impacts of GILTI in our consolidated financial statements for the year ended December 30, 2017.

As of December 31, 2017 and 2016, we had federal net operating loss (“NOL”) carryforwards of $179 million and $192 million, respectively. The federal NOL carryforward includes Israeli NOL carryovers of $61 million that do not expire. As of December 31, 2017 and 2016, we had state NOL carryforwards of $4 million and $5 million, respectively. The NOL carryforwards expire in various amounts starting in 2020 for both federal and state tax purposes. The utilization of the federal NOL carryforwards is subject to limitation under the rules regarding changes in stock ownership as determined by the Internal Revenue Code; however, we are not subject to any material limits at this point in time due to excess limitations in prior years.

For federal purposes, 2013 to 2017 tax years remain subject to income tax examination by federal authorities. For our state tax jurisdictions, 2006 to 2017 tax years remain open to income tax examination by state tax authorities. In Canada, the 2013 to 2017 tax years remain open for examination and in India the 2012 to 2017 tax years remain open.

We have a subsidiary in India that is entitled to a tax holiday that allows for tax-free operations during such tax holiday. The tax holiday for the subsidiary began to partially expire in 2012 and will fully expire in 2017. Tax savings realized from this holiday totaled $0.4 million, $0.7 million and $0.4 million for the years ended December 31, 2017, 2016 and 2015, respectively, which reduced our diluted loss per share by less than $0.01 in each of those years. There is a potential for a partial tax holiday for 5 years beginning on April 1, 2017, which is contingent upon a certain level of capital expenditure spending, among other conditions. At this time, we do not believe we have met the requirements for this holiday; therefore, no tax savings impact has been recorded for this potential tax holiday for the year ended December 31, 2017.

U.S. GAAP principles prescribe a threshold of more-likely-than-not to be sustained upon examination for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. These principles also provide guidance on de-recognition, classification, interest and penalties, accounting in interim periods, disclosure and transition.

Changes in the amounts of unrecognized tax benefits were as follows:


	Year Ended December 31,
(In thousands)	2017			2016			2015
Beginning balance as of January 1	$	11,380		$	11,777		$	15,314
Increases for tax positions related to the current year		990			733			600
Decreases for tax positions related to prior years		(205	)		(16	)		0
Increases for tax positions related to prior years		153			104			50
Decreases relating to settlements with taxing authorities		0			0			(3,805	)
Increases acquired in business acquisitions		0			617			0
Foreign currency translation		10			(1	)		(24	)
Reductions due to lapsed statute of limitations		(334	)		(1,834	)		(358	)
Ending balance as of December 31	$	11,994		$	11,380		$	11,777

During the three months ended September 30, 2015, we concluded our Internal Revenue Service (the “IRS”) audit for all open years through December 31, 2012. The conclusion of this audit provided us with confirmation about the NOL carryforwards actual balance as of December 31, 2012. As a result, we recognized certain unrecognized income tax benefits totaling $4.0 million during the three months ended September 30, 2015. The recognition of these benefits did not impact our effective tax rate due to the valuation allowance. We were not able to obtain confirmation regarding the actual balance of our research and development credit carryforwards because none of these research and development credits have been utilized against any tax liability as of the date of this Form 10-K. Therefore, our analysis of eligible research and development credit carryforwards remains unchanged.

We had gross unrecognized tax benefits of $12.0 million and $11.4 million as of December 31, 2017 and 2016, respectively. If the current gross unrecognized tax benefits were recognized, the result would be an increase in our income tax benefit of $0.1 million and $1.0 million, respectively. These amounts are net of accrued interest and penalties relating to unrecognized tax benefits of $0.7 million and $1.2 million, respectively. We believe that it is reasonably possible that $1.0 million of our currently remaining unrecognized tax benefits may be recognized by the end of 2018, as a result of a lapse of the applicable statute of limitations.

We recognized interest and penalties related to uncertain tax positions in our consolidated statements of operations as follows:


	Year Ended December 31,
(In thousands)	2017		2016		2015
Interest and penalties included in the provision for income taxes	$	446	$	6	$	103

The amount of interest and penalties included in our consolidated balance sheets is as follows:


	December 31,
(In thousands)	2017		2016
Interest and penalties included in the liability for uncertain tax positions	$	741	$	1,187

During the year ended December 31, 2017, we recorded valuation allowance of $42.7 million related to federal capital loss carryforwards not expected to be realized before expiration. In addition, we recorded valuation allowance of $5.3 million related to federal credit carryforwards, and foreign and state NOL carryforwards. During the year ended December 31, 2016, we released valuation allowances of $17.5 million related to federal credit carryforwards, and foreign and state NOL carryforwards to offset current year taxable income. In evaluating our ability to recover our deferred tax assets within the jurisdiction from which they arise, we consider all available positive and negative evidence, including scheduled reversals of deferred tax liabilities, tax-planning strategies, and results of recent operations. In evaluating the objective evidence that historical results provide, we consider three years of cumulative operating income (loss). Using all available evidence, we determined that it was uncertain that we will realize the deferred tax asset for certain of these carryforwards within the carryforward period.

Our effective rate was lower for the year ended December 31, 2017 as compared with the prior year, primarily due to the recording of valuation allowance of $48.0 million in the current year as compared with the release of valuation allowance of $17.5 million in the prior year.

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States. We are subject to the continuous examination of our income tax returns by the IRS and other tax authorities. A change in the assessment of the outcomes of such matters could materially impact our consolidated financial statements.

Effective January 1, 2017, we adopted ASU 2016-09. The guidance in ASU 2016-09, among other things, requires all income tax effects of share-based awards to be recognized in the statement of operations when the awards vest or are settled as a discrete item in the period in which they occur. During the year ended December 31, 2017, we recorded $2.1 million of tax expense for awards in which the compensation cost recorded was higher than the tax deductions for the awards. ASU 2016-09 also requires entities to recognize excess tax benefits, regardless of whether the tax deduction reduces taxes payable. As part of adopting this new standard, we recorded a gross cumulative effect adjustment of $5.6 million to the opening balance of accumulated deficit to create a deferred tax asset to recognize excess tax benefits not previously recorded. The net decrease to accumulated deficit was $1.8 million due to the recognition of a corresponding valuation allowance of $3.8 million.

We intend to indefinitely reinvest the undistributed earnings of our foreign subsidiaries as a general rule, as most of our foreign subsidiaries have third party customers, as well as formal sales proposals that could require significant resources. Specifically, our subsidiary in India may repatriate all current 2017 earnings at the discretion of management. Certain earnings of our Israel subsidiary may also be repatriated depending on resource needs of our growing international business. For this reason, all potential withholding taxes have been recorded for these possible exceptions to our general rule of indefinitely reinvesting. As of December 31, 2016, we had established a Netherlands holding company, which currently holds all of our foreign subsidiaries. Our holding company makes it more efficient for us to share resources between the respective foreign subsidiaries. As we have determined that the earnings of these subsidiaries are not required as a source of funding for our United States operations, such earnings are not planned to be distributed to the United States in the foreseeable future

During 2017, tax reform was enacted that requires a calculation of a “toll charge” for all company’s controlled foreign corporations. As of December 31, 2017, we have estimated and recorded a liability for this tax of $5 million.

Netsmart Income Taxes

The Company has both U.S. federal and state net operating losses which are carried forward 20 years for federal tax purposes and from 5 to 20 years for state tax purposes. Both the federal and state loss carryovers are analyzed each year to determine the likelihood of realization. The United States federal loss carryover at December 31, 2017, was $91.4 million and if not used, would begin to expire in 2034. The state net operating loss was $120.0 million and if not used, would begin to expire in part beginning in 2018 through 2036. In addition, the Company has $10.7 million of federal and state tax credit carryovers consisting of $0.4 million of federal Alternative Minimum Tax credits, $5.5 million of federal and state research and development tax credits which if not used, will begin to expire in 2028 and $4.8 million of Kansas High Performance Incentive Program credits which if not used, will begin to expire in 2027.

Effective in 2018, the Tax Act reduces the United States statutory tax rate from 35% to 21%. As a result, Netsmart revalued its ending net deferred tax liabilities at December 31, 2017 and recognized a $36.2 million tax benefit in its statement of income for the year ended December 31, 2017.

Netsmart files a U.S. consolidated return. The 2014 through 2017 tax returns of Netsmart, LLC remain subject to examination by the Internal Revenue Service (IRS). The IRS examined the 2014 and 2015 federal income tax returns and closed the exams with no changes. The Company also files state tax returns with varying statutes of limitations. The 2013 through 2017 state tax returns remain subject to examination by most state tax authorities.

In assessing the realizability of its deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income. The Company believes that it is more likely than not that its deferred tax assets will be realized, except for certain state tax credits. As a result, the Company recorded a valuation allowance associated with its deferred tax assets of $0.1 million as of both December 31, 2017 and December 31, 2016, respectively.

Stock Award Plans

12 Months Ended

Dec. 31, 2017

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock Award Plans

8. Stock Award Plans

Total recognized stock-based compensation expense was as follows:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Cost of revenue:
Software delivery, support and maintenance	$	2,944	$	4,228	$	4,224
Client services		4,537		4,493		4,508
Total cost of revenue		7,481		8,721		8,732
Selling, general and administrative expenses		25,547		27,256		20,069
Research and development		8,666		8,175		7,826
Total stock-based compensation expense	$	41,694	$	44,152	$	36,627

The estimated income tax benefit of stock-based compensation expense included in the provision for income taxes for the year ended December 31, 2017 is approximately $4.7 million. No stock-based compensation costs were capitalized during the years ended December 31, 2017, 2016 and 2015. The calculation of stock-based compensation expenses includes an estimate for forfeitures at the time of grant. This estimate can be revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. As of December 31, 2017, total unrecognized stock-based compensation expense related to non-vested awards and options was $53.4 million and this expense is expected to be recognized over a weighted-average period of 2.3 years.

Allscripts Long-Term Incentive Plan

Allscripts Amended and Restated 2011 Stock Incentive Plan (the “Plan”) provides for the granting of stock options, service-based share awards, performance-based share awards and market-based share awards, among other awards. As of December 31, 2017, there were 7.7 million shares of common stock reserved for issuance under future share-based awards to be granted to any of Allscripts employees, officers, directors or independent consultants at terms and prices to be determined by our Board, and subject to the terms of the Plan.

We issue service-based, performance-based and market-based awards in the form of restricted stock units, stock options or shares. A description of each category of awards is presented below.

Service-based Share Awards

Service-based share awards include stock options, restricted stock units and restricted shares, and typically vest over a four-year period commencing on the date of grant subject to continued service with the company. Upon termination of an employee’s employment, any unvested service-based share awards are forfeited unless otherwise provided in an employee’s employment agreement. Deferred share units are awarded to directors and vest within one year, when issued in lieu of annual share awards, or immediately, when issued in lieu of cash compensation. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures.

As of December 31, 2017, there was $40.5 million of total estimated unrecognized stock-based compensation expense related to the service-based share awards, which is expected to be recognized over a weighted-average period of 2.6 years.

Performance-based Share Awards

Performance-based share awards include restricted stock units and restricted shares. The purpose of such awards is to align management’s compensation with our financial performance and other operational objectives and, in certain cases, to retain key employees over a specified performance period. Awards granted under this category are based on the achievement of various targeted financial measures, including, but not limited to, non-GAAP EBITDA and revenue growth, as defined in the grant agreements. The awards are earned based on actual results achieved compared to targeted amounts. Stock-based compensation expense related to these awards is recognized over three-year and four-year vesting periods under the accelerated attribution method if and when we conclude that it is probable that the performance conditions will be achieved.

As of December 31, 2017, there was $4.5 million of total estimated unrecognized stock-based compensation expense, assuming various target attainments related to the performance-based share awards, which is expected to be recognized over a weighted-average period of 1.4 years.

Market-based Share Awards

Market-based share awards include restricted stock units. The purpose of such awards is to align management’s compensation with the performance of our common stock relative to the market. Awards granted under this category are dependent on our total shareholder returns relative to a specified peer group of companies over three-year performance periods with vesting based on three annual performance segments from the grant dates. Fair values of the awards were estimated at the date of the grants using the Monte Carlo pricing model. Following completion of each of the three-year performance periods, the Compensation Committee of our Board will determine the number of awards that would vest considering overall performance over the three-year performance periods. If the number of shares that would vest under this scenario is greater than the amount vesting under the three annual performance segments, then such greater number of awards shall vest, reduced by the number of awards previously vested. Stock-based compensation expense related to these awards will be recognized over three-year vesting periods under the accelerated attribution method.

As of December 31, 2017, there was $8.4 million of total estimated unrecognized stock-based compensation expense, which is expected to be recognized over a weighted-average period of 1.8 years.

Restricted Stock Units and Awards

The following table summarizes the activity for restricted stock units during the periods presented:

				Weighted-Average
(In thousands, except per share amounts)	Shares			Grant Date Fair Value
Unvested restricted stock units as of December 31, 2014		5,096		$	15.69
Awarded		2,937			12.07
Vested		(1,612	)		14.84
Forfeited		(1,042	)		14.74
Unvested restricted stock units as of December 31, 2015		5,379			14.15
Awarded		3,480			12.88
Vested		(2,095	)		13.84
Forfeited		(517	)		14.30
Unvested restricted stock units as of December 31, 2016		6,247			13.54
Awarded		3,690			12.52
Vested		(1,835	)		13.74
Forfeited		(843	)		16.97
Unvested restricted stock units as of December 31, 2017		7,259		$	12.57

Net Share-settlements

Restricted stock units and awards are generally net share-settled upon vesting to cover the required withholding tax and the remaining amount is converted into an equivalent number of shares of common stock. The majority of restricted stock units that vested during the years ended December 31, 2017, 2016 and 2015 were net-share settled such that we withheld shares with value equivalent to the employees’ minimum statutory obligation for the applicable income and other employment taxes, and remitted the cash to the appropriate taxing authorities. Total payments for the employees’ minimum statutory tax obligations to the taxing authorities are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld during the years ended December 31, 2017, 2016 and 2015 were 606 thousand, 648 thousand and 523 thousand, respectively, and were based on the value of the restricted stock units on their vesting date as determined by our closing stock price. These net-share settlements had the effect of share repurchases by us as they reduced the number of shares that would have otherwise been issued as a result of the vesting.

Stock Options

The following table summarizes the status of stock options outstanding and the changes during the periods presented:

	Options			Weighted-Average		Options		Weighted-Average
(In thousands, except per share amounts)	Outstanding			Exercise Price		Exercisable		Exercise Price
Balance as of December 31, 2014		3,427		$	14.35		1,393	$	14.97
Options granted		0			0.00
Options exercised		(317	)		11.44
Options forfeited		(767	)		15.89
Balance as of December 31, 2015		2,343			14.24		1,282		14.52
Options granted		0			0.00
Options exercised		(6	)		14.01
Options forfeited		(434	)		15.51
Balance as of December 31, 2016		1,903			13.95		1,431		13.98
Options granted		0			0.00
Options exercised		(108	)		14.01
Options forfeited		(160	)		15.00
Balance as of December 31, 2017		1,635		$	13.85		1,635	$	13.85

We estimate the fair value of our service-based stock option awards on the date of grant using the Black-Scholes-Merton option-pricing model. Option valuation models, including the Black-Scholes-Merton option-pricing model, require the input of certain assumptions that involve judgment. Changes in the input assumptions can materially affect the fair value estimates and, ultimately, how much we recognize as stock-based compensation expense. Our stock options have a contractual term of 7 years.

The aggregate intrinsic value of stock options outstanding or exercisable as of December 31, 2017 was $1.2 million, based on our closing stock price of $14.55 as of December 31, 2017. The intrinsic value of stock options outstanding represents the amount that would have been received by the option holders had all option holders exercised their stock options as of that date.

The following activity occurred under the Plan:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Total intrinsic value of stock options exercised	$	45	$	1	$	972
Total fair value of share awards vested	$	25,220	$	26,892	$	21,673

The following table summarizes information about stock options outstanding under the Plan as of December 31, 2017:

	Number of				Number of
	Options		Weighted-Average		Options		Weighted-Average
Range of Exercise Prices	Outstanding		Exercise Price		Exercisable		Exercise Price
$12.72 to $14.01		1,498,901	$	13.72		1,498,901	$	13.72
$14.78 to $15.22		136,454	$	15.19		136,454	$	15.19
		1,635,355				1,635,355

The weighted average remaining contractual life of the options outstanding and exercisable as of December 31, 2017 is 2.1 years.

Allscripts Employee Stock Purchase Plan

Our Employee Stock Purchase Plan (the “ESPP”) allows eligible employees to authorize payroll deductions of up to 20% of their base salary to be applied toward the purchase of full shares of common stock on the last business day of each offering period. Offering periods under the ESPP are three months in duration and begin on each March 1^st, June 1^st, September 1^st, and December 1^st. Shares are purchased on the last day of each offering period at a discount of 15% to the fair market value of our common stock as reported on Nasdaq based on the lower of the closing price either on the first or last business day of each offering period. Employees are limited to purchasing shares under the ESPP having a collective fair market value no greater than $25,000 in any one calendar year. The shares available for purchase under the ESPP may be drawn from either authorized but previously unissued shares of common stock or from reacquired shares of common stock, including shares purchased by us in the open market and held as treasury shares.

We treat the ESPP as a compensatory plan in accordance with GAAP. There were 1.0 million and 756 thousand shares purchased under the ESPP during the years ended December 31, 2017 and 2016, respectively.

Netsmart Long-Term Incentive Plan

Netsmart has established the Nathan Holding LLC 2016 Unit Option Plan (the “Netsmart Plan”) in order to provide key employees, managers, advisors and consultants of Netsmart and its affiliates with an opportunity to acquire an equity interest in Netsmart. The Plan provides for the maximum issuance of 115.3 million options related to Netsmart’s Class B Non-Voting Common Member Units (“Option Units”). The Option Unit grants may contain varying vesting conditions, including service, performance and market conditions established on a grant‑by‑grant basis as determined by the Compensation Committee of Netsmart’s Board of Directors and expire no more than 10 years after the date of grant. The Netsmart Plan includes a call right which enables Netsmart to repurchase any outstanding units in the event of termination of employment. At December 31, 2017, there were 25.4 million Class B Non-Voting Common Units available for further issuance under the Netsmart Plan. As discussed further below, for the years ended December 31, 2017 and December 31, 2016, Netsmart issued 3.1 and 89.9 million Option Units, respectively, to officers and employees at an exercise price of $1.00 per Option Unit, which was equal to the fair value of Netsmart’s Common Units at the date of grant.

Netsmart established a 2017 CAGR Unit Option Plan (the “Netsmart CAGR Plan”) during the year ended December 31, 2017. The CAGR Plan provides for the maximum issuance of 300 option units which reduce the amount available in the Netsmart Plan. These options expire 10 years after the date of grant. Option grants contain performance vesting conditions tied to the performance of a subset of Netsmart’s revenue. During 2017, all 300 option units were issued at an exercise price of $1.00 to current associates and all expire ten years after the date of grant.

Time-based Awards

During the years ended December 31, 2017 and December 31, 2016, Netsmart granted 2.2 million and 64.2 million Option Units, respectively, to certain of its executives and employees. During the same periods, 0.5 million and 1.7 million time-based Option Units, respectively, were forfeited. The Option Units vest ratably over a period of four years, with the first twenty-five percent vesting at the first anniversary of the issuance and the remaining vesting in equal monthly increments over the next three years. The Option Units are liability‑classified awards requiring the Option Units to be re‑measured at fair value at each reporting period.

Performance-based Awards

Under the Netsmart Plan, Netsmart granted 0.9 million and 25.7 million Option Units to certain of its executives and employees during the years ended December 31, 2017 and December 31, 2016, respectively, to reward the recipients if certain future financial objectives are met. During the same periods, 0.2 million and 0.7 million performance-based Option Units, respectively, were forfeited. In addition to a service condition, these Option Units only vest upon attaining certain future performance and market conditions. There was no stock compensation expense recorded for these performance‑based Option Units, since achievement of the performance conditions was not considered probable at December 31, 2017.

Under the Netsmart CAGR Plan, Netsmart granted 300 performance-based option units to certain of its employees to reward the recipients if certain future financial objectives are met. The options were granted with an exercise price of $1.00 per common unit, which was equal to the fair market value of Netsmart’s common unit at the date of grant. In addition to a service condition, these options only vest upon attaining certain performance conditions. There was no stock compensation expense recognized during the year ended December 31, 2017 for these performance-based awards, since achievement of the performance conditions were not considered probable.

A summary of the activity under the Netsmart Plan during the years ended December 31, 2016 and December 31, 2017 is as follows:

(Option Units in thousands, except per unit amounts)	Option Units			Weighted Average Exercise Price
Balance as of December 31, 2015		0		$	0.00
Granted		89,889			1.00
Called		0			0.00
Exercised		0			0.00
Forfeited		(2,316	)		1.00
Outstanding – December 31, 2016		87,573			1.00
Exercisable – December 31, 2016		0			0.00
Granted		3,385			1.00
Called		0			0.00
Exercised		0			0.00
Forfeited		(701	)		1.00
Outstanding – December 31, 2017		90,257			1.00
Exercisable – December 31, 2017		26,625		$	1.00

Option Units outstanding at December 31, 2017 are as follows:

(Option Units in thousands, except per unit amounts)

Outstanding

Exercisable

Exercise price

Option Units

Weighted

Average

Fair

Value

Weighted

Average

Remaining

Life

Option Units

Average

Fair

Value

Weighted

Average

Remaining

Life

1.00

90,257

0.30

8.34

26,625

0.30

8.31

There were no option exercises for the years ended December 31, 2017 and December 31, 2016. As the current fair value of a common unit at December 31, 2017 and December 31, 2016 were less than the exercise price, there was no intrinsic value related to the outstanding Option Units.

The stock-based compensation expense was included in the following categories in our consolidated statement of operations for the years ended December 31, 2017 and December 31, 2016:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Cost of revenue:
Software delivery, support and maintenance	$	65	$	103	$	0
Client services		53		130		0
Total cost of revenue		118		233		0
Selling, general and administrative expenses		2,050		5,427		0
Research and development		61		146		0
Total stock-based compensation expense (benefit)	$	2,229	$	5,806	$	0

The company recognized no tax benefits related to share-based compensation expense for the years ended December 31, 2017 and December 31, 2016. At December 31, 2017 and December 31, 2016, the liability for outstanding awards was $8.0 million and $5.8 million, respectively.

The fair value of Option Units vested as of December 31, 2017 and December 31, 2016 was estimated using the Black‑Scholes‑Merton option pricing model using the following weighted-average assumptions:

	2017			2016
Average expected term in years		4.53			5.50
Risk free rate (weighted average)		2.2	%		2.0	%
Expected dividends		0.0	%		0.0	%
Average volatility		60.0	%		55.0	%

Netsmart determined the estimated unit fair value of $0.72 and $0.47 at December 31, 2017 and December 31, 2016, respectively. The December 31, 2017 and 2016 values were determined using a weighting between a discounted cash flow model and a market comparable model.

The expected term of the awards was determined based upon an estimate of the expected term of “plain vanilla” options as prescribed by the simplified method. The risk‑free interest rate is based on the U.S. Treasury yield curve in effect at the time of grant. Netsmart estimates expected volatility based primarily on historical monthly volatility of comparable companies in the healthcare information technology sector that are publicly traded.

Netsmart has $11.3 million of share‑based compensation expense remaining to be recognized (based on the December 31, 2017 option unit fair values) over future periods as follows: $4.8 million in 2018, $4.8 million in 2019, $1.6 million in 2020 and $0.1 million in 2021.

Stockholders' Equity	12 Months Ended
Stockholders' Equity	Dec. 31, 2017
Equity [Abstract]
Stockholders' Equity	9. Stockholders’ Equity Stock Repurchases On November 17, 2016, we announced that our Board approved a new stock purchase program under which we may repurchase up to $200 million of our common stock through December 31, 2019. The new stock program supersedes the previously existing stock repurchase program, which authorized us to repurchase up to $150 million of our common stock through December 31, 2018. During the year ended December 31, 2017, we purchased 1.0 million shares of our common stock under the new program for a total of $12.1 million. During the year ended December 31, 2016, we purchased 2.2 million shares of our common stock under the new program for a total of $24 million and 8.1 million shares of our common stock under the prior program for a total of $97 million. Any share repurchase transactions may be made through open market transactions, block trades, privately negotiated transactions (including accelerated share repurchase transactions) or other means, subject to market conditions. Any repurchase activity will depend on many factors such as our working capital needs, cash requirements for investments, debt repayment obligations, economic and market conditions at the time, including the price of our common stock, and other factors that we consider relevant. Our stock repurchase program may be accelerated, suspended, delayed or discontinued at any time. Issuance of Common Stock and Warrants On June 30, 2016, we issued to a commercial partner, as part of an overall commercial relationship, unregistered warrants to purchase (i) 900,000 shares of our common stock, par value $0.01 per share at a price per share of $12.47, (ii) 1,000,000 shares of common stock at a price per share of $14.34 and (iii) 1,100,000 shares of common stock at a price per share of $15.59, in each case subject to customary anti-dilution adjustments. The warrants vest in four equal annual installments of 750 thousand shares beginning in June 2017 and expire in June 2026. Our issuance of the warrants was a private placement exempt from registration pursuant to Section 4(a)(2) under the Securities Act of 1933, as amended. These warrants are not actively traded and were valued based on an option pricing model that uses observable and unobservable market data for inputs. The warrants are valued at $11 million and are being amortized into earnings over the four-year vesting period. The amortization of the warrant value is included as a reduction to revenue in the accompanying consolidated statements of operations. In June 2015, we sold 7,434,944 unregistered shares of our common stock previously held as treasury shares and issued warrants to purchase 1,486,989 shares of our common stock at an exercise price equal to $17.675 per share of common stock, subject to customary anti-dilution adjustments, to Nant Capital, LLC in a private placement exempt from registration pursuant to Section 4(a)(2) under the Securities Act of 1933, as amended. These transactions were meant to strengthen our strategic and commercial relationship with NantHealth and were made in conjunction with our investment in NantHealth as of the same date (refer to Note 2, “Business Combinations and Other Investments”). The common stock shares were sold at a price of $13.45 per share, being the average closing price per share of our common stock on the Nasdaq Global Select Market for the 60 consecutive trading day period ending on and including June 24, 2015, for an aggregate purchase price of $100.0 million. The total proceeds of $100.0 million were allocated to the common stock shares and the warrants in the amounts of $98.3 million and $1.7 million, respectively. The warrants expired unexercised during 2016. In June 2013, in connection with the issuance of the 1.25% Notes, we issued the 1.25% Warrants exercisable for 20.1 million shares of our common stock (subject to anti-dilution adjustments under certain circumstances) with an initial exercise price of $23.135 per share, subject to customary adjustments. The net proceeds from the sale of the 1.25% Warrants of $51.2 million are included as additional paid in capital in the accompanying consolidated balance sheets as of December 31, 2017 and 2016. The 1.25% Warrants expire over a period of 70 trading days beginning on October 1, 2020 and are exercisable only upon expiration. Additionally, if the market value per share of our common stock exceeds the strike price of the 1.25% Warrants on any trading day during the 70 trading day measurement period, we will, for each such trading day, be obligated to issue to the counterparties a number of shares equal in value to the product of the amount by which such market value exceeds such strike price and 1/70th of the aggregate number of shares of our common stock underlying the 1.25% Warrants transactions, subject to a share delivery cap. For each 1.25% Warrant that is exercised, we will deliver to the option counterparties a number of shares of our common stock equal to the amount by which the settlement price exceeds the exercise price, divided by the settlement price, plus cash in lieu of fractional shares. We will not receive any additional proceeds if the 1.25% Warrants are exercised. The number of warrants and the strike price are subject to adjustment under certain circumstances. The 1.25% Warrants could separately have a dilutive effect to the extent that the market value per share of our common stock (as measured under the terms of the warrant transactions) exceeds the applicable strike price of the 1.25% Warrants. In June 2013, we agreed to issue a warrant to a commercial partner as part of an overall commercial relationship pursuant to which the warrant holder has the right to purchase 1.5 million shares of our common stock at a strike price of $12.94 per share. The warrant vests in four equal annual installments of 375 thousand shares (beginning in June 2014) and expires in June 2020. Our issuance of the warrant was a private placement exempt from registration pursuant to Section 4(a)(2) under the Securities Act of 1933, as amended. This warrant is not actively traded and was valued based on an option pricing model that uses observable and unobservable market data for inputs. The warrant was valued at $10.2 million and is being amortized into earnings over the four-year vesting period. The amortization of the warrant value is included in stock-based compensation expense in the accompanying consolidated statements of cash flows.

Accumulated Other Comprehensive Loss

12 Months Ended

Dec. 31, 2017

Equity [Abstract]

Accumulated Other Comprehensive Loss

10. Accumulated Other Comprehensive Loss

Accumulated Other Comprehensive Loss

Changes in the balances of each component included in accumulated other comprehensive loss (“AOCI”) are presented in the tables below. All amounts are net of tax and exclude non-controlling interest.

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains (Losses) on Available for Sale Securities			Unrealized Net Gains (Losses) on Interest Rate Swap		Unrealized Net Gains (Losses) on Foreign Exchange Contracts			Total
Balance as of December 31, 2014 ⁽¹⁾	$	(2,119	)	$	140		$	-	$	0		$	(1,979	)
Other comprehensive income (loss) before reclassifications		(2,381	)		0			0		191			(2,190	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			(140	)		0		67			(73	)
Net other comprehensive (loss) income		(2,381	)		(140	)		0		258			(2,263	)
Balance as of December 31, 2015 ⁽²⁾		(4,500	)		0			0		258			(4,242	)
Other comprehensive (loss) income before reclassifications		(1,528	)		(56,420	)		0		683			(57,265	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			0			0		(322	)		(322	)
Net other comprehensive (loss) income		(1,528	)		(56,420	)		0		361			(57,587	)
Balance as of December 31, 2016 ⁽³⁾		(6,028	)		(56,420	)		0		619			(61,829	)
Other comprehensive (loss) income before reclassifications		3,352			(106,445	)		0		1,697			(101,396	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			162,865			0		(1,625	)		161,240
Net other comprehensive (loss) income		3,352			56,420			0		72			59,844
Balance as of December 31, 2017 ⁽⁴⁾	$	(2,676	)	$	0		$	0	$	691		$	(1,985	)

⁽¹⁾ Net of taxes of $88 thousand for unrealized net gains on marketable securities

⁽²⁾ Net of taxes of $166 thousand for unrealized net gains on marketable securities and foreign exchange contract derivatives

⁽³⁾ Net of taxes of $463 thousand for unrealized net gains on marketable securities and foreign exchange contract derivatives

⁽⁴⁾ Net of taxes of $445 thousand for unrealized net gains on foreign exchange contract derivatives

Income Tax Effects Related to Components of Other Comprehensive Loss

The following tables reflect the tax effects allocated to each component of other comprehensive loss (“OCI”)

	Year Ended December 31, 2017
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	3,352		$	0		$	3,352
Available for sale securities:
Net gain arising during the period		(106,506	)		61			(106,445	)
Net gain reclassified into income		162,865			0			162,865
Net change in unrealized gains on available for sale securities		56,359			61			56,420
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		2,776			(1,079	)		1,697
Net (gains) losses reclassified into income		(2,662	)		1,037			(1,625	)
Net change in unrealized gains (losses) on foreign exchange contracts		114			(42	)		72
Net gain (loss) on cash flow hedges		114			(42	)		72
Other comprehensive loss	$	59,825		$	19		$	59,844

	Year Ended December 31, 2016
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(1,528	)	$	0		$	(1,528	)
Available for sale securities:
Net gain arising during the period		(56,359	)		(61	)		(56,420	)
Net gain reclassified into income		0			0			0
Net change in unrealized gains on available for sale securities		(56,359	)		(61	)		(56,420	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		1,128			(445	)		683
Net (gains) losses reclassified into income		(531	)		209			(322	)
Net change in unrealized gains (losses) on foreign exchange contracts		597			(236	)		361
Net gain (loss) on cash flow hedges		597			(236	)		361
Other comprehensive loss	$	(57,290	)	$	(297	)	$	(57,587	)

	Year Ended December 31, 2015
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(2,381	)	$	0		$	(2,381	)
Available for sale securities:
Net gain arising during the period		0			0			0
Net gain reclassified into income		(228	)		88			(140	)
Net change in unrealized gains on available for sale securities		(228	)		88			(140	)
Derivatives qualifying as cash flow hedges:
Interest rate swap:
Net loss arising during the period		0			0			0
Net loss reclassified into income		0			0			0
Net change in unrealized losses on interest rate swap		0			0			0
Foreign exchange contracts:
Net gains (losses) arising during the period		314			(123	)		191
Net (gains) losses reclassified into income		110			(43	)		67
Net change in unrealized gains (losses) on foreign exchange contracts		424			(166	)		258
Net gain (loss) on cash flow hedges		424			(166	)		258
Other comprehensive loss	$	(2,185	)	$	(78	)	$	(2,263	)

Derivative Financial Instruments

12 Months Ended

Dec. 31, 2017

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Derivative Financial Instruments

11. Derivative Financial Instruments

The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates:

December 31, 2017

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

1,136

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

46,578

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

47,777

Total derivatives

47,714

47,777

December 31, 2016

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

1,021

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

17,080

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

17,659

Total derivatives

18,101

17,659

N/A – We define “N/A” as disclosure not being applicable

Foreign Exchange Contracts

Starting in 2015, we entered into non-deliverable forward foreign currency exchange contracts with reputable banking counterparties in order to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. These forward contracts cover a decreasing percentage of forecasted monthly INR expenses over time. As of December 31, 2017, there were 6 forward contracts outstanding that were staggered to mature monthly starting in January 2018 and ending in June 2018. In the future, we may enter into additional forward contracts to increase the amount of hedged monthly INR expenses or initiate hedges for monthly periods beyond June 2018. As of December 31, 2017, the notional amounts of outstanding forward contracts were 120 million INR, or the equivalent of $1.9 million United States dollars, based on the exchange rate between the United States dollar and the INR in effect as of December 31, 2017. These amounts also approximate the ranges of forecasted future INR expenses we target to hedge in any one month in the future.

The critical terms of the forward contracts and the related hedged forecasted future expenses matched and allowed us to designate the forward contracts as highly effective cash flow hedges. The effective portion of the change in fair value is initially recorded in AOCI and subsequently reclassified to income in the period in which the cash flows from the associated hedged transactions affect income. Any ineffective portion of the change in fair value of the cash flow hedges is recognized in current period income. During the year ended December 31, 2017, no amount was excluded from the effectiveness assessment and no gains or losses were reclassified from AOCI into income as a result of forecasted transactions that failed to occur. As of December 31, 2017, we estimate that $1.1 million of net unrealized derivative gains included in AOCI will be reclassified into income within the next twelve months.

The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive loss:

	Amount of Gain (Loss) Recognized in OCI (Effective Portion)						Location of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)
	Year Ended December 31,							Year Ended December 31,
(In thousands)	2017		2016		2015			2017		2016		2015
Foreign exchange contracts	$	2,776	$	1,128	$	314	Cost of Revenue	$	905	$	165	$	(34	)
							Selling, general and administrative expenses		692		133		(28	)
							Research and development		1,065		233		(48	)

1.25% Call Option

In June 2013, concurrent with the issuance of the 1.25% Notes, we entered into the 1.25% Call Option with certain of the initial purchasers of the 1.25% Notes (the “Option Counterparties”). Assuming full performance by the option counterparties, the 1.25% Call Option is intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes.

Aside from the initial payment of a premium to the Option Counterparties of $82.8 million for the 1.25% Call Option, we will not be required to make any cash payments to the Option Counterparties under the 1.25% Call Option, and, subject to the terms and conditions thereof, will be entitled to receive from the Option Counterparties an amount of cash, generally equal to the amount by which the market price per share of our common stock exceeds the strike price of the 1.25% Call Option during the relevant valuation period. The strike price under the 1.25% Call Option is initially equal to the conversion price of the 1.25% Notes of $17.19 per share of our common stock.

The 1.25% Call Option, which is indexed to our common stock, is a derivative asset that requires mark-to-market accounting treatment due to the cash settlement features until the 1.25% Call Option settles or expires. The 1.25% Call Option is measured and reported at fair value on a recurring basis within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the 1.25% Call Option, refer to Note 1, “Basis of Presentation and Significant Accounting Policies.”

The 1.25% Call Option does not qualify for hedge accounting treatment. Therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of operations in other income, net. Because the terms of the 1.25% Call Option are substantially similar to those of the 1.25% Notes embedded cash conversion option, discussed next, we expect the net effect of those two derivative instruments on our results of operations to continue to be minimal.

1.25% Notes Embedded Cash Conversion Option

The embedded cash conversion option within the 1.25% Notes is required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value recognized immediately in our consolidated statements of operations in other income, net until the cash conversion option settles or expires. The initial fair value liability of the embedded cash conversion option was $82.8 million, which simultaneously reduced the carrying value of the 1.25% Notes (effectively an original issuance discount). The embedded cash conversion option is measured and reported at fair value on a recurring basis within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the embedded cash conversion option, refer to Note 1, “Basis of Presentation and Significant Accounting Policies.”

The following table shows the net impact of the changes in fair values of the 1.25% Call Option and 1.25% Notes embedded cash conversion option in the consolidated statements of operations:

	Year Ended December 31,
(In thousands)	2017			2016			2015
1.25% Call Option	$	29,498		$	(63,128	)	$	23,117
1.25% Embedded cash conversion option		(30,118	)		63,551			(23,371	)
Net (loss) gain included in other income, net	$	(620	)	$	423		$	(254	)

Commitments

12 Months Ended

Dec. 31, 2017

Commitments And Contingencies Disclosure [Abstract]

Commitments

12. Commitments

Operating and Capital Leases

We conduct our operations from leased premises under a number of operating leases. We also lease office and IT equipment under capital leases. Certain office leases contain renewal options and rent escalation clauses calling for rent increases over the term of the leases. All leases which contain a rent escalation clause are accounted for on a straight-line basis. Total rent expense recognized, which consists of the base rental amount and other lessor charges when mandated in a lease agreement, was as follows:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Rent expense	$	32,657	$	24,745	$	18,164

Our future commitments under capital and operating leases are shown below. The capital lease amounts related to prepaid maintenance, as well as the related prepaid maintenance costs, are not included in our financials as they are considered executory costs. Future operating lease commitments are calculated using the base rental amount and foreign currency exchange rates in effect as of December 31, 2017.

	Capital			Operating
(In thousands)	Leases			Leases
2018	$	11,148		$	28,534
2019		5,976			25,297
2020		1,203			22,195
2021		158			18,008
2022		0			13,955
Thereafter		0			35,239
		18,485		$	143,228
Less amount representing interest		(1,246	)
Less amount related to executory costs		(2,269	)
		14,970
Current maturities of capital lease obligations		7,865
Capital lease obligations, net of current maturities	$	7,105

Commitment with Strategic Partner

During 2017, we completed renegotiations with Atos and our other largest hosting partners to improve the operating cost structure of our private cloud hosting operations. As a result of these renegotiations, we signed a new restated and amended agreement with Atos and, therefore, starting in 2018, we will begin to transition substantially all of our hosting services to Atos. The increased scale of the relationship is expected to result in future reductions in the base fees and volume fee rates.

We are currently in the seventh year of a ten-year agreement with Atos (formerly known as Xerox Consultant Services) to provide services to support our private cloud hosting services for our Sunrise acute care clients. We maintain all client relationships and domain expertise with respect to the hosted applications. The new amended and restated agreement extends the term to 2023 with annual auto-renewal periods for an additional two years thereafter. The new agreement also provides for the payment of initial annual base fees of $30 million per year (decreasing to $25 million by the end of the agreement) plus charges for volume-based services currently projected using volumes estimated based on historical actuals and forecasted projections. During the year ended December 31, 2017, we incurred $59 million of expenses under our existing agreement with Atos, which are included in cost of revenue in our consolidated statements of operations.

	Year Ended December 31,
(In thousands)	2017		2016		2015
Expenses incurred under Atos agreement	$	58,787	$	62,266	$	67,058

Discontinued Operations

12 Months Ended

Dec. 31, 2017

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations

13. Discontinued Operations

Two of the product offerings acquired with the EIS Business, Horizon Clinicals and Series2000 Revenue Cycle, are to be sunset after the first quarter of 2018. The decision to discontinue these solutions was made prior to our acquisition of the EIS Business and, therefore, are presented below as discontinued operations. Until the end of the first quarter of 2018, we will be involved in ongoing maintenance and support for these solutions until customers have transitioned to other platforms. No disposal gains or losses were recognized during the year ended December 31, 2017 related to this discontinued operation.

The following table summarizes the major classes of assets and liabilities of the discontinued operation, as reported on the consolidated balance sheet as of December 31, 2017:


(In thousands)	December 31, 2017
Carrying amounts of major classes of assets included as part of discontinued operations:
Accounts receivable, net	$	8,196
Prepaid expenses and other current assets		3,080
Other classes of assets that are not major		0
Total assets attributable to discontinued operations	$	11,276

Carrying amounts of major classes of liabilities included as part of discontinued operations:
Accounts payable	$	114
Accrued expenses		5,599
Accrued compensation and benefits		7,728
Deferred revenue		7,241
Other classes of liabilities that are not major		676
Total liabilities attributable to discontinued operations	$	21,358

The following table summarizes the major classes of line items constituting income (loss) of the discontinued operation, as reported in the consolidated statements of operations for the year ended December 31, 2017:

	Year Ended
(In thousands)	December 31, 2017
Major classes of line items constituting pretax profit (loss) of discontinued operations
Revenue:
Software delivery, support and maintenance	$	10,949
Client services		1,044
Total revenue		11,993
Cost of revenue:
Software delivery, support and maintenance		2,918
Client services		261
Total cost of revenue		3,179
Gross profit		8,814
Selling, general and administrative expenses		0
Research and development		1,148
Income (loss) before income taxes		7,666
Income tax benefit (provision)		(2,990	)
Income from discontinued operations, net of tax	$	4,676

During the year ended December 31, 2017, the discontinued operation generated $3.1 million of cash.

Business Segments

12 Months Ended

Dec. 31, 2017

Segment Reporting [Abstract]

Business Segments

14. Business Segments

We primarily derive our revenues from sales of our proprietary software (either as a direct license sale or under a subscription delivery model), which also serves as the basis for our recurring service contracts for software support and maintenance and certain transaction-related services. In addition, we provide various other client services, including installation, and managed services such as outsourcing, private cloud hosting and revenue cycle management.

During 2017, we completed the acquisitions of EIS and NantHealth’s provider and patient engagement solutions business. These acquisitions initially resulted in the formation of four new operating segments: (i) EIS-Paragon, (ii) EIS-Enterprise Workflow Solutions (“EIS-EWS”), (iii) EIS-Classics, and (iv) NantHealth. Refer to Note 2, “Business Combinations and Other Investments,” in Part II, Item 8, “Financial Statements and Supplementary Data” of this Form 10-K for further information about these acquisitions. The EIS-Paragon operating segment provides integrated electronic health record and revenue cycle management solutions for the small hospital market segment and was integrated within our Hospitals and Health Systems operating segment during the fourth quarter of 2017. The EIS-EWS operating segment primarily provides document, content and supply chain management solutions. The EIS-Classics operating segment primarily provides revenue cycle management solutions. The NantHealth operating segment provides provider and patient engagement solutions. Based on the qualitative and quantitative criteria under Accounting Standards Codification Topic 280, Segment Reporting, we concluded that the EIS-Classics operating segments can be included as part of the Clinical and Financial reportable segment while the EIS-EWS and NantHealth operating segments can be included as part of the Population Health reportable segment.

As a result of the above changes, as of December 31, 2017, we had ten operating segments, which are aggregated into three reportable segments. The Clinical and Financial Solutions reportable segment includes the Hospitals and Health Systems, Ambulatory, Payer and Life Sciences, and EIS-Classics strategic business units, each of which represents a separate operating segment. This reportable segment derives its revenue from the sale of integrated clinical software applications and financial and information solutions, which primarily include Electronic Health Record-related software, financial and practice management software, related installation, support and maintenance, outsourcing, private cloud hosting, revenue cycle management, training and electronic claims administration services. The Population Health reportable segment is comprised of five separate operating segments which include Population Health, FollowMyHealth^®, EPSi^TM, EIS-EWS and NantHealth. This reportable segment derives its revenue from the sale of health management and coordinated care solutions, which are mainly targeted at hospitals, health systems, other care facilities and Accountable Care Organizations (“ACOs”). These solutions enable clients to connect, transition, analyze, and coordinate care across the entire care community. The Netsmart reportable segment is comprised of the Netsmart strategic business unit, which represents a separate operating segment. Netsmart operates in the behavioral healthcare information technology field throughout the United States and provides software and technology solutions to the health and human services sector, which comprises behavioral health, addiction treatment, intellectual and developmental disability services, child and family services, and public health market segments.

The results of operations related to two of the product offerings acquired with the EIS Business are presented throughout these financial statements as discontinued operations and are included in the Clinical and Financial Solutions reportable segment, except for acquisition-related deferred revenue adjustments, which are included in “Unallocated Amounts”. Refer to Note 13, “Discontinued Operations”.

Our Chief Operating Decision Maker (“CODM”) uses segment revenues, gross profit and income from operations as measures of performance and to make decisions on allocation of resources. With the exception of the Netsmart segment, in determining these performance measures, we do not include in revenue the amortization of acquisition-related deferred revenue adjustments, which reflect the fair value adjustments to deferred revenues acquired in a business acquisition. With the exception of the Netsmart segment, we also exclude the amortization of intangible assets, stock-based compensation expense, non-recurring expenses and transaction-related costs, and non-cash asset impairment charges from the operating segment data provided to our CODM. Non-recurring expenses relate to certain severance, product consolidation, legal, consulting and other charges incurred in connection with activities that are considered one-time. Accordingly, these amounts are not included in our reportable segment results and are included in an “Unallocated Amounts” category within our segment disclosure. The “Unallocated Amounts” category also includes corporate general and administrative expenses (including marketing expenses), which are centrally managed, as well as revenue and the associated cost from the resale of certain ancillary products, primarily hardware, other than the respective amounts associated with the Netsmart segment. The historical results of our Homecare^TM business prior to the Netsmart Transaction in 2016, which were previously reported as part of Population Health, are also included in the “Unallocated Amounts” category. The Netsmart segment, as presented, includes all revenue and expenses incurred by Netsmart since it operates as a stand-alone business entity and its resources allocation and performance are reviewed and measured at such all-inclusive level. The eliminations of intercompany transactions between Allscripts and Netsmart are included in the “Unallocated Amounts” category. We do not track our assets by segment.

	Year Ended December 31,
(In thousands)	2017			2016			2015
Revenue:
Clinical and Financial Solutions	$	1,251,299		$	1,125,617		$	1,105,504
Population Health		270,447			234,662			219,861
Netsmart		319,074			173,361			0
Unallocated Amounts		(22,485	)		16,259			61,028
Discontinued Operations		(11,993	)		0			0
Total revenue	$	1,806,342		$	1,549,899		$	1,386,393

Gross Profit:
Clinical and Financial Solutions	$	532,152		$	471,814		$	452,058
Population Health		190,394			171,404			147,095
Netsmart		149,550			70,289			0
Unallocated Amounts		(81,121	)		(42,468	)		(18,588	)
Discontinued Operations		(8,814	)		0			0
Total gross profit	$	782,161		$	671,039		$	580,565

Income (loss) from operations:
Clinical and Financial Solutions	$	285,552		$	251,886		$	234,146
Population Health		131,174			111,956			91,887
Netsmart		29,473			(7,412	)		0
Unallocated Amounts		(396,616	)		(296,659	)		(294,150	)
Discontinued Operations		(7,666	)		0			0
Total income from operations	$	41,917		$	59,771		$	31,883

Supplemental Disclosures

12 Months Ended

Dec. 31, 2017

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Supplemental Disclosures

15. Supplemental Disclosures

The majority of the restricted cash balance as of December 31, 2017 represents Netsmart’s cash deposits to maintain two letters of credit with a financial institution related to customer agreements and an escrow fund related to a previous acquisition associated with the acquired EIS Business.

	Year Ended December 31,
(In thousands)	2017		2016		2015
Cash paid during the period for:
Interest	$	67,764	$	41,954	$	15,750
Income taxes paid, net of tax refunds	$	6,897	$	2,951	$	5,037
Non-cash transactions:
Exchange of Netsmart, Inc. common stock for redeemable convertible preferred stock in Netsmart by Netsmart, Inc. management	$	0	$	25,543	$	0
Accretion of redemption preference on redeemable convertible non-controlling interest in Netsmart	$	43,850	$	28,536	$	0
Obligations incurred to purchase capitalized software or enter into capital leases	$	5,244	$	28,970	$	393
Change in fair value of commercial agreement with NantHealth	$	22,900	$	0	$	0

Accrued expenses consist of the following:

	December 31,		December 31,
(In thousands)	2017		2016
Royalties, certain third-party product costs and licenses	$	14,718	$	17,359
Other		71,197		68,776
Total accrued expenses	$	85,915	$	86,135

Other consists of various accrued expenses and no individual item accounted for more than 5% of the current liabilities balance at the respective balance sheet dates.

Other assets consist of the following:

	December 31,		December 31,
(In thousands)	2017		2016
Reseller agreement with Nant Health, LLC	$	22,252	$	0
Fair value of 1.25% Call Option		46,578		17,080
Long-term prepaid commissions		32,938		40,668
Investments in non-marketable securities		30,013		29,603
Long-term deposits and other assets		17,068		10,440
Total other assets	$	148,849	$	97,791

Geographic Information

12 Months Ended

Dec. 31, 2017

Segment Reporting [Abstract]

Geographic Information

16. Geographic Information

Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below:

	Year Ended December 31,
(In thousands)	2017		2016		2015
United States	$	1,749,476	$	1,500,629	$	1,338,095
Canada		15,818		18,694		18,024
Other international		41,048		30,576		30,274
Total	$	1,806,342	$	1,549,899	$	1,386,393

A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below:

	December 31,		December 31,
(In thousands)	2017		2016
United States	$	159,207	$	140,552
India		4,154		5,735
Israel		1,322		1,568
Canada		146		353
Other international		774		602
Total	$	165,603	$	148,810

Contingencies	12 Months Ended
Contingencies	Dec. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Contingencies	17. Contingencies In addition to commitments and obligations in the ordinary course of business, we are currently subject to various legal proceedings and claims that have not been fully adjudicated, certain of which are discussed below. We intend to vigorously defend ourselves in these matters. No less than quarterly, we review the status of each significant matter and assess our potential financial exposure. We accrue a liability for an estimated loss if the potential loss from any legal proceeding or claim is considered probable and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made. The outcome of legal proceedings or investigations is inherently uncertain, and we may incur substantial defense costs and expenses defending any of these matters. In the opinion of our management, the ultimate disposition of pending legal proceedings or investigations will not have a material adverse effect on our consolidated financial position, liquidity or results of operations. However, if one or more of these matters were resolved against us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that reporting period could be materially adversely affected. Additionally, the resolution of any of these matters against us could prevent us from offering our products and services to current or prospective clients or cause us to incur increased compliance costs, either of which could further adversely affect our operating results. On May 1, 2012, Physicians Healthsource, Inc. filed a class action complaint in the U.S. District Court for the Northern District of Illinois against us. The complaint alleges that, on multiple occasions between July 2008 and December 2011, we or our agent sent advertisements by fax to the plaintiff and a class of similarly situated persons, without first receiving the recipients’ express permission or invitation in violation of the Telephone Consumer Protection Act, 47 U.S.C. § 227 (the “TCPA”). The plaintiff sought $500 for each alleged violation of the TCPA, treble damages if the Court finds the violations to be willful, knowing or intentional; and injunctive and other relief. Allscripts answered the complaint denying all material allegations and asserting a number of affirmative defenses, as well as counterclaims for breach of a license agreement. On March 31, 2016, plaintiff filed its motion for class certification. On May 31, 2016, we filed our opposition to plaintiff’s motion for class certification, and simultaneously moved for summary judgment on all of plaintiff’s claims. On June 2, 2017, an order was entered denying class certification and, accordingly, the case will not proceed on a class-wide basis. The EIS Business acquired from McKesson on October 2, 2017 is subject to a May 2017 civil investigative demand (“CID”) from the U.S. Attorney’s Office for the Eastern District of New York. The CID requests documents and information related to the certification McKesson obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program. McKesson has agreed, with respect to the CID, to indemnify Allscripts for amounts paid or payable to the government (or any private relator) involving any products or services marketed, sold or licensed by the EIS Business as of or prior to the closing of the acquisition. Practice Fusion, Inc. (“Practice Fusion”), acquired by Allscripts on February 13, 2018, received in March 2017 a request for documents and information from the U.S. Attorney’s Office for the District of Vermont pursuant to a CID. The CID relates to the certification of Practice Fusion’s software under the U.S. Office of the National Coordinator for Health Information Technology’s electronic health record certification program, and related business practices. It has been Practice Fusion’s practice to respond to such matters in a cooperative, thorough and timely manner. To date, the CID has not led to a claim or legal proceeding against Practice Fusion. On January 25, 2018, a complaint was filed in Surfside Non-Surgical Orthopedics, P.A. v. Allscripts Healthcare Solutions, Inc., No. 1:18-cv-00566, in the Northern District of Illinois. This is a purported class action lawsuit related to a January 18, 2018 ransomware attack, and alleges the following counts: (1) negligence, gross negligence and negligence per se; (2) breach of contract; (3) unjust enrichment; (4) violation of the Illinois Consumer Fraud Act; and (5) violation of the Illinois Deceptive Trade Practices Act.

Quarterly Financial Information (Unaudited)

12 Months Ended

Dec. 31, 2017

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Information (Unaudited)

18. Quarterly Financial Information (Unaudited)

The following tables contain a summary of our unaudited quarterly consolidated results of operations for our last eight fiscal quarters.

	Quarter Ended
	December 31,				September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2017 ⁽¹⁾				2017 ⁽¹⁾			2017			2017
Revenue	$	517,334			$	449,442		$	426,091		$	413,475
Cost of revenue		303,235				247,523			238,600			234,823
Gross profit		214,099				201,919			187,491			178,652
Selling, general and administrative expenses		146,037				117,352			112,037			110,845
Research and development		73,471				51,057			46,459			49,232
Asset impairment charges		0				0			0			0
Amortization of intangible and acquisition-related assets		10,414				8,137			7,891			7,312
Income from operations		(15,823	)			25,373			21,104			11,263
Interest expense		(24,757	)			(22,252	)		(20,290	)		(20,180	)
Other income (expense), net		958				(570	)		(214	)		239
Impairment of and losses on long-term investments		0				(20,700	)		(144,590	)		0
Equity in net income (loss) of unconsolidated investments		115				449			(28	)		285
Loss from continuing operations before income taxes		(39,507	)			(17,700	)		(144,018	)		(8,393	)
Income tax benefit (provision)		49,694		⁽²⁾		238			1,007			(172	)
Income (loss) from continuing operations, net of tax		10,187				(17,462	)		(143,011	)		(8,565	)
Income from discontinued operations, net of tax		4,676				0			0			0
Net income (loss)		14,863				(17,462	)		(143,011	)		(8,565	)
Less: Net loss (income) attributable to non-controlling interest		1,918				(163	)		264			(453	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart		(10,963	)			(10,962	)		(10,963	)		(10,962	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	5,818			$	(28,587	)	$	(153,710	)	$	(19,980	)

Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share:
Basic
Continuing operations	$	0.00			$	(0.16	)	$	(0.85	)	$	(0.11	)
Discontinued operations	$	0.03			$	0.00		$	0.00		$	0.00
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	0.03			$	(0.16	)	$	(0.85	)	$	(0.11	)

Diluted
Continuing operations	$	0.00			$	(0.16	)	$	(0.85	)	$	(0.11	)
Discontinued opererations	$	0.03			$	0.00		$	0.00		$	0.00
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	0.03			$	(0.16	)	$	(0.85	)	$	(0.11	)

	Quarter Ended
	December 31,				September 30,				June 30,				March 31,
(In thousands, except per share amounts)	2016 ⁽³⁾				2016 ⁽³⁾				2016 ⁽³⁾				2016
Revenue	$	425,436			$	392,384			$	386,521			$	345,558
Cost of revenue		239,138				226,225				219,837				193,660
Gross profit		186,298				166,159				166,684				151,898
Selling, general and administrative expenses		115,132				98,778				94,802				84,153
Research and development		47,836				45,142				47,891				47,037
Asset impairment charges		0				0				0				4,650
Amortization of intangible and acquisition-related assets		10,903				5,365				5,417				4,162
Income from operations		12,427				16,874				18,574				11,896
Interest expense		(25,384	)	⁽⁵⁾		(19,367	)			(16,421	)			(6,969	)
Other income (expense), net		621				(6	)			106				366
Equity in net loss of unconsolidated investments		0				0				(4,898	)			(2,603	)
(Loss) income before income taxes		(12,336	)			(2,499	)			(2,639	)			2,690
Income tax benefit (provision)		15,218		⁽⁴⁾		2,656		⁽⁴⁾		503		⁽⁴⁾		(563	)	⁽⁴⁾
Net income (loss)		2,882				157				(2,136	)			2,127
Less: Net (income) loss attributable to non-controlling interest		(4	)			(151	)			87				(78	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart		(10,192	)			(10,191	)			(8,153	)			0
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(7,314	)		$	(10,185	)		$	(10,202	)		$	2,049
(Loss) earnings per share - basic and diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.04	)		$	(0.06	)		$	(0.05	)		$	0.01

⁽¹⁾	Results of operations for the quarter include the results of operations of (i) DeVero since July 17, 2017, (ii) the provider and patient engagement business of NantHealth since August 25, 2017 and (iii) the results of operations of the EIS Business since October 2, 2017.

⁽²⁾	Income tax benefit (provision) for the quarter ended December 31, 2017, reflects the estimated impact of the United States Tax Cuts and Jobs Act which was enacted on December 22, 2017 and introduced significant changes to the income tax law in the United States.

⁽³⁾

Results of operations for the quarter include the results of operations of (i) Netsmart since April 19, 2016, (ii) HealthMEDX since October 27, 2016, and (iii) the results of operations of three third parties in which we acquired a controlling interest during the quarters ended September 30^th December 31^st, 2016 from the date of each acquisition.

⁽⁴⁾

Income tax benefit (provision) reflects the recognition (release) of a valuation allowance of ($14.3) million, ($3.3) million, $0.9 million and ($0.9) million for federal credit carryforwards, and foreign and state net operating loss carryforwards in the quarters ended December 31, 2016, September 30, 2016, June 30, 2016, and March 31, 2016, respectively.

⁽⁵⁾

Interest expense includes the write-off of $5.2 million deferred debt issuance costs in connection with Netsmart’s amendment of its First Lien Credit Agreement during the quarter ended December 31, 2016 and the write-off of $1.4 million of deferred debt issuance costs in connection with amending the Senior Secured Credit Facility during the quarter ended September 30, 2015.

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2017
Subsequent Events [Abstract]
Subsequent Events	19. Subsequent Events Acquisition of Practice Fusion, Inc. On January 5, 2018, Healthcare LLC and Presidio Sub, Inc., a Delaware corporation (“Sub”) and wholly-owned subsidiary of Healthcare LLC, entered into that certain Agreement and Plan of Merger (the “Merger Agreement”), by and among Healthcare LLC, Sub, Practice Fusion, Inc., a Delaware corporation (the “Practice Fusion”), Fortis Advisors LLC, as Holders’ Representative (as defined in the Merger Agreement), and Allscripts, solely for the purposes set forth therein, whereby Healthcare LLC would acquire all of the issued and outstanding shares of capital stock of Practice Fusion through the merger (the “Merger”) of Sub with and into Practice Fusion, with Practice Fusion surviving the Merger as a wholly-owned subsidiary of Healthcare LLC, upon the terms and subject to the conditions contained in the Merger Agreement. The purchase price for the Merger, which closed on February 13, 2018, was $100 million (subject to adjustments for net working capital, cash, debt and transaction expenses, in each case on the terms and subject to the conditions set forth in the Merger Agreement). The Merger Agreement requires Allscripts to issue restricted stock units to certain employees of Practice Fusion promptly following the consummation of the Merger, subject to satisfaction of the conditions set forth in the Merger Agreement. Subject to certain exceptions and limitations, after the consummation of the Merger, the equityholders of Practice Fusion are obligated to indemnify Allscripts for breaches of representations, warranties and covenants and for certain other matters. At the closing, Healthcare LLC deposited $5 million of the purchase price in escrow to be available to satisfy the indemnification obligations of the equityholders of Practice Fusion under the Merger Agreement. Divestiture of OneContent business On February 15, 2018, Allscripts, Healthcare, LLC and certain subsidiaries of Healthcare LLC and Hyland Software, Inc., an Ohio corporation (“Purchaser”), entered into an Asset Purchase Agreement (the “Asset Purchase Agreement”). Upon the terms and subject to the conditions set forth in the Asset Purchase Agreement, Purchaser has agreed to acquire (the “ECM Transaction”) substantially all of the assets of the Allscripts’ business providing hospitals and health systems document and other content management software and services generally known as “OneContent” (the “ECM Business”). Allscripts acquired the OneContent business during the fourth quarter of 2017 through the acquisition of McKesson’s EIS business. Certain assets of Allscripts relating to the ECM Business will be excluded from the transaction and retained by Allscripts, as described in the Asset Purchase Agreement. In addition, Purchaser will assume certain liabilities related to the ECM Business under the terms of the Asset Purchase Agreement. The total consideration for the ECM Business is $260 million, which is subject to certain adjustments for liabilities assumed by the Purchaser and net working capital as described in the Asset Purchase Agreement. Completion of the ECM Transaction is subject to various conditions, including, among others, (i) no order or other legal restraint or prohibition being in effect that would prohibit or prevent the transactions from being consummated; (ii) no legal proceeding having been commenced by any governmental entity that seeks to prohibit, enjoin or restrain the consummation of the transactions; and (iii) the applicable waiting period (and any extensions thereof) under the Hart-Scott-Rodino Antitrust Improvements Act having expired or otherwise having been terminated. Each party’s obligation to consummate the ECM Transaction is also subject to certain additional conditions, including performance in all material respects by the other party of its obligations under the Asset Purchase Agreement. The Asset Purchase Agreement contains certain termination rights for both Purchaser and Allscripts, including if the closing of the ECM Transaction has not occurred by May 16, 2018. The Asset Purchase Agreement contains customary representations and warranties of Allscripts and Purchaser as set forth therein, and Allscripts and Purchaser also agreed to customary covenants, including covenants requiring Allscripts to conduct the ECM Business in the ordinary course prior to the completion of the ECM Transaction. Second Amended Credit Agreement On February 15, 2018, Allscripts and Healthcare LLC entered into a Second Amended and Restated Credit Agreement (the “Second Amended Credit Agreement”), with JPMorgan Chase Bank, N.A., as administrative agent (the “Administrative Agent”), the several banks and other financial institutions or entities from time to time party thereto, and Fifth Third Bank, KeyBank National Association, SunTrust Bank and Wells Fargo Bank, National Association, as syndication agents, amending and restating the Amended and Restated Credit Agreement, dated September 30, 2015, as amended on March 28, 2016 and December 22, 2016 (the “Existing Credit Agreement”). The Second Amended Credit Agreement provides for a $400 million senior secured term loan (an increase from the $250 million term loan provided under the Existing Credit Agreement) (the “Term Loan”) and a $900 million senior secured revolving facility (an increase from the $550 million revolving facility provided under the Existing Credit Agreement) (the “Revolving Facility”), each with a five-year term. The Term Loan is repayable in quarterly installments commencing on June 30, 2018. A total of up to $50 million of the Revolving Facility is available for the issuance of letters of credit, up to $10 million of the Revolving Facility is available for swingline loans, and up to $100 million of the Revolving Facility could be borrowed under certain foreign currencies. Proceeds from the borrowings under the Second Amended Credit Agreement were used for the refinancing of loans under the Existing Credit Agreement. As of February 14, 2018, approximately $510 million was outstanding under the Revolving Facility. The proceeds of the Revolving Facility can be used to finance Allscripts’ working capital needs and for general corporate purposes, including, without limitation, financing of permitted acquisitions, and for share repurchases. Allscripts is also permitted to add one or more incremental revolving and/or term loan facilities in an aggregate amount of up to $600 million, subject to certain conditions (an increase from the $300 million incremental facility permitted under the Existing Credit Agreement). The initial applicable interest rate margin for Base Rate borrowings is 1.00%, and for Eurocurrency Rate borrowings is 2.00%. On and after September 30, 2018, the interest rate margins will be determined from a pricing table and will depend upon Allscripts’ total leverage ratio. The applicable margins for Base Rate borrowings under the Second Amended Credit Agreement range from 0.50% to 1.25% depending on Allscripts’ total leverage ratio (as compared to the 0.00% to 1.25% range provided under the Existing Credit Agreement). The applicable margins for Eurocurrency Rate loans range from 1.50% to 2.25%, depending on Allscripts’ total leverage ratio (as compared to the 1.00% to 2.25% range provided under the Existing Credit Agreement).

Schedule II-Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2017

Valuation And Qualifying Accounts [Abstract]

Schedule II-Valuation and Qualifying Accounts

Schedule II—Valuation and Qualifying Accounts

			Charged to
	Balance at		Expenses/		Deferred			Write-Offs,			Balance at
	Beginning of		Against		Revenue			Net of			End of
(In thousands)	Year		Revenue		Reclassification			Recoveries			Year
Allowance for doubtful accounts and sales credits
Year ended December 31, 2017	$	32,670		19,434		(8,234	)		(6,135	)		37,735
Year ended December 31, 2016	$	31,266		11,039		616			(10,251	)		32,670
Year ended December 31, 2015	$	36,047	$	8,089	$	(363	)	$	(12,507	)	$	31,266

All other schedules are omitted, since the required information is not applicable or is not present in amounts sufficient to require submission of the schedule, or because the information required is included in the consolidated financial statements and notes thereto.

Basis of Presentation and Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Principles of Consolidation

Use of Estimates

Revenue Recognition

We record reimbursements for out-of-pocket expenses incurred as client services revenue in our consolidated statements of operations. These amounts totaled:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Reimbursements for out-of-pocket expenses incurred	$	10,276	$	9,528	$	12,873

	December 31,
(In thousands)	2017		2016
Revenue earned on contracts in excess of billings
Unbilled revenue (current)	$	133,368	$	98,917
Unbilled revenue (long-term)		0		0
Total revenue earned on contracts in excess of billings	$	133,368	$	98,917

Fair Value Measurements

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	December 31, 2017										December 31, 2016
(In thousands)	Classifications	Level 1		Level 2		Level 3			Total			Level 1		Level 2		Level 3			Total
NantHealth Common Stock	Available for sale marketable securities	$	0	$	0	$	0		$	0		$	149,100	$	0	$	0		$	149,100
1.25% Call Option	Other assets		0		0		46,578			46,578			0		0		17,080			17,080
1.25% Embedded cash conversion option	Other liabilities		0		0		(47,777	)		(47,777	)		0		0		(17,659	)		(17,659	)
Foreign exchange derivative assets	Prepaid expenses and other current assets		0		1,136		0			1,136			0		1,021		0			1,021
Total		$	0	$	1,136	$	(1,199	)	$	(63	)	$	149,100	$	1,021	$	(579	)	$	149,542

Financial Instruments

Allowance for Doubtful Accounts Receivable

Contingent Liabilities

Fixed Assets

Business Combinations

Goodwill and Intangible Assets

Long-Lived Assets and Long-Lived Assets to Be Disposed Of

Software Development Costs

The unamortized balances of capitalized software were as follows:

	December 31,
(In thousands)	2017			2016
Software development costs	$	318,824		$	321,265
Less: accumulated amortization		(96,635	)		(157,386	)
Software development costs, net	$	222,189		$	163,879

	Year Ended December 31,
(In thousands)	2017		2016		2015
Capitalized software development costs	$	115,394	$	126,003	$	46,464
Write-offs of capitalized software development costs	$	0	$	4,625	$	0
Amortization of capitalized software development costs	$	57,084	$	43,274	$	46,842

Redeemable Convertible Non-Controlling Interest – Netsmart

A rollforward of the balance of redeemable convertible non-controlling interest for the year ended December 31, 2017 follows:

(In thousands)
Balance as of December 31, 2016	$	387,685
Issuance of redeemable convertible non-controlling interest		0
Accretion of redemption preference on redeemable convertible non-controlling interest		43,850
Balance as of December 31, 2017	$	431,535

Income Taxes

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States.

Earnings (Loss) Per Share

The calculations of earnings (loss) per share are as follows:

	Year Ended December 31,
(In thousands, except per share amounts)	2017			2016			2015
Basic Loss per Common Share:
(Loss) income from continuing operations, net of tax	$	(158,851	)	$	3,030		$	(2,056	)
Less: Net income attributable to non-controlling interests	$	1,566		$	(146	)	$	(170	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	(43,850	)	$	(28,536	)	$	0
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(201,135	)	$	(25,652	)	$	(2,226	)
Net income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	4,676		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(196,459	)	$	(25,652	)	$	(2,226	)

Weighted-average common shares outstanding		180,830			186,188			185,082

Basic Loss from continuing operations per Common Share	$	(1.12	)	$	(0.14	)	$	(0.01	)
Basic Income from discontinued operations per Common Share	$	0.03		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.09	)	$	(0.14	)	$	(0.01	)

Diluted Loss per Common Share:
(Loss) income from continuing operations, net of tax	$	(158,851	)	$	3,030		$	(2,056	)
Less: Net income attributable to non-controlling interests	$	1,566		$	(146	)	$	(170	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	(43,850	)	$	(28,536	)	$	0
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(201,135	)	$	(25,652	)	$	(2,226	)
Net income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	4,676		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(196,459	)	$	(25,652	)	$	(2,226	)

Weighted-average common shares outstanding		180,830			186,188			185,082
Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0
Weighted-average common shares outstanding assuming dilution		180,830			186,188			185,082

Diluted Loss from continuing operations per Common Share	$	(1.12	)	$	(0.14	)	$	(0.01	)
Diluted Income from discontinued operations per Common Share	$	0.03		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.09	)	$	(0.14	)	$	(0.01	)

Year Ended December 31,

(In thousands)

2017

2016

2015

Shares subject to anti-dilutive stock options, restricted stock unit awards and

warrants excluded from calculation

26,515

25,277

25,063

Stock-Based Compensation

Employee Benefit Plans

	Year Ended December 31,
(In thousands)	2017		2016		2015
Company contributions to employee benefit plans	$	18,861	$	18,329	$	16,397

Foreign Currency

Concentrations of Credit Risk

Recently Adopted Accounting Pronouncements

Accounting Pronouncements Not Yet Adopted

We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

Basis of Presentation and Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Reimbursements for Out-of-Pocket Expenses Incurred as Client Services Revenue

We record reimbursements for out-of-pocket expenses incurred as client services revenue in our consolidated statements of operations. These amounts totaled:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Reimbursements for out-of-pocket expenses incurred	$	10,276	$	9,528	$	12,873

Revenue Earned on Contracts in Excess of Billings Included in Accounts Receivable and Other Assets

	December 31,
(In thousands)	2017		2016
Revenue earned on contracts in excess of billings
Unbilled revenue (current)	$	133,368	$	98,917
Unbilled revenue (long-term)		0		0
Total revenue earned on contracts in excess of billings	$	133,368	$	98,917

Summary of Financial Assets and Liabilities Measured at Fair value on Recurring Basis

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	December 31, 2017										December 31, 2016
(In thousands)	Classifications	Level 1		Level 2		Level 3			Total			Level 1		Level 2		Level 3			Total
NantHealth Common Stock	Available for sale marketable securities	$	0	$	0	$	0		$	0		$	149,100	$	0	$	0		$	149,100
1.25% Call Option	Other assets		0		0		46,578			46,578			0		0		17,080			17,080
1.25% Embedded cash conversion option	Other liabilities		0		0		(47,777	)		(47,777	)		0		0		(17,659	)		(17,659	)
Foreign exchange derivative assets	Prepaid expenses and other current assets		0		1,136		0			1,136			0		1,021		0			1,021
Total		$	0	$	1,136	$	(1,199	)	$	(63	)	$	149,100	$	1,021	$	(579	)	$	149,542

Unamortized Balances of Capitalized Software

The unamortized balances of capitalized software were as follows:

	December 31,
(In thousands)	2017			2016
Software development costs	$	318,824		$	321,265
Less: accumulated amortization		(96,635	)		(157,386	)
Software development costs, net	$	222,189		$	163,879

Capitalized Software Development Costs, Write Offs Included in Asset Impairment Changes and Amortization of Capitalized Software Development Costs Included in Cost of Revenue

	Year Ended December 31,
(In thousands)	2017		2016		2015
Capitalized software development costs	$	115,394	$	126,003	$	46,464
Write-offs of capitalized software development costs	$	0	$	4,625	$	0
Amortization of capitalized software development costs	$	57,084	$	43,274	$	46,842

Balance of Redeemable Convertible Non-Controlling Interest

A rollforward of the balance of redeemable convertible non-controlling interest for the year ended December 31, 2017 follows:

(In thousands)
Balance as of December 31, 2016	$	387,685
Issuance of redeemable convertible non-controlling interest		0
Accretion of redemption preference on redeemable convertible non-controlling interest		43,850
Balance as of December 31, 2017	$	431,535

Calculations of Earnings (Loss) Per Share

The calculations of earnings (loss) per share are as follows:

	Year Ended December 31,
(In thousands, except per share amounts)	2017			2016			2015
Basic Loss per Common Share:
(Loss) income from continuing operations, net of tax	$	(158,851	)	$	3,030		$	(2,056	)
Less: Net income attributable to non-controlling interests	$	1,566		$	(146	)	$	(170	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	(43,850	)	$	(28,536	)	$	0
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(201,135	)	$	(25,652	)	$	(2,226	)
Net income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	4,676		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(196,459	)	$	(25,652	)	$	(2,226	)

Weighted-average common shares outstanding		180,830			186,188			185,082

Basic Loss from continuing operations per Common Share	$	(1.12	)	$	(0.14	)	$	(0.01	)
Basic Income from discontinued operations per Common Share	$	0.03		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.09	)	$	(0.14	)	$	(0.01	)

Diluted Loss per Common Share:
(Loss) income from continuing operations, net of tax	$	(158,851	)	$	3,030		$	(2,056	)
Less: Net income attributable to non-controlling interests	$	1,566		$	(146	)	$	(170	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	(43,850	)	$	(28,536	)	$	0
Net loss from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(201,135	)	$	(25,652	)	$	(2,226	)
Net income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	4,676		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(196,459	)	$	(25,652	)	$	(2,226	)

Weighted-average common shares outstanding		180,830			186,188			185,082
Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0
Weighted-average common shares outstanding assuming dilution		180,830			186,188			185,082

Diluted Loss from continuing operations per Common Share	$	(1.12	)	$	(0.14	)	$	(0.01	)
Diluted Income from discontinued operations per Common Share	$	0.03		$	0		$	0
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.09	)	$	(0.14	)	$	(0.01	)

Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share

Year Ended December 31,

(In thousands)

2017

2016

2015

Shares subject to anti-dilutive stock options, restricted stock unit awards and

warrants excluded from calculation

26,515

25,277

25,063

Company Contributions to Employee Benefit Plan

	Year Ended December 31,
(In thousands)	2017		2016		2015
Company contributions to employee benefit plans	$	18,861	$	18,329	$	16,397

Business Combinations and Other Investments (Tables)

12 Months Ended

Dec. 31, 2017

Proforma Results

	(Unaudited) Year Ended December 31,
(In thousands, except per share amounts)	2017			2016
Actual from Netsmart since acquisition date of April 19, 2016:
Revenue	$	0		$	173,361
Net loss	$	0		$	(27,709	)

Actual from HealthMEDX since acquisition date of October 27, 2016:
Revenue	$	0		$	4,725
Net income	$	0		$	602

Actual from NantHealth since acquisition date of August 25, 2017:
Revenue	$	6,268		$	0
Net loss	$	(4,393	)	$	0

Actual from EIS Business since acquisition date of October 2, 2017: ⁽¹⁾
Revenue	$	77,046		$	0
Net loss	$	(15,160	)	$	0

Supplemental pro forma data for combined entity:
Revenue	$	2,113,761		$	2,002,253
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(192,653	)	$	(477,744	)
Loss per share, basic and diluted	$	(1.07	)	$	(2.57	)

______________________

(1)	Revenue and Net loss from the EIS Business excludes revenue and income from discontinued operations. Refer to Note 13, “Discontinued Operations”.

Summary of Other Equity Investments Included in Other Assets

The following table summarizes our other equity investments which are included in other assets in the accompanying consolidated balance sheets:

	Number of
	Investees		Original		Carrying Value at
(In thousands, except # of investees)	at December 31, 2017		Investment		December 31, 2017		December 31, 2016
Equity method investments ⁽¹⁾		3	$	1,658	$	3,258	$	2,436
Cost method investments		7		32,784		26,755		26,041
Total equity investments		10	$	34,442	$	30,013	$	28,477

(1)

Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

NantHealth, Inc. [Member]

Schedule of Business Acquisitions by Acquisition, Contingent Consideration

Total consideration for the transaction was as follows:

	(In thousands)
Cash	$	1,742
Add: Final net working capital surplus		906
Add: NantHealth common stock		42,750
Less: Value assigned to modification of existing commercial agreement with NantHealth		(22,900	)
Total consideration for NantHealth provider/patient solutions business	$	22,498

Assets Acquired and Liabilities Assumed

	(In thousands)
Cash and cash equivalents	$	21
Accounts receivable, net		2,069
Prepaid expenses and other current assets		1,735
Fixed assets		3,401
Intangible assets		12,442
Goodwill		13,350
Other assets		204
Accounts payable and accrued expenses		(1,519	)
Deferred revenue		(9,205	)
Net assets acquired	$	22,498

Acquired Intangible Assets Amortization

The following table summarizes the estimated fair values of the most significant identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	19	$	9,200
Technology	5		3,000
Tradenames	5		200
		$	12,400

EIS Business [Member]

Assets Acquired and Liabilities Assumed

The following table summarizes the preliminary allocation of the purchase consideration as of the acquisition date:

	(In thousands)
Cash and cash equivalents	$	1,068
Accounts receivable, net		65,632
Prepaid expenses and other current assets		19,633
Fixed assets		9,808
Intangible assets		136,200
Goodwill		29,227
Other assets		1,601
Accounts payable and accrued expenses		(32,497	)
Deferred revenue		(58,490	)
Other liabilities		(2,685	)
Net assets acquired	$	169,497

Acquired Intangible Assets Amortization

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	10	$	75,200
Technology	7		57,200
Tradenames	7		3,800
		$	136,200

Schedule of Consideration Funded by Sources of Funds

	(In thousands)
Aggregate purchase price	$	185,000
Add: Final net working capital surplus		1,331
Less: Assumption of restructuring indebtedness		(16,834	)
Net consideration paid in cash for the EIS Business	$	169,497

Netsmart [Member]

Assets Acquired and Liabilities Assumed

The final allocation of the fair value of the consideration transferred, including measurement period adjustments through December 31, 2017, is shown in the table below.

	(In thousands)
Cash and cash equivalents	$	5,982
Accounts receivable, net		50,472
Prepaid expenses and other current assets		9,667
Fixed assets		26,829
Intangible assets		409,500
Goodwill		619,283
Other assets		6,540
Accounts payable		(14,151	)
Accrued expenses		(9,595	)
Deferred revenue		(18,843	)
Capital lease obligations		(17,833	)
Deferred taxes, net		(127,729	)
Other liabilities		(3,056	)
Net assets acquired	$	937,066

Acquired Intangible Assets Amortization

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Technology	10	$	144,000
Corporate Trademark	indefinite		27,000
Product Trademarks	10		8,500
Customer Relationships	12-20		230,000
		$	409,500

Schedule of Consideration Funded by Sources of Funds

The consideration was funded by the sources of funds as described in the table below.

	(In thousands)
Cash contribution for redeemable convertible non-controlling interest in Netsmart - GI Partners	$	333,606
Exchange of Netsmart, Inc.'s common stock for redeemable convertible non-controlling interest in Netsmart - Netsmart, Inc. management		25,543
Cash contribution from borrowings under revolver in exchange for common stock in Netsmart - Allscripts		43,782
Net borrowings under new term loans - Netsmart		534,135
Total consideration for Netsmart, Inc.	$	937,066

HealthMEDX, LLC [Member]

Assets Acquired and Liabilities Assumed

The final allocation of the fair value of the consideration transferred is shown in the table below:

	(In thousands)
Cash and cash equivalents	$	489
Accounts receivable, net		3,109
Prepaid expenses and other current assets		773
Fixed assets		603
Intangible assets		20,940
Goodwill		18,568
Other assets		45
Accounts payable		(768	)
Accrued expenses		(1,427	)
Deferred revenue		(1,838	)
Current maturities of capital lease obligations		(808	)
Long-term maturities of debt and capital lease obligations		(503	)
Net assets acquired	$	39,183

Acquired Intangible Assets Amortization

The following table summarizes the estimated fair values of HealthMEDX’s identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Technology	10	$	11,410
Product Trademarks	10		680
Customer Relationships	15		8,850
		$	20,940

Schedule of Consideration Funded by Sources of Funds

	(In thousands)
Incremental term loan - Netsmart	$	36,195
Contingent consideration payable to former HealthMEDX owners		2,888
Deferred cash consideration		100
Total consideration for HealthMEDX, LLC	$	39,183

Fixed Assets (Tables)

12 Months Ended

Dec. 31, 2017

Property Plant And Equipment [Abstract]

Fixed Assets

Fixed assets consist of the following:

	Estimated	December 31,			December 31,
(Dollar amounts in thousands)	Useful Life	2017			2016
Computer equipment and software	3 to 10 years	$	332,640		$	336,784
Facility furniture, fixtures and equipment	5 to 7 years		28,705			23,398
Leasehold improvements	Shorter of 7 years or life of lease		37,735			36,600
Assets under capital lease	3 to 5 years		28,132			23,204
Fixed assets, gross			427,212			419,986
Less: Accumulated depreciation and amortization			(261,609	)		(271,176	)
Fixed assets, net		$	165,603		$	148,810

Depreciation and Amortization Expense

Fixed assets depreciation and amortization expense were as follows:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Fixed assets depreciation and amortization expense, including capital leases	$	52,152	$	40,315	$	42,153

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2017

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	December 31, 2017							December 31, 2016
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	695,354	$	(405,114	)	$	290,240	$	627,819	$	(347,477	)	$	280,342
Customer contracts and relationships		922,492		(464,860	)		457,632		813,021		(430,960	)		382,061
Total	$	1,617,846	$	(869,974	)	$	747,872	$	1,440,840	$	(778,437	)	$	662,403

Intangibles not subject to amortization:
Registered trademarks						$	79,000						$	79,000
Goodwill							2,004,953							1,924,052
Total						$	2,083,953						$	2,003,052

Changes in Carrying Amount of Goodwill

Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2017 and 2016 were as follows:

	Clinical and			Population
(In thousands)	Financial Solutions			Health			Netsmart		Total
Balance as of December 31, 2015	$	796,367		$	426,234		$	0	$	1,222,601
Additions arising from business acquisitions:
Netsmart		0			0			619,283		619,283
HealthMEDX		0			0			18,457		18,457
Other additions		49,093			16,241			0		65,334
Total additions to goodwill		49,093			16,241			637,740		703,074
Reallocation		0			(37,600	)		37,600		0
Foreign exchange translation		(1,623	)		0			0		(1,623	)
Balance as of December 31, 2016	$	843,837		$	404,875		$	675,340	$	1,924,052
Additions arising from business acquisitions:
DeVero acquisition		0			0			32,363		32,363
Nanthealth provider/patient solutions business		0			13,350			0		13,350
Enterprise Information Solutions business		16,367			12,860			0		29,227
Other additions		420			47			4,503		4,970
Total additions to goodwill		16,787			26,257			36,866		79,910
Foreign exchange translation		991			0			0		991
Balance as of December 31, 2017	$	861,615		$	431,132		$	712,206	$	2,004,953

Amortization Expense Related to Intangible Assets

Intangible assets are being amortized over their estimated useful lives and amortization expense related to intangible assets was as follows:

	Year Ended December 31,
(In thousands)	2017		2016		2015
Proprietary technology amortization included in cost of revenue	$	57,517	$	45,357	$	35,144
Intangible amortization included in operating expenses		33,754		25,847		23,172
Total intangible amortization expense	$	91,271	$	71,204	$	58,316

Estimated Future Amortization Expense for Intangible Assets


Year Ended December 31,	(In thousands)
2018	$	106,859
2019		105,191
2020		100,509
2021		91,428
2022		79,315
Thereafter		264,570
Total	$	747,872

Asset Impairment Charges (Tables)

12 Months Ended

Dec. 31, 2017

Asset Impairment Charges [Abstract]

Asset Impairment Charges

	Year Ended December 31,
(In thousands)	2017		2016		2015
Asset impairment charges	$	0	$	4,650	$	1,544
Impairment of and losses on long-term investments	$	165,290	$	0	$	0

Debt (Tables)

12 Months Ended

Dec. 31, 2017

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Sep. 30, 2017	Jun. 30, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Basis Of Presentation And Significant Accounting Policies [Line Items]
Other-than-temporary impairments		$ 142,200,000	$ 142,200,000	$ 0	$ 0
Capitalized software development costs			$ 115,394,000	126,003,000	$ 46,464,000
Percentage of revenues			No single client accounted for more than 10% of our revenue in the years ended December 31, 2017, 2016 and 2015.
Customer concentration			No client represented more than 10% of accounts receivable as of December 31, 2017 or 2016.
ASU 2016-09 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Decrease in accumulated deficit due to the recognition of excess tax benefit after valuation allowance			$ 1,800,000
ASU 2014-09 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated deferred costs not yet capitalized			$ 11,000,000
Class A Preferred Units [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Temporary equity redemption period			5 years
Third-Party Software Purchases [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software development costs				44,000,000
Accrued Software Development Cost				$ 24,000,000
Nant Health, LLC [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Loss on disposition of available for sale securities	$ (20,700,000)
1.25% Cash Convertible Senior Notes [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Interest rate			1.25%
Interest rate increase (decrease)			(7.00%)
Minimum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Outsourcing services arrangements period			3 years
Capitalized software estimated economic life			3 years
Maximum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Outsourcing services arrangements period			10 years
Capitalized software estimated economic life			5 years

Revenue Earned on Contracts in Excess of Billings Included in Accounts Receivable and Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Unbilled revenue (current)	$ 133,368	$ 98,917
Unbilled revenue (long-term)	0	0
Total revenue earned on contracts in excess of billings	$ 133,368	$ 98,917

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available for sale marketable securities	$ 0	$ 149,100
Prepaid expenses and other current assets	115,463	102,551
Total	(63)	149,542
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	1,136	1,021
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	(47,777)	(17,659)
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	46,578	17,080
Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available for sale marketable securities	0	149,100
Total	0	149,100
Level 1 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Level 1 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 1 [Member] \| 1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available for sale marketable securities	0	0
Total	1,136	1,021
Level 2 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	1,136	1,021
Level 2 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 2 [Member] \| 1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Available for sale marketable securities	0	0
Total	(1,199)	(579)
Level 3 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Level 3 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	(47,777)	(17,659)
Level 3 [Member] \| 1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	$ 46,578	$ 17,080

Unamortized Balances of Capitalized Software (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Software development costs	$ 318,824	$ 321,265
Less: accumulated amortization	(96,635)	(157,386)
Software development costs, net	$ 222,189	$ 163,879

Balance of Redeemable Convertible Non-Controlling Interest (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2017 USD ($)
Accounting Policies [Abstract]
Balance as of December 31, 2016	$ 387,685
Issuance of redeemable convertible non-controlling interest	0
Accretion of redemption preference on redeemable convertible non-controlling interest	43,850
Balance as of December 31, 2017	$ 431,535

Business Combinations and Other Investments - Acquisition of DeVero - Additional Information (Detail) - USD ($)			12 Months Ended
	Jul. 17, 2017	Oct. 14, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Cash paid for business acquisitions			$ 222,310,000	$ 994,876,000	$ 9,372,000
Goodwill			2,004,953,000	1,924,052,000	1,222,601,000
Date of acquisition		Oct. 14, 2016
Netsmart [Member]
Business Acquisition [Line Items]
Goodwill			$ 712,206,000	675,340,000	$ 0
Netsmart [Member] \| DeVero, Inc. [Member]
Business Acquisition [Line Items]
Cash paid for business acquisitions	$ 50,500,000
Goodwill	32,400,000
Acquired cash and cash equivalents, and restricted cash	2,000,000
Assets acquired, other operating assets	800,000
Liabilities assumed, accounts payable and accrued expenses	2,600,000
Liabilities assumed, deferred revenue	900,000
Liabilities assumed, deferred tax liabilities net	7,600,000
Date of acquisition			Jul. 17, 2017
Goodwill, expected tax deductible amount	0
Netsmart [Member] \| DeVero, Inc. [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets	19,000,000
Intangible assets, useful life (in years)			7 years
Netsmart [Member] \| DeVero, Inc. [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets	6,900,000
Intangible assets, useful life (in years)			20 years
Netsmart [Member] \| DeVero, Inc. [Member] \| Product Trademarks [Member]
Business Acquisition [Line Items]
Intangible assets	$ 500,000
Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs			$ 0	$ 4,100,000
Selling, General and Administrative Expenses [Member] \| Netsmart [Member] \| DeVero, Inc. [Member]
Business Acquisition [Line Items]
Acquisition-related costs			$ 400,000

Business Combinations and Other Investments - Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc. - Additional Information (Detail) - NantHealth, Inc. [Member] $ in Thousands	Aug. 25, 2017 USD ($) shares
Business Acquisition [Line Items]
Number of shares as consideration for asset purchase agreement \| shares	15,000,000
Aggregate consideration with a fair value \| $	$ 42,750

Schedule of Consideration Transaction (Detail) - NantHealth, Inc. [Member] $ in Thousands	Aug. 25, 2017 USD ($)
Business Acquisition [Line Items]
Cash	$ 1,742
Add: Final net working capital surplus	906
Add: NantHealth common stock	42,750
Less: Value assigned to modification of existing commercial agreement with NantHealth	(22,900)
Total consideration for NantHealth provider/patient solutions business	$ 22,498

Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Oct. 02, 2017	Aug. 25, 2017	Dec. 31, 2016	Oct. 27, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 2,004,953			$ 1,924,052		$ 1,222,601
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Cash and cash equivalents			$ 21
Accounts receivable, net			2,069
Prepaid expenses and other current assets			1,735
Fixed assets			3,401
Intangible assets	12,400		12,442
Goodwill			13,350
Other assets			204
Accounts payable and accrued expenses			(1,519)
Deferred revenue			(9,205)
Net assets acquired			$ 22,498
EIS Business [Member]
Business Acquisition [Line Items]
Cash and cash equivalents		$ 1,068
Accounts receivable, net		65,632
Prepaid expenses and other current assets		19,633
Fixed assets		9,808
Intangible assets		136,200
Goodwill		29,227
Other assets		1,601
Accounts payable and accrued expenses		(32,497)
Deferred revenue		(58,490)
Other liabilities		(2,685)
Net assets acquired		$ 169,497
Netsmart [Member]
Business Acquisition [Line Items]
Cash and cash equivalents	5,982
Accounts receivable, net	50,472
Prepaid expenses and other current assets	9,667
Fixed assets	26,829
Intangible assets	409,500			$ 409,500
Goodwill	619,283
Other assets	6,540
Accounts payable and accrued expenses	(14,151)
Accrued expenses	(9,595)
Deferred revenue	(18,843)
Capital lease obligations	(17,833)
Deferred taxes, net	(127,729)
Other liabilities	(3,056)
Net assets acquired	$ 937,066
HealthMEDX, LLC [Member]
Business Acquisition [Line Items]
Cash and cash equivalents					$ 489
Accounts receivable, net					3,109
Prepaid expenses and other current assets					773
Fixed assets					603
Intangible assets					20,940
Goodwill					18,568
Other assets					45
Accounts payable and accrued expenses					(768)
Accrued expenses					(1,427)
Deferred revenue					(1,838)
Current maturities of capital lease obligations					(808)
Long-term maturities of debt and capital lease obligations					(503)
Net assets acquired					$ 39,183

Acquired Intangible Assets Amortization (Detail) - USD ($) $ in Thousands			12 Months Ended
	Oct. 02, 2017	Oct. 27, 2016	Dec. 31, 2017	Dec. 31, 2016	Aug. 25, 2017
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Intangible assets			$ 12,400		$ 12,442
NantHealth, Inc. [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)			19 years
Intangible assets, fair value			$ 9,200
NantHealth, Inc. [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)			5 years
Intangible assets, fair value			$ 3,000
NantHealth, Inc. [Member] \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)			5 years
Intangible assets, fair value			$ 200
EIS Business [Member]
Business Acquisition [Line Items]
Intangible assets	$ 136,200
EIS Business [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)	10 years
Intangible assets, fair value	$ 75,200
EIS Business [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)	7 years
Intangible assets, fair value	$ 57,200
EIS Business [Member] \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)	7 years
Intangible assets, fair value	$ 3,800
Netsmart [Member]
Business Acquisition [Line Items]
Intangible assets			$ 409,500	$ 409,500
Netsmart [Member] \| Corporate Trademark [member]
Business Acquisition [Line Items]
Indefinite intangible assets, fair value				27,000
Netsmart [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 230,000
Netsmart [Member] \| Customer Relationships [Member] \| Minimum [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)				12 years
Netsmart [Member] \| Customer Relationships [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)				20 years
Netsmart [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)				10 years
Intangible assets, fair value				$ 144,000
Netsmart [Member] \| Product Trademarks [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)				10 years
Intangible assets, fair value				$ 8,500
HealthMEDX, LLC [Member]
Business Acquisition [Line Items]
Intangible assets		$ 20,940
HealthMEDX, LLC [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)		15 years
Intangible assets, fair value		$ 8,850
HealthMEDX, LLC [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)		10 years
Intangible assets, fair value		$ 11,410
HealthMEDX, LLC [Member] \| Product Trademarks [Member]
Business Acquisition [Line Items]
Intangible assets, useful life (in years)		10 years
Intangible assets, fair value		$ 680

Business Combinations and Other Investments - Acquisition of the Enterprise Information Solutions Business from McKesson Corporation - Additional Information (Detail)			12 Months Ended
	Oct. 02, 2017 USD ($) Subsidiary	Oct. 14, 2016	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Business Acquisition [Line Items]
Date of acquisition		Oct. 14, 2016
Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs			$ 0	$ 4,100,000
EIS Business [Member]
Business Acquisition [Line Items]
Number of wholly owned subsidiaries in which outstanding equity interest acquired \| Subsidiary	2
Business combination, aggregate consideration	$ 185,000,000
Date of acquisition			Oct. 02, 2017
EIS Business [Member] \| Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs			$ 4,800,000

Schedule of Acquisition of EIS Business Based on Total Enterprise Value (Detail) - EIS Business [Member] $ in Thousands	Oct. 02, 2017 USD ($)
Business Acquisition [Line Items]
Total consideration for NantHealth provider/patient solutions business	$ 185,000
Add: Final net working capital surplus	1,331
Less: Assumption of restructuring indebtedness	(16,834)
Cash	$ 169,497

Business Combinations and Other Investments - Asset Purchase Agreement with Third Party - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended
	Oct. 14, 2016	Mar. 31, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Date of acquisition	Oct. 14, 2016
Goodwill			$ 2,004,953	$ 1,924,052	$ 1,222,601
Asset Purchase Agreement
Business Acquisition [Line Items]
Date of acquisition		Mar. 31, 2017
Business combination, aggregate consideration		$ 4,000
Business combination, estimated consideration payable		500
Contingent consideration, fair value			$ 600
Goodwill		$ 4,400

Business Combinations and Other Investments - Formation of Joint Business Entity and Acquisition of Netsmart, Inc. - Additional Information (Detail) - USD ($)		12 Months Ended
	Apr. 19, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 02, 2016	Oct. 14, 2016
Business Acquisition [Line Items]
Contribution and investment agreement date		Mar. 20, 2016
Description of liquidation preference		The liquidation preference is equal to the greater of (i) a return of the original issue price plus a preferred return (accruing on a daily basis at the rate of 11% per annum and compounding annually on the last day of each calendar year) or (ii) the as-converted value of Class A Common Units in Nathan.
Preferred return percentage		11.00%
Equity ownership percentage	49.10%			100.00%	100.00%
Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		$ 0	$ 4,100,000
Homecare Business [Member]
Business Acquisition [Line Items]
Escrow deposit related to the integration of homecare business	$ 15,000,000	$ 10,000,000
Escrow deposit period	4 years
GI Partners [Member]
Business Acquisition [Line Items]
Minority interest percentage	47.20%
Netsmart Management [Member]
Business Acquisition [Line Items]
Minority interest percentage	3.70%
Netsmart [Member]
Business Acquisition [Line Items]
Netsmart transaction completion date		Apr. 19, 2016
Business combination, purchase price	$ 950,000,000
Business combination, aggregate consideration	937,066,000
Extinguishment of debt	325,000,000
Accrued interest and fees	2,000,000
Decrease in accounts receivable, net acquired			3,600,000
Increase in prepaid expenses and other assets, acquired			300,000
Decrease in other assets, acquired			300,000
Increase in deferred taxes, net acquired			700,000
Decrease in other liabilities			600,000
Increase in the residual allocation to goodwill			$ 3,700,000
Netsmart [Member] \| Nathan [Member]
Business Acquisition [Line Items]
Business combination, aggregate consideration	$ 937,000,000

Business Combinations and Other Investments - Other Acquisitions and Investments - Additional Information (Detail) - USD ($)					3 Months Ended	12 Months Ended
	Dec. 02, 2016	Oct. 14, 2016	Sep. 08, 2016	Apr. 17, 2015	Dec. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 21, 2017	Apr. 19, 2016
Business Acquisition [Line Items]
Equity ownership percentage	100.00%	100.00%								49.10%
Goodwill					$ 1,924,052,000	$ 2,004,953,000	$ 1,924,052,000	$ 1,222,601,000
Date of acquisition		Oct. 14, 2016
Total consideration for non marketable equity securities						5,606,000	21,185,000	$ 215,786,000
Carrying values of cost method investments					26,041,000		26,041,000		$ 26,755,000
Equity Method Debt Investments [Member]
Business Acquisition [Line Items]
Total consideration for non-marketable convertible note of a third party						2,600,000
Cost Method Debt Investments [Member]
Business Acquisition [Line Items]
Total consideration for non-marketable convertible note of a third party							1,000,000
Other Assets [Member] \| Equity Method Debt Investments [Member]
Business Acquisition [Line Items]
Convertible note carrying value						2,600,000
Other Assets [Member] \| Cost Method Debt Investments [Member]
Business Acquisition [Line Items]
Convertible note carrying value					1,000,000	$ 1,000,000	1,000,000
Third Party
Business Acquisition [Line Items]
Equity ownership percentage			51.00%
Majority interest acquired in a third party	$ 5,100,000	$ 24,000,000	$ 29,700,000	$ 11,100,000
Goodwill	2,900,000	16,200,000	46,200,000	22,300,000
Intangible assets				4,300,000
Liabilities assumed, deferred tax liabilities net	1,200,000	3,700,000	8,500,000
Estimated fair value of the aggregate consideration of net working capital and deferred revenue	600,000	200,000
Business combination, estimated consideration payable	2,500,000
Contingent consideration, fair value					2,000,000		2,000,000
Accounts receivable, net			5,900,000
Assets Acquired, deferred tax assets			600,000
Assets acquired, fixed assets			1,500,000
Liabilities assumed, accounts payable, deferred revenue and accruals			6,000,000
Other long-term liabilities			800,000
Estimated fair value of non controlling interest			$ 29,400,000	11,000,000
Decrease in deferred tax liability					(200,000)
Increase in the residual allocation to goodwill					1,000,000
Minority interest percentage			49.00%
Description of call feature						the minority owners of the third party were granted a call option to repurchase the 51% equity share owned by Allscripts at the same pre-defined future enterprise value applicable to Allscripts call option for a period of 9 months after the third anniversary of the transaction date. Such call option can only be exercised in the event that Allscripts chooses not to exercise its call option after the third anniversary of the transaction date.
Provided loan to third party to refinance outstanding indebtedness				$ 9,300,000
Third Party \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets	$ 3,400,000	200,000	$ 8,300,000
Intangible assets, useful life (in years)	8 years		13 years			8 years
Decrease in the value of customer relationship intangibles					(1,200,000)
Third Party \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets	$ 600,000	$ 11,500,000	$ 10,300,000
Intangible assets, useful life (in years)	8 years		10 years			8 years
Third Party \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets			$ 1,600,000
Intangible assets, useful life (in years)			10 years
2017 Business Acquisitions [Member] \| Cost Method Equity Investments
Business Acquisition [Line Items]
Total consideration for non marketable equity securities						$ 2,800,000
2017 Business Acquisitions [Member] \| Other Assets [Member] \| Cost Method Equity Investments
Business Acquisition [Line Items]
Carrying values of cost method investments						2,800,000
2016 Business Acquisitions [Member] \| Cost Method Equity Investments
Business Acquisition [Line Items]
Total consideration for non marketable equity securities							10,200,000
2016 Business Acquisitions [Member] \| Other Assets [Member] \| Cost Method Equity Investments
Business Acquisition [Line Items]
Carrying values of cost method investments					$ 10,200,000	$ 10,200,000	$ 10,200,000

Fixed Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
Fixed Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 427,212	$ 419,986
Less: Accumulated depreciation and amortization	(261,609)	(271,176)
Fixed assets, net	165,603	148,810
Computer Equipment and Software [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 332,640	336,784
Computer Equipment and Software [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Computer Equipment and Software [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	10 years
Facility Furniture, Fixtures and Equipment [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 28,705	23,398
Facility Furniture, Fixtures and Equipment [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years
Facility Furniture, Fixtures and Equipment [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	7 years
Leasehold Improvements [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 37,735	36,600
Estimated useful life (in years)	Shorter of 7 years or life of lease
Assets Under Capital Lease [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 28,132	23,204
Less: Accumulated depreciation and amortization	$ (13,700)	$ (5,600)
Assets Under Capital Lease [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Assets Under Capital Lease [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years

Fixed Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 261,609	$ 271,176
Assets Under Capital Lease [Member]
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 13,700	$ 5,600

Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,617,846	$ 1,440,840
Accumulated Amortization	(869,974)	(778,437)
Intangible Assets, Net	747,872	662,403
Registered trademarks	79,000	79,000
Goodwill	2,004,953	1,924,052	$ 1,222,601
Total	2,083,953	2,003,052
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	695,354	627,819
Accumulated Amortization	(405,114)	(347,477)
Intangible Assets, Net	290,240	280,342
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	922,492	813,021
Accumulated Amortization	(464,860)	(430,960)
Intangible Assets, Net	$ 457,632	$ 382,061

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Sep. 30, 2015
Goodwill And Intangible Assets Disclosure [Abstract]
Cash flow discount rate	9.00%
Accumulated impairment losses associated with goodwill	$ 0	$ 0
Goodwill, impairments recorded	$ 0	$ 0	$ 0

Changes in Carrying Amount of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Goodwill	$ 1,924,052	$ 1,222,601
Additions arising from business acquisitions	79,910	703,074
Other additions	4,970	65,334
Reallocation		0
Foreign exchange translation	991	(1,623)
Goodwill, net	2,004,953	1,924,052
Netsmart Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		619,283
HealthMEDX, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		18,457
DeVero Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	32,363
NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	13,350
Enterprise Information Solutions [Member]
Goodwill [Line Items]
Increase in the residual allocation to goodwill	29,227
Clinical and Financial Solutions [Member]
Goodwill [Line Items]
Goodwill	843,837	796,367
Additions arising from business acquisitions	16,787	49,093
Other additions	420	49,093
Reallocation		0
Foreign exchange translation	991	(1,623)
Goodwill, net	861,615	843,837
Clinical and Financial Solutions [Member] \| Netsmart Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		0
Clinical and Financial Solutions [Member] \| HealthMEDX, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		0
Clinical and Financial Solutions [Member] \| DeVero Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Clinical and Financial Solutions [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Clinical and Financial Solutions [Member] \| Enterprise Information Solutions [Member]
Goodwill [Line Items]
Increase in the residual allocation to goodwill	16,367
Population Health [Member]
Goodwill [Line Items]
Goodwill	404,875	426,234
Additions arising from business acquisitions	26,257	16,241
Other additions	47	16,241
Reallocation		(37,600)
Foreign exchange translation	0	0
Goodwill, net	431,132	404,875
Population Health [Member] \| Netsmart Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		0
Population Health [Member] \| HealthMEDX, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		0
Population Health [Member] \| DeVero Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Population Health [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	13,350
Population Health [Member] \| Enterprise Information Solutions [Member]
Goodwill [Line Items]
Increase in the residual allocation to goodwill	12,860
Netsmart [Member]
Goodwill [Line Items]
Goodwill	675,340	0
Additions arising from business acquisitions	36,866	637,740
Other additions	4,503	0
Reallocation		37,600
Foreign exchange translation	0	0
Goodwill, net	712,206	675,340
Netsmart [Member] \| Netsmart Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		619,283
Netsmart [Member] \| HealthMEDX, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions		$ 18,457
Netsmart [Member] \| DeVero Acquisition [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	32,363
Netsmart [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Netsmart [Member] \| Enterprise Information Solutions [Member]
Goodwill [Line Items]
Increase in the residual allocation to goodwill	$ 0

Estimated Future Amortization Expense for Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Goodwill And Intangible Assets Disclosure [Abstract]
2018	$ 106,859
2019	105,191
2020	100,509
2021	91,428
2022	79,315
Thereafter	264,570
Intangible Assets, Net	$ 747,872	$ 662,403

Asset Impairment Charges (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
Asset Impairment Charges (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Asset Impairment Charges [Abstract]
Asset impairment charges	$ 0	$ 0	$ 0	$ 0	$ 0	$ 0	$ 0	$ 4,650	$ 0	$ 4,650	$ 1,544
Impairment of and losses on long-term investments		$ 20,700	$ 144,600						$ 165,290	$ 0	$ 0

Summary of Future Debt Payments (Parenthetical) (Detail)		12 Months Ended
	Jun. 18, 2013	Dec. 31, 2017
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Notes maturity period	Jul. 01, 2020	Jul. 01, 2020

Components of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Deferred tax assets
Accruals and reserves, net	$ 26,126	$ 22,305
Allowance for doubtful accounts	7,741	12,386
Stock-based compensation, net	12,654	15,939
Deferred revenue	12,466	15,092
Net operating loss carryforwards	67,677	91,859
Research and development tax credit	38,310	32,952
AMT credits	7,901	7,085
State tax credits	3,795	2,911
Other	11,106	15,065
Less: Valuation Allowance	(79,732)	(23,761)
Total deferred tax assets	150,746	191,833
Capital loss carryforwards	42,702	0
Deferred tax liabilities
Prepaid expense	(6,407)	(9,532)
Property and equipment, net	(13,201)	(15,879)
Acquired intangibles, net	(219,559)	(305,361)
Other	(648)	(22)
Total deferred tax liabilities	(239,815)	(330,794)
Net deferred tax liabilities	$ (89,069)	$ (138,961)

Deferred Tax Assets (Liabilities) Classified in Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Non-current deferred tax assets, net	$ 4,574	$ 2,791
Non-current deferred tax liabilities, net	(93,643)	(141,752)
Net deferred tax liabilities	$ (89,069)	$ (138,961)

Amount of Interest and Penalties Included in Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Interest and penalties included in the liability for uncertain tax positions	$ 741	$ 1,187

Stock Options Outstanding (Detail) - $ / shares	12 Months Ended
Stock Options Outstanding (Detail) - $ / shares	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Options Outstanding
Options Outstanding, beginning balance	1,903,000	2,343,000	3,427,000
Options Outstanding, options granted	0	0	0
Options Outstanding, options exercised	(108,000)	(6,000)	(317,000)
Options Outstanding, options forfeited	(160,000)	(434,000)	(767,000)
Options Outstanding, ending balance	1,635,355	1,903,000	2,343,000
Weighted-Average Exercise Price
Weighted-average exercise price, beginning balance	$ 13.95	$ 14.24	$ 14.35
Weighted-average exercise price, Options granted	0.00	0.00	0.00
Weighted-average exercise price, options exercised	14.01	14.01	11.44
Weighted-average exercise price, options forfeited	15.00	15.51	15.89
Weighted-average exercise price, ending balance	$ 13.85	$ 13.95	$ 14.24
Options Exercisable
Options Exercisable	1,635,355	1,431,000	1,282,000	1,393,000
Weighted-Average Exercise Price, Exercisable	$ 13.85	$ 13.98	$ 14.52	$ 14.97

Stock Option Activity (Detail) - USD ($) $ in Thousands	12 Months Ended
Stock Option Activity (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Total intrinsic value of stock options exercised	$ 45	$ 1	$ 972
Total fair value of share awards vested	$ 25,220	$ 26,892	$ 21,673

Stock Option Awards (Detail) - $ / shares	12 Months Ended
Stock Option Awards (Detail) - $ / shares	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Schedule Of Stock Options [Line Items]
Number of options Outstanding	1,635,355	1,903,000	2,343,000	3,427,000
Weighted-Average Exercise Price, Outstanding	$ 13.85	$ 13.95	$ 14.24	$ 14.35
Number of options exercisable	1,635,355	1,431,000	1,282,000	1,393,000
Weighted-Average Exercise Price, Exercisable	$ 13.85	$ 13.98	$ 14.52	$ 14.97
$12.72 to $14.01 [Member]
Schedule Of Stock Options [Line Items]
Range of exercise prices, lower limit	12.72
Range of exercise prices, upper limit	$ 14.01
Number of options Outstanding	1,498,901
Weighted-Average Exercise Price, Outstanding	$ 13.72
Number of options exercisable	1,498,901
Weighted-Average Exercise Price, Exercisable	$ 13.72
$14.78 to $15.22 [Member]
Schedule Of Stock Options [Line Items]
Range of exercise prices, lower limit	14.78
Range of exercise prices, upper limit	$ 15.22
Number of options Outstanding	136,454
Weighted-Average Exercise Price, Outstanding	$ 15.19
Number of options exercisable	136,454
Weighted-Average Exercise Price, Exercisable	$ 15.19

Schedule of Fair Value of Option Units Weighted Average Assumptions (Detail) - Netsmart [Member] - Class B Non Voting Common Units	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Average expected term in years	6 years 3 months 22 days	5 years 6 months
Risk free rate (weighted average)	2.20%	2.00%
Expected dividends	0.00%	0.00%
Average volatility	60.00%	55.00%